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자료유형
학술저널
저자정보
저널정보
대한내과학회 대한내과학회지 대한내과학회지 제86권 제5호
발행연도
2014.1
수록면
573 - 576 (4page)

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A permanent pacemaker is a mainstay treatment for symptomatic bradyarrhythmia, including atrioventricular node blocks andsick sinus syndrome. Although this device was introduced to aid electrical recovery, pacemakers can cause mechanical dysfunctionof the tricuspid valve, resulting in significant tricuspid regurgitation (TR). Because pacemaker-related TR is a correctable cause ofright heart failure, it is of paramount importance to assess the presence or severity of TR and its association with pacemakers. However, acoustic shadowing from the pacemaker wire hampers the accurate visualization of TR jets, and increases the risk of failingto detect severe TR. Accordingly, goal-directed imaging with a high index of clinical suspicion should be performed when patientspresent with right heart failure after pacemaker implantation. In this issue of the Journal, the authors sought to investigate thefrequency of aggravated TR in patients after pacemaker implantation. They also explored the predictors of TR aggravation, whichmight provide valuable information for identification of patients who require meticulous follow-up to allow timely intervention. These data regarding the predictive variables for pacemaker-related TR can serve as a roadmap for future studies to identify strategiesfor reducing the risk of significant TR, such as a tailored approach based on heart rhythm (bradyarrhythmia only vs. combinedatrial fibrillation), pacemaker mode (VVI vs. DDD), the location of the pacemaker lead (apical vs. base), and the use of state-of-theart techniques (classical lead vs. leadless).

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