BACKGROUND Tricuspid transcatheter edge-to-edge repair (T-TEER) is an important treatment option for symptomatic severe tricuspid valve regurgitation. Interaction with a preexisting right ventricular (RV) pacing lead can result in clinically significant RV lead dysfunction over time.
OBJECTIVES The goal of this study was to evaluate the 2-year safety and function of preexisting RV leads after T-TEER.
METHODS The Tri-LEAD (Tricuspid Right Ventricular lead entrapment in transcatheter tricuspid interventions) study was a retrospective multicenter international registry of 146 patients who underwent T-TEER with an RV lead in situ from 2015 to 2023. Primary outcome was RV lead dysfunction after T-TEER at 2 years (defined as change in RV lead function, dislodgement, or fracture) and need for intervention due to RV lead dysfunction or cardiac complication.
RESULTS Mean patient age was 78.1 ± 8.6 years, and 54% were male. Over a median follow-up of 557 days (Q1-Q3: 278-966 days), 10 patients (6.8%) had an impedance change >200 Ω and 2 patients (1.4%) had a threshold change $1 V, with no observed cases of RV lead fracture, dislodgement, cardiac structure perforation, or pacemakerrelated re-interventions. T-TEER was not associated with an increased risk of the composite safety endpoint (adjusted SHR: 1.39; 95% CI: 0.64 to 3.02; P = 0.41). Over time, changes in RV lead sensing (–0.53 mV/year; 95% CI: –1.15 to 0.08; P = 0.094), impedance (–2.4 Ω/year; 95% CI: –15.4 to 10.6; P = 0.72), and threshold (–0.011 V/year; 95% CI: –0.052 to 0.031; P = 0.62) were minimal and not clinically significant.
CONCLUSIONS T-TEER has no detrimental impact on the performance of transvenous RV leads in the short term or midterm. (JACC Clin Electrophysiol. 2026;12:489–497) © 2026 by the American College of Cardiology Foundation.
Editor-in-Chief
Kalyanam Shivkumar, MD, PhD, FACC
CME Editor
Kenneth A. Ellenbogen, MD, FACC
Authors
Liesbeth Rosseel, MD, PhD
Tatyana Storozhenko, MD, PhD
Maurizio Taramasso, MD, PhD
Important Dates
Date of Release: March 23, 2026
Term of Approval/Date of CME/MOC Expiration: March 22, 2027