Management of patients with transvalvular right ventricular leads undergoing transcatheter tricuspid valve interventions: a scientific statement of the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions of the ESC endorsed by the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society and the Canadian Heart Rhythm Society

Europace. 2025 May 7;27(5):euaf061. doi: 10.1093/europace/euaf061.

Abstract

Up to one-third of patients referred for transcatheter tricuspid valve intervention (TTVI) have a transvalvular pacemaker (PPM) or implantable cardioverter-defibrillator (ICD) lead in place. Both the electrophysiology and interventional cardiology communities have been alerted to the complexity of decision-making in this situation due to potential interactions between the leads and the TTVI material, including the risk of jailing or damage to the leads. This document, commissioned by the European Heart Rhythm Association and the European Association of Percutaneous Cardiovascular Interventions of the ESC, reviews the scientific evidence to inform Heart Team discussions on the management of patients with a PPM or ICD who are scheduled for or have undergone TTVI.

Keywords: Transcatheter tricuspid valve intervention; cardiac implantable electronic device lead; lead extraction; lead jailing; tricuspid regurgitation.

Publication types

  • Practice Guideline

MeSH terms

  • Cardiac Catheterization* / adverse effects
  • Cardiac Catheterization* / instrumentation
  • Cardiac Catheterization* / standards
  • Consensus
  • Defibrillators, Implantable* / standards
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Heart Valve Prosthesis Implantation* / instrumentation
  • Heart Valve Prosthesis Implantation* / methods
  • Heart Valve Prosthesis Implantation* / standards
  • Humans
  • Pacemaker, Artificial* / standards
  • Risk Factors
  • Treatment Outcome
  • Tricuspid Valve* / physiopathology
  • Tricuspid Valve* / surgery