Lead and Tricuspid valve

About 3 months ago my EP heard a murmur and after a TEE said my tricuspid valve was leaking high moderate range and borderline of needing surgical repair.  I see my EP every 6-8 weeks to monitor the cardiomyopathy and ventricular arrhythmias and make med changes. I had a 3-month followup echo yesterday and the cardiologist that shares his office came into the room where the tech was doing the echo and said that the lead looked like it was twisted and may be causing a problem with the valve, but there was also thickening of the muscle and tissue around the valve.  He and my EP were going to discuss.  I don't see the cardiologist, only my EP, but it was my EP's hospital day and the cardiologist's patient day and he said the EP has discussed at length my case.  I also have thickening of the heart muscle (reasons not determined) that caused me to have my mitral valve repaired 11 months ago on an emergency basis--3 months earlier it was fine.  My tricuspid valve was fine 3 months before the EP heard the murmur--similar that happened to the mitral valve. Has anybody had a problem with their lead and tricuspid valve?  My aortic valve is also leaking because of thickening, but not bad enough to repair.  I had a pacer in 2015 for SSS, and after SCA due to ventricular arrhythmias, ICD/PM in 2016.  I see my EP Tuesday.   I remain active and exercise regularly and work as a field plant and animal biologist.  Any advice, questions to ask, or knowledge would be greatly appreciated.


3 Comments

Interesting subject

by AgentX86 - 2019-10-10 22:22:32

It sounds like you're pretty well on top of your situation.  I don't know what I'd have to add but there seems to be a lot of information on the web regarding PM leads, valve damage, and cardiomyopathy.  I don't know how much online research you've done but it's rather an interesting topic.

Interesting example: <http://www.onlinejacc.org/content/accj/69/18/2331.full.pdf>

I'm the learner here

by crustyg - 2019-10-11 11:18:30

If you feel up to it, please do share the outcome later, and their thinking about whether a twisted lead really did cause tricuspid valve damage, or whether it's just a chance association.

focus changed at appt

by islandgirl - 2019-10-16 22:32:27

A few days before my appt I received a call from my EP that he was alerted I was having sustained episodes of Aflutter--19 hours for one.  The rates have been from 257 - 350+ bpm.   I had been feeling very lightheaded and pounding, like I was having tachycardia with pvcs (I often have pvcs).  What I was feeling was my ICD--it is set for burst pacing.  I was in Aflutter at my appt, and he was going to try to give me a mild shock or something with the ICD, and if that didn't work he was going to send me to the hospital to do a cardioversion, but by the time he checked my rate, it had converted, thank goodness.  I take sotalol and I had lab work today to check the levels.  He may put me on Tikosyn.  He discussed an electrical study and ablation.  I am pacing 49% in the ventricals and 99.6% in the atrium (sick sinus syndrome).  The tricuspid valve wasn't discussed in any detail.  He had not seen the echo CD.  He said if the wire is twisted in the tricuspid valve, that's not the problem with the valve and it wasn't like that 3 months ago.  

Now I know why I've been lightheaded, near passing out, and lots of palpitations.  

 

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