P3252Prospective study of tricuspid valve regurgitation associated with permanent leads in patients undergoing cardiac rhythm device implantation
Bibliographic record
Abstract
Background: Tricuspid regurgitation (TR) has been identified as a complication of cardiac rhythm device implantation with intracardiac lead insertion. Data regarding the incidence of post-device TR vary widely and are limited. A better understanding of the incidence and risk factors of lead-related TR is important, particularly given the advent of leadless devices. Purpose: To prospectively evaluate the association between permanent cardiac rhythm device implantation with intracardiac leads and progression of TR. Methods: We prospectively included 328 consecutive patients (71±15 years old, 62% of male) with a clinical indication for cardiac rhythm device implantation after informed consent at 3 centres (in Canada, Belgium and Italy). Patients with a previous endocardial lead or with congenital heart disease were excluded. Eligible patients were scheduled for a comprehensive transthoracic echocardiography within 1 month before, and 1 year after cardiac device implantation. Results: Echocardiograms before and 1 year after cardiac device implantation were available in 277 patients (6 died, 45 lost to follow up). Overall, there was an increase in TR at 1-year post-device insertion compared to baseline (p<0.001); however, this was mainly due to patients progressing from no or trivial TR to mild TR (see Figure). 5% of patients had moderate to severe TR at baseline, and 9% of patients had moderate or severe TR 1 year after device insertion (absolute change = 4%; relative change = +80%; p=0.064). In the 234 patients with a pacemaker or implantable cardiac defibrillator without cardiac resynchronisation therapy (CRT), there was a significant increase in moderate to severe TR (4% vs. 9%, p=0.035). In contrast, there was no progression to moderate or severe TR in the 41 patients who received CRT (15% vs. 12%, p=1). A medical history of atrial fibrillation was associated with progression towards moderate or severe TR (p=0.008), while age (p=0.068), gender (p=0.264), hypertension (p=0.414), diabetes (p=0.414), left ventricular ejection fraction (p=0.547), systolic pulmonary artery pressure (p=0.057) and right ventricular end-diastolic dimension (p=0.366) were not.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".