Abstract: Objective To analyze the factors affecting the occurrence of tricuspid regurgitation(TR) after pacemaker implantation in the elderly patients. Methods A retrospective analysis of the clinical data of 264 elderly patients who were implanted with pacemakers in our department from January 2012 to January 2021 was performed. All patients were divided into lead induced tricuspid regurgitation (LITR)group and no LITR group according to whether they experienced an exacerbation of TR or a new TR occurred after surgery or not. The pre-operation clinical data and the indexes of two-dimensional echocardiographic measurements between the two groups were compared. The influencing factors of LITR in the elderly patients were analyzed by multivariate Logistic regression model. Results LITR occurred in 87 out of 264 elderly patients with pacemaker implantation, and the incidence rate of LITR was 33.0%. There were significant differences between the two groups in age, the rates of mild preoperative TR, right ventricular apical pacing, and years of implantation(P<0.01). The left atrial diameter(LAD) and right atrial diameter(RAD) in LITR group were significantly higher than those in no LITR group(P<0.01). Multivariate Logistic regression analysis showed that higher RAD, mild preoperative TR, right ventricular apical pacing and years of pacemaker implantation were the influencing factors of the occurrence and exacerbation of TR after pacemaker implantation(P<0.05). Conclusions Increased RAD, pacing electrodes located in the right ventricular apex and long years of pacemaker implantation are risk factors, and mild preoperative TR is a protective factor for postoperative TR.

Key words: permanent pacemaker, lead-induced tricuspid regurgitation, right ventricular pacing, right ventricular apical pacing