Assessing the influence of RV lead position on tricuspid regurgitation using 4 d echocardiography

This study will be conducted in the Department of Cardiology at Kasturba Hospital, Manipal, following IEC approval and CTRI registration. It aims to explore the effects of right ventricular (RV) lead positioning on tricuspid regurgitation (TR) and right atrial (RA) function using 4D echocardiography. The primary objective will be to determine how RV lead placement influences TR. Secondary objectives will include comparing the accuracy of 4D echocardiography and fluoroscopic landmarks in identifying the pacing site, as well as evaluating the acute and short-term effects of permanent pacemaker implantation (PPI) on RA and RV function. Participants will undergo echocardiographic assessments 1-2 days before the procedure, immediately after implantation, and at a three-month follow-up. Additionally, post-implantation, the study will document fluoroscopic lead placement and landmarks. This research will address the gap in understanding the impact of RV lead positioning on TR and RA changes, with the potential to reveal whether RA dysfunction precedes RV issues, thereby enhancing clinical management for symptomatic patients with no further visits or follow-ups required beyond these assessments.