Tricuspid Regurgitation Following Implantation of a Pacemaker/Cardioverter-Defibrillator

Tricuspid regurgitation due to permanent pacemaker/defibrillator lead implantation (LITR) has been described more than 3 decades ago, but has come into attention recently due to the dramatic increase in the use of these devices. This entity has not been well defined and its impact on the patient and the health care system is largely unknown. This complication can have important implications. First, the presence and severity of tricuspid regurgitation in general is associated with reduced patient survival, and in the severe cases may require corrective surgery. Second, with the increasing age of the population and the expanding indications of these devices, one expects to encounter many more cases of LITR in the future. Third, this is an iatrogenic complication and therefore potentially preventable. This review discusses the prevalence, mechanisms, and risk factors of LITR as well as the management and potential strategies to prevent its occurrence.