Tricuspid regurgitation in patients with pacemakers and implantable cardiac defibrillators: a comprehensive review

Clin Cardiol. 2013 May;36(5):249-54. doi: 10.1002/clc.22104. Epub 2013 Mar 25.


Implantable cardiac devices, including defibrillators and pacemakers, may be the cause of tricuspid regurgitation (TR) or may worsen existing TR. This review of the literature suggests that TR usually occurs over time after lead implantation. Diagnosis by clinical exam and 2-dimensional echocardiography may be augmented by 3-dimensional echocardiography and/or computed tomography. The mechanism may be mechanical perforation or laceration of leaflets, scarring and restriction of leaflets, or asynchronized activation of the right ventricle. Pacemaker-related TR might cause severe right-sided heart failure, but data regarding associated mortality are lacking. This comprehensive review summarizes the data regarding incidence, mechanism, and treatment of lead-related TR.

Publication types

  • Review

MeSH terms

  • Cardiac Pacing, Artificial / adverse effects*
  • Cardiac Pacing, Artificial / mortality
  • Defibrillators, Implantable / adverse effects*
  • Diagnostic Imaging / methods
  • Electric Countershock / adverse effects*
  • Electric Countershock / instrumentation
  • Electric Countershock / mortality
  • Humans
  • Incidence
  • Pacemaker, Artificial / adverse effects*
  • Predictive Value of Tests
  • Risk Factors
  • Treatment Outcome
  • Tricuspid Valve Insufficiency / diagnosis
  • Tricuspid Valve Insufficiency / etiology*
  • Tricuspid Valve Insufficiency / mortality
  • Tricuspid Valve Insufficiency / therapy