Severe tricuspid regurgitation due to interactions with right ventricular permanent pacemaker or defibrillator leads

Although thought to be a rare event, permanent pacemakers and implantable cardioverter‐defibrillators with right ventricular intracardiac leads have the potential to induce tricuspid valve dysfunction. Adverse lead‐valve interactions can take place through a variety of mechanisms including damage at the time of implantation, leaflet pinning, or long‐term fibrosis encapsulating the leaflet tissue. Clinical manifestations can display a wide range of severity, as well as a highly variable time span between implantation and hemodynamic deterioration. This review aims to describe the potential pathophysiologic effects of intracardiac device leads on the tricuspid valve, with a focus on ideal diagnostic strategies and treatment options once lead‐induced valvular dysfunction is suspected.