Tricuspid valve regurgitation in the presence of endocardial leads – an underestimated problem

In about 80% of the population, a small degree of tricuspid insufficiency occurs and therefore is considered almost physiological [1]. Higher mortality has been described among patients with moderate and severe tricuspid regurgitation compared to patients without it, irrespective of the pulmonary pressure value or systolic function of the left and right ventricle [2–4]. A fourfold increase in the risk of substantial tricuspid regurgitation is caused by the presence of the endocardial lead [5]. A chest X-ray examination is used in order to assess the position of the lead in the heart [6]. The influence of endocardial lead position in the chest X-ray on tricuspid valve function and the presence of its insufficiency has not yet been described in the literature.