Tricuspid Regurgitation in the Setting of Cardiac Implantable Electronic Devices

Cardiac implantable electronic devices (CIEDs) have been increasingly used in the management of various rhythm disorders amidst an aging population with more prevalent cardiovascular comorbidities. Although generally well-tolerated and safe, implantation of CIEDs may result in or worsen tricuspid regurgitation (TR), which is associated with a higher risk of morbidity and mortality. Several mechanisms of TR following device implantation have been proposed, and multiple diagnostic tests, percutaneous and surgical interventions, and alternative pacing methods have been developed to address this. CIED-related TR thus requires a multidisciplinary team of experts in cardiac imaging, interventional cardiology, electrophysiology, and cardiothoracic surgery with a comprehensive understanding of this multifaceted disease. The objective of this review is to summarize the epidemiology, clinical presentation, and management of CIED-related TR.