There is an increasing recognition of the importance of tricuspid valve
disease. Surgical treatment has been less than optimal and medical
therapy has poor results. Catheter based delivery has revolutionized the
delivery of aortic valve prostheses and trials of catheter based
tricuspid valve prostheses are ongoing. Like surgical tricuspid
interventions, these procedures are associated with a significant risk
of heart block, as expected from their anatomic location. The complexity
of these valve prostheses makes placement of a standard transvenous
system undesirable. We present a series of patients who had successful
placement of a leadless pacemaker system through the valve orifice.