title: [Right heart failure after pacemaker implantation].
abstract: OBJECTIVE
  Severe tricuspid regurgitation (TR) secondary to interference pacemaker (PM) cable is a rare cause of progressive right heart failure (HF), which can worsen patient outcomes.
  
  
  METHODS
  We present 3 clinical cases of right HF secondary to TR after PM implantation.
  
  
  RESULTS
  In these patients the clinic is right HF, which can appear early, as in our second patient, or after years of implementation of the PM, as in the first and third patients. The diagnosis is confirmed by echocardiography, the most accurate 3D, followed by transesophageal. The 2D transthoracic can not detect it, because it has low sensitivity for TR associated with PM. Medical treatment is always the first choice, since any other procedure carries significant morbidity and mortality.
  
  
  CONCLUSIONS
  Probably this is a condition that we will diagnose with increasing frequency, because there are more and more patients with devices and, at the same time, the diagnostic tools are improving.
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España. Electronic address: juan_gallego_galiana@yahoo.es.
authors.forename: Juan
authors.initials: J
authors.lastname: Gallego Galiana
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Genoveva
authors.initials: G
authors.lastname: López Castellanos
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gioia
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Raúl Antonio
authors.initials: RA
authors.lastname: Ruiz Ortega
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Cobo Reinoso
authors.affiliation: Servicio de Medicina Interna, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Manzano Espinosa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058385:Cardiac Valve Annuloplasty; D020878:Device Removal; D017548:Echocardiography, Transesophageal; D004567:Electrodes, Implanted / Q000009:adverse effects*; D055590:Electromagnetic Phenomena; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D012680:Sensitivity and Specificity; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology
keywords: Echocardiography; Ecocardiografía; Insuficiencia cardiaca derecha; Insuficiencia tricuspídea; Marcapasos; Pacemaker; Right heart failure; Tricuspid regurgitation