“…Permanent pacing leads in heart causes fibrosis of adjacent structures, such as RV apex, tricuspid valve, SVC, and brachiocephalic veins 1 . Tricuspid valve stenosis 2 as a consequence of ventricular pacing leads is infrequent, and only few cases have been published in the literature 3, 4, 5, 6, 7. The mechanism for tricuspid valve stenosis includes continuous friction between leads and valve leaflets leading to endothelial damage and later fibrosis 8, 6, 9.…”