Tricuspid regurgitation and pacemaker lead

[frgwmn63]

I am 48 and am on my 3rd pacemaker since 1999 for SSS.  In Dec 2011, I was found to have moderate to severe tricuspid regurgitation.  I had an echo which also indicated mild enlargement of the right atrium and ventricle;  I then had a right heart cath and I do not have pulmonary hypertension.  I don't pace very much and I have about two years left on this system.  (Medtronic EnPulse)
Questions include why I would develop tricuspid regurg all of a sudden?  Could my lead be causing this?  Should I have the lead removed?  What are the risks if I do not have the lead removed?  What are the long terms complications of having this tricuspid problem?  The echo report indicates the valve looks normal.  Will I develop heart failure?  If I have the lead moved to an epicardial system, will that prevent future complications?  Should I be taking blood thinners?  Should I take antibiotics before dental work?  
My local EP and Cardiologist haven't really been helpful to me at all and I am ready to go to the Cleveland Clinic and visit with the doctors there.
I hope you can give me some ideas to get started on figuring out a good course of action here.  I am not one to just sit back and wait for months on end.
Thank you!!

[barbara6852]

I am 68 and was diagnosed with moderate to severe regurgitation of tricuspid valve last April after complaining of near fainting spells with racing heartbeat events that have been increasing over the last 5 years.  With the echocardiogram they were able to see that the right atrium was enlarged.  The second opinion cardiologist felt that my near fainting/racing heart episodes were due to the right atrium being enlarged.  She sent me to an EP who also feels this is the case and is doing a catheter ablation Thursday.  So in my case, it looks like 100's of SVT's caught on 2 week monitor and the episodes mentioned above(not captured on monitor) are caused by the enlarged atrium which is caused by the leaky valve.  It would be interesting to know if you had the enlarged atrium which caused  you to need a pacemaker in the first place.

[leopardtortoise]

Hi, I ran into your post while researching for tricuspid regurgitation cause by pacemaker lead/s. I'm wondering how you've been since then and if you've found answers to your questions. I am on my fourth double chamber pacemaker and when they took out my old leads and put the new ones, my tricuspid valve got damaged in the process and now it's leaking. That was 3 years ago and I had a mild TR. Now, it got worse and it's moderate TR now. I'm concerned that in a few years it would turn severe.

[frgwmn63]

Thank you for your comments.  I hope to get some answers soon!

[MichelleP_3811]

I can't answer your questions because I have no experience in your issues but what I will say is if your doctors aren't forthcoming in explaining things to you then find a doctor who will take the time to properly care for you.  My doctor is very receptive to any questions I ask.  You deserve to be informed.  Take care and hopefully someone will jump on who can answer your questions in more detail.