RV lead placement – A forgotten cause of right heart failure

•CIED leads causing TV dysfunction has gained increasing recognition recently but all evidence supporting this premise emanates from retrospective analyses.•When clinical, hemodynamic, and echocardiographic assessment provides compelling evidence of lead related severe TR, corrective intervention should be provided in a timely fashion, before the onset of severe annular and chamber dilation and severe RV dysfunction because, by that time, the lead itself will no longer be the problem, and the extant problem may not be as amenable to corrective intervention.•Leadless pacemakers and subcutaneous ICD devices likely to be associated with a reduction in lead-related cardiac dysfunction.