The aim of the study was to investigate the tricuspid valve (TV) insufficiency induced by the electrode of permanent pacemaker (pm). Methods 150 patients (pts) (mean age 67.3 years (range 27–86), 82 men, with ischaemic heart disease n=57, idiopathic dilated cardiomyopathy n=7, diabetes mellitus n=20, valvular heart disease n=19, hypertension n=45, myopericarditis n=2, 120 with VVI and 30 with DDD pm, 18 pts with EF <35%), underwent standard Echo-Doppler examination. The time from implantation to examination was 4.5±2.1 years (6 monts to 7 years). Results On the basis of Doppler data we stated tricuspid regurgitation (TR) in 88(59%) pts as I0, 48 (33%) as II0, 11(7%) as III0, 3(1%) as IV0. In 12(72%) out of 18 pts with EF 35% (p<0.01). Out of 11 pts with mitral valve disease in 8(72%) TR III0 /VI0 was found while in 142 pts with “normal” mitral valve 6(4%) had TR III0 . Out of 9 patients with aortic valve disease TR III0 was found in 1(11%) patient while TR I0 was found 6(67%) and TR II0 was found in 2(22%) patients. Conclusion The severity of significant TR (≥ II°) in permanent right ventricular pacing patients was associated with decreased LV function and mitral valve disease, not with the presence of pacemaker lead through the tricuspid valve. TR did not intensified by time of pacing.