Atrial fibrillation deteriorates tricuspid regurgitation following implantable cardioverter defibrillator lead placement in patient with hypertrophic obstructive cardiomyopathy

Although atrial fibrillation (AF) often exists in patients with hypertrophic obstructive cardiomyopathy (HOCM), combination of tricuspid regurgitation (TR) and AF after implantation of pacemaker/implantable cardioverter defibrillator (ICD) lead and its optimal management have not been well discussed in this population. Herein, we present a patient with HOCM who subsequently died due to severe heart failure and deterioration of TR following ICD lead placement with AF. Autopsy findings demonstrated that ICD leads were entrapped by anomaly structure in the right atrium and ventricle, which might affect deterioration of TR.