Background: The development or progression of tricuspid regurgitation (TR) following the implantation of cardiovascular implantable electronic devices (CIED) represents a significant concern. Although the link between transvalvular lead placement and TR is well established, further research is required to elucidate the underlying factors that predispose patients to develop patient-related and lead-induced TR. The impact of the number of leads passing through the tricuspid valve and the lead diameter on the severity of tricuspid regurgitation remains unclear. This study investigated the effect of adding a pacing/ sensing lead (PSL) or an add-on ICD lead implantation on tricuspid valve function. Methods: In this retrospective, single-center, case-control study, all ICD implantation patients, in cases performed by one of these authors, presenting with lead failure were screened. Echocardiographic reports of patients who underwent additional PSL or ICD lead implantation were reviewed. Results: A total of 52 patients were included in the study. An additional pacing/sensing lead was implanted in 28 patients and an add-on ICD lead was implanted in 24 patients. The mean echocardiographic follow-up time (months) after intervention was similar in both groups (19.7 ± 17.7 vs. 18.2 ± 16.5 p:0.94). There was no significant difference between groups regarding age, gender, etiology of heart disease, and types of ICD. The addition of PSL did not result in a statistically significant increase in the degree of tricuspid regurgitation. (p:0,705). We did not find a significant increase in the degree of tricuspid regurgitation in patients in whom ICD leads were added (p: 0.059). There was no significant difference between the two groups in terms of the change in TR grade (p: 0.130). Conclusion: Although the relationship between CIED-mediated TV dysfunction and tricuspid valve dysfunction is clear, the effect of lead-related factors, such as the increased number and diameter of leads, on tricuspid valve dysfunction is unknown. This is the first study to investigate the effect of new shock lead insertion versus new PSL insertion strategies on lead-related tricuspid regurgitation in patients with lead failure. The findings indicate that adding a PSL or ICD lead in patients requiring lead addition due to lead failure did not increase tricuspid valve dysfunction.