Significant mitral regurgitation regression by slight modification of the right ventricular pacing site.

A dual-chamber pacemaker was implanted because of symptomatic bradycardia in a 60-year-old patient free from other heart disease. Then, the patient developed acute congestive heart failure due to pacing-induced mitral regurgitation (MR). Under echocardiographic guidance, modification of location of the right ventricular pacing lead led to a significant decrease in MR severity resulting in immediate clinical improvement.