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RVP was also associated with a significant worsening of tricuspid annular plane systolic excursion (TAPSE) (p.0001) and S wave velocity (p.0001) at follow up. Conversely from RVP, HBP significantly improved pulmonary artery systolic pressure (PASP) [baseline HBP 38 IQR (32-42) mmHg vs. RVP 34 IQR (31.5-37) mmHg,p=.060; 6-months HBP 32 IQR (26-38) mmHg vs. RVP 39 IQR (36-41) mmHg, p.0001] and tricuspid regurgitation (p=.005) irrespectively from lead position above or below the tricuspid valve. In patients undergoing PM implant