Background: Tricuspid regurgitation after pacemaker implantation is relatively common. The mechanism by which a pacemaker lead causes tricuspid regurgitation is not clear. This study was performed to determine the relation between atrioventricular dyssynchrony and pacemaker-related tricuspid regurgitation. Methods: We reviewed 679 patients with RV pacing pacemaker such as VVI, VDD, and DDD mode. We regarded VVI mode as dyssynchrony. Tricuspid regurgitation severity was analyzed depending on VVI and non-VVI mode by using paired t-test. Change of tricuspid regurgitation severity was defined as difference of tricuspid regurgitation grade in each patient. Results: Mean age of patients was 64.8 짹 13.4 year (280 males). We reviewed patients with 164 DDD, 161 VDD, and 354 VVI mode pacemakers. In VVI mode group, mean implantation-age was 67.8 짹 12.6 year. In non-VVI mode group, mean implantation-age was 61.5 짹 13.6 year. There were no significant differences of LV ejection fraction and LV end diastolic diameter. Baseline tricuspid regurgitation severity and follow-up tricuspid regurgitation severity were more severe in VVI group (0.89 짹 1.03 vs. 0.49 짹 0.81 p = 0.005; 1.44 짹 1.02 vs. 0.80 짹 1.16, p = 0.005). In both group, tricuspid regurgitation grade increased. However, change of tricuspid regurgitation severity was not different between groups (0.25 짹 1.17 vs. 0.03 짹 0.86, p = 0.333). Conclusions: Atrioventricular dyssynchrony does not affect on the severity of pacemaker-related tricuspid regurgitation.