There is an increasing recognition of the importance of tricuspid valve disease. Surgical treatment has been less than optimal and medical therapy has poor results. Catheter based delivery has revolutionized the delivery of aortic valve prostheses and trials of catheter based tricuspid valve prostheses are ongoing. Like surgical tricuspid interventions, these procedures are associated with a significant risk of heart block, as expected from their anatomic location. The complexity of these valve prostheses makes placement of a standard transvenous system undesirable. We present a series of patients who had successful placement of a leadless pacemaker system through the valve orifice.