Transcatheter edge-to-edge mitral valve repair (TEER) with the MitraClip device has proven to be a safe and effective treatment for severe mitral regurgitation (MR) in the high-risk surgical patient population . Prior studies have shown significantly lower pacemaker implantation rates with MitraClip compared with surgical mitral valve repair , and that MitraClip improves prognosis (reduced death or heart failure hospitalization) across a broad range of patient presentations, including in patients with a history of cardiac resynchronization therapy (CRT) . Though frequently encountered, the presence of endovascular pacemaker and defibrillator leads can pose a technical challenge to MitraClip placement. Despite this, there are limited data on the need for urgent re-do cardiac implantable electronic device (CIED) placement due to lead dislodgement during MitraClip placement. Therefore, we performed a nationwide study to determine the real-world incidence of new permanent pacemaker (PPM), implantable cardioverter defibrillator (ICD) or CRT in patients with a history of prior CIED (i.e. prior PPM, ICD, or CRT) undergoing MitraClip.