Giant Interventricular Septal Hematoma Complicating Left Bundle Branch Pacing: A Cautionary Tale
Rohan Trivedi1, Eileen Rattigan1, Terry D Bauch1
1Geisinger Heart Institute, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA.
JACC. Case Reports
|July 3, 2023
Summary
A rare interventricular septal hematoma occurred after cardiac procedures for atrial fibrillation. This condition resolved successfully with conservative medical management.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Interventional Cardiology
Background:
- Atrial fibrillation management often involves procedures like atrioventricular node ablation and left bundle branch pacing.
- These interventions carry potential risks, necessitating vigilant post-procedural monitoring.
Observation:
- An 88-year-old female presented with acute dyspnea hours after undergoing atrioventricular node ablation and left bundle branch pacing.
- Diagnostic imaging revealed a large interventricular septal hematoma, a rare complication.
Findings:
- The interventricular septal hematoma, despite its size, was successfully managed non-surgically.
- Conservative medical therapy led to the complete resolution of the hematoma.
Implications:
- This case highlights the importance of recognizing and managing rare cardiac complications following electrophysiological procedures.
- Conservative management can be effective for interventricular septal hematomas, reducing the need for invasive interventions.
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