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Postcardiotomy syndrome following transvenous pacemaker insertion

M Hargreaves¹, Y Bashir

¹Cardiac Department, John Radcliffe Hospital, Headington, Oxford.

European Heart Journal

|July 1, 1994

Summary

Post-pacemaker insertion syndrome, a rare complication, can cause fever and malaise. Prompt diagnosis and corticosteroid treatment, like prednisolone, can effectively manage symptoms.

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Area of Science:

Cardiology
Immunology

Background:

Complete heart block necessitates pacemaker implantation for hemodynamic stability.
Transvenous pacemaker insertion is a common procedure for managing bradyarrhythmias.

Observation:

A 79-year-old woman developed fever and malaise two weeks post-permanent pacemaker insertion.
Laboratory tests revealed an acute rise in inflammatory markers, prompting investigation for systemic infection.

Findings:

Systemic infection was excluded, and postcardiotomy syndrome was suspected.
Initiation of prednisolone resulted in immediate symptom resolution and normalization of inflammatory markers.

Implications:

Post-pacemaker syndrome is a rare but important consideration in patients presenting with post-operative fever and malaise.
Corticosteroid therapy demonstrates efficacy in managing this condition, with symptoms resolving upon withdrawal.

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