Postcardiotomy syndrome following transvenous pacemaker insertion

We describe a case of postcardiotomy syndrome following permanent pacemaker insertion. A 79-year-old woman presented with complete heart block. Following temporary pacing, a dual chamber permanent pacemaker was inserted. Two weeks later she developed fevers and malaise with an acute rise in inflammatory markers. After systemic infection had been carefully excluded, she was commenced on prednisolone with immediate benefit. Prednisolone was withdrawn over 2 months without recurrence of symptoms. Although the postcardiotomy syndrome is rare following transvenous pacemaker insertion it should be considered in the differential diagnosis of fevers and malaise after implantation.