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Delayed pericardial effusion due to perforation of the right ventricular outflow tract by an ICD lead

Masaomi Chinushi1, Yukio Hosaka, Shinsuke Okada

  • 1School of Health Science, Niigata University School of Medicine. masaomi@clg.niigata-u.ac.jp

Internal Medicine (Tokyo, Japan)
|March 2, 2010
PubMed

Insights

A delayed pericardial effusion occurred in a patient after receiving an implantable cardioverter defibrillator (ICD). Physicians should consider this delayed complication, even without typical cardiac tamponade signs, for timely diagnosis and treatment.

Area of Science:

  • Cardiology
  • Medical Device Complications
  • Diagnostic Imaging

Background:

  • Implantable cardioverter defibrillators (ICDs) are crucial for managing cardiac arrhythmias.
  • Post-implantation monitoring is essential to detect potential complications.

Observation:

  • A patient developed delayed pericardial effusion 48 days after ICD implantation.
  • Initial presentation included fatigue and loss of appetite, with stable vital signs and normal chest X-ray.
  • Anemia and liver dysfunction were noted on blood work.

Findings:

  • Echocardiography confirmed a diffuse pericardial effusion.
  • Computed tomography suggested ICD lead perforation of the right ventricular outflow tract.
  • The effusion developed without overt signs of cardiac tamponade.

Implications:

  • Delayed pericardial effusion is a potential complication following ICD lead implantation.
  • Physicians must maintain a high index of suspicion for this complication, even in the absence of classic cardiac tamponade symptoms.
  • Prompt diagnosis and intervention are critical for patient outcomes.

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