Nguyen Danh Q, Huntley Geoffrey D, Zaki Timothy A, McGuire Darren K
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Parkland Health and Hospital System, Dallas, TX, USA.
Eur Heart J Case Rep. 2022 Mar 11;6(4):ytac114. doi: 10.1093/ehjcr/ytac114. eCollection 2022 Apr.
Epicardial pacemaker placement is often necessary in pacemaker-dependent patients with ongoing device pocket infection or lack of venous access. Pericardial effusion and tamponade are rare but serious complications of this procedure.
A 38-year-old woman presented with nausea, diaphoresis, and hypotension 7 days after epicardial lead placement. Echocardiography revealed a large pericardial effusion with signs of tamponade. Despite initial improvement after pericardiocentesis, she continued to develop symptomatic pericardial effusions. The patient ultimately underwent pleuro-pericardial window surgery, which resulted in sustained resolution of effusion recurrence.
Cases of recurrent pericardial effusion and tamponade following epicardial lead placement have been reported in the literature, although they are rare. While extensive partial pericardiectomy or total pericardiectomy was required to achieve adequate control of fluid accumulation in prior case reports, our patient was successfully managed with a pleuro-pericardial window.
对于起搏器依赖且存在持续的起搏器囊袋感染或缺乏静脉通路的患者，通常需要进行心外膜起搏器植入。心包积液和心脏压塞是该手术罕见但严重的并发症。
一名38岁女性在心外膜导线植入7天后出现恶心、多汗和低血压。超声心动图显示大量心包积液并有心脏压塞征象。尽管心包穿刺术后最初有所改善，但她仍持续出现有症状的心包积液。该患者最终接受了胸膜心包开窗手术，积液复发得以持续缓解。
文献中已报道心外膜导线植入后复发性心包积液和心脏压塞的病例，尽管较为罕见。在既往病例报告中，需要进行广泛的部分心包切除术或全心包切除术才能充分控制液体蓄积，而我们的患者通过胸膜心包开窗手术成功得到了治疗。
