Kamarulzaman Nurshafira, Wan Abdullah Wan Nur Amirah, Othman Mohd Khairi, Isa W Yus Haniff W, Yusof Zurkurnai, Mohamad Jamali Ahmad Aizuddin, Muhammad Zulkeflee
Cardiology Unit, Internal Medicine Department, Hospital Universiti Sains Malaysia, Kelantan, Malaysia.
School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia.
Eur J Case Rep Intern Med. 2025 Jan 29;12(2):005144. doi: 10.12890/2025_005144. eCollection 2025.
Post-cardiac injury syndrome (PCIS) is one of the complications of cardiac interventional procedures. This condition has been postulated to be due to an immune reaction, especially with pacemaker lead implantation. Patients with PCIS can have uncomplicated pericardial effusion until they develop cardiac tamponade. The management of PCIS, which can be conservative management or require pericardiocentesis or surgery depends on the patient's clinical symptoms. As the left bundle branch area pacing (LBBAP) implantation technique and technology are still new, it is associated with longer procedural time than conventional pacemaker implantation. Herein, we report a case of PCIS in a patient who had a prolonged LBBAP procedure due to difficult anatomy and presented with recurrent cardiac tamponade.
Prolonged fluoroscopy in cardiac procedures can potentially lead to post-cardiac injury syndrome.Active pacemaker lead fixation is one of the risk factors for post-cardiac injury syndrome due to immune reaction.Left bundle branch area pacing in adults with congenital heart disease is challenging because of anatomical differences.
心脏损伤后综合征（PCIS）是心脏介入手术的并发症之一。这种情况被认为是由于免疫反应引起的，尤其是在起搏器导线植入时。PCIS患者可能会出现单纯性心包积液，直到发展为心脏压塞。PCIS的治疗方法可以是保守治疗，也可能需要心包穿刺或手术，这取决于患者的临床症状。由于左束支区域起搏（LBBAP）植入技术仍较新，与传统起搏器植入相比，其手术时间更长。在此，我们报告一例因解剖结构复杂导致LBBAP手术时间延长并出现反复心脏压塞的PCIS患者。
心脏手术中长时间的透视可能会导致心脏损伤后综合征。主动固定起搏器导线是免疫反应导致心脏损伤后综合征的危险因素之一。由于解剖结构差异，先天性心脏病成人患者的左束支区域起搏具有挑战性。
