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Symptomatic Pericardial Disease Associated with Patch Electrodes of the Automatic Implantable Cardioverter Defibrillator: An Underestimated Complication?
Author(s) -
CHEVALIER PHILIPPE,
MONCADA ENRIQUE,
CANU GUILLAUME,
CLAUDEL JEANPHILIPPE,
BELLON CHRISTIAN,
KIRKORIAN GILBERT,
TOUBOUL PAUL
Publication year - 1996
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1996.tb03292.x
Subject(s) - medicine , constrictive pericarditis , heart failure , cardiology , implantable cardioverter defibrillator , decompensation , pericarditis , complication , hemodynamics , surgery , thoracotomy , defibrillation
Constrictive pericarditis can be associated with ICD patch electrodes. During a mean follow‐up of 24 months, in a population of 35 patients who received ICDs with a patch electrodes configuration, we identified three patients with clinical and hemodynamic signs compatible with this event. Patient 1, a 35‐year‐old male, underwent implantation of an ICD because of a primary electrical disease complicated by cardiac arrest. Fourteen months later he complained ofexertional dyspnea without any signs of heart failure. Right heart catheter‐ ization showed high filling pressures and diastolic dip and plateau in pressure curves. Thoracotomy and pericardia! exploration were performed. Three months after removal of the patches and insertion of an endocardial lead system, the patient had normal respiration. Patients 2 and 3, who suffered from coronary heart disease without heart failure, exhibited a hemodynamic profile suggestive of constrictive pericarditis: in one patient, 10 months after ICD implantation, associated with right heart failure; and in the other, 18 months after ICD implantation with left heart failure. Patch electrodes were removed in these two patients and replaced by endocardial lead electrodes with subsequent clinical improvement. It is concluded that constrictive pericarditis related to epicardial patch is not an uncommon occurrence during ICD therapy and should be considered in patients who show clinical signs of cardiac decompensation.