Document Detail


Proper management of pericardial tamponade as a late complication of implantable cardiac device placement.
MedLine Citation:
PMID:  16828597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac tamponade as a late complication of device placement is exceedingly rare, with only several case reports previously published. We sought to characterize our institution's experience with cardiac tamponade occurring >30 days after permanent pacemaker or implantable cardioverter-defibrillator placement. From January 2000 to June 2003, 2,535 patients received an implantable cardiac device at our institution. Four patients (0.17%) presented with cardiac tamponade>30 days after the procedure. A fifth patient who had undergone implantation at another institution but was referred to our group with tamponade was also included in the analysis. The baseline characteristics varied widely with respect to age, gender, device type, and anticoagulation status. Lead parameters were altered in 2 of 5 patients. Two patients were treated with pericardiocentesis, 1 patient had pericardiocentesis followed by lead extraction, and 2 patients required cardiac surgical intervention. Pericardial fluid culture and cytologic findings were negative in all patients. All patients had normal recovery and were well at a mean follow-up of 31 months. In conclusion, cardiac tamponade is a rare, but serious late complication of permanent pacemaker and implantable cardioverter-defibrillator placement. The patient characteristics and mode of presentation vary widely. Once tamponade is recognized and treated, these patients appear well at long-term follow-up, with no other device-related problems. A role for lead manipulation does not appear to exist in the standard treatment of these patients.
Authors:
Glenn M Polin; Erica Zado; Hemal Nayak; Joshua M Cooper; Andrea M Russo; Sanjay Dixit; David Lin; Francis E Marchlinski; Ralph J Verdino
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-05-11
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-10     Completed Date:  2006-08-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiac Tamponade / etiology,  radiography,  surgery*
Defibrillators, Implantable / adverse effects*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pacemaker, Artificial / adverse effects*
Pericardiocentesis*
Radiography, Thoracic
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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