Recurrent pericardial effusion and tamponade after epicardial pacemaker lead placement: a case report

Danh Q. Nguyen, Geoffrey D. Huntley, Timothy A. Zaki, Darren K. McGuire

Research output: Contribution to journalArticlepeer-review


Background: 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. Case summary: 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. Discussion: 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.

Original languageEnglish (US)
Article numberytac114
JournalEuropean Heart Journal - Case Reports
Issue number4
StatePublished - Apr 1 2022
Externally publishedYes


  • Atrial fibrillation
  • Case report
  • Electrophysiology
  • Pacemaker
  • Pericardial effusion
  • Systolic heart failure
  • Tamponade

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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