Postcardiac injury syndrome following radiofrequeny ablation of atrial flutter

• Published in: Zeitschrift für Kardiologie 2004-07, Vol.93 (7), p.560-565
• Main Authors: Koller, M L, Maier, S K G, Bauer, W R, Schanzenbächer, P
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Atrial Flutter - surgery; Catheter Ablation - adverse effects; Diagnosis, Differential; Drug Therapy, Combination; Electrocardiography; Female; Follow-Up Studies; Humans; Inflammation Mediators - blood; Middle Aged; Pericardial Effusion - diagnosis; Pericardial Effusion - drug therapy; Pleural Effusion - diagnosis; Pleural Effusion - drug therapy; Postpericardiotomy Syndrome - diagnosis; Postpericardiotomy Syndrome - drug therapy
• ISSN: 0300-5860; 1435-1285
• DOI: 10.1007/s00392-004-0093-1

We report the case of a 64-year-old woman who was admitted to our hospital for radiofrequency ablation of isthmus-dependent counterclockwise atrial flutter. Following an initially uncomplicated right atrial linear isthmus ablation that was associated with conversion of atrial flutter to sinus rhythm and evidence of complete isthmus block, the patient developed a small pericardial effusion, a marked and recurrent left-sided pleural effusion, and had significantly elevated inflammatory markers. After an extensive diagnostic work-up which excluded infectious, malignant and thromboembolic causes of the effusions, a diagnosis of postcardiac injury syndrome was made and the patient was treated with oral corticosteroids and nonsteroidal anti-inflammatory drugs. Over a treatment period of 2 months there was complete resolution of the pericardial and left-sided pleural effusions and normalization of inflammatory markers. Postcardiac injury syndrome is a rare complication of radiofrequency ablation that is characterized by signs of pericardial, pleural and pulmonary parenchymal inflammation.