Pericarditis following permanent pacemaker insertion

The appearance of pericarditis following insertion of a permanent pacemaker is not widely acknowledged in the literature. To describe our experience with pericarditis following 395 permanent pacemaker implantations over 2 years. We retrospectively reviewed the medical records of 395 consecutive pati...

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Bibliographic Details
Published in:The Israel Medical Association journal 2004-10, Vol.6 (10), p.599-602
Main Authors: Levy, Yair, Shovman, Ora, Granit, Chava, Luria, David, Gurevitz, Osnat, Bar-Lev, David, Eldar, Michael, Shoenfeld, Yehuda, Glikson, Michael
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Cardiac Pacing, Artificial - adverse effects
Device Removal
Female
Humans
Incidence
Male
Middle Aged
Pacemaker, Artificial - adverse effects
Pericarditis - diagnosis
Pericarditis - epidemiology
Pericarditis - etiology
Pericarditis - therapy
Retrospective Studies
Treatment Outcome
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Summary:The appearance of pericarditis following insertion of a permanent pacemaker is not widely acknowledged in the literature. To describe our experience with pericarditis following 395 permanent pacemaker implantations over 2 years. We retrospectively reviewed the medical records of 395 consecutive patients in whom new pacing systems or pacemaker leads had been implanted over a 2 year period. We searched the records for pericarditis that developed within 1 month after pacemaker implantation according to the ICD-9 code. The incidence, clinical picture, response to treatment, and relationship to lead design and location were studied. Eight cases (2%) of pericarditis following implantation were detected. Clinical manifestations in all patients were similar to those of post-pericardiotomy syndrome and included chest pain (n = 7), friction rub (n = 1), fever (n = 2), fatigue (n = 2), pleural effusion (n = 2), new atrial fibrillation (n = 2), elevated erythrocyte sedimentation rate (n = 4), and echcardiographic evidence of pericardial effusion (n = 8). All affected patients had undergone active fixation (screw-in) lead implantation in the atrial position. The incidence of pericarditis with screw-in atrial leads was 3% compared to 0% in other cases (P < 0.05). Pericarditis is not uncommon following pacemaker implantation with active fixation atrial leads. Special attention should be paid to identifying pericardial complications following pacemaker implantation, especially when anticoagulant therapy is resumed or initiated. The use of passive fixation leads is likely to reduce the incidence of pericarditis but this issue should be further investigated.
ISSN:1565-1088