title: Incidence and clinical characteristics of postcardiac injury syndrome complicating cardiac perforation caused by radiofrequency catheter ablation for cardiac arrhythmias.
abstract: BACKGROUND
  Postcardiac injury syndrome (PCIS) is a complication of a variety of cardiac injuries, of which small heart perforation is the etiology that is often unrecognized. We reported a series of patients with PCIS secondary to cardiac perforation during catheter ablation procedures.
  
  
  RESULTS
  Out of 1728 radiofrequency catheter ablation procedures, 21 patients (1.2%) were complicated by echo-defined cardiac perforation not requiring surgical intervention. Among them, 6 patients (6/21, 28.6%) were diagnosed with PCIS secondary to cardiac perforation because they also developed pleural effusions (6/6, 100%) and fever (4/6, 66.7%) in addition to pericardial effusion/tamponade. Four patients with PCIS (4/6, 66.7%) and four patients without PCIS (4/15, 26.7%) underwent pericardial drainage but the drainage volume during the first 24 h was not significantly different (441.3±343.9 mL vs. 182.5±151.3 mL, P=0.248). In the 6 PCIS patients, pleural effusion was detected from 3 h to 4 days (median: 2 days) after ablation procedure, predominantly bilateral (66.7%) or left-sided if unilateral. Patients with PCIS were older (64.8±7.3 years vs. 45.9±14.8 years, P=0.0078), were more likely accompanied by hypertension (66.7% vs. 6.7%, P=0.0114) and had a prolonged hospital stay (34.2±15.8 days).
  
  
  CONCLUSIONS
  More than 25% of patients with small cardiac perforation during catheter ablation may develop PCIS which can be masked by pericardial effusion/tamponade. This kind of PCIS is more likely associated with elder or hypertensive patients and is usually characterized by early onset of pleural effusion.
authors: Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors: Yang
authors: Y
authors: Liu
authors: Chao
authors: C
authors: Wang
authors: Ruifu
authors: R
authors: Zhao
authors: Deli
authors: D
authors: Wan
authors: Han
authors: H
authors: Xie
authors: Guozhu
authors: G
authors: Jin
authors: Jinli
authors: J
authors: Wang
authors: Li
authors: L
authors: Lin
authors: Qigong
authors: Q
authors: Liu
authors: Rong
authors: R
authors: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011859:Radiography
keywords: Arrhythmia; Catheter ablation; Complication; Postcardiac injury syndrome