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Case Report: Pericardial tamponade during left ventricular radiofrequency ablation with spontaneous hemostasis

Year: 2025

Type: article

Abstract: Background: Pericardial tamponade is a rare but life-threatening complication of catheter ablation for ventricular arrhythmias. While overt perforation-often steam-pop related-is classically implicated, alternative bleeding mechanisms are less well defined. Case: A 66-year-old man underwent left ventricular (LV) ablation for frequent idiopathic premature ventricular beats (34.3%). RF energy (30-40 W, ≤90 s) at the LV anterior wall markedly suppressed ectopy, followed by abrupt chest discomfort and hypotension. Fluoroscopy suggested pericardial effusion; emergent pericardiocentesis yielded 150 ml of bright red, arterialized blood with rapid hemodynamic recovery. Biventricular angiography showed no contrast extravasation, and serial echocardiography confirmed no recurrent effusion. The patient stabilized with indwelling drainage and was discharged uneventfully. Conclusion: Tamponade during LV ablation may occur without overt perforation. Prompt recognition and targeted drainage can be definitive when bleeding is self-limited.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2025.1669648

Authors: Changjian He, Jinming Lin, Chunhua Ding, Wenchang Zhang

Institutions: Peking University, Aerospace Center Hospital

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801