Key result
Prolonged LBBAP linked to PCIS and recurrent tamponade successfully resolved with corticosteroids.
Why the study?
LBBAP is a new technique associated with longer procedural times, and reports of complications like PCIS leading to recurrent cardiac tamponade remain relevant.
Case Report (n=1)
No
Prolonged LBBAP procedures, particularly in patients with challenging anatomy such as congenital heart disease, carry a risk of post-cardiac injury syndrome and recurrent cardiac tamponade.
Answers are grounded in this paper and cite their sources.
Prolonged LBBAP may cause PCIS with recurrent tamponade; this Level 5 case leaves open incidence, risk factors, and steroid role.
Post-cardiac injury syndrome (PCIS) is one of the complications of cardiac interventional procedures. This condition has been postulated to be due to an immune reaction, especially with pacemaker lead implantation. Patients with PCIS can have uncomplicated pericardial effusion until they develop cardiac tamponade. The management of PCIS, which can be conservative management or require pericardiocentesis or surgery depends on the patient's clinical symptoms. As the left bundle branch area pacing (LBBAP) implantation technique and technology are still new, it is associated with longer procedural time than conventional pacemaker implantation. Herein, we report a case of PCIS in a patient who had a prolonged LBBAP procedure due to difficult anatomy and presented with recurrent cardiac tamponade. LEARNING POINTS: Prolonged fluoroscopy in cardiac procedures can potentially lead to post-cardiac injury syndrome.Active pacemaker lead fixation is one of the risk factors for post-cardiac injury syndrome due to immune reaction.Left bundle branch area pacing in adults with congenital heart disease is challenging because of anatomical differences.
No takes yet. Share an insight, caveat, or question.
Kamarulzaman et al. (2025) conducted a case report in Post-cardiac injury syndrome (PCIS) with recurrent cardiac tamponade (n=1). Prolonged left bundle branch area pacing (LBBAP) and subsequent corticosteroid therapy was evaluated on Resolution of pericardial effusion. A prolonged left bundle branch area pacing procedure resulted in post-cardiac injury syndrome with recurrent cardiac tamponade, which was successfully resolved using corticosteroid therapy.
Synapse has enriched 10 related papers. Consider them for comparative context: