Catheter-Associated Post-Cardiac Injury Syndrome after Epicardial Ventricular Tachycardia Ablation in a patient with Dilated Cardiomyopathy due to Becker type Muscular Dystrophy

Background Post-cardiac injury syndrome (PCIS) is a clinical entity caused by immune reactions against antigens released after primary or secondary cardiac damage. This condition, which has been reported to occur generally after cardiac perforation, may also occur after epicardial ablation of ventricular arrhythmias. Case summary We report a case of a 33-year-old Male who developed chest pain accompanied by electrocardiogram (ECG) changes—extensive ST segment elevation in V1–V6 leads after an initially uncomplicated ventricular tachycardia CA procedure by epicardial approach. After examination and investigations, including transthoracic echocardiography (TTE), invasive coronary angiography (ICA), he was diagnosed with regional pericarditis, which occurred even though the ablation was uneventful. Furthermore, the diagnosis was difficult due to the absence of pericardial effusion on TTE and the unique ECG with changes that can be confused with acute coronary syndrome (ACS), findings that are not characteristic of pericarditis. The most important factor that made our case interesting was the improvement of the complaints and ECG findings after the removal of the epicardial catheter. The patient was discharged after a certain period of TTE and ECG follow-up. Discussion Regional pericarditis after ablation is a relatively rare PCIS. Coronary events should definitely be considered in the differential diagnosis. It is important to confirm the diagnosis with non-invasive and, if necessary, invasive imaging methods and to perform treatments and interventions for the underlying cause.