CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1669648
Pericardial Tamponade During Left Ventricular Radiofrequency Ablation with Spontaneous Hemostasis
Provisionally accepted
- Aerospace Clinical Medical College of Peking University, Beijing, China
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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.
Keywords: Pericardial tamponade, left ventricular premature, Radiofrequency ablation, Spontaneous hemostasis, Pericardial puncture
Received: 20 Jul 2025; Accepted: 15 Oct 2025.
Copyright: © 2025 He, Lin, Ding and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenchang Zhang, tom-z@yeah.net
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