The Postcardiotomy Syndrome Following Transvenous Pacemaker Insertion

We describe a syndrome of fever, pericarditis, and symptomatic pericardial effusion beginning 2 months after transvenous insertion of a permanent pacemaker in a 75-year-old woman. The syndrome improved dramalicaily following pericardiocentesis and resolved after subsequent administration of indomethacin. Although right ventricuiar perforation during pacemaker insertion was not recognized, inadvertent perforation leading to the postcardiotomy syndrome is postulated.