DEFIBRILLATOR PATCH ELECTRODE CONSTRICTION - AN UNDERRECOGNIZED ENTITY

Pericardial constriction associated with the placement of intrapericar dial defibrillator patches is a rare occurrence that is reported only one tenth as often in defibrillator patients as in patients undergoing other types of cardiac operations. Although this discrepancy may be a ttributable to a lower incidence of constriction with the defibrillato r patch electrode procedure, it may also indicate a failure to recogni ze that progressive right heart failure and signs of low cardiac outpu t that could be due to pericardial constriction and not progressive sy stolic dysfunction. Because surgical removal of the patches and decort ication of the epicardial surface is the only effective therapy, it is important to recognize this uncommon, but profoundly debilitating ent ity.