Implantable epicardial cardioverter–defibrillator-induced localized constrictive pericarditis

In the 1990s, epicardial implantable cardioverter-defibrillator (ICD) patches were frequently implanted to treat life-threatening ventricular arrhythmia. However, owing to the high rates of functional failure, the patch system has been replaced by transvenous ICD leads system. Although morphological abnormalities such as dense fibrosis around the patch are quite frequent, epicardial ICD patch-induced localized constrictive pericarditis is very rare. We encountered a patient who had severe heart failure due to constrictive pericarditis, 23 years after the implantation of epicardial ICD patches. The heart failure was treated after complete resection of the patches and dense fibrosis on the surface of both the right and the left ventricles. To our knowledge, this is the first report on the treatment of epicardial ICD patch-induced localized constrictive pericarditis.