Images and Case Reports in Heart Failure Constrictive Pericarditis Presenting as a Late Complication of Epicardial Ventricular Tachycardia

Radiofrequency epicardial ablation of ventriculartachycardia (VT) is a safe, effective modality for treat-ment of VT.1 Epicardial VT circuits were originally described in Chagas disease, but the importance of nonendocardial substrates for VT increasingly are recognized in other car-diomyopathies.2 In arrhythmogenic right ventricular cardio-myopathy (ARVC), failure of endocardial VT ablation often is related to epicardial VT origination, with high rates of success seen with epicardial VT ablation.3 While hemoperi-cardium or pericardial inflammation are rare complications of epicardial VT ablation, to our knowledge no case of pericar-dial constriction and heart failure following epicardial VT ablation has been reported.4 Here we describe a case of pericardial constriction and severe heart failure requiring stripping and “bridge to recovery ” right-ventricular assist-device (RVAD) support, which occurred subsequent to recur