Case Report: Diaphragmatic Hernia after Epicardial Catheter Ablation

Abstract Background Catheter ablation from the epicardial space is increasingly utilized to treat ventricular tachycardias (VTs). We report a rare complication. Case summary A 67-year-old male with dilated cardiomyopathy and frequent, exercise-induced VTs had been ablated once with endocardial and twice with epicardial access. Six weeks after the last procedure he was hospitalized with abdominal and back pain due to an iatrogenic diaphragmatic hernia with displacement of stomach and spleen into the left thoracic cavity. Following an acute exacerbation with cardiac arrest and splenic bleeding, he underwent successful surgery with splenectomy, reposition of the ventricle and direct suture of the diaphragmatic hernia. Conclusion This is a rare complication, but notable for its delayed clinical manifestation several weeks after the procedure and necessitates urgent surgical treatment.