KEY TEACHING POINTS

•Pericardial constriction should be included in the differential diagnosis of new-onset congestive heart failure after epicardial access and epicardial ablation procedures. •Pericardial constriction can occur with even small amounts of delivered radiofrequency energy and a single, uncomplicated epicardial access procedure. •Intrapericardial steroid administration may reduce the risk of pericarditis, but this finding has not been confirmed in human cases.