Open AccessPhrenic nerve stimulation, a rare complication of pacemaker
Author(s) -
Meddy Dalex,
Astrid Malezieux,
Thibault Parent,
Dina Zekry,
J. Serratrice
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000025060
Subject(s) - medicine , complication , phrenic nerve , cardiac resynchronization therapy , left bundle branch block , surgery , cardiology , anesthesia , heart failure , ejection fraction , respiratory system
Rationale: The phrenic nerve stimulation (PNS) is a rare complication after pacemaker setting. We report a case report that describes this complication and how it can be resolved. Patient concerns: An 88-year-old man presented himself to the emergency geriatric unit with intermittent painless abdominal contraction due to phrenic nerve stimulation. He has a history of transcatheter aortic valve implantation with cardiac resynchronization therapy pacemaker due to persistent left bundle branch block. Diagnoses: All the usual causes for abdominal spasms were eliminated and the possibility of a link with the pacemaker was considered. The phrenic nerve stimulation is a rare complication of a pacemaker implantation. It can be clinically nonrelevant but challenging to diagnose for those not familiar with cardiac devices technology. Interventions: Initial setting was an axis of stimulation between distal left ventricular (LV) and right ventricular. It was changed to LV and D1-M2. Outcomes: This noninvasive procedure managed to eradicate the involuntary abdominal spasms. Lessons: PNS could be challenging to diagnose for those not familiar with cardiac devices technology but easy to manage with noninvasive methods.