Case report: An unusual case of phrenic nerve stimulation in a patient with single chamber implantable cardioverter defibrillator
Phrenic nerve stimulation is a well-recognized complication related to cardiac implantable electronic devices, in particular with left ventricular coronary sinus pacing leads for cardiac resynchronization therapy. We report an unusual case of symptomatic phrenic nerve stimulation due to inadvertent...
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| Published in: | Frontiers in cardiovascular medicine Vol. 10; p. 1088697 |
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| Format: | Journal Article |
| Language: | English |
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| Abstract | Phrenic nerve stimulation is a well-recognized complication related to cardiac implantable electronic devices, in particular with left ventricular coronary sinus pacing leads for cardiac resynchronization therapy.
We report an unusual case of symptomatic phrenic nerve stimulation due to inadvertent placement of a right ventricular defibrillation lead in coronary sinus posterior branch in a patient with heart failure with reduced ejection fraction with a recently implanted single-chamber cardioverter defibrillator.
Phrenic nerve stimulation is a relatively common complication of left ventricular pacing. Inadvertent placement of a right ventricular lead in a coronary sinus branch is a rare but possible cause of phrenic nerve stimulation. Careful evaluation of intraprocedural fluoroscopic and electrocardiographic appearance of pacing and defibrillation leads during implantation may prevent inadvertent placement of a right ventricular lead in the coronary sinus. |
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| AbstractList | BackgroundPhrenic nerve stimulation is a well-recognized complication related to cardiac implantable electronic devices, in particular with left ventricular coronary sinus pacing leads for cardiac resynchronization therapy.Case presentationWe report an unusual case of symptomatic phrenic nerve stimulation due to inadvertent placement of a right ventricular defibrillation lead in coronary sinus posterior branch in a patient with heart failure with reduced ejection fraction with a recently implanted single-chamber cardioverter defibrillator.DiscussionPhrenic nerve stimulation is a relatively common complication of left ventricular pacing. Inadvertent placement of a right ventricular lead in a coronary sinus branch is a rare but possible cause of phrenic nerve stimulation. Careful evaluation of intraprocedural fluoroscopic and electrocardiographic appearance of pacing and defibrillation leads during implantation may prevent inadvertent placement of a right ventricular lead in the coronary sinus. Phrenic nerve stimulation is a well-recognized complication related to cardiac implantable electronic devices, in particular with left ventricular coronary sinus pacing leads for cardiac resynchronization therapy. We report an unusual case of symptomatic phrenic nerve stimulation due to inadvertent placement of a right ventricular defibrillation lead in coronary sinus posterior branch in a patient with heart failure with reduced ejection fraction with a recently implanted single-chamber cardioverter defibrillator. Phrenic nerve stimulation is a relatively common complication of left ventricular pacing. Inadvertent placement of a right ventricular lead in a coronary sinus branch is a rare but possible cause of phrenic nerve stimulation. Careful evaluation of intraprocedural fluoroscopic and electrocardiographic appearance of pacing and defibrillation leads during implantation may prevent inadvertent placement of a right ventricular lead in the coronary sinus. |
| Author | De Innocentiis, Carlo Buonpane, Angela Santamaria, Matteo Astore, Pasquale Santamaria, Antonia Pia Patragnoni, Francesco |
| AuthorAffiliation | 3 Cardiac Rehabilitation Unit, Gemelli Molise Hospital , Campobasso, CB , Italy 2 Agostino Gemelli IRCCS University Hospital Foundation , Rome , Italy 4 Medtronic Italia , Milan , Italy 1 Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital , Campobasso, CB , Italy |
| AuthorAffiliation_xml | – name: 2 Agostino Gemelli IRCCS University Hospital Foundation , Rome , Italy – name: 1 Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital , Campobasso, CB , Italy – name: 3 Cardiac Rehabilitation Unit, Gemelli Molise Hospital , Campobasso, CB , Italy – name: 4 Medtronic Italia , Milan , Italy |
| Author_xml | – sequence: 1 givenname: Carlo surname: De Innocentiis fullname: De Innocentiis, Carlo organization: Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Campobasso, CB, Italy – sequence: 2 givenname: Pasquale surname: Astore fullname: Astore, Pasquale organization: Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Campobasso, CB, Italy – sequence: 3 givenname: Angela surname: Buonpane fullname: Buonpane, Angela organization: Agostino Gemelli IRCCS University Hospital Foundation, Rome, Italy – sequence: 4 givenname: Antonia Pia surname: Santamaria fullname: Santamaria, Antonia Pia organization: Cardiac Rehabilitation Unit, Gemelli Molise Hospital, Campobasso, CB, Italy – sequence: 5 givenname: Francesco surname: Patragnoni fullname: Patragnoni, Francesco organization: Medtronic Italia, Milan, Italy – sequence: 6 givenname: Matteo surname: Santamaria fullname: Santamaria, Matteo organization: Arrhythmology and Electrophysiology Unit, Gemelli Molise Hospital, Campobasso, CB, Italy |
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| Cites_doi | 10.1093/europace/euv270 10.1186/s12933-017-0554-2 10.1007/s10840-013-9811-9 10.1093/europace/eus237 10.1016/S1880-4276(07)80008-1 10.1097/MD.0000000000006558 10.1016/j.hrthm.2012.07.021 10.1161/CIRCEP.108.836254 10.1111/jce.14760 10.1111/jce.12625 10.1111/pace.12664 |
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| Copyright | Copyright © 2023 De Innocentiis, Astore, Buonpane, Santamaria, Patragnoni and Santamaria. Copyright © 2023 De Innocentiis, Astore, Buonpane, Santamaria, Patragnoni and Santamaria. 2023 De Innocentiis, Astore, Buonpane, Santamaria, Patragnoni and Santamaria |
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| Keywords | case report cardiac implantable electronic devices implantable cardioverter defibrillator cardiac resynchronization therapy phrenic nerve stimulation |
| Language | English |
| License | Copyright © 2023 De Innocentiis, Astore, Buonpane, Santamaria, Patragnoni and Santamaria. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | Reviewed by: Jean-benoît Le Polain de Waroux, AZ Sint-Jan Brugge-Oostende AV, Belgium; Alexander H. Maass, University Medical Center Groningen, Netherlands This article was submitted to Cardiac Rhythmology, a section of the journal Frontiers in Cardiovascular Medicine Edited by: Masateru Takigawa, Tokyo Medical and Dental University, Japan |
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| References | Ohlow (B11) 2016; 18 Forleo (B8) 2012; 9 Behar (B7) 2015; 26 Sardu (B4) 2017; 96 Sekihara (B9) 2020; 31 Goetze (B1) 2013; 38 Biffi (B3) 2009; 2 Oswald (B6) 2015; 38 Biffi (B2) 2013; 15 Fujimori (B10) 2007; 23 Sardu (B5) 2017; 16 |
| References_xml | – volume: 18 start-page: 1049 year: 2016 ident: B11 article-title: Incidence, predictors, and outcome of inadvertent malposition of transvenous pacing or defibrillation lead in the left heart. publication-title: Europace. doi: 10.1093/europace/euv270 contributor: fullname: Ohlow – volume: 16 start-page: 75 year: 2017 ident: B5 article-title: Multipolar pacing by cardiac resynchronization therapy with a defibrillators treatment in type 2 diabetes mellitus failing heart patients: impact on responders rate, and clinical outcomes. publication-title: Cardiovasc Diabetol. doi: 10.1186/s12933-017-0554-2 contributor: fullname: Sardu – volume: 38 start-page: 1 year: 2013 ident: B1 article-title: Phrenic nerve stimulation in CRT patients and benefits of electronic lead repositioning: the ERACE trial. publication-title: J Interv Card Electrophysiol. doi: 10.1007/s10840-013-9811-9 contributor: fullname: Goetze – volume: 15 start-page: 77 year: 2013 ident: B2 article-title: Occurrence of phrenic nerve stimulation in cardiac resynchronization therapy patients: the role of left ventricular lead type and placement site. publication-title: Europace. doi: 10.1093/europace/eus237 contributor: fullname: Biffi – volume: 23 start-page: 250 year: 2007 ident: B10 article-title: Left phrenic nerve stimulation due to breakage of the endocardial right ventricular lead at the costoclavicular ligament. publication-title: J Arrhythm. doi: 10.1016/S1880-4276(07)80008-1 contributor: fullname: Fujimori – volume: 96 start-page: e6558 year: 2017 ident: B4 article-title: Cardiac electrophysiological alterations and clinical response in cardiac resynchronization therapy with a defibrillator treated patients affected by metabolic syndrome. publication-title: Medicine (Baltimore). doi: 10.1097/MD.0000000000006558 contributor: fullname: Sardu – volume: 9 start-page: 1822 year: 2012 ident: B8 article-title: Clinical and procedural outcome of patients implanted with a quadripolar left ventricular lead: early results of a prospective multicenter study. publication-title: Heart Rhythm. doi: 10.1016/j.hrthm.2012.07.021 contributor: fullname: Forleo – volume: 2 start-page: 402 year: 2009 ident: B3 article-title: Phrenic stimulation: a challenge for cardiac resynchronization therapy. publication-title: Circ Arrhythm Electrophysiol. doi: 10.1161/CIRCEP.108.836254 contributor: fullname: Biffi – volume: 31 start-page: 3330 year: 2020 ident: B9 article-title: Phrenic nerve stimulation during right ventricular outflow tract pacing: a rare but possible complication. publication-title: J Cardiovasc Electrophysiol. doi: 10.1111/jce.14760 contributor: fullname: Sekihara – volume: 26 start-page: 540 year: 2015 ident: B7 article-title: Cardiac resynchronization therapy delivered via a multipolar left ventricular lead is associated with reduced mortality and elimination of phrenic nerve stimulation: long-term follow-up from a multicenter registry. publication-title: J Cardiovasc Electrophysiol. doi: 10.1111/jce.12625 contributor: fullname: Behar – volume: 38 start-page: 942 year: 2015 ident: B6 article-title: Effectiveness and reliability of selected site pacing for avoidance of phrenic nerve stimulation in CRT patients with quadripolar LV leads: the EffaceQ study. publication-title: Pacing Clin Electrophysiol. doi: 10.1111/pace.12664 contributor: fullname: Oswald |
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| SubjectTerms | cardiac implantable electronic devices cardiac resynchronization therapy Cardiovascular Medicine case report implantable cardioverter defibrillator phrenic nerve stimulation |
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| Title | Case report: An unusual case of phrenic nerve stimulation in a patient with single chamber implantable cardioverter defibrillator |
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