Phrenic nerve stimulation, a rare complication of pacemaker: A case report
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Updated: Nov 12, 2025
Implantation and Control of Wireless, Battery-free Systems for Peripheral Nerve Interfacing
Published on: October 20, 2021
Meddy Dalex1, Astrid Malezieux1, Thibault Parent1
1Division of Internal Medicine for the Aged.
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.
