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Phrenic nerve stimulation, a rare complication of pacemaker: A case report
Meddy Dalex1, Astrid Malezieux1, Thibault Parent1
1Division of Internal Medicine for the Aged.
Medicine
|March 17, 2021
Summary
Phrenic nerve stimulation (PNS) from pacemakers can cause abdominal spasms. Adjusting pacemaker settings noninvasively resolved this rare complication, highlighting a manageable diagnostic challenge.
Area of Science:
- Cardiology
- Medical Devices
- Neurology
Background:
- Phrenic nerve stimulation (PNS) is a rare complication following pacemaker implantation.
- This case report details a patient experiencing abdominal contractions due to PNS.
Observation:
- An 88-year-old male presented with intermittent, painless abdominal contractions.
- The patient had a history of transcatheter aortic valve implantation and a cardiac resynchronization therapy pacemaker for left bundle branch block.
Findings:
- Abdominal spasms were attributed to phrenic nerve stimulation from the pacemaker.
- Adjusting the pacemaker's stimulation axis from distal left ventricular (LV) and right ventricular to LV and D1-M2 successfully eliminated the spasms.
Implications:
- Phrenic nerve stimulation, though challenging to diagnose, is manageable with noninvasive adjustments to pacemaker settings.
- This case underscores the importance of considering device-related complications in patients with pacemakers presenting with unusual symptoms.
