[Technical expedient in the case of phrenic stimulation complicating an epicardial pacemaker]

In the event of abnormal stimulation of the phrenic nerve with diaphragm contractions, a possible complication in carriers of pacemakers with epicardial electrodes, interposition of an insulating lamina in the pericardial lead between electrodes and pericardium is proposed. This expedient has been adopted in a case followed up over an 8 year period and can protect the phrenic nerve from pacemaker stimuli and resolve the complication simply and lastingly.