Unidad de Arritmias. Servicio de Cardiología, Hospital Universitario 12 de Octubre, Avda de Córdoba, s/n., Madrid 28041, Spain
Unidad de Arritmias. Servicio de Cardiología, Hospital Universitario 12 de Octubre, Avda de Córdoba, s/n., Madrid 28041, Spain.
Europace. 2016 Oct;18(10):1561-1564. doi: 10.1093/europace/euv423. Epub 2016 Jan 29.
Phrenic paralysis is a known complication of central venous catheterization, but it is not listed as a complication related to cardiac implantable electronic device (CIED) implants. The aim of this study is to describe the incidence, causes, clinical picture, and management of phrenic paralysis occurring in this scenario.
We retrospectively analysed data from our CIED implantation database and identified those patients who suffered phrenic paralysis during the implantation procedure. Four of 891 patients (subclavian puncture in 626) developed phrenic paralysis during pacemaker or defibrillator implant procedures. Severe respiratory failure needing ventilatory support occurred in two, being the phrenic paralysis transient in all of the cases.
Transient phrenic paralysis may occur during CIED implantation probably related to the infiltration of local anaesthesia in the subclavian area. Mechanism, prevention, and management are discussed.
膈神经麻痹是中心静脉置管的已知并发症，但它并未被列为与心脏植入式电子设备（CIED）植入相关的并发症。本研究旨在描述在这种情况下发生的膈神经麻痹的发生率、原因、临床表现和处理方法。
我们回顾性地分析了我们的 CIED 植入数据库中的数据，并确定了在植入过程中发生膈神经麻痹的患者。在 891 例患者中（626 例经锁骨下穿刺），有 4 例（2 例严重呼吸衰竭需要通气支持）在起搏器或除颤器植入过程中发生膈神经麻痹。所有病例的膈神经麻痹均为一过性。
CIED 植入过程中可能会发生短暂性膈神经麻痹，可能与局部麻醉剂渗透到锁骨下区域有关。讨论了发病机制、预防和处理方法。
