Division of Internal Medicine for the Aged.
Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Medicine (Baltimore). 2021 Mar 19;100(11):e25060. doi: 10.1097/MD.0000000000025060.
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.
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.
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.
Initial setting was an axis of stimulation between distal left ventricular (LV) and right ventricular. It was changed to LV and D1-M2.
This noninvasive procedure managed to eradicate the involuntary abdominal spasms.
PNS could be challenging to diagnose for those not familiar with cardiac devices technology but easy to manage with noninvasive methods.
膈神经刺激（PNS）是心脏起搏器设置后的一种罕见并发症。我们报告了一例病例报告，描述了这种并发症及其解决方法。
一名 88 岁男性因膈神经刺激导致间歇性无痛性腹部收缩而到老年急救单元就诊。他因持续性左束支传导阻滞而接受了经导管主动脉瓣植入术和心脏再同步治疗起搏器。
排除了所有常见的腹部痉挛原因，并考虑与起搏器有关。膈神经刺激是心脏起搏器植入的罕见并发症。对于不熟悉心脏设备技术的人来说，它可能在临床上没有相关性，但在诊断方面具有挑战性。
初始刺激轴为左心室（LV）远端和右心室之间，后改为 LV 和 D1-M2。
这种非侵入性程序成功消除了无意识的腹部痉挛。
对于不熟悉心脏设备技术的人来说，PNS 的诊断具有挑战性，但可以通过非侵入性方法轻松管理。
