Dong Tony, Chami Tarek, Janus Scott, Hajjari Jamal, Fernandez Antonio Sotolongo, Josephson Richard
Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Harrington Heart and Vascular Institute, University Hospital Cleveland Medical Center, 11100 Euclid Ave Cleveland 44106, OH, USA.
Eur Heart J Case Rep. 2021 Sep 7;5(9):ytab352. doi: 10.1093/ehjcr/ytab352. eCollection 2021 Sep.
Diaphragmatic pacemakers are used to assist respiration in ventilator-dependent patients. Electromagnetic interference with intrinsic cardiac electrical activity is a theoretical risk but has never been reported in the literature. This case highlights a serious complication of cardiac arrest as a result of diaphragmatic pacing.
We report a quadriplegic patient with recent diaphragmatic pacemaker implantation who presented with ventricular tachycardia leading to cardiac arrest. Extensive workup was negative for other aetiologies for ventricular arrhythmias. Reduction of the left-sided diaphragmatic pacemaker voltage resulted in cessation of ventricular ectopy.
Diaphragmatic pacing at high voltages can cause unwanted transmission of impulses to the cardiac myocytes as a rare complication. This should be noted as a possible complication of intramuscular diaphragmatic pacing, and efforts should be taken to circumvent this risk in the future.
膈肌起搏器用于辅助依赖呼吸机的患者进行呼吸。对心脏固有电活动的电磁干扰是一种理论上的风险，但在文献中从未有过报道。本病例突出了膈肌起搏导致心脏骤停的严重并发症。
我们报告了一名近期植入膈肌起搏器的四肢瘫痪患者，该患者出现室性心动过速并导致心脏骤停。对室性心律失常的其他病因进行的广泛检查均为阴性。降低左侧膈肌起搏器的电压可使室性早搏停止。
高电压下的膈肌起搏可导致冲动意外传导至心肌细胞，这是一种罕见的并发症。应注意这是肌内膈肌起搏的一种可能并发症，未来应努力规避这种风险。
