State University of New York Upstate Medical University, Syracuse, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221103380. doi: 10.1177/23247096221103380.
Ventricular fibrillation can lead to sudden cardiac death. Automatic implantable cardioverter defibrillator (AICD) devices have shown to be highly successful in the termination of these arrhythmias and are a first-line modality of treatment for the prevention of sudden cardiac death. We present the case of a 69-year-old female with a history of paroxysmal atrial fibrillation on anticoagulation with apixaban and rate controlled with metoprolol who presented from home with a chief complaint of hiccups. She had a prior admission to the hospital after she was found to have monomorphic ventricular tachycardia during a nuclear stress test. A cardiac work-up including cardiac catheterization and cardiac magnetic resonance imaging did not show any evidence of significant coronary artery disease or reversible cardiomyopathy. The patient underwent successful placement of a single chamber ICD and was discharged home. Twelve weeks after placement of the AICD, the patient was lifting furniture and experienced sudden onset of hiccups. A chest X-ray showed displacement of the AICD lead from the right ventricular apex to the superior vena cava. The patient underwent lead repositioning with complete resolution of her hiccups. The etiology hiccups was suspected to be secondary to irritation of the right phrenic nerve which travels along the anterolateral border of the superior vena cava. We present the case of hiccups following ICD lead displacement. This serves to highlight a rare complication of ICD displacement that healthcare providers should consider when patients with recently placed ICD devices complain of hiccups.
心室颤动可导致心源性猝死。自动植入式心脏复律除颤器（AICD）已被证明在终止这些心律失常方面非常成功，是预防心源性猝死的一线治疗方法。我们报告了一例 69 岁女性的病例，该女性有阵发性心房颤动病史，服用阿哌沙班抗凝，美托洛尔控制心率，她因呃逆主诉从家中就诊。她曾因在核应激试验中发现单形性室性心动过速而入院治疗。心脏检查包括心导管检查和心脏磁共振成像，未发现任何明显的冠状动脉疾病或可逆转的心肌病证据。患者成功植入了单腔 ICD，并出院回家。在植入 AICD 后 12 周，患者正在搬运家具，突然开始呃逆。胸部 X 线片显示 AICD 导线从右心室心尖移位到上腔静脉。患者接受了导线重新定位，呃逆完全缓解。呃逆的病因被怀疑是由于右侧膈神经受到刺激，膈神经沿上腔静脉的前外侧缘走行。我们报告了一例 ICD 导线移位后呃逆的病例。这例病例突出了 ICD 移位的一种罕见并发症，当最近植入 ICD 装置的患者抱怨呃逆时，医疗保健提供者应考虑这种并发症。
