: Pacemaker or implantable cardioverter defibrillator (ICD) phrenic nerve stimulation is a rare complication of the implantation of a pacemaker or ICD. This can occur when the electrical impulse from the device stimulates the phrenic nerve, which runs from the neck to the diaphragm, causing it to contract.
: Pacemaker or ICD phrenic nerve stimulation can be diagnosed by a physical examination, chest X-ray, and electrocardiogram (ECG). An ECG will show a regular rhythm with no pauses between beats, and a chest X-ray will reveal an enlarged diaphragm.
of pacemaker or ICD phrenic nerve stimulation should include other causes of diaphragmatic contraction, such as myasthenia gravis, muscular dystrophy, or a chest infection.
: The most common treatment for pacemaker or ICD phrenic nerve stimulation is to reprogram the pacemaker or ICD to reduce the electrical impulse to the phrenic nerve. If reprogramming is not successful, the device can be surgically repositioned or replaced.
: The prognosis for pacemaker or ICD phrenic nerve stimulation is good, and symptoms usually resolve after the device is reprogrammed or repositioned. However, if the device is not reprogrammed or replaced in a timely manner, the phrenic nerve can become permanently damaged, leading to respiratory problems.