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- W4377014715 abstract "The phrenic nerve stimulator (PNS) is a novel treatment for central sleep apnea (CSA). The device (Remede, Respicardia Inc) consists of a pulse generator and a lead positioned in the left pericardiophrenic or right brachiocephalic vein. This stimulates the phrenic nerve during sleep resulting in diaphragmatic contraction to restore normal breathing. We report a case of PNS lead migration into the right atrium resulting in atrial dysrhythmias during device stimulation. N/A An 83 year old female with history of ischemic cardiomyopathy status post primary prevention ICD, and severe CSA underwent PNS placement two years ago with the pacing lead in the right brachiocephalic vein. Due to ongoing dyspnea and LBBB she had an upgrade to CRT-D using an epicardial LV lead. Post operatively she developed palpitations with several recorded episodes of wide complex tachycardia (image 1a). Interrogation of her CRT showed nocturnal atrial arrhythmias with aberrancy seemingly triggered by rhythmic electrical interference on her atrial marker channels (image 1b). There were no recorded daytime episodes. When interrogating the CRT-D with the PNS turned on, atrial arrhythmias were reproduced by periods of phrenic nerve stimulation, and ceased with the PNS turned off. A chest X-ray obtained showed migration of the PNS lead below the superior vena cava (SVC)-right atrial junction, possibly stimulating myocardial tissue (image 1c). She was treated by reprogramming the PNS device to pace from the proximal poles of the lead still within the SVC, thereby preventing future atrial arrhythmias. This is the first reported case of PNS lead migration into the right atrium causing atrial dysrhythmias." @default.
- W4377014715 created "2023-05-19" @default.
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- W4377014715 date "2023-05-01" @default.
- W4377014715 modified "2023-10-01" @default.
- W4377014715 title "PO-04-076 PHRENIC NERVE STIMULATOR LEAD MIGRATION RESULTING IN ATRIAL DYSRHYTHMIA" @default.
- W4377014715 doi "https://doi.org/10.1016/j.hrthm.2023.03.1251" @default.
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