Key result
Surgical graft interpositioning successfully isolated the phrenic nerve from the previously implanted coronary sinus epicardial LV lead to suppress diaphragmatic contraction.
Why the study?
Does surgical graft interpositioning successfully isolate the phrenic nerve to suppress diaphragmatic contraction induced by CRT when lead repositioning is not feasible?
Case Report (n=1)
Does surgical graft interpositioning successfully isolate the phrenic nerve to suppress diaphragmatic contraction induced by CRT when lead repositioning is not feasible?
Surgical graft interpositioning can be a successful strategy to manage left phrenic nerve stimulation induced by CRT when electronic or anatomical repositioning of the LV lead is not feasible.
Answers are grounded in this paper and cite their sources.
Surgical graft isolation may salvage refractory phrenic stimulation in CRT when repositioning fails; hypothesis-generating and leaves open need for prospective data.
Phrenic Nerve Isolation in Cardiac Resynchronization. Left phrenic nerve stimulation is a well‐known complication of cardiac resynchronization therapy (CRT). We report a case where electronic or anatomical repositioning of the left ventricular (LV) electrode (within the coronary sinus tributaries) was not feasible/effective. Surgical graft interpositioning was performed to successfully isolate the phrenic nerve from the previously implanted coronary sinus epicardial LV lead. (J Cardiovasc Electrophysiol, Vol. 23, pp. 778‐780, July 2012)
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Doguet et al. (2012) conducted a case report in Left phrenic nerve stimulation complicating cardiac resynchronization therapy (n=1). Surgical graft interpositioning was evaluated on Successful isolation of the phrenic nerve. Surgical graft interpositioning successfully isolated the phrenic nerve from the previously implanted coronary sinus epicardial LV lead to suppress diaphragmatic contraction.
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