Key result
Double-layer spacer isolation eliminates ultra-late phrenic nerve stimulation while preserving LV pacing thresholds at 1 year.
Why the study?
Ultra-late phrenic nerve stimulation after CRT is rarely refractory to reprogramming or in need of reintervention.
Does a double-layer spacer isolation technique resolve ultra-late phrenic nerve stimulation in a patient with CRT?
Case Report (n=1)
No
Does a double-layer spacer isolation technique resolve ultra-late phrenic nerve stimulation in a patient with CRT?
A double-layer spacer isolation technique using PET felt and an artificial blood vessel safely and effectively resolved ultra-late phrenic nerve stimulation 12 years after CRT implantation.
Spacer isolation may resolve refractory ultra-late PNS post-CRT; leaves open safety and efficacy in larger cohorts.
Ultra-late phrenic nerve stimulation (PNS) without evidence of lead dislodgement after cardiac resynchronization therapy (CRT) can be frequently solved by reprogramming and seldom leads to reintervention. We reported a case of super-response to CRT patient, PNS occurred after twelve years of the surgery. Reprogramming the parameters was ineffective. We innovatively used a double-layer spacer isolation technique to effectively isolate the left ventricular lead and the phrenic nerve, achieving the effect of cardiac resynchronization therapy.
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He et al. (2026) conducted a case report in Ultra-late phrenic nerve stimulation after cardiac resynchronization therapy (n=1). Double-layer spacer isolation technique was evaluated on Elimination of phrenic nerve stimulation. The double-layer spacer isolation technique successfully eliminated ultra-late phrenic nerve stimulation while maintaining stable left ventricular pacing thresholds at 1-year follow-up.
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