Intermediate
Technical
IVT
phrenic nerve stimulation
Unintended stimulation of the phrenic nerve during cardiac pacing, causing hiccups or diaphragmatic contractions.
Full Definition
An unwanted complication of cardiac pacing, particularly with left ventricular or high-output pacing, where electrical stimulation inadvertently captures the phrenic nerve, resulting in diaphragmatic contractions or hiccups. Phrenic nerve stimulation is more common with left ventricular leads due to their anatomical proximity to the phrenic nerve course. Management typically involves reducing pacing output, changing pacing vectors, or in severe cases, lead repositioning.
Usage
Usage note: Specify location (left/right) and relationship to pacing parameters when documented.
In Context
- "Phrenic nerve stimulation was observed at outputs above 3.5V on the left ventricular lead." — Device implant report
- "The patient reported intermittent hiccups consistent with phrenic nerve stimulation." — Follow-up clinic note
Also known as
diaphragmatic stimulation
Don't confuse with
muscle stimulation
chest wall stimulation