Diaphragmatic stimulation

My first dual chamber, on demand pacemaker implanted when I was 32 due to a heart block. Have had 7 of these pacemakers with a few problems that were easily taken care of. About 18 mos ago I began to have symptoms of congestive heart failure. I had no swelling anywhere so LASIK didn't help. More tests two months ago concluded that the left side of my heart had become weak because the right side, upper and lower, for 32 years. So three days ago I had an Invive pacemaker implanted. New left lead wire working ok plus the two lead wires in the right side of heart functioned perfectly. Seven hours later I began to experience diaphragmatic stimulation. A chest x-ray was taken to compare x-ray taken while still in cath lab (after new pacemaker and lead wire procedure), and one approx. 5 hrs later. Then 2 hrs later during ds. The Guidant tech tried adjusting but nothing worked so left side was turned off. Comparison of x-rays showed no lead wire movement. Now heart dr wants me to wait 4 weeks before trying to turn left lead wire back on. What does this mean and what does the dr hope to accomplish?

Over the past 32yrs with the seven pacemakers, I have had one develop a glitch in it and needed a new one. Another one had to be replaced after a year because one of the lead wires broke and drained the battery. And now after only 7 hrs this pacemaker, number 8, is giving me problems! It was supposed to take of the CHF. I am very discouraged and impatient for the next four weeks to pass. I just want the new one and all the leads to work so I can get back to my life...so tired of being tired and out of breath.

Thank you so much for any help and encouragement!
Tealady

7 Comments

Phrenic nerve stimulation

by parmeterr - 2013-11-15 08:11:19

The left ventricular wire sometimes touches the phrenic nerve and produces a "hic up" type action. Find out if the left ventricular wire is bi-polar. If so, there is the possibility of adjustment. I experience this action off and on and it is a minor nuisance.

Diaphragmatic stimulation

by philip.thecyclist - 2013-11-15 08:11:47

When my current pacemaker was implanted in May, I was warned of the possibility that insertion of the lead to the left ventricle could result in stimulation of my diaphragm. This in fact happened quite noticeably during the procedure, and the team withdrew the lead and inserted another type through a different route. This has been successful. The problem as I understand it is with lead routing rather than with the PM itself. Whether this is appropriate in your case I would not like to say, but it's worth asking the question of your doc. My device, an Inliven, is similar to the Invive except that it has a minute ventilation sensor. A Boston Scientific rep. (Guidant is now BS) was present during the procedure so the phenomenon should be known to them.

Good luck,
Philip.

Diaphragmatic Stimulatiob

by Tealady - 2013-11-15 09:11:28

Thank you both for your comments! Both gave me encouragement and new information. My heart doctor's office called to see how I was doing plus had already set up an appointment to see him on Monday, so much better than waiting four weeks for more answers! God answered my prayers!!

I have a temporary pacemaker device I.D. card but it doesn't say whether the left lead wire is bipolar. Any suggestions were I might find this information? I do have the model number for the Invive pacemaker. Thanks!!

Diaphragmatic stimulation

by philip.thecyclist - 2013-11-16 07:11:35

My PM ID card lists the model and serial numbers of leads I have, as does the surgeon's notes on the procedure, but neither specifies whether the LV lead is bi-polar.I should know as a result of the research I did prior to the procedure, but I've forgotton. Your doctor should be able to tell you the lead type, which is important to have on record, I think, as it may be helpful info. for any future procedures.

Diaphargmatic stimulation

by cgomez - 2013-11-16 08:11:16

Wow this is a terrible experience you have had . My prayers are with you . Keep your faith and Good luck.

Diaphragmatic stimulation

by Tealady - 2013-12-04 06:12:43

When I saw my heart dr he turned the left bipolar lead wire turned back on...took some adjusting to keep the DF from happening too often...dr said that as the scar tissue forms this will happen less n less...some days are fine with little episodes of these hiccups but some days are challenging with the hiccups becoming more like thumping...can see my chest move like it have an alien living inside--way too old to compare it to a baby kicking my insides--

I find that if I sleep on my left side the thumping goes away but sleeping on my back or right side the thumping pounds against my diaphragm...if I sit for periods of time the thumping goes away .....any thoughts on these weird episodes? Any suggestions for when the thumping becomes annoying?

I do feel soooo much better with the left side turned on...lots of energy and emotionally feeling like I am back to my old self before the congestive heart failure came to live with me!!!

I don't want to have the left lead wire shut off again...I can live with the thumping but wonder if it will get less and less? I see the dr in February and feel like I can live through the thumping until then.

And suggestions? This pacemaker and new lead wire make me feel like I can do just about anything!!! Would not want to even think about living without it.

Any thoughts about using wireless devices with this pacemaker? Wasn't given any restrictions but know that those living with a pacemaker would be the first to know if there are problems...I am right handed and when I do yes my cell phone I always gave it to my right ear...it travels in my back right pocket of my jeans when I go out.

I do use my iPad and Mac air book pro along with my kindle--in the wireless off position 99% of the time.

Thanks from the bottom of my battery-operated heart!

Gerry Richter

by gerryrichter - 2014-05-06 03:05:54

After 7 years with a defibulator when the battery started to get low. Since I have CHF my Dr implanted a St Jude CRT-ICD last Thursday May 1st. All went well until I started to get this thumping sensation when I sat in certain positions. I finally got into the Office today and the tech explained that Diaphragm Stimulation was what I was experiencing. She made a slight change in the power going to the lead on the outside lower section and told me to try that and if it was still flexing she could try and turn the power down again. She said it was not a problem but more of an annoyance. Also mentioned it was quite common. Everything else read good. So, I'm hoping the 3 wire PM helps my CHF.

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