muscle spasm's

Just had a Medtronics BIVICD bi-ventricular icd installed Monday, 5/6/14. I was down to 23-4 % heart function (ejection fraction) So Tim decided it was time for the big one. Tim Kreth is my cardiologist and Tommy (Tom Williams) did the surgery. I am asking for feedback because I won't see Tom till Tuesday and I am having a lot of muscle contractions on the left side and belly (possibly the diaphram) strong enough when I lay on my stomach or right or left side Karen can feel it through the mattress and see it if she watches me. If I lay on my back it seems to stop. Just wonder if anybody else had this happen and what seems to be the fix. I'm not really worried but it is uncomfortable and I think Karen is really worried. Any reply would be appreciated. Thanks Bob

5 Comments

sounds familiar

by Reboot1212 - 2014-05-10 09:05:04

Happens to me too. Dr says one of my leads is near a nerve such that in certain positions it will stimulate the muscle on my left side. They adjusted the output so it wasn't as noticeable. I was told it is common, not a problem, and won't impact battery life. Mention it to your EP / Dr but don't fret. My wife is amused when "Sparky" pokes me in the side for lying on him.

This is NOT normal

by donr - 2014-05-10 09:05:15

I'd suggest that you contact someone about this. At 75, it is more serious than at age 35! It could be a precursor of something worse.

There are members who have had an errant implant involving the ventricular lead that causes stimulation of the diaphragm & symptoms that sound roughly like yours.

It is probably worth a trip to the ER if it does NOT improve soon.

Hopefully, when the world finishes waking up, one of those folks will wander by.

Meanwhile - don't wait till you have to call 911 - make the trip to the ER on your own & suggest to the ER Doc that they explore what I described in my second paragraph.

Donr

important follow up

by Reboot1212 - 2014-05-10 09:05:51

I should mention that my device is a CRT -P and not an ICD. Not the same situation.

Same Thing Here...

by Marty - 2014-05-11 11:05:58

I had my 3rd CRT device implanted about 6 weeks ago. I experience the same diaphragm spasms you described, and they're definitely relative to my position while laying down. Yawning or stretching especially bring the "thumps" just below the bottom left rib.

Normal PM folks don't often have to contend with this issue, and the name of it is "Phrenic Nerve Stimulation." You can Google it if you want to learn more.

There are two phrenic nerves on each side of your body. They run from your brain to your diaphragm, and are the circuits your brain uses to regulate your breathing. With a CRT (Cardiac Resynchronization Therapy) device, it is necessary to have a lead placed in each of your two ventricles, so the device can go to work getting the LV and RV to beat in a more coordinated way, or at least a lot closer to the same time than before. It will drastically improve the pumping efficiency of your heart. The problem is having that lead in the LV is tricky because it ends up being in close proximity to your left side phrenic nerve, and it sometimes picks up the pacing impulse meant only for your heart in some positions, ...so you either hiccup, or just feel that disconcerting JAB in your left side, as your diaphragm is suddenly being "paced." It's not life threatening. It will not even hurt you, it just feels lousy. It interferes with sleep, and it can make your partner scared.

They can make adjustments to your CRT settings to reduce the phrenic nerve stimulation, but you may just have to avoid certain positions, as I do. They offered to reduce the voltage to that LV lead for me, to reduce the phrenic nerve issues, but I am not ready to take any chances on the effectiveness of the device. I WANT that LV side to listen to the impulses from the CRT, not miss them because they've turned it down. They can also adjust the polarity of the lead in the LV, rerouting the signal from one side of the lead tip --instead of pacing from one prong of that lead tip, they can use the other side of it. It may help.

The good news is that having this phrenic nerve involvement indicates a very good placement of your LV lead (from a pacing perspective), and it will allow the device to do its job very well, with a much longer battery life. My EF went from 25% to 50% after getting my first CRT.

That's the good news. Let your EP doc know you're having phrenic nerve stimulation, and get the best tuneup possible without reducing the effectiveness of the CRT.

Hope this helps. God bless, and all the best to you.

Marty

Spasm Man's thank you

by WaspCVS-18 - 2014-05-13 04:05:28

I Just want to say thank you to you guys who wrote back to me. Still not sure how to navigate all this site but will gradually learn. Any way Don, Reboot, and Marty thank you so much, how do I repay. Thank you again.
Don, did you get the messages I sent about Cousin Harry, if not as as a repeat, Louis Truman, Ralph Truman & Corby Truman were all Generals and may have been my Cousin Vivian Truman's Kids. I told you I would try and call the Library and ask Kim to give me a rundown as to whom sired whom. But President Truman (Harry) is my 1st cousin twice removed. Bob

You know you're wired when...

Jerry & The Pacemakers is your favorite band.

Member Quotes

My muscles are very sore but each day it gets better and my range of movement is improving.