Phrenic nerve help

Hi there, 23 year old pacemaker recipient for CHB caused by ablation for SVT. Pacer installed (Medtronic azure mri) late January in the his bundle position. Since the procedure, I have had irritation which at first felt like palpitations but now I think it's my phrenic nerve. This irritation, which feels like a flutter right below my heart, is only when I am in certain positions like bending over or when I yawn, laugh or do anything strenuous. It is really taking a damper on my life overall because it is sometimes heart to breathe when it flutters for 5-10 seconds. It is causing me mass anxiety and sometimes panic at times. So far I have gone in to lower the voltage down which seems to have helped slightly but did not eradicate it. The voltage was lowered from 2.5v to 2.0. I would really appreciate anyone's help and guidance on this because it seems to be such a rare occurrence, and getting it fixed soon is very high priority right now so I can get my life back. Thank you.



by Tracey_E - 2020-04-11 22:21:18

Have you had an xray to confirm the lead hasn't moved? I'm no expert but it sounds like maybe it's not in a good position. 


by AgentX86 - 2020-04-11 22:24:54

It sounds like your diaphragm is being "paced".  The heart and diaphragm are very close to one another and once in a while the lead will pace the diaphragm.  The normal solution is to lower the voltage but your EP has already tried that fix and obviously it isn't working.  You may have to push to get them to do anything so be sure to tell them that is seriously affecting your life.


by Mike417 - 2020-05-21 13:51:35

It could be the phrenic nerve.  I had diaphramatic paralyzed from spinal stenosis, a very rare condition.  You need to see pulmonologist, and he will do some tests of diaphragm strength, but most importantly he needs to do a sniff test. 

If you have unilateral or bilateral hemi diaphragm affected bending over will make breathing worse.  You are putting pressure on the diaphragm and it cannot expand on inhilation. 

Good luck


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