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Minimizing Device–Device Interactions Using Bipolar Pacemaker Leads in a Pediatric Patient

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Abstract

Phrenic nerve injury can lead to a disruption of the autonomic nervous system (ANS) resulting in episodes of bradycardic arrest. Implanted diaphragmatic pacing has been used to overcome phrenic nerve paralysis, but these do not change the ANS. Therefore, patients with phrenic nerve paralysis may require the implantation of a permanent cardiac pacemaker to overcome bradycardic episodes. Having two electronic devices in the same patient may lead to device–device interaction (DDI). This can result in over-sensing leading to lack of pacing of either device. We present the case of a 17-year-old pediatric male with phrenic nerve injury who required implantation of both diaphragm and cardiac pacemaker. Intra-procedural interrogation of the cardiac pacemaker demonstrated DDI in unipolar mode, but not in bipolar. Thus, we demonstrated the safe utilization of multiple implantable electronic devices in the pediatric patient without device–device interaction.

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References

  1. Glenn WW, Hageman JH, Mauro A, Eisenberg L, Flanigan S, Harvard M (1964) Electrical stimulation of excitable tissue by radiofrequency transmission. Ann Surg 160(3):338–350

    Article  CAS  Google Scholar 

  2. Weese-Mayer DE, Hunt CE, Brouillette RT, Silvestri JM (1992) Diaphragm pacing in infants and children. J Pediatr 120(1):1–8

    Article  CAS  Google Scholar 

  3. Alshekhlee A, Onders RP, Syed TU, Elmo M, Katirji B (2008) Phrenic nerve conduction studies in spinal cord injury: applications for diaphragmatic pacing. Muscle Nerve 38(6):1546–1552

    Article  Google Scholar 

  4. Onders R, Khansarinia S, Weiser T et al (2010) Multicenter analysis of diaphragm pacing in tetraplegics with cardiac pacemakers: positive implications for ventilator weaning in intensive care units. Surgery 148(4):893–898

    Article  Google Scholar 

  5. Posluszny JA Jr, Onders R, Kerwin AJ et al (2014) Multicenter review of diaphragm pacing in spinal cord injury: successful not only in weaning from ventilators but also in bridging to independent respiration. J Trauma Acute Care Surg 76(2):303–310

    Article  Google Scholar 

  6. Shaikh N, Rhaman M, Raza A, Shabana A, Malstrom M, Al-Sulaiti G (2016) Prolonged bradycardia, asystole and outcome of high spinal cord injury patients: risk factors and management. Asian J Neurosurg 11(4):427–432

    Article  Google Scholar 

  7. Evans D, Kobrine A, Rizzoli H (1980) Cardiac arrhythmias accompanying acute compression of the spinal cord. J Neurosurg 52(1):52–59

    Article  CAS  Google Scholar 

  8. Kolb C, Eicken A, Zrenner B, Schmitt C (2006) Cardiac pacing in a patient with diaphragm pacing for congenital central hypoventilation syndrome (Onidine’s curse). J Cardiovasc Electrophysiol 17(7):789–791

    Article  Google Scholar 

  9. Movahed MR, Jalili M, Kiciman N (2005) Absence of Device-Device Interaction (DDI) in a patient with cardiac and diaphragmatic pacemakers for congential central hypoventilation syndrome. Pacing Clin Electrophysiol 28(11):1238–1239

    Article  Google Scholar 

  10. Fernandes K, McLeod RL, Nikfarjam M, Weinberg L (2016) Intraoperative analysis of cross-talk inhibition between diaphragmatic and cardiac pacemakers. BMJ Case Rep bcr2015213992

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Funding

All authors disclose that we do not have any funding, financial, or non-financial interests that would affect this manuscript (Dr. Snyder, Hoyt, Khan).

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Authors and Affiliations

  1. The Congenital Heart Collaborative, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, MS 6011, Cleveland, OH, 44106, USA

    Mohammad S. Khan, Walter Hoyt Jr. & Christopher Snyder

Authors
  1. Mohammad S. Khan
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  2. Walter Hoyt Jr.
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  3. Christopher Snyder
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Drs. CS, WH, and MSK. The first draft of the manuscript was written by Dr. MSK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Christopher Snyder.

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Informed consent was obtained from the study subject and no animals were used or harmed in this study.

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Khan, M.S., Hoyt, W. & Snyder, C. Minimizing Device–Device Interactions Using Bipolar Pacemaker Leads in a Pediatric Patient. Pediatr Cardiol 43, 923–925 (2022). https://doi.org/10.1007/s00246-022-02816-0

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  • DOI: https://doi.org/10.1007/s00246-022-02816-0

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