A novel therapy for eliminating phrenic nerve stimulation: a long-term follow-up case report

Phrenic nerve stimulation (PNS) is a frequent occurrence in patients implanted with a cardiac resynchronization therapy (CRT) device. Most PNS can be eliminated by external programming of pacing threshold, pacing polarity, etc., but there are still a small number of refractory PNS cases that need electrode reset. The latter has many uncertainties, such as poor coronary sinus (CS) target vessel conditions, venous pathway obstruction or occlusion, recurrence of PNS, pacemaker sac infection, disappearance of CRT super response, etc. In view of this, we reported one case of PNS after CRT treated by isolating the left phrenic nerve (PN) and the left ventricular (LV) electrode.