Int J Arrhythm.  2016 Jun;17(2):108-111. 10.18501/arrhythmia.2016.020.

Delayed Onset Transient Diaphragmatic Paralysis after Pacemaker Implantation

• Kim SY
• Park JS

• KMID: 2352416
• DOI: http://doi.org/10.18501/arrhythmia.2016.020

Abstract

A 77-year-old woman presented with exertional dyspnea six days after left pectoral pacemaker implantation. Chest radiography at presentation showed that her left diaphragm was elevated when compared to earlier films. A fluoroscopic sniff test confirmed left diaphragmatic paralysis. Thoracic computed tomography did not reveal any major vascular or lung parenchymal injury; however, phrenic nerve injury on direct needle puncture during the original surgery was suspected. The patient's small body size may have increased the risk of this injury. Delayed-onset unilateral diaphragmatic paralysis appears to be a rare complication of cardiac device implantation.

Keyword

Pacemaker; Diaphragmatic Paralysis; Phrenic nerve

MeSH Terms

Aged
Body Size
Diaphragm
Dyspnea
Female
Humans
Lung
Needles
Phrenic Nerve
Punctures
Radiography
Respiratory Paralysis*
Thorax