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Ann Thorac Surg 2003;76:1757-1758
© 2003 The Society of Thoracic Surgeons

How to do it

Management of phrenic nerve stimulation caused by epicardial pacemaker leads in children

Winfield J. Wells, MDa*, Anjan S. Batra, MDa

a Divisions of Cardiothoracic Surgery and Pediatric Cardiology, Keck School of Medicine, University of Southern California, and Childrens Hospital Los Angeles, Los Angeles, California, USA

Accepted for publication March 17, 2003.

* Address reprint requests to Dr Wells, Division of Cardiothoracic Surgery, Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS 66, Los Angeles, CA 90027, USA
e-mail: wwells{at}chla.usc.edu

To find a suitable site with good sensing and low pacing thresholds, it may be necessary to place an epicardial pacemaker lead in close proximity to the phrenic nerve. To prevent phrenic stimulation, a silastic patch can be sewn over the area of the pacing electrode to shield it from the nerve. This simple technique prevents diaphragm contraction and has not interfered with long-term pacemaker lead function.






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