title: Pacing electrode selection in a quadripolar left heart lead determines presence or absence of phrenic nerve stimulation.
abstract: A 60-year-old ischaemic patient presented for routine cardiac resynchronization therapy (CRT)-D implantation. An investigational quadripolar left ventricular lead was placed in the posterolateral vein. Phrenic nerve stimulation (PNS) was observed, but it occurred during pacing from only one of the four electrodes. A lead with multiple pacing electrodes is a potential alternative to physical adjustment of the lead or discontinuing CRT when PNS occurs.
authors.affiliation: Montreal Heart Institute, 5000, Belanger Street East, Montreal, QC, Canada. b_thibault@icm-mhi.com
authors.forename: Bernard
authors.initials: B
authors.lastname: Thibault
authors.forename: Edward
authors.initials: E
authors.lastname: Karst
authors.forename: Kyungmoo
authors.initials: K
authors.lastname: Ryu
authors.forename: Patrice
authors.initials: P
authors.lastname: Paiement
authors.forename: Taraneh G
authors.initials: TG
authors.lastname: Farazi
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods*; D009202:Cardiomyopathies / Q000503:physiopathology / Q000628:therapy*; D004558:Electric Stimulation; D004566:Electrodes; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010791:Phrenic Nerve / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology