title: Intercostal muscle twitching from right ventricular apical pacing.
abstract: A patient with a dilated cardiomyopathy underwent successful implantation of a cardiac resynchronization therapy defibrillator. The device system included an active fixation lead placed at the right ventricular (RV) apex. Pacing from the RV apex unexpectedly led to left-sided intercostal muscle stimulation and twitching. This intercostal muscle twitching resolved completely with movement of the lead to the RV outflow tract.
authors.affiliation: Rush University Medical Center, Chicago, Illinois, USA. Siddharth_Kakodkar@rush.edu
authors.forename: Siddharth A
authors.initials: SA
authors.lastname: Kakodkar
authors.forename: Milind G
authors.initials: MG
authors.lastname: Parikh
authors.forename: Christopher
authors.initials: C
authors.lastname: Madias
authors.forename: Richard G
authors.initials: RG
authors.lastname: Trohman
authors.forename: Kousik
authors.initials: K
authors.lastname: Krishnan
mesh_terms: D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004556:Electric Injuries / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007366:Intercostal Muscles; D008297:Male; D013035:Spasm / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000517:prevention & control