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

## TL;DR

This case report describes a novel therapy for eliminating phrenic nerve stimulation in a cardiac resynchronization therapy patient by isolating the left phrenic nerve and electrode.

## Contribution

The paper introduces a novel approach using isolation of the left phrenic nerve and electrode for treating refractory phrenic nerve stimulation.

## Key findings

- Isolating the left phrenic nerve and electrode successfully eliminated refractory phrenic nerve stimulation.
- The approach avoided electrode reset and its associated risks like infection and recurrence of stimulation.

## Abstract

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.