Journal of Clinical Medicine Current Research

Multiple Electronic Devices That Utilize Bipolar Leads Are Safe in Pediatrics

Mohammad S. Khan MD, Christopher Snyder MD, FACC FAAP

The Congenital Heart Collaborative, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, MS 6011, Cleveland, Ohio 44106, USA

Abstract

Phrenic nerve injury can lead to a disruption of the autonomic nervous system (ANS) resulting in episodes of bradycardic arrest. Implanted diaphragmatic pacing has been used to overcome phrenic nerve paralysis, but these do not change the ANS. Therefore, patients with phrenic nerve paralysis may require the implantation of a permanent cardiac pacemaker (PPM) to overcome bradycardic episodes. Having two electronic devices in the same patient may lead to device-device interaction (DDI). This can result in oversensing leading to lack of pacing of either device. We present the case of a 17-year-old pediatric male with phrenic nerve injury who required implantation of both diaphragm and cardiac pacemaker. Intra-procedural interrogation of the cardiac pacemaker demonstrated DDI in unipolar mode, but not in bipolar. Thus, we demonstrated the safe utilization of multiple implantable electronic devices in pediatric patients without device-device interaction.

Keywords:

Bipolar, unipolar, leads, pacemaker, pacer, interference, electromagnetic