Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Cardiol. Apr 26, 2026; 18(4): 118863
Published online Apr 26, 2026. doi: 10.4330/wjc.v18.i4.118863
Published online Apr 26, 2026. doi: 10.4330/wjc.v18.i4.118863
Phrenic nerve capture caused by atrial electrode dislodgement: A case report
Xue-Song Zhang, Department of Cardiology, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Fei Wang, Department of Cardiology, Shandong Corps Hospital of Chinese People’s Armed Police Forces, Jinan 252000, Shandong Province, China
Xue-Wen Qi, Pella Shafii, Xiao-Ning Cui, Yue-Hai Wang, Department of Cardiology, Liaocheng People’s Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, Liaocheng 252000, Shandong Province, China
Author contributions: Zhang XS collected the case materials and participated in writing the manuscript; Wang F participated in the discussion of the medical records and in writing the manuscript; Qi XW contributed to the case discussion and verified the materials; Shafii P participated in the case discussion and in polishing the manuscript; Cui XN participated in collecting the case materials; Wang YH was involved in collecting and discussing the case materials, as well as in writing and revising the manuscript; and all authors have read and approved the final manuscript.
Supported by Key Research and Development Plan Policy Guidance Projects in Liaocheng City, No. 2024YD24; and 2025 Liaocheng Health Policy Research Project.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Yue-Hai Wang, MD, Associate Professor, Chief Physician, Department of Cardiology, Liaocheng People’s Hospital and Liaocheng Hospital Affiliated to Shandong First Medical University, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Pro
Received: January 14, 2026
Revised: February 24, 2026
Accepted: March 18, 2026
Published online: April 26, 2026
Processing time: 90 Days and 22.9 Hours
Revised: February 24, 2026
Accepted: March 18, 2026
Published online: April 26, 2026
Processing time: 90 Days and 22.9 Hours
Core Tip
Core Tip: During the dual-chamber pacemaker implantation through the same venous puncture site, a passive lead was positioned in the atrium and an active lead was positioned in the ventricle. The patient developed diaphragmatic flutter postoperatively. Electrophysiological evaluation confirmed poor atrial sensing. The frequency of diaphragmatic flutter varied according to the programmed atrial pacing rate, whereas ventricular sensing and pacing thresholds remained normal. After reprogramming the device to VVI mode, the diaphragmatic flutter resolved completely. X-ray examination revealed atrial lead displacement. The displaced atrial lead triggered diaphragmatic flutter by stimulating the phrenic nerve.