Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report

Jumper, Natalie; Radotra, Ishan; Witt, Paulina; Campbell, Niall; Mishra, Anuj

doi:10.5999/aps.2018.01158

Cited by 6 publications

(10 citation statements)

References 15 publications

(16 reference statements)

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“…7 BPs have been rarely reported post cardiac implantable electronic device (CIED) implantations. [8][9][10][11][12] Possible mechanisms include injury with local anesthetic injection; injury with electrocautery while dissection; direct needle trauma during venous access; and hematoma formation leading to nerve compression. Traditionally cephalic, axillary and subclavian veins have been used for venous access.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic brachial plexopathy after pacemaker implant

Kumar

Singal

Bansal

et al. 2021

Pacing Clinical Electrophis

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A middle-aged woman presented with symptomatic complete heart block and underwent an uneventful dual chamber pacemaker implantation. Three weeks post procedure, she developed left arm pain and weakness, with neurological localization to the lower trunk of left brachial plexus. Possibilities of traumatic compression by the device/leads or postoperative idiopathic brachial plexopathy were considered. After ruling out traumatic causes, she was started on oral steroids, to which she responded remarkably. This case highlights the importance of recognizing this rare cause of brachial plexopathy following pacemaker implantation, because not only does an expedited diagnosis and medical treatment lead to prompt recovery with minimal neurological deficits, but it also circumvents an unnecessary surgical re-exploration.

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Section: Discussionmentioning

confidence: 99%

Idiopathic brachial plexopathy after pacemaker implant

Kumar

Singal

Bansal

et al. 2021

Pacing Clinical Electrophis

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“…One challenge for practitioners is that biotechnological syndromes manifesting in their specialty, may result from a technology initiated within an unfamiliar domain. For example, (i) Refractory sexual arousal subsequent to a neurostimulator ( 55); (ii) New onset tinnitus following spinal stimulator implantation (54); (iii) Abdominal spasms resulting from pacemaker phrenic nerve stimulation ( 70); (iv) Arm pain secondary to brachial plexus injury caused by impingement from a loop of ICD lead (71).…”

Section: Cross-disciplinary and Public Healthmentioning

confidence: 99%

21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

Straw

Rees

Nachev

2023

Preprint

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Background Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints. Methods PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic). Results Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology (n = 162), Microbiology and Infectious Diseases (n = 36), and Emergency and Trauma (n = 26). Discussion The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks). Limitations This was a retrospective systematic review of heterogeneous reports which may only reflect a small proportion of true prevalence rates in the population.

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“…When falling, she has impacted the bridge of her nose and right Abdominal spasms resulting from pacemaker phrenic nerve stimulation (6). In this case we focus on an unusual ICD complication, in which the impingement of an ICD loop causes a brachial plexus injury (7). Through this case, we aim to widen the practitioner's diagnostic perspective to include device-related causes that may originated in a different bodily system.…”

Section: Casementioning

confidence: 99%

Simulation based research for digital health pathologies: a multi-site mixed-methods study

Straw,

Dobbin,

Luna-Reaver

et al. 2023

Preprint

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Background The advance of digital health technologies has created new forms of potential pathology which are not captured in current clinical guidelines. Through simulation-based research we have identified the challenges to clinical care that emerge when patients suffer from illnesses stemming from failures in digital health technologies. Methods Clinical simulation sessions were designed based on patient case reports relating to (i) medical device hardware errors (ii) medical device software errors, (iii) complications of consumer technology, and (iv) technology-facilitated abuse. Clinicians were recruited to participate in simulations at three UK hospitals; audiovisual suites were used to facilitate group observation of simulation experience and focused debrief discussions. Invigilators scored clinicians on performance, clinicians provided individual qualitative and quantitative feedback, and extensive notes were taken throughout. Findings Paired t-tests of pre and post-simulation feedback demonstrated significant improvements in clinician’s diagnostic awareness, technical knowledge, and confidence in clinical management following simulation exposure (p<0.01). Barriers to care included: (i) low suspicion of digital agents, (ii) attribution to psychopathology, (iii) lack of education in technical mechanisms and (iv) little utility of available tests. Suggested interventions for improving future practice included: (i) education initiatives, (ii) technical support platforms, (iii) digitally-oriented assessments in hospital workflows, (iv) cross-disciplinary staff and (v) protocols for digital cases. Conclusion We provide an effective framework for simulation training focused on digital health pathologies and uncover barriers that impede effective care for patients dependent on technology. Our recommendations are relevant to educators, practising clinicians, and professionals working in regulation, policy and industry.

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Brachial plexus impingement secondary to implantable cardioverter defibrillator: A case report

Cited by 6 publications

References 15 publications

Idiopathic brachial plexopathy after pacemaker implant

Idiopathic brachial plexopathy after pacemaker implant

21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

Simulation based research for digital health pathologies: a multi-site mixed-methods study

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