Harvard Heart Letter

Ask the doctor: Could getting a pacemaker have damaged my vagus nerve?

Q. I recently had a pacemaker implanted. While the process was going on, I felt a pulsation that I reported to the doctor. I still feel it seven months later. Other symptoms include low blood pressure, an increase in weight, and digestive changes. My primary care doctor thinks that my vagus nerve could have been damaged when the pacemaker was implanted. Is that possible?

A. I don't have enough information to comment on your case. In general, pacemaker placement rarely damages the vagus nerve, which runs from the brain to the throat, voice box, windpipe, lungs, heart, esophagus, stomach, and intestines. Symptoms such as you describe could be caused by a number of problems, including lead perforation or pacemaker syndrome. Here is more information on those problems:

Lead perforation. The wires (also called leads, pronounced leeds) that deliver tiny pulses of electricity to the heart usually stay where a doctor places them. Sometimes, though, a lead can move out of position and poke through the heart muscle and into the sac around the heart (the pericardium), the chest wall, or the diaphragm. Perforation can cause symptoms ranging from shortness of breath or chest pain to cough, constant hiccups, or abdominal pain.

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