Might a Pacemaker Be at the Heart of Hiccup Problem?

Is there any relationship between hiccups and an implanted cardiac pacemaker? Could hiccups possibly trigger a change in the pacemaker?

---- Sharon Weeaks, CNP
Denver

Yes, there is a relationship between pacemaker placement and hiccups. Rarely, placement of an atrial lead or a lead in the left ventricular epicardial vein may result in stimulation of the phrenic nerve, with resultant hiccups during atrial pacing or during pacing of the left ventricular lead. Hiccups in these settings can often be eliminated by pacing at the lowest possible voltage that captures the myocardium. However, sometimes any stimulation will cause phrenic nerve-associated hiccups, and the lead may need to be removed or repositioned or pacing from that site terminated.

I know of no cases in which hiccups affected a pacing system.

---- Kenneth A. Ellenbogen, MD
Kontos Professor of Medicine
Medical College of Virginia
Richmond