Pacemaker and defibrillator is causing phrenic nerve stimulation. what can be done?

Phrenic nerve: This is a complication caused by electrical signal getting to the phrenic nerve. The problem can sometimes be ameliorated by reprogramming the pacer. If this doesn't work, repositioning the lead(s) may be necessary.

Needs attention: The output can be lowered but if that doesn't provide sufficient safety margin, the leads will need to be revised.