Evaluation of scapulothoracic dysfunction in patients with implantable cardiac electronic device

Generator-induced shoulder impairment is a common complication of cardiac implantable electronic device (CIED) implantation. There is no study in the literature examining the effects of CIED implantation on the scapulothoracic joint. This study aimed to investigate the effects of CIED implantation on the ipsilateral scapulothoracic joint. In this study, 30 patients with CIED implanted were enrolled in the study group (SG), and 30 healthy participants with similar demographic and clinical characteristics were enrolled in the control group (CG). Detailed shoulder evaluation was performed, including shoulder range of motion (ROM), grip strength, scapulothoracic dyskinesia, and shoulder functionality, and the data were compared between groups. Shoulder flexion (p = 0.016) and abduction (p = 0.001) ROMs were significantly lower in SG than CG. There was no difference between the groups in the ROMs of the shoulder in other directions. The grip strength evaluated with the Jamar hydraulic hand dynamometer was significantly decreased in SG compared to CG (p = 0.36). In scapular dyskinesia evaluated with the lateral scapular slide test; while there was no difference between the groups in the neutral position, a significantly higher incidence of scapular dyskinesia was detected in SG compared to CG at 45 (p = 0.01) and 90 (p = 0.038) degrees of abduction. Similarly, Kibler Type 3 dyskinesia incidence was higher in SG than CG (p = 0.038), and there was no difference between groups in other types of Kibler dyskinesia. In shoulder functionality assessed by the American Shoulder and Elbow Surgeons Score, shoulder impairment in SG was significantly higher than CG (p = 0.014). Our study showed that CIED implantation, which has previously been reported as having adverse effects on the shoulder joint, has similar adverse effects on the scapulothoracic joint. It is thought that it would be beneficial to add methods for scapulothoracic disorders to the treatment of patients who develop postoperative shoulder disorders.