Novel phrenic nerve stimulator treats Cheyne-Stokes respiration: polysomnographic insights

NoneA symptomatic patient with atrial fibrillation and Cheyne-Stokes respiration (CSR) was implanted with a transvenous phrenic nerve stimulation (TPNS) device-the remedē System-that is indicated for adult patients with moderate to severe central sleep apnea. Sleep recordings demonstrated that TPNS...

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Bibliographic Details
Published in:Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2020, Vol.16 (5), p.817-820
Main Authors: Schwartz, Alan R, Sgambati, Francis P, James, Kristofer J, Goblish, Todd P, Germany, Robin E, Jackson, Seamus E, Samtani, Nikhil, Berger, Ronald D
Format: Report
Language:English
Online Access:Get full text
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Summary:NoneA symptomatic patient with atrial fibrillation and Cheyne-Stokes respiration (CSR) was implanted with a transvenous phrenic nerve stimulation (TPNS) device-the remedē System-that is indicated for adult patients with moderate to severe central sleep apnea. Sleep recordings demonstrated that TPNS eliminated periodic breathing by activating the diaphragm and stabilizing respiratory patterns. These recordings of preprogrammed periods on versus off TPNS illustrate prompt (1) stabilization of tidal airflow, respiratory effort, and oxygenation as stimulation amplitude increased stepwise and (2) recurrence of CSR immediately after TPNS deactivated. Despite differences in respiratory patterns, minute ventilation was comparable during periods on and off TPNS. These findings suggest that diaphragmatic pacing entrains ventilation without disrupting sleep, accounting for observed improvements in periodic breathing, gas exchange, sleep architecture, and quality of life. Effective means to relieve CSR could potentially mitigate nocturnal cardiovascular stress and disease progression.
ISSN:1550-9397
DOI:10.5664/jcsm.8328