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

被引:5
|
作者
Schwartz, Alan R. [1 ]
Sgambati, Francis P. [2 ]
James, Kristofer J. [3 ]
Goblish, Todd P. [3 ]
Germany, Robin E. [3 ]
Jackson, Seamus E. [3 ]
Samtani, Nikhil [4 ]
Berger, Ronald D. [5 ]
机构
[1] Univ Penn, Dept Otorhinolaryngol, Perelman Sch Med, Philadelphia, PA 19104 USA
[2] Johns Hopkins Sch Med, Ctr Interdisciplinary Sleep Res & Educ, Baltimore, MD USA
[3] Respicardia Inc, Minnetonka, MN USA
[4] ProHlth Care Sleep Ctr, Delafield, WI USA
[5] Johns Hopkins Sch Med, Div Cardiol, Baltimore, MD USA
来源
JOURNAL OF CLINICAL SLEEP MEDICINE | 2020年 / 16卷 / 05期
基金
美国国家卫生研究院;
关键词
CENTRAL SLEEP-APNEA; VENTILATION; PRESSURE;
D O I
10.5664/jcsm.8328
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
A symptomatic patient with atrial fibrillation and Cheyne-Stokes respiration (CSR) was implanted with a transvenous phrenic nerve stimulation (TPNS) device-the remede 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.
引用
收藏
页码:817 / 820
页数:4
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