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

Alan R. Schwartz, Francis P. Sgambati, Kristofer J. James, Todd P. Goblish, Robin E. Germany, Seamus E. Jackson, Nikhil Samtani, Ronald D. Berger

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)817-820
Number of pages4
JournalJournal of Clinical Sleep Medicine
Volume16
Issue number5
DOIs
StatePublished - May 15 2020

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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