Diaphragm pacing by radiofrequency transmission in the treatment of chronic ventilatory insufficiency

Glenn, William W. L.; Holcomb, Wade G.; Hogan, James; Matano, Ichiro; Gee, J. Bernard L.; Motoyama, E. K.; Kim, C S; Poirier, R; Forbes, Glenn S.

doi:10.1016/s0022-5223(19)40583-7

Cited by 93 publications

(17 citation statements)

References 6 publications

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“…(1) the type of neurostimulator receiver, (2) the RF power of the MR imager, (3) the frequency separation between the neurostimulator, receiver's tuned RF and the MR imager's. transmitted RF, (4) the distance between the implant and the imager's RF coils, (5) the therapeutic amplitude of the neurostimulator output, (6) the strength of the static magnetic field, and (7) the length of the extension of leads and the orientation of the pulse generator.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Magnetic Resonance Imagers on Implanted Neurostimulators

Gleason

Kaula

Hricak

et al. 1992

Pacing Clinical Electrophis

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This in-vitro study was designed to investigate the safety of various implanted neurostimulators in magnetic resonance (MR) imagers. The effects of the static and changing magnetic fields and the radio frequency (RF) electromagnetic field generated by 0.35 and 1.5 T MR imagers on the voltage output of four models of implantable passive neurostimulators and two models of implantable self-powered neurostimulators was studied. The neurostimulators were mounted on a support and placed in the imagers. An oscilloscope monitored the voltages at the outputs of the neurostimulators. For an Avery single-channel stimulator, located at the isocenter, the amplitude of the output pulses induced by the 0.35 T imager was 6V; from a 1.5 T imager, it was 12 V. These amplitudes can cause discomfort and possible harm to a patient if the typical therapeutic value is 1-5 V. The amplitude of the stimulator receiver's output decreased to relatively safe values beyond 40 cm from the isocenter. By contrast, there was no significant voltage output from the Medtronic SE-4 receiver. For two models of self-powered neurostimulators, the Medtronic Itrel and the Cordis MK II, the programmed stimulus parameters were not affected by the pulsed magnetic fields of the MR imagers. However, the RF fields at the isocenter heated the metal case of the stimulators. The rotational and linear forces produced by the fixed magnet on the Cordis MK II were judged to be too strong for a patient with this implant to be scanned. The study showed that patients with certain types of implanted neurostimulators can be scanned safely under certain conditions.

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Section: Discussionmentioning

confidence: 99%

The Effect of Magnetic Resonance Imagers on Implanted Neurostimulators

Gleason

Kaula

Hricak

et al. 1992

Pacing Clinical Electrophis

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“…18,19 Diaphragm pacing is used in selected neuromuscular patients to enhance independence from mechanical ventilation. This consists of a radio frequency transmitter and antenna that send stimulatory signals to internal receivers placed subdermally in the subclavicular region bilaterally, and electrodes placed surgically near the phrenic nerve, usually in the supraclavicular region 20 Diaphragm pacing is used mainly in patients who have an intact diaphragm and phrenic nerve such as those with quadriplegia due to high spinal cord lesions or with central hypoventilation. Advances in surgical technique now permit implantation of internal mammary nerves into the diaphragm, allowing some patients with phrenic nerve damage to be paced.…”

Section: Other Methods Of Noninvasive Ventilatorymentioning

confidence: 99%

Ventilator Management for Neuromuscular Disease

Hill¹

2002

Seminars in Respiratory and Critical Care Medicine

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Many progressive neuromuscular disorders involve the muscles of the respiratory system, and respiratory insufficiency is a major cause of morbidity and mortality. Thus ventilatory assistance becomes an important part of disease management for patients with advanced neuromuscular disease. The following discusses the evaluation of patients with neuromuscular disease to characterize the nature and severity of respiratory muscle involvement, indications and contraindications for the use of noninvasive ventilation, and techniques for initiation and monitoring. Indications for invasive ventilation are also discussed, and major principles of management and monitoring of invasive mechanical ventilation are outlined. For optimal ventilator management of patients with neuromuscular disease, clinicians must be familiar with the principles discussed in this article so that treatment can be tailored to the individual's goals and desires. With proper implementation, ventilatory support of patients with neuromuscular disease can bring about improvements in quality of life and, for those who desire, potential prolongation of survival.

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“…(2) organic lesions of the brainstem or above; (3) high cervical (above C 2 ) cord lesions; (4) selected cases of COAD; and (5) occasional cases of intrac table hiccupping. 112 Diaphragm pacing has no role in systemic dis orders with muscle or peripheral nerve damage. As limited as the role of diaphragmtic pacing has been, some patients with CAH and high quadriplegia have been maintained for as long as 10 to 15 years.…”

Section: Diaphragm Pacingmentioning

confidence: 99%

Respiratory Muscle Function in Systemic Disorders

Baydur¹

1988

Semin Respir Crit Care Med

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Diaphragm pacing by radiofrequency transmission in the treatment of chronic ventilatory insufficiency

Cited by 93 publications

References 6 publications

The Effect of Magnetic Resonance Imagers on Implanted Neurostimulators

The Effect of Magnetic Resonance Imagers on Implanted Neurostimulators

Ventilator Management for Neuromuscular Disease

Respiratory Muscle Function in Systemic Disorders

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