What is the role of diaphragm pacing in the treatment of hypoventilation syndromes?

Updated: Jul 22, 2021
  • Author: Jazeela Fayyaz, DO; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Diaphragm pacing in appropriate patients with primary alveolar hypoventilation may allow for a more normal lifestyle. In the pacing procedure, an electrode is surgically placed onto the phrenic nerve, which is connected to a subcutaneous receiver. An external, battery-operated transmitter and antenna are placed on the skin over the receiver, and the phrenic nerve is stimulated by electric current, resulting in a diaphragmatic contraction.

The transmitter settings may be adjusted for respiratory rate and to give enough tidal volume to allow for adequate oxygenation and ventilation. Unfortunately, phrenic nerve stimulation results in irreversible injury to the nerve. Thus, over time, pacing of the phrenic nerve becomes ineffective. [25]

Direct pacing of the diaphragm in patients with phrenic nerve paralysis has been of interest. Studies are ongoing to determine the utility of this treatment modality. [26]

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