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Mapping for Acute Transvenous Phrenic Nerve Stimulation Study (MAPS Study).

Lukas R C Dekker1, Bart Gerritse2, Avram Scheiner3

  • 1Catharina Hospital, Eindhoven, the Netherlands.

Pacing and Clinical Electrophysiology : PACE
|January 6, 2017
PubMed
Summary
This summary is machine-generated.

Phrenic nerve stimulation via the venous system can induce diaphragmatic movement, offering a potential new treatment for central sleep apnea. This technique is feasible, with minimal discomfort in most patients.

Keywords:
heart failurenerve stimulationphrenic nervesleep apnea

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Area of Science:

  • Cardiovascular Medicine
  • Sleep Medicine
  • Medical Device Engineering

Background:

  • Central sleep apnea syndrome is linked to heart failure and causes insufficient ventilation during sleep.
  • Current treatments for central sleep apnea are limited.
  • Investigating novel methods to improve ventilation during sleep is crucial.

Purpose of the Study:

  • To map the venous system for phrenic nerve stimulation.
  • To determine if diaphragmatic movement can be achieved via phrenic nerve stimulation at various venous locations.
  • To assess the feasibility and safety of this approach.

Main Methods:

  • 15 patients undergoing catheter ablation were studied.
  • An electrophysiology catheter was placed in the superior/inferior vena cava and jugular/brachiocephalic vein junctions.
  • Phrenic nerve stimulation was applied, and diaphragmatic movement was assessed.

Main Results:

  • Diaphragmatic movement was induced in all patients at median thresholds of 2-7.5 V.
  • The right brachiocephalic vein required the lowest median current (4.7 mA) for stimulation without discomfort.
  • 12/15 patients experienced no discomfort, while 3 had hiccups.

Conclusions:

  • Diaphragmatic stimulation from brachiocephalic and caval veins is feasible.
  • Adapting stimulation patterns may mitigate side effects like hiccups.
  • This approach could inform the design of devices combining cardiac pacing and sleep apnea treatment.