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Updated: Feb 2, 2026
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Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
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Dysfunctional hypoglossal nerve stimulator after electrical cardioversion: A case series.
Adam P Vasconcellos1, Colin T Huntley1, Amy E Schell2
1Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
The Laryngoscope
|November 17, 2018
Summary
Electrical cardioversion can damage hypoglossal nerve stimulators (HGNS) used for obstructive sleep apnea (OSA), potentially requiring surgical replacement. Anteroposterior electrode placement may mitigate this risk.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Biomedical Engineering
Background:
- Obstructive sleep apnea (OSA) affects millions, with upper airway stimulation (UAS) offering an alternative to CPAP.
- Cardiac arrhythmias are common in OSA patients and often treated with electrical cardioversion.
- Hypoglossal nerve stimulators (HGNS) are effective UAS devices, but their interaction with cardioversion is unclear.
Purpose of the Study:
- To report cases of HGNS device dysfunction following electrical cardioversion.
- To describe the operative management of HGNS damage caused by cardioversion.
- To provide recommendations for minimizing HGNS damage during cardioversion.
Main Methods:
- Retrospective case series of 201 HGNS implantations.
- Analysis of four cases with HGNS dysfunction after electrical cardioversion.
- Review of device performance, cardioversion parameters, and surgical repair.
Main Results:
- Four patients experienced HGNS dysfunction or complete failure after electrical cardioversion.
- Anterolateral electrode placement was used in at least two cases.
- All affected patients required IPG replacement, with successful intraoperative device function.
Conclusions:
- Electrical cardioversion poses a risk of HGNS damage, necessitating patient counseling and potential device replacement.
- Anteroposterior electrode placement is recommended to reduce the risk of HGNS damage during cardioversion.
- Surgical management involves IPG replacement and intraoperative device interrogation.
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