Related Experiment Video
Updated: Dec 29, 2025

Breathing-controlled Electrical Stimulation BreEStim for Management of Neuropathic Pain and Spasticity
Published on: January 10, 2013
Novel phrenic nerve stimulator treats Cheyne-Stokes respiration: polysomnographic insights
Alan R Schwartz1, Francis P Sgambati2, Kristofer J James3
1Department of Otorhinolaryngology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Abstract:
A symptomatic patient with atrial fibrillation and Cheyne-Stokes respiration (CSR) was implanted with a transvenous phrenic nerve stimulation (TPNS) device-the remedē 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.
Related Concept Videos
Neural Control of Respiration
Respiratory Centers in the Brainstem
Two primary areas comprise the respiratory center: the medullary respiratory center in the medulla oblongata and the pontine respiratory group in the pons. The...
Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Physiology of Respiration II: Neurogenic Control of Respiration
Central Control
The brainstem is the primary site of central control, hosting respiratory centers:
Sleep Apnea
The condition is more prevalent among...
Hyperpnea and Hyperventilation
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...

