Phrenic nerve stimulation in an ovine model with temporary removable pacing leads

Area of Science:

• Medical Devices
• Neurosurgery
• Respiratory Physiology

Background:

• Investigating novel temporary neurostimulation techniques for respiratory support.
• Assessing the feasibility and safety of surgically implanted, removable electrodes targeting the phrenic nerve.

Purpose of the Study:

• To evaluate a new method of temporary phrenic nerve neurostimulation.
• To determine the safety and efficacy of removable, surgically implanted electrodes in the distal phrenic nerve.

Main Methods:

• Surgical implantation of temporary phrenic nerve pacing electrodes in an ovine model (4 animals).
• Primary endpoint: matching minute-ventilation on day 1. Secondary endpoints: neurostimulation at 15 and 30 days.
• Assessed safe removal of electrodes at 15 and 30 days post-implantation.

Main Results:

• Successful implantation in 3 of 4 animals; neurostimulation matched baseline ventilation on day 1.
• Left-sided neurostimulation remained possible at 15 and 30 days.
• Right-sided electrode displacement occurred in 3 animals, impacting diaphragm pacing; all nerves showed integrity upon removal.

Conclusions:

• Temporary phrenic nerve neurostimulation is feasible and safe for short-term use.
• Electrode displacement, particularly on the right side in the ovine model, presents a challenge for sustained diaphragm pacing.
• Percutaneous removal of electrodes was safe, preserving phrenic nerve integrity.