Threshold currents of platinum electrodes used for functional electrical stimulation of the phrenic nerves for treatment of central apnea.
Pacing Clin Electrophysiol
; 36(6): 714-8, 2013 Jun.
Article
en En
| MEDLINE
| ID: mdl-23305494
BACKGROUND: Stability of threshold currents during long-term use of phrenic nerve stimulation has been questioned. METHODS AND RESULTS: Between January 5, 1988, and March 5, 2008, 49 patients with functional C2-tetraplegia received an Atrostim PNS (Atrotech Ltd., Tampere, Finland) as treatment of their respiratory insufficiency; a follow-up of 35 of such patients was carried out exclusively in our institution for 6.3 (4.44) 0.04-15.75 years (mean [standard deviation (SD)] range). The device employed four-pole sequential nerve stimulation, which provided four threshold currents subsequently evaluated for each phrenic nerve. Stimulation data were prospectively recorded. The differences between threshold currents recorded 1 year after implantation and the last recorded values were 0.33-0.43 (0.44-0.63) 0-2.9 mA. After having excluded the data of eight patients with values >1 mA (= mean + SD), we registered the differences for the remaining patients of 0.15-0.24 (0.14-0.24) 0-0.95 mA, which is just twice the adjustment accuracy of the device. Out of the eight problem cases one had, and two were suspected to have, surgical trauma; all three nerves recovered. In two cases the values steadily increasing over years might have been caused by unspecific foreign body reaction. Two cases with values >1 mA for different durations at different electrodes might be caused by biofilm, and one patient displaying steadily increasing values lived, unwilling to live, only 2 years after the implantation. CONCLUSION: Thus, there was no permanent nerve injury and in 77% of the presented cases threshold currents remained stable.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Nervio Frénico
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Cuadriplejía
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Estimulación Eléctrica Transcutánea del Nervio
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Apnea Central del Sueño
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Electrodos
Tipo de estudio:
Diagnostic_studies
Límite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
2013
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Estados Unidos