A breathing pacemaker consists of surgically implanted receivers and electrodes and an external transmitter with antennas worn directly over the implanted receivers.
The external transmitter and antennas send radiofrequency energy to the implanted receivers just under the skin. The receivers then convert the radio waves into stimulating pulses.
These pulses are then sent down the electrodes to the phrenic nerves, causing the diaphragms to contract. This contraction causes inhalation of air. When the pulses stop, the diaphragms relax and exhalation occurs. Repetition of this series of pulses produces a normal breathing pattern.
A breathing pacemaker can provide ventilatory support for patients with chronic respiratory insufficiency whose diaphragm, lungs, and phrenic nerves have residual function. Typically, these patients have high spinal cord injuries, central sleep apnea or other central neurological disorders or a paralyzed diaphragm.
TAYLOR PACING SINCE 2006
Pacing has many advantages over PPV, including: Breathing pacemakers provide respiratory function superior to mechanical ventilators since the inhaled air is drawn into the lungs by the diaphragm under negative pressure, rather than being forced into the chest under positive pressure. This is physiologically more accurate and comfortable for the patient.
MARK IV TRANSMITTER
Breathing pacemakers have been in commercial distribution since the early 1970′s. Over time, the system has undergone numerous upgrades and improvements.
A surgical procedure is required to place the implanted electrode on the phrenic nerve and the implanted receiver just under the surface of the skin. This procedure can take place at the neck (cervically) or in the chest (thoracically).
An upcoming issue of the journal Spinal Cord will feature an analysis 1 of the cost reduction associated with use of a breathing pacemaker in place of mechanical ventilation.