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Diaphragm Pacing with a Quadripolar Phrenic Nerve Electrode: An International Study
Author(s) -
WEESEMAYER DEBRA E.,
SILVESTRI JEAN M.,
KENNY ANNA S.,
ILBAWI MICHEL N.,
HAUPTMAN SUSAN A.,
LIPTON JACK W.,
TALONEN PASI P.,
GARCIA HONESTO GARRIDO,
WATT JOHN W.,
EXNER GERHARD,
BAER GERHARD A.,
ELEFTERIADES JOHN A.,
PERUZZI WILLIAM T.,
ALEX CHARLES G.,
HARLID RICHARD,
VINCKEN WOLTER,
DAVIS G. MICHAEL,
DECRAMER MARC,
KUENZLE CHRISTOPH,
SÆTERHAUG ARNE,
SCHÖBER JOHANNES G.
Publication year - 1996
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1996.tb04209.x
Subject(s) - medicine , incidence (geometry) , complication , congenital central hypoventilation syndrome , pediatrics , surgery , hypoventilation , respiratory system , physics , optics
We sought to determine the international experience with the quadripolar diaphragm pacer system and to test two hypotheses: the incidence of pacer complications would be (1) increased among pediatric as compared to adult patients; and (2) highest among active pediatric patients with idiopathic congenital central hypoventilation syndrome (CCHS). Data were collected via a questionnaire coupled with the Atrotech Registry data for a total of 64 patients (35 children and 29 adults) from 14 countries. Thoracic implantation of electrodes and bilateral pacer use each occurred in 94% of all subjects. Tetraplegic (vs pediatric CCHS) patients were more typically paced 24 hours/day (P = 0.001). Pacing duration averaged 2.0 ± 1.0 years among children and 2.2 ± 1.1 years among adults. Infections occurred among 2.9% of surgical procedures, all in pediatric CCHS patients (vs pediatric tetraplegic patients, P = 0.01). The incidence of mechanical trauma was 3.8%, without significant differences among patient groups. The incidence of presumed electrode and receiver failure were 3.1% and 5.9%, respectively, with internal component failure greater among pediatric CCHS than pediatric tetraplegic patients (P < 0.01). Intermittent or absent function of 0–4 electrode combinations occurred among 19% of all patients, with increased frequency among pediatric CCHS than pediatric tetraplegic patients (P < 0.03). Complication‐ free successful pacing occurred in 60% of pediatric and 52% of adult patients. In all, 94 % of the pediatric and 86% of the adult patients paced successfully after the necessary intervention. Although pacer complications were not increased among pediatric as compared to adult patients, the incidence of complications was highest among the active pediatric patients with CCHS. Longitudinal study of these patients will provide invaluable information for modification and improvement of the quadripolar system.