Proof of concept of an accelerometer as a trigger for unilateral diaphragmatic pacing: a porcine model

Author:

Kratz Tobias,Ruff Roman,Koch Timo,Kronberg Anne-Sophie,Breuer Johannes,Asfour Boulos,Herberg Ulrike,Bierbach Benjamin

Abstract

Abstract Background Unilateral diaphragmatic paralysis in patients with univentricular heart is a known complication after pediatric cardiac surgery. Because diaphragmatic excursion has a significant influence on perfusion of the pulmonary arteries and hemodynamics in these patients, unilateral loss of function leads to multiple complications. The current treatment of choice, diaphragmatic plication, does not lead to a full return of function. A unilateral diaphragmatic pacemaker has shown potential as a new treatment option. In this study, we investigated an accelerometer as a trigger for a unilateral diaphragm pacemaker (closed-loop system). Methods Seven pigs (mean weight 20.7 ± 2.25 kg) each were implanted with a customized accelerometer on the right diaphragmatic dome. Accelerometer recordings (mV) of the diaphragmatic excursion of the right diaphragm were compared with findings using established methods (fluoroscopy [mm]; ultrasound, M-mode [cm]). For detection of the amplitude of diaphragmatic excursions, the diaphragm was stimulated with increasing amperage by a cuff electrode implanted around the right phrenic nerve. Results Results with the different techniques for measuring diaphragmatic excursions showed correlations between accelerometer and fluoroscopy values (correlation coefficient 0.800, P < 0.001), accelerometer and ultrasound values (0.883, P < 0.001), and fluoroscopy and ultrasound values (0.816, P < 0.001). Conclusion The accelerometer is a valid method for detecting diaphragmatic excursion and can be used as a trigger for a unilateral diaphragmatic pacemaker.

Funder

kinderherzen Fördergemeinschaft Deutsche Kinderherzzentren e.V.

Universitätsklinikum Bonn

Publisher

Springer Science and Business Media LLC

Subject

Radiology, Nuclear Medicine and imaging,Biomedical Engineering,General Medicine,Biomaterials,Radiological and Ultrasound Technology

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