Diaphragmatic pacemaker

A breathing pacemaker or diaphragmatic pacemaker is an implant with electrical stimulation of the diaphragm via the phrenic for ventilation of paraplegics who are paralyzed from the neck down. The term " respiratory pacemaker " is an analogy to the well-known pacemaker.

Area of ​​application

Quadriplegic with high cross-section violation ( above C3 - see segmental innervation, segments of the spine) must be ventilated, as the excitation ( innervation ) of the diaphragm via the two Phrenikusnerven no longer works. Previously, this was done using the ventilator so-called iron lung - now with ventilators via tracheostomy. The functional electrical stimulation offers an alternative by the still intact diaphragm including the associated motor nerves ( phrenic nerve ) is activated for breathing again. An implanted electrical stimulator stimulates the / the Phrenikusnerven with small electrodes, which are sewn there. The diaphragm is contracted, thereby creating a vacuum in the lung.

As the German newspaper reported doctors, surgeons have implanted the Charité such a pacemaker in December 2007, two German patients with ALS as part of an ongoing study. Having an effective several hours of liberation had been detected by the ventilator in a study of 50 paraplegics, the U.S. government agency FDA has approved a further Zwechfellschrittmacher in June 2008.

Respiratory pacemakers are rarely used, although the technical conditions exist. The main reason is the high cost of manufacture, maintenance, and implantation of such systems.