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About Diaphragm Pacing

Helping ALS and SCI patients to breathe easier

Diaphragm Pacing, offered at Swedish Medical Center, Denver, is a surgical treatment to help treat patients with ALS.

The Treatment

Swedish offers a minimally invasive procedure to implant a NeuRx Diaphragm Pacing System® which can decrease a patient's reliance on a ventilator. Unlike a mechanical ventilator, the NeuRx Diaphragm Pacing System provides a gentle, rhythmic, electrical stimulation to your diaphragm, causing it to contract as it normally would.

The Neurx DPS Device

The NeuRx Diaphragm Pacing System (DPS) was developed by physicians and engineers at several institutions with initial funding of $1 million from the Department of Veterans Affairs. Neurx DPS allows patients with conditions affecting their respiratory muscles and nerves to breathe without using a mechanical ventilator. In 2009, NeuRx DPS ranked third at the prestigious 6th annual Cleveland Clinic Medical Innovations Summit for the Top 10 Medical Innovations for 2009.

How It Works

The NeuRx DPS consists of four electrodes implanted in the diaphragm to stimulate the muscle, a fifth electrode under the skin to complete the electrical circuit, a connector holder, a cable and an external battery-powered pulse generator. The pulse generator regulates movement of the diaphragm muscle, creating a vacuum-like effect in the chest cavity that draws air into the lungs. When this contraction eases, the air is expelled from the lungs. On average, this process is repeated 10-14 times per minute.

The Procedure

During minimally invasive laparoscopic surgery, a surgeon creates four dime-sized holes in the abdomen and inserts a laparoscope to see the diaphragm muscle. The surgeon then places small electrodes in areas near the phrenic nerves that control diaphragm contractions. The electrodes are attached through wires under the skin to a small battery powered external pulse generator (EPG) that stimulates the muscle and phrenic nerves to cause the contraction of the diaphragm.

The surgery is done with an overnight stay for observation. After surgery, the EPG is programmed for the volume of air taken in during diaphragm contractions. Patients with SCI perform daily physical therapy, called “conditioning,” to strengthen their diaphragms. Because the diaphragm of a Spinal Cord Injured (SCI) patient atrophies while on a ventilator, the patient begins using NeuRx EPG to breathe for short periods of time. For SCI patients, NeuRx DPS gradually extends the amount of time off the ventilator. For Amyotrophic Lateral Sclerosis (ALS) patients with chronic hypoventilation, the NeuRx DPS conditioning delays the inevitable need for a ventilator. Both SCI and ALS patients can condition in the hospital, at a rehabilitation hospital or at home.

Its Success

More than 400 SCI and ALS patients, including the late actor Christopher Reeve, have been treated at leading centers around the world with the NeuRx DPS technology.

Swedish Medical Center is proud to be the only facility in Colorado offering this procedure for ALS.