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Phrenic nerve stimulator

Case contributed by Jayanth Keshavamurthy
Diagnosis not applicable

Presentation

History withheld.

Patient Data

Age: 59

Name the device.

x-ray

FINDINGS: There is a right chest wall phrenic nerve stimulator with the tip of the lead overlying the right side of the neck. There is a right rotator cuff anchor in place. Cholecystectomy clips are seen. Mild kyphosis with diffuse idiopathic skeletal hyperostosis of the thoracic spine.

Heart/Mediastinum: The cardiopericardial silhouette is normal in size. There is no mediastinal widening.

Lungs: There are no focal areas of consolidation within the chest.

Pleura: There are no pleural effusions.. There is no pneumothorax..

Soft tissues: The soft tissues are unremarkable.

Upper abdomen: Unremarkable

IMPRESSION:
Phrenic nerve stimulator is in position.

Case Discussion

 Unlike cardiac pacemakers, the battery is not implanted. 

The phrenic electrode is placed under the nerve and a receiver is placed under the skin on the chest wall.  The receiver converts radio frequency (RF) energy to an electrical signal for the phrenic nerve.  The radio frequency is generated by an external transmitter (Mark IV) attached to 2 antennae (one per implanted receiver). 

The external transmitter is powered by two 9-Volt batteries.  The transmitter weighs about 1 lb, 3 oz (540 grams; with batteries).  The antennae are placed on the skin overlying the receivers and held in place with tegaderm or tape.

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