First at Hadassah, Dr. Uzi Izhar, Head of the General Thoracic Surgery Unit, performed along with Dr. Mark Ginsburg, a cardiothoracic surgeon from Columbia Presbyterian hospital, a transplant of a diaphragmatic / phrenic nerve stimulator to pace the 2 side diaphragm muscle. The pacing system consists of electrodes sutured to the phrenic nerves, radio receivers implanted in subcutaneous pockets, and an external transmitter/antenna assembly that provides power to the system via 9-volt batteries. The pacemaker will replace the ventilatory machine to which the patient was plugged in the past decade, due to a car accident in which he injured his cervical spinal cord caused paralysis of his 4 limbs and diaphragm muscle.
The external transmitter and antenna send energy and stimulus information to the receiver implant. The receiver translates radio waves into stimulating pulses that are delivered to the phrenic nerve by the electrode. The diaphragm muscle contracts and produces the inhalation phase of breathing. The transmitter then stops generating signals, which allows the diaphragm to relax and exhalation occurs.
The diaphragm pacing system provides support for patients with chronic ventilatory insufficiency whose diaphragm, lungs and phrenic nerves have residual function.
The operation and the postoperative course were uneventful. The patient was discharged to his home when he still uses the ventilator machine. The diaphragm pacing requires a period in which the muscle will "exercise", after being inactive for years. This "exercise" starts only a month after the transplant, and lasts for a few weeks. This process has been started already by Dr. Be'eri , director of the respiratory rehabilitation unit, Alyn Hospital. At his first exercise the patient was breathing one hour using the pacer with no problems, was able to talk and enjoyed the sensation of his new breathing. During the following weeks Dr. Be'eri will increase this time gradually.