Battery-powered implantable nerve stimulator for chronic activation of twoskeletal muscles using multichannel techniques

Chronic activation of skeletal muscle is used clinically in representative numbers for diaphragm pacing to restore breathing and for dynamic gracilopl asty to achieve fecal continence. The 3 different stimulation techniques cu rrently used for electrophrenic respiration (EPR) all apply high frequency powered implants. It was our goal to make these stimulation methods applica ble for EPR by a battery-powered nerve stimulator that would maximize the p atient's freedom of movement. Additionally, the system should allow the imp lementation of multichannel techniques and alternating stimulation of 2 ske letal muscles as a further improvement in graciloplasty. Generally, the dev eloped implantable nerve stimulator can be used for simultaneous and altern ating activation of 2 skeletal muscles. Stimulation of the motor nerve is a chieved by either single channel or multichannel methods. Carousel stimulat ion and sequential stimulation can be used far graciloplasty as well as for EPR. For EPR we calculated an operating time of the implant battery of 4.1 years based on the clinically used stimulation parameters with carousel st imulation. The multichannel pulse generator is hermetically sealed in a tit anium case sized 65 x 17 mm (diameter x height) and weighs 88 g.