Long-term electromyogram recording from the posterior cricoarytenoid muscle as a potential biological trigger for phrenic pacing: Results of an animal study

Diaphragm pacing has been used to restore respiration in approximately 1,00 0 patients worldwide suffering from high quadriplegia or from central alveo lar hypoventilation syndrome. Compared with conventional mechanical ventila tion, electrophrenic respiration (EPR) reduces the risk of pulmonary infect ions and increases the mobility of patients. Voluntary activation of the pa cemaker during speech would improve patients' quality of life and allow app lication of EPR in a more physiological way. An animal study was performed to investigate the electromyogram (EMG) of the posterior cricoarytenoid (PC A) muscle and the movement of the glottis via impedance measurement (electr oglottography) with the aim to examine reproducibility and stability of the recordings from the PCA muscle as a potential biological trigger for a phr enic pacemaker. The EMG of the PCA muscle was recorded via implanted electr odes for a 200 day period. The EMG signal proved stable for that period, ar tifacts caused by movements can be suppressed, and swallowing can be detect ed. In contrast, impedance measurement to detect movement of the glottis pr oved not useful. Based on the results of this study, the use of the PCA EMG as a biological trigger for a phrenic pacemaker has to be considered a rea listic option.