Transvascular nerve stimulation electrodes

Patients in intensive care units (ICU) who require mechanical ventilation (MV) for more than a week have an increased risk of medical complications, such as ventilator acquired pneumonia and nosocomial infections, and are seven-times more likely to die in the ICU. The disused diaphragm muscle atrophies rapidly in ventilated patients, contributing to complications and frequent failure to wean from MV. Current phrenic nerve and diaphragm pacing systems require long, complicated, and risky surgery, unsuitable for those in the ICU. This study documents the prototype development of a simple, minimally invasive, transvascular device for electrically pacing the diaphragm intended to maintain diaphragm viability, reduce mortality, facilitate weaning from MV, shorten duration of ICU stay, and decrease hospitalization costs. Proof-of-concept, safety and stability data from acute and 3-week chronic pig experiments were analyzed. This thesis provides insight into endovascular electrode designs, fabrication, material selection, and configuration and orientation effects on phrenic nerve stimulation.