In selected individuals with ventilator-dependent tetraplegia, phrenic nerve pacing can offer long-term freedom from mechanical ventilation. Developments in receiver and electrode technology have resulted in improved outcomes and greater durability of the implanted materials. There are presently three commercial manufacturers of phrenic nerve pacing devices. These systems differ primarily in electrode design and method of stimulus current application. The technical features of each of these devices are described. The evaluation and selection of potential candidates for this technique, the surgical procedures necessary for implantation, and the expected outcomes are also reviewed. In carefully screened individuals, phrenic nerve pacing may provide several clinical benefits including increased mobility, improved speech, reduced anxiety and embarassment associated with ventilator tubing and noise, reduced nursing requirements, and reduced overall costs.

phrenic nerve, respiratory failure, tetraplegia
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