ISSN: 2167-0277
+44 1478 350008
The Christ Hospital Physicians Pulmonary & Sleep Medicine, -2123 Auburn Ave Suite 334, Cincinnati, OH, United States
Dr. Karthikeyan Kanagarajan, MD, serves as the medical director for the sleep centers at The Christ Hospital. He received his medical degree from the Madurai Medical College and completed his internship at the Government Rajaji Hospital in Madurai, India. He completed his residency in internal medicine and his fellowship in pulmonary disease at the Coney Island Hospital in Brooklyn, NY. He also completed a fellowship in critical care medicine at the Mount Sinai School of Medicine.
Case Report
Transvenous Phrenic Nerve Stimulation and Automatic Positive Airway Pressure Therapy for Treating Central Sleep Apnea and Residual Obstructive Sleep Apnea
Author(s): Daniel Beyerbach, Jill Fricke, Kris James, Scott McKane and Karthik Kanagarajan*
Central sleep apnea (CSA) is a neurological breathing disorder resulting from intermittent disruptions in the neural drive to breath. CSA and obstructive sleep apnea (OSA), caused by partial or complete airway blockage, sometimes occur together. The remede System (Respicardia, Minnetonka, MN) is an implantable device that delivers transvenous phrenic nerve stimulation therapy (TPNS) to treat CSA. A patient who failed previous Positive Airway Pressure (PAP) therapies presented with severe CSA and OSA with a baseline Apnea Hypopnea Index (AHI) of 98.1 events/hour. The patient was implanted with a TPNS device and titrated to maximum effectiveness. His CSA improved, but still had persistent OSA. PAP therapy was added to supplement the TPNS. With TPNS off, PAP therapy treated obstructive events but not the central events. TPNS alone treated the central events but not the obstructive events.. View More»
DOI:
10.35248/2167-0277.20.9.311