This week, a 69-year-old patient of Deborah Heart and Lung Center became the first in the region to receive the implanted remedē System to treat central sleep apnea (CSA).
The system consists of a small, pacemaker-like device that is implanted under the skin on the upper chest under light sedation. A wire sends an electrical impulse to the phrenic nerve in the chest, which signals the diaphragm to contract.
Deborah electrophysiologist Dr. Pedram Kazemian performed the remedē System implant.
“We are excited to be able to offer this implantable device to our patients,” said Kazemian. “This device is implanted during a minimally-invasive procedure, and in some way, it is like a ‘pacemaker’ for the lungs. Patients who have CSA experience frequent nighttime drops in oxygen levels which contribute to increased cardiac stress. And, if a patient has heart failure on atrial fibrillation, these CSA events can make their cardiovascular disease so much worse.”
“There are two types of sleep apnea, obstructive and central,” said Dr. Marcella Frank, a pulmonologist and sleep specialist at Deborah. “Obstructive sleep apnea (OSA) occurs when the airway gets blocked by the tongue and relaxed throat muscles during sleep. This type of sleep apnea causes blockage, and the most common symptom is snoring. We usually treat this with CPAP, or continuous positive airway pressure. CSA, on the other hand, occurs when the brain does not send a signal to the diaphragm, which controls breathing.”
Frank says that the two conditions are separate and need to be treated as such, adding that these new advances in sleep apnea technology have made treating the condition much easier.
“For CSA, we can now offer the remedē System as an option,” Frank explained. “Deborah’s electrophysiologists can implant the device at the hospital. For obstructive sleep apnea, CPAP remains the gold standard, however, we can now also offer the Inspire Hypoglossal Nerve Stimulator, another FDA-approved device.”
The Inspire is an implanted device placed into a patient by an ear, nose and throat physician outside of the hospital setting.
“The Inspire provides mild stimulation to the tongue, allowing the airway to remain open during sleep, and keeping oxygen levels normal,” said Frank. “It is exciting to have both of these new technologies in our toolbox.”