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The Annals of Thoracic Surgery, Vol 54, 925-931, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Comparison of 180-degree and 360-degree skeletal muscle nerve cuff electrodes

GV Letsou, JF Hogan, P Lee, JH Kim, S Ariyan, ML Dewar, JC Baldwin and JA Elefteriades
Department of Surgery, Yale University, New Haven, Connecticut.

Use of skeletal muscle for cardiac augmentation is a promising technique for treatment of end-stage cardiac failure. An electrode woven through the latissimus dorsi that recruits nearby nerve fibers is commonly used to pace skeletal muscles both in clinical practice and in the laboratory. A proximally placed nerve cuff electrode offers potential advantages in improved recruitment of muscle fibers and low threshold for stimulation. We tested the effectiveness of a nerve cuff electrode passed directly about the proximal thoracodorsal nerve. Our report looks at the efficacy of nerve cuff electrode stimulation and compares electrical and histologic characteristics of a 180-degree wrap of the thoracodorsal nerve to a 360-degree wrap in dogs over 3 months. Threshold voltage at the commonly used pulse width of 200 microseconds was typically in the range of 400 to 600 mV for each electrode after 3 months. Statistical analysis revealed no significant difference (p < 0.05) in threshold voltage or current between the 180-degree and 360- degree nerve cuff electrode either at acute evaluation or after 3 months. Even contraction of latissimus dorsi was achieved with all implants. Adenosine triphosphatase staining revealed 100% conversion of type II to type I fibers in all stimulated muscles. Histologic examination of the thoracodorsal nerve and latissimus dorsi muscle revealed no abnormalities grossly or by light microscopy. Thus, a carefully applied nerve cuff electrode is an atraumatic, effective method for skeletal muscle stimulation. The 180-degree and 360-degree nerve cuff configurations are equally effective.

This article has been cited by other articles:

				J. A. Elefteriades and J. A. Quin Diaphragm pacing Ann. Thorac. Surg., February 1, 2002; 73(2): 691 - 692. [Full Text] [PDF]