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. Author manuscript; available in PMC: 2023 Feb 21.
Published in final edited form as: J Am Coll Cardiol. 2021 Aug 31;78(9):931–956. doi: 10.1016/j.jacc.2021.06.040

Figure 4.

Figure 4.

Cardiac contractility modulation and phrenic nerve stimulation

OPTIMIZER System delivers a biphasic, long-duration, high-voltage electrical signals to the septum of the right ventricle during the absolute refractory period, resulting in myocardial changes that lead to enhancement of contractility (A). The results of the OPTIMIZER system on peak VO2 are shown in (B).

Phrenic Nerve Stimulation: (C) Device-based phrenic nerve stimulation during sleep in patients with central sleep apnea leads to diaphragmatic contraction, and thus, restoring normal breathing and stabilizing the level of oxygen and cardon dioxide throughout sleep. (D) Device-based phrenic nerve stimulation (using remedē System) results in improvement in the apnea-hypopnea index (AHI). From Costanzo MR, Ponikowski P, Javaheri S, Augostini R, Goldberg L, Holcomb R, Kao A, Khayat RN, Oldenburg O, Stellbrink C, Abraham WT and remede System Pivotal Trial Study G. Transvenous neurostimulation for central sleep apnoea: a randomised controlled trial. Lancet. 2016;388:974-82.