Diaphragmatic Pacing

Joanne Kocourek (jskocour(AT)midway.uchicago.edu)
Thu, 7 May 1998 12:46:45 -0600

There are two diaphragmatic pacing systems available in the US. One by
Dobelle Institute in NY, the other by MedLink in Arizona. We evaluated
Kristen for pacing last year and opted to wait. We learned that
diaphragmatic pacing works well with a significantly lower complication
rate in the children with spinal cord injury vs the CCHS children.

Information can be obtained directly from the maunfacturers. There are a
small number of published articles which can be found via a MedLIne search.
Many of those pertaining to pediatrics have been authored (or coauthored)
by Dr. D. Weese-Mayer or Dr. M. Ilbawi. Dr. Ilbawi was the physician we
consulted as he had previously done an artery correction/suspension for
Kristen. We did make the decision that if we were to proceed with pacing
for Kristen this year, we would place the AstroStim by MedLink (I think I
have the right unit mane with the manufacturer) instead of the
Avery/Dobelle System for a variety of reasons. The biggest benefit to an
insurance company is REDUCED cost for patient support with pacing. That
was the "selling" factor many of the CCHS parents successfully used when
seeking insurance approval for pacing as an option for their children.
Pacing does involve a surgical procedure with the typical surgical risks.
The printed materials supplied by the pacing manufacturers describes the
presurgical evaluation and diaphragm conditioning that is required prior to
utilizing the pacing system in spinal cord injury patients.

Joanne Kocourek
The University of Chicago
jskocour(AT)midway.uchicago.edu