Dr. Uzi Izhar, head of the Hadassah Medical Center’s General Thoracic Surgery Unit, together with Dr. Mark Ginsburg, a cardiothoracic surgeon from Columbia Presbyterian Hospital (New York) have performed Hadassah’s first transplant of a pacemaker into a man’s diaphragm, which enabled him to breathe without the ventilator he had been attached to for a decade.

When the patient injured his cervical spinal cord many years ago, his diaphragm muscle became paralyzed. This pacemaker system, featuring a diaphragmatic/phrenic nerve stimulator, consists of electrodes sutured to the phrenic nerves, radio receivers implanted in subcutaneous pockets, and an external transmitter/antenna assembly that provides power to the system via nine-volt batteries. The external transmitter and antenna send energy and stimulus information to the receiver implant. The receiver translates radio waves into stimulating pulses, which are delivered to the phrenic nerve by the electrode. The diaphragm muscle contracts and produces the inhalation phase of breathing. The transmitter then stops generating signals, which allows the diaphragm to relax and exhalation occurs.

The patient’s diaphragm will have to acclimate gradually to the system so, initially, the patient still uses the ventilator at home. As the diaphragm becomes used to functioning again, the patient will spend more time without the ventilator.