Sleep Disorders | Sleep Review
Tampa General Hospital and USF Health are the first in Florida to use the Respicardia System to treat central sleep apnea. In this approach, the cardiologist / electrophysiologist implants a pacemaker-like device under the skin in the patient’s chest to improve the patient’s breathing during sleep.
Central sleep apnea is a serious breathing disorder that is separate from the more commonly known obstructive sleep apnea. Central sleep apnea occurs when the brain and the muscles that control breathing become unable to communicate with each other, causing pauses in breathing that last between 10 and 30 seconds during sleep. Currently, Tampa General is the only Florida hospital offering the operation.
“The device has been shown to be effective in reducing the frequency of respiratory arrests during sleep,” says Dr. Bengt Herweg, FACC, FHRS, professor and director of electrophysiology for the Department of Cardiovascular Sciences at USF Health Morsani College of Medicine and medical director of electrophysiology at Tampa General Hospital, in a press release. “Before this device was introduced, other standard therapies for central sleep apnea, such as Continuous Positive Airway Pressure (CPAP) machines, simply weren’t effective. Now 91% of patients receiving the treatment experience dramatic improvements in their nighttime breathing and quality of life. “
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The Respicardia Remedy System is an implantable pacemaker-like battery that stimulates the phrenic nerve, which is located in the chest and is responsible for sending signals to the diaphragm to stimulate breathing. The system, which is slightly smaller than a standard-sized deck of cards, monitors the patient’s breathing signals while they sleep. “Once implanted and activated, this pacemaker-like device stimulates the phrenic nerve, which controls the diaphragm and restores a normal breathing pattern during sleep,” says Herweg. Tampa General performed the first Respicardia surgery in December 2020.
“Central sleep apnea isn’t caused by upper airway obstruction like obstructive sleep apnea, and snoring doesn’t always happen,” says Dr. W. McDowell Anderson, professor and director of the division of pulmonary, critical care and sleep medicine at USF Health Morsani College of Medicine and Tampa General Hospital, in a press release. “It can be a hidden disease and patients may not know they have it, which can lead to potentially serious illness for the patient,” said Anderson. Central sleep apnea is diagnosed through a sleep study, and Respicardia Remedies are recommended for patients with moderate to severe cases.
Most patients with central sleep apnea also develop cardiovascular diseases such as heart failure and atrial fibrillation. “Untreated central sleep apnea can cause life-changing fatigue and an increased risk of heart failure and atrial fibrillation,” says Dr. Debbie Rinde-Hoffman, Tampa General Hospital medical director for advanced heart failure, in a press release. “The risks for heart disease in patients with central sleep apnea are well documented and may include doubling in death rates and increased hospital stays, while other effects include excessive daytime sleepiness, cognitive impairment, depression and memory impairment.”
The device has been shown to help reduce the effects of heart failure. “In patients with heart failure, the symptoms can improve after just six months from the time of activation,” says Rinde-Hoffman.
Respicardia remedy is typically implanted during an outpatient procedure. A few weeks later the system will activate and patients will typically see improvement three to six months later.
Tampa General is one of a select group of hospitals in the country offering the Respicardia agent.
Photo: Dr. Bengt Herweg, FACC, FHRS, professor and director of electrophysiology for the Department of Cardiovascular Sciences at USF Health Morsani College of Medicine and medical director of electrophysiology at Tampa General Hospital, was the first in Florida to implant a central drug Sleep apnea patient.