title: Comparison of 180-degree and 360-degree skeletal muscle nerve cuff electrodes.
abstract: 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.
authors.affiliation: Department of Surgery, Yale University, New Haven, Connecticut.
authors.forename: G V
authors.initials: GV
authors.lastname: Letsou
authors.forename: J F
authors.initials: JF
authors.lastname: Hogan
authors.forename: P
authors.initials: P
authors.lastname: Lee
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Ariyan
authors.forename: M L
authors.initials: ML
authors.lastname: Dewar
authors.forename: J C
authors.initials: JC
authors.lastname: Baldwin
authors.forename: J A
authors.initials: JA
authors.lastname: Elefteriades
mesh_terms: D000251:Adenosine Triphosphatases / Q000032:analysis; D000818:Animals; D004285:Dogs; D004558:Electric Stimulation / Q000379:methods; D004567:Electrodes, Implanted; D006651:Histocytochemistry; D009119:Muscle Contraction; D009132:Muscles / Q000737:chemistry / Q000294:innervation*; D013900:Thoracic Nerves / Q000648:ultrastructure
chemical_list: D000251:Adenosine Triphosphatases