The surgery is performed by placing an electrode around the
phrenic nerve, either in the neck, or in the chest. This electrode is
connected to a radiofrequency receiver which is implanted just under
the skin. An external transmitter sends radio signals to the device by
an antenna which is worn over the receiver.
For the cervical placement, the phrenic nerve is approached via an incision slightly above, and midline to, the clavicle. The phrenic nerve is then isolated under the scalenus anticus muscle. For the thoracic surgical technique, an incision is made over the 2nd or 3rd intercostal space. The electrodes are placed around the phrenic nerves alongside the pericardium.
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