Figure 4

Instrumentation of the right hemi-diaphragm. The orientation is the same in all pictures: the rostral direction is at the bottom and the caudal direction at the top of the picture, except for panel (a), in which caudal is top right and rostral bottom left of the picture. ♥ designates the heart.▲ designates the sternum. ● designate the pericardium. ■ designates the diaphragm. ♦ designates the lung. ⌂ designates the thymus. (a) Fixation of the cables to the skin directly adjacent to the sternotomy wound with simple stitches. (b) Implantation of an accelerometer to the most cranial point of the right hemi-diaphragm. (c) Fixation of the accelerometer to the right hemi-diaphragm via simple stitches to the edges of the accelerometer. (d) Detailed depiction of the hook electrodes used for diaphragmatic pacing. (e) Implantation of the pacing electrodes directly adjacent to the insertion of the phrenic nerve into the diaphragm. (f) Fixation of the cables of the implanted devices to the skin. Note the distance of approximately 10 mm between the poles of the pacing electrodes.