Abstract: The disclosure notably relates to an apparatus for minimally invasive medical use, comprising an elongated part including a catheter and/or a catheter sheath, the elongated part having a distal portion and an intermediate portion, the elongated part being configured for being introduced inside the inferior vena cava of a human patient and positioned at an operating location where the distal portion is in and/or beyond the right atrium and the intermediate portion is in the inferior vena cava, and one or more monitoring electrodes arranged on the intermediate portion of the elongated part, the one or more monitoring electrodes being configured for monitoring an electrical activity of the diaphragm of the human patient when the elongated part is positioned at the operating location. This forms an improved solution for monitoring an electrical activity of the diaphragm of a human patient.

Abstract: The disclosure relates to a computer-implemented method for monitoring diaphragmatic response to phrenic nerve stimulation. The method comprises receiving in real-time a diaphragmatic CMAP signal. The method comprises computing a baseline value of a characteristic of the CMAP signal. The characteristic represents a diaphragmatic response intensity to a phrenic nerve stimulation. The method comprises determining a threshold value of the characteristic, representing a boundary of values of the characteristic indicative of upcoming diaphragmatic palsy. The determining of the threshold value includes shifting the baseline value. The method comprises receiving in real-time a ECG signal. The method comprises repeating in real-time: detecting a QRS complex in the ECG signal, monitoring the CMAP signal, computing a real-time value of the characteristic, comparing the real-time value to the threshold value, and outputting an alert when the threshold is passed.

Abstract: The disclosure notably relates to a system for phrenic nerve stimulation. The stimulation system comprises a catheter including one or more intravascular electrodes each arranged on a distal portion of the catheter. The catheter is configured to be introduced in the superior vena cava of a human patient. The stimulation system also comprises an extracorporeal electrode patch configured to be affixed to the patient opposite to the distal portion relative to the phrenic nerve. The extracorporeal electrode patch is operable in a bipolar mode with the one or more intravascular electrodes. Such a system forms an improved solution for phrenic nerve stimulation, in particular during a cryoablation procedure.