Discussion
This radiograph demonstrates a transvenous phrenic nerve stimulator. The lead travels from the generator under the skin into the right subclavian vein, right brachiocephalic vein, left brachicephalic vein, and terminates in the left pericardiophrenic vein, which drains the superior diaphragm and pericardium. This allows the device to stimulate the left phrenic nerve, which courses alongside the left percardiophrenic vein (and artery). This device is approved for the treatment of central sleep apnea under the brand name Remedē.
This patient also has sternal wires from a prior, unrelated open sternotomy.