US20130296973A1 - Breathing therapy device and method - Google Patents
Breathing therapy device and method Download PDFInfo
- Publication number
- US20130296973A1 US20130296973A1 US13/851,003 US201313851003A US2013296973A1 US 20130296973 A1 US20130296973 A1 US 20130296973A1 US 201313851003 A US201313851003 A US 201313851003A US 2013296973 A1 US2013296973 A1 US 2013296973A1
- Authority
- US
- United States
- Prior art keywords
- stimulation
- medical device
- breathing
- respiratory
- period
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36132—Control systems using patient feedback
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3601—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
- A61B5/395—Details of stimulation, e.g. nerve stimulation to elicit EMG response
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/389—Electromyography [EMG]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4806—Sleep evaluation
- A61B5/4818—Sleep apnoea
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
Definitions
- the invention relates to a device and method for detection, diagnosis and treatment of breathing disorders and to the management of pulmonary or cardiac rhythms, heart failure and other cardiac and/or respiratory related conditions.
- Diaphragm stimulation has been used to provide breathing in patients unable to breath on their own. Diaphragm stimulation has also been proposed to treat sleep apnea. However, these uses of diaphragm stimulation have not provided optimal breathing responses or control of breathing.
- Breathing is typically intrinsically controlled by complex brain control and feedback sensing by the body.
- the body's involuntary control of respiration is mediated by the brain's respiratory center located in the brainstem, particularly in the medulla oblongata and pons.
- the respiratory center regulates the rhythmic alternating cycles of inspiration and expiration.
- the dorsal respiratory group within the medulla is responsible for the generation of respiratory rhythm through a reciprocal inhibition with other cell groups.
- central and peripheral receptors e.g., chemoreceptors and mechanoreceptors play important roles in regulation of inspiration.
- Central chemoreceptors of the central nervous system located on the ventrolateral medullary surface are sensitive to pH of their environment. It is believed that these chemoreceptors act to detect a change in pH of the cerebral spinal fluid.
- An increase in carbon dioxide tension of the arteries will indirectly cause the blood to become more acidic; the cerebral spinal fluid pH is closely comparable to plasma pH, as carbon dioxide easily diffuses across the blood/brain barrier.
- the detection of variation in the arterial carbon dioxide tension acts as a quick response system, useful in short term regulation. This system utilizes a negative feedback system, therefore if the pH of the cerebral spinal fluid is too low, then the receptor is believed in effect send an error signal to the medulla and respiration is adjusted accordingly.
- Peripheral chemoreceptors are believed most importantly to act to detect variation of the oxygen in the arterial blood, in addition to detecting arterial carbon dioxide and pH. These receptors are typically referred to as aortic or carotid bodies, and respectively are location on the arch of the aorta and on the arch of the common carotid artery. A continuous signal is sent, via cranial nerves from the peripheral chemoreceptors. With a decrease in arterial oxygen tension, the signal intensities, calling for an increase in respiration. However, increase in respiration typically results in falling PCO2 and hydrogen ion concentration which creates strong respiratory inhibitory effects that oppose the excitatory effects of diminished oxygen.
- Mechanoreceptors are located for example, in the airways and parenchyma, and are responsible for a variety of reflex responses.
- Pulmonary Stretch Receptors are located in smooth muscles of the trachea down to the terminal bronchioles. They are innervated by large, myelinated fibers and they discharge in response to distension of the lung. Their vagally mediated inhibition of inspiration and promotion of expiration is believed to be sustained as long as the lung is distended. They contribute to what is known as the Hering-Breuer reflex which prevents over-inflation of the lungs, by providing feedback signals that cause termination of inspiration.
- receptors such as respiratory proprioreceptors located in muscle spindle endings and tendon organs of the respiratory muscles, are stimulated in response to rib movement or intercostals/diaphragmatic tendon force of contraction.
- respiration can be affected by conditions such as, e.g., emotional state via input from the limbic system, or temperature, via the hypothalamus.
- Voluntary control of the respiration is provided via the cerebral cortex, although chemoreceptor reflex is capable of overriding conscious control.
- the invention provides a device and method for electrically stimulating the diaphragm to control breathing while inhibiting respiratory drive.
- a stimulation phase is identified.
- the stimulation phase is a period of time within the breathing cycle in which stimulation will inhibit respiratory drive and most likely will occur during a first fraction of the rest phase.
- Baseline breathing is sensed and stored.
- the length of the rest period in a breathing cycle is identified and a stimulation phase is determined.
- the baseline is used to determine when to stimulate.
- the stimulator may include a pulse generator configured to deliver stimulating pulses.
- EMG or other respiratory indicators may be sensed on a breath by breath basis or over time to determine when to stimulate within the respiratory phase. For a given tidal volume stimulation amplitude, duration and respiratory rate may be varied to inhibit respiratory drive when stimulating.
- the respiratory drive inhibition may be used in a number of applications such as improving or remodeling the heart in heart failure patients, treating apnea, chronic obstructive pulmonary disorder (COPD), and hypertension.
- COPD chronic obstructive pulmonary disorder
- FIG. 1 is an exemplary respiratory waveform with an identified stimulation phase in accordance with the invention.
- FIG. 2 is a flow showing a baseline establishment accordance with the invention.
- FIG. 3 is a flow chart showing identification of delivery boundaries in accordance with the invention.
- FIGS. 4A-4D illustrate various stimulation schemes in accordance with the invention, for controlling breathing in comparison to intrinsic breathing.
- FIG. 5 is a table illustrating a breathing therapy scheme in accordance with the invention.
- FIG. 6 is a flow chart showing a breathing therapy scheme in accordance with the invention.
- FIG. 7 illustrates an immediate control mode of a breathing therapy device in accordance with the invention.
- FIG. 8 illustrates a gradual control scheme in accordance with the invention.
- FIG. 9 is a flow chart showing an apnea control in accordance with the invention.
- FIG. 10 illustrates treatment of apnea in accordance with the invention.
- FIG. 11 illustrates a breathing therapy mode in accordance with the invention.
- FIG. 12 illustrates a diaphragm stimulator in accordance with the invention.
- a diaphragm stimulation device as shown in FIG. 12 is used.
- the diaphragm stimulation device 1200 electrically stimulates the diaphragm 1290 with an electrical signal supplied from a signal source 1260 to at least one electrode 1220 on an implantable unit 1210 .
- the electrode may also sense EMG of the diaphragm which may include respiration parameters.
- the sensed EMG is communicated to a processor 1280 of a control unit 1240 .
- the control unit also includes an input/output device 1250 for coupling to external communications device.
- the input/output device 1250 may be used to communicate to or from the device 1210 or the processor 1280 to or from a programmer, user or provider (e.g.
- the implantable unit 1210 also includes a motion sensor 1230 that senses the motion of the diaphragm 1290 to determine respiration parameters or responses to stimulation.
- the motion sensor 1230 may also be used to sense patient activity levels.
- the sensed signals are communicated to a processor 1280 that stores and uses the motion and EMG signals, as described herein, to control breathing.
- the phrenic nerve may be stimulated to control breathing.
- the waveform 100 has a total respiratory interval length 105 that comprises an inspiration period 110 , followed by an exhalation period 120 and ending in a rest period 130 .
- the respiratory interval 105 begins at the beginning 101 of the inspiration period 110 and ends at the end 160 of the rest period 130 which is the beginning of the next respiratory cycle.
- a time period is identified for stimulating a diaphragm and/or phrenic nerve to elicit a breathing response where the stimulation is believed to capture or take over breathing control and/or inhibit breathing driven by a subject's innate respiratory drive.
- the stimulation period 170 is identified by an earliest acceptable stimulation boundary 140 and a latest acceptable stimulation boundary 150 .
- the stimulation period 170 falls within the rest period 130 .
- the earliest stimulation boundary 140 may be selected on a patient by patient basis and is the earliest time at which the innate respiratory drive is captured by a particular stimulation.
- the stimulation boundary may be determined, e.g., on a patient by patient basis by optimizing stimulation response prior to implanting the device. Accordingly stimulation is provided and observed at different times near the beginning of the rest period to identify when the respiratory drive is captured for a particular stimulation waveform. In general, it is believed that such earliest stimulation boundary 140 is after the end of the exhalation period 120 and at or near the beginning of the rest cycle 130 .
- an earliest time may be selected for example as the end of the exhalation period 120 or a given time after the end of the exhalation cycle. It may also be selected as a predetermined fraction of the respiratory interval or its various components based on a baseline respiratory interval or interval component.
- the latest stimulation boundary 150 may be similarly selected on a patient by patient basis or using a predetermined value or a value based on a baseline.
- the latest stimulation boundary 150 is selected to occur at a time prior to the generation of an inspiration signal from the dorsal respiratory group.
- the latest stimulation boundary 150 is typically at time substantially before the expected onset of the next breath, before the end of the rest period.
- the latest stimulation boundary 150 is at about 0.9 of the total rest cycle length 130 .
- the latest stimulation boundary is a predetermined time prior to the end of the rest cycle 160 , more preferably at about 100 to 500 milliseconds prior to the end 160 of the rest cycle 130 .
- the identification of the inspiration cycle, exhalation cycle rest period, tidal volume and respiratory rate may be accomplished by sensing the respiration waveform, e.g., with a pneumotachometer, movement sensor or using EMG.
- An example of such determination is described, for example in related U.S. application Ser. No. 10/686,891 incorporated herein by reference.
- Various methods and devices that may be used to map ideal electrode placement for a desired result or to optimize stimulation to achieve such result are described in related U.S. application Ser. No. 10/966,484 filed Oct. 15, 2004, now abandoned, entitled “SYSTEM AND METHOD FOR MAPPING DIAPHRAGM ELECTRODE SITES” and is incorporated herein by reference.
- FIG. 2 is a flow chart illustrating a baseline determination in accordance with the invention.
- the device identifies the phase in which stimulation may be applied by sensing the respiratory phase length. This may be used during patient set up to establish patient baseline breathing.
- the baseline may be determined for several tidal volume levels or for one patient tidal volume, typically in a resting state. Baselines are established on a patient to patient basis because, e.g., each patient may have unique chest/lung compliance that could affect exhalation characteristics.
- a patient is connected to a flow sensor (e.g., a pneumotachometer).
- a flow sensor e.g., a pneumotachometer
- a patient is instructed to breathe at a resting respiratory rate and tidal volume.
- the respiration waveform is used as a baseline.
- respiration parameters are measured, e.g., tidal volume, inspiration duration, exhalation duration, rest period, and respiratory rate.
- tidal volume e.g., inspiration duration, exhalation duration, rest period, and respiratory rate.
- the minute ventilation may also be determined from the tidal volume and respiratory rate.
- step 230 which occurs with step 220 , the EMG is sensed and the EMG is correlated with the information sensed by the pneumotachometer in step 220 .
- the correlation is useful when the patient is no longer connected to the pneumotachometer. From the EMG and measured tidal volume the tidal volume for a subsequently observed EMG may be estimated or determined. At rest, exhalation is correlated to tidal volume. As tidal volume increases, so does the duration of exhalation. Thus, the exhalation phase for a given title volume can be generally determined as the exhalation phase is generally the same for a given tidal volume.
- step 240 diaphragm motion is sensed with a motion sensor. Diaphragm motion indicates when the lungs are inspiring, exhaling or at rest. This step is optional but provides additional correlation information.
- the motion sensor information is also correlated with EMG and pneumotachometer information.
- the respiration parameters are stored, i.e. the measured tidal volume and other sensed measured or calculated parameter, and correlated EMG, pneumotachometer and motion sensor data.
- steps 220 through 250 are repeated for a decreased tidal volume.
- a patient may be coached or instructed by a provider or programmer via telemetry to breathe at a lower tidal volume and the same measurements are then made as were made for a resting tidal volume.
- the implanted device may be programmed accordingly and the device turned on.
- FIG. 3 illustrates the identification of phase boundaries when the device is in operation.
- the device senses EMG.
- step 320 the EMG is stored along with respiratory parameters that may be ascertained from EMG. This includes the inspiration period where EMG is active, the exhalation and rest period combined where EMG is inactive.
- step 340 the motion detector is used to differentiate between the exhalation phase in which there is diaphragm movement and the rest phase in which there is minimal diaphragm movement.
- the data points stored in step 230 of FIG. 2 are used to extrapolate the tidal volume for a given EMG.
- the exhalation period is generally known, thus the rest period may be determined by subtracting the exhalation period from the combined sensed exhalation and rest periods.
- the stimulation delivery boundaries are determined, i.e. the earliest stimulation boundary 140 and latest stimulation boundary 150 are determined.
- the stimulation may occur in the same cycle as the EMG or in a subsequent cycle assuming the previous cycle would be approximately the same.
- the earliest stimulation boundary is at a predetermined time after the end of the exhalation period.
- the latest stimulation boundary is a predetermined time before the end of the rest period.
- the earliest stimulation boundary is after a predetermined fraction of the expected rest cycle has passed.
- the latest stimulation boundary is before a predetermined fraction of the expected rest cycle has passed.
- Other ways of determining the stimulation phase may be used in accordance with the invention, including but not limited to using optimization as described above with reference to FIG. 1 .
- step 370 if treatment is desirable, then at step 380 , stimulation is provided during the stimulation phase as programmed. Subsequently, or if no treatment is required, the system resumes monitoring EMG.
- FIGS. 4A-4B and 4 D illustrate various stimulation schemes in accordance with the invention, for controlling breathing while maintaining central respiratory drive inhibition.
- FIG. 4C illustrates spontaneous breathing 450 with the dotted line showing what spontaneous breathing would continue to look like without stimulated breathing.
- stimulation is provided within the defined stimulation phase (See FIGS. 1 and 3 ) of the rest phase before the effect of the lack of mechanoreceptor activation allows the brain to initiate inspiration.
- tidal volume is maintained which is believed to help prevent other brain receptor functions from causing the initiation of inspiration.
- various stimulation responses may be tested until a desired response (e.g., tidal volume an respiratory rate) is obtained.
- a set or a series of stimulation pulses 410 , 411 , 412 is illustrated following a spontaneous breath 400 .
- Each of the series of pulses 410 , 411 , 412 elicit a slower rate and more shallow breathing (e.g., flow) response 420 , 421 , 422 in comparison to the spontaneous breaths 490 , 496 , 497 , 498 , while each maintaining a tidal volume approximately the same as the tidal volume of the spontaneous breaths 496 , 497 , 498 ( FIG. 4C ).
- Each of the initiation points 402 , 404 , 406 fall within a stimulation phase that is a less than or is a fraction of the spontaneous breath rest phase 495 ( FIG. 4C ).
- the rest phases 403 , 405 , 407 are shorter. Accordingly, spontaneous breathing is inhibited.
- FIG. 4B a set of a series of stimulation pulses 440 , 441 , 442 is illustrated following a spontaneous breath 430 .
- Each of the series of pulses 440 , 441 , 442 elicit a slower rate and more shallow breathing response 450 , 451 , 452 in comparison to the spontaneous breaths 490 , 496 , 497 , 498 , while each maintaining a tidal volume approximately the same as the tidal volume of the spontaneous breaths 496 , 497 , 498 ( FIG. 4C ).
- Each of the initiation points 432 , 434 , 436 fall within a stimulation phase that is a less than or is a traction of the spontaneous breath rest phase 495 ( FIG. 4C ).
- the rest phases 433 , 435 , 437 are shorter than the rest phase 495 while somewhat longer than the rest phases 403 , 405 , and 407 of FIG. 4A . Accordingly, spontaneous breathing is inhibited.
- FIGS. 5-8 Examples of a breathing therapy schemes are shown in FIGS. 5-8 .
- tidal volume respiratory rate and minute ventilation are observed as described with respect to FIGS. 1-3 herein.
- Tidal volume is maintained at the normal level while respiratory rate is increased, thus increasing minute ventilation and SaO2 levels, decreasing PCO2 levels, and therefore maintaining central respiratory drive inhibition.
- This therapy mode is maintained for a programmable amount of time, e.g., for one or more intervals of time during the night or during the day.
- breathing therapy mode breathing is normalized to allow PCO2 to slowly increase so spontaneous breathing can be restored.
- FIG. 6 is a flow chart illustrating the scheme set forth in FIG. 5 .
- the breathing therapy scheme is activated, e.g. at a programmed time.
- control of breathing is taken over either immediately as described with respect to FIG. 7 , or gradually as described with respect to FIG. 8 .
- step 630 the stimulation delivery boundaries identified as described in FIG. 2 are recalled (which have been dynamically observed and recorded).
- the diaphragm is stimulated at an increased minute ventilation for a given or programmed duration.
- the weaning mode is activated and minute ventilation is decreased for a given duration or until spontaneous breathing returns.
- FIG. 8 illustrates a gradual control mode.
- stimulated breaths 801 are induced between spontaneous breaths 800 .
- the effective minute ventilation is gradually increased as the rest period 812 between the spontaneous breath 800 and the subsequent stimulated breath 801 are shorter than the intrinsic rest period 811 .
- SaO2 will increase and PCO2 will decrease gradually decreasing the respiratory drive.
- the length of the rest period is determined, e.g., using a motion sensor, until it reaches a critical length that has increased due to decreased respiratory drive (e.g. at rest period 820 ending at 802 ).
- breathing is controlled by the stimulator as it has transitioned to the immediate control mode for a period of time 830 .
- breathing is normalized 840 and finally the patient is weaned 850 .
- stimulation is provided. If stimulation is provided during an apnea interval, (preferably at the beginning of the apnea level before SaO2 levels are depleted) stimulation is provided at a predetermined rate and tidal volume based on previous baseline determinations. In particular stimulation is provided at lower minute ventilation than normal. This is to gradually allow for more oxygenation than will occur during apnea while also allowing an increase in the PCO2 levels until the respiratory drive increases at least above the apneac threshold, and spontaneous breathing at a desired level returns. Cheyne-Stokes and apnea tend to occur in repeated cycles in heart failure patients.
- apnea therapy is to stabilize the blood gas levels more gradually and to reduce the extreme fluctuations between Cheyne-Stokes hyperventilation and apnea.
- the stimulation rate is set and may gradually be reduced by increasing the intervals between successive breaths or stimulations. If no EMG 940 is sensed within interval 930 or a sensed EMG does not meet the amplitude criterion and the interval length has not reached a maximum length, then the stimulation is delivered at step 920 and the cycle 930 & 940 repeated. If an EMG is sensed 940 within the 930 interval and meets amplitude criterion then the stimulation will be inhibited at step 950 . If a defined number of successive sensed EMGs meeting step 940 criterion are not met then the interval is again set at step 930 . If a defined number of successive sensed EMGs meeting step 940 criterion are met in step 960 then the episode is over and the device returns to apnea detection mode 910 .
- FIG. 10 illustrates apnea treatment as described with respect to FIG. 9 .
- the waveform at 1000 may be a normal intrinsic breath.
- a breath with an increased amplitude may be a precursor to Cheyne-Stokes hyperventilation that may indicate the imminent onset of Cheyne-Stokes.
- Cheyne-Stokes hyperventilation is at a peak amplitude.
- the amplitude is decreasing indication the imminent onset of apnea.
- apnea has occurred.
- a precursor to apnea may be sensed and stimulation may be provided to take over breathing in a manner similar to that described with reference to FIGS. 5-8 .
- the stimulation may be adjusted to increase or decrease minute ventilation to stabilize blood gas fluctuations and avoid further episodes of Cheyne-Stokes and/or apnea. Maintaining stable blood gas levels with stimulation may prevent Cheyne-Stokes hyperventilation and hence avoid arousal events otherwise associated with large swings of these gases.
- stimulation begins at 1050 .
- stimulation is at minute ventilation that is reduced from a normal baseline.
- the intervals between stimulation cycles increase.
- an EMG is sensed but it is not at a desired level and the stimulation continues.
- an EMG is sensed and stimulation is inhibited until an interval passes.
- a set interval has passed without spontaneous breathing and stimulation then resumes.
- spontaneous breathing has resumed and continues for a requisite number of cycles (until point 1099 is reached). It is then determined that the episode is over and the system returns to apnea sensing mode.
- FIGS. 11A-B illustrate an example of a hypertension breathing therapy device.
- capture of breathing as described in FIGS. 5-8 may occur on a nightly basis for specific preprogrammed durations.
- stimulation may also be provided during an exhalation cycle to further extend the length of the active breathing portion (inspiration and exhalation) of the respiration cycle.
- the duration of the rest period is greatly reduced so that the central respiratory drive may remain inhibited.
- the minute ventilation is maintained in accordance with a baseline determined as described with reference to FIG. 2 .
- the goal is to create long slow breathing, e.g., at about 6 cycles per minute or at another rate that provides desired therapy.
- period 1120 stimulation ramps up to induce an inspiration cycle, as in period 1110 , and gradually ramps down during exhalation to extend the length of the exhalation cycle.
- the normally passive exhalation phase is now influenced with active stimulation.
- the increase in the duration of the active breathing portion of the respiration cycle decreases the rest phase duration which tends to inhibit the occurrence of spontaneous breathing.
- minute ventilation is approximately equal to minute ventilation during period 1110 which is achieved by increasing the tidal volume and decreasing the rate.
- the stimulation 1131 becomes longer in duration than stimulation 1130 , further extending the duration of the breaths and decreasing the rest phase, which inhibits spontaneous breathing and maintains a decreased respiration rate.
- the stimulation 1132 decreases in duration and stimulation is inhibited.
- the stimulation is turned off or stimulation is gradually returned to normal breathing in a manner similar to that described in examples above. Spontaneous breathing will then resume.
- the breathing rate is reduced to 20 breaths per minute or less, more preferably about 10 breaths per minute or less and most preferably between about 4 and 8 breaths per minute.
- the respiratory drive inhibition may also be used in treating COPD patients.
- COPD patients have difficulties exhaling CO 2 and therefore typically retain high levels of CO 2 in their blood.
- Low levels of inspiration with high levels of exhalation may be induced by inducing longer periods of exhalation in a manner similar to that described with respect to FIGS. 11A-11B where the exhalation period is extended.
Abstract
A device and method is provided for electrically stimulating the diaphragm to control breathing while inhibiting respiratory drive. A stimulation phase is identified. The stimulation phase is it period of time within the breathing cycle in which stimulation will inhibit respiratory drive. The respiratory drive inhibition may be used in a number of applications including but not limited to: improving or remodeling the heart in heart failure patients, treating apnea, chronic obstructive pulmonary disorder (COPD), and hypertension.
Description
- This application is a continuation of U.S. application Ser. No. 10/966,474, filed Oct. 15, 2004, which is a continuation-in-part of U.S. application Ser. No. 10/686,891 filed Oct. 15, 2003, both of which are fully incorporated herein by reference.
- The invention relates to a device and method for detection, diagnosis and treatment of breathing disorders and to the management of pulmonary or cardiac rhythms, heart failure and other cardiac and/or respiratory related conditions.
- BACKGROUND OF THE INVENTION
- Diaphragm stimulation has been used to provide breathing in patients unable to breath on their own. Diaphragm stimulation has also been proposed to treat sleep apnea. However, these uses of diaphragm stimulation have not provided optimal breathing responses or control of breathing.
- Accordingly it would be desirable to provide improved diaphragm stimulation.
- Breathing is typically intrinsically controlled by complex brain control and feedback sensing by the body. The body's involuntary control of respiration is mediated by the brain's respiratory center located in the brainstem, particularly in the medulla oblongata and pons. The respiratory center regulates the rhythmic alternating cycles of inspiration and expiration. The dorsal respiratory group within the medulla is responsible for the generation of respiratory rhythm through a reciprocal inhibition with other cell groups.
- In addition, various central and peripheral receptors, e.g., chemoreceptors and mechanoreceptors play important roles in regulation of inspiration.
- Central chemoreceptors of the central nervous system located on the ventrolateral medullary surface, are sensitive to pH of their environment. It is believed that these chemoreceptors act to detect a change in pH of the cerebral spinal fluid. An increase in carbon dioxide tension of the arteries will indirectly cause the blood to become more acidic; the cerebral spinal fluid pH is closely comparable to plasma pH, as carbon dioxide easily diffuses across the blood/brain barrier. The detection of variation in the arterial carbon dioxide tension acts as a quick response system, useful in short term regulation. This system utilizes a negative feedback system, therefore if the pH of the cerebral spinal fluid is too low, then the receptor is believed in effect send an error signal to the medulla and respiration is adjusted accordingly.
- Peripheral chemoreceptors are believed most importantly to act to detect variation of the oxygen in the arterial blood, in addition to detecting arterial carbon dioxide and pH. These receptors are typically referred to as aortic or carotid bodies, and respectively are location on the arch of the aorta and on the arch of the common carotid artery. A continuous signal is sent, via cranial nerves from the peripheral chemoreceptors. With a decrease in arterial oxygen tension, the signal intensities, calling for an increase in respiration. However, increase in respiration typically results in falling PCO2 and hydrogen ion concentration which creates strong respiratory inhibitory effects that oppose the excitatory effects of diminished oxygen.
- Mechanoreceptors are located for example, in the airways and parenchyma, and are responsible for a variety of reflex responses.
- Pulmonary Stretch Receptors are located in smooth muscles of the trachea down to the terminal bronchioles. They are innervated by large, myelinated fibers and they discharge in response to distension of the lung. Their vagally mediated inhibition of inspiration and promotion of expiration is believed to be sustained as long as the lung is distended. They contribute to what is known as the Hering-Breuer reflex which prevents over-inflation of the lungs, by providing feedback signals that cause termination of inspiration.
- Other receptors, such as respiratory proprioreceptors located in muscle spindle endings and tendon organs of the respiratory muscles, are stimulated in response to rib movement or intercostals/diaphragmatic tendon force of contraction.
- In addition to involuntary control of respiration by the respiratory center, respiration can be affected by conditions such as, e.g., emotional state via input from the limbic system, or temperature, via the hypothalamus. Voluntary control of the respiration is provided via the cerebral cortex, although chemoreceptor reflex is capable of overriding conscious control.
- Known diaphragm stimulation techniques have not interacted with this complex respiratory control system to override, influence or work with the system.
- Accordingly improved stimulation devices and methods would be desirable.
- The invention provides a device and method for electrically stimulating the diaphragm to control breathing while inhibiting respiratory drive. According to the invention, a stimulation phase is identified. The stimulation phase is a period of time within the breathing cycle in which stimulation will inhibit respiratory drive and most likely will occur during a first fraction of the rest phase. Baseline breathing is sensed and stored. The length of the rest period in a breathing cycle is identified and a stimulation phase is determined.
- The baseline is used to determine when to stimulate. The stimulator may include a pulse generator configured to deliver stimulating pulses. EMG or other respiratory indicators may be sensed on a breath by breath basis or over time to determine when to stimulate within the respiratory phase. For a given tidal volume stimulation amplitude, duration and respiratory rate may be varied to inhibit respiratory drive when stimulating.
- The respiratory drive inhibition may be used in a number of applications such as improving or remodeling the heart in heart failure patients, treating apnea, chronic obstructive pulmonary disorder (COPD), and hypertension.
-
FIG. 1 is an exemplary respiratory waveform with an identified stimulation phase in accordance with the invention. -
FIG. 2 is a flow showing a baseline establishment accordance with the invention. -
FIG. 3 is a flow chart showing identification of delivery boundaries in accordance with the invention. -
FIGS. 4A-4D illustrate various stimulation schemes in accordance with the invention, for controlling breathing in comparison to intrinsic breathing. -
FIG. 5 is a table illustrating a breathing therapy scheme in accordance with the invention. -
FIG. 6 is a flow chart showing a breathing therapy scheme in accordance with the invention. -
FIG. 7 illustrates an immediate control mode of a breathing therapy device in accordance with the invention. -
FIG. 8 illustrates a gradual control scheme in accordance with the invention. -
FIG. 9 is a flow chart showing an apnea control in accordance with the invention. -
FIG. 10 illustrates treatment of apnea in accordance with the invention. -
FIG. 11 illustrates a breathing therapy mode in accordance with the invention. -
FIG. 12 illustrates a diaphragm stimulator in accordance with the invention. - In accordance with the invention a diaphragm stimulation device as shown in
FIG. 12 is used. Thediaphragm stimulation device 1200 electrically stimulates thediaphragm 1290 with an electrical signal supplied from asignal source 1260 to at least oneelectrode 1220 on animplantable unit 1210. The electrode may also sense EMG of the diaphragm which may include respiration parameters. The sensed EMG is communicated to aprocessor 1280 of acontrol unit 1240. The control unit also includes an input/output device 1250 for coupling to external communications device. The input/output device 1250 may be used to communicate to or from thedevice 1210 or theprocessor 1280 to or from a programmer, user or provider (e.g. via, telemetry, wireless communications or other user/provider/programmer interface). Theimplantable unit 1210 also includes amotion sensor 1230 that senses the motion of thediaphragm 1290 to determine respiration parameters or responses to stimulation. Themotion sensor 1230 may also be used to sense patient activity levels. The sensed signals are communicated to aprocessor 1280 that stores and uses the motion and EMG signals, as described herein, to control breathing. In addition to stimulation of the diaphragm the phrenic nerve may be stimulated to control breathing. - Referring to
FIG. 1 an intrinsic, breathingwaveform 100 is illustrated. Thewaveform 100 has a totalrespiratory interval length 105 that comprises aninspiration period 110, followed by an exhalation period 120 and ending in arest period 130. Therespiratory interval 105 begins at the beginning 101 of theinspiration period 110 and ends at the end 160 of therest period 130 which is the beginning of the next respiratory cycle. In accordance with the invention as described below a time period is identified for stimulating a diaphragm and/or phrenic nerve to elicit a breathing response where the stimulation is believed to capture or take over breathing control and/or inhibit breathing driven by a subject's innate respiratory drive. Thestimulation period 170 is identified by an earliestacceptable stimulation boundary 140 and a latestacceptable stimulation boundary 150. - In general the
stimulation period 170 falls within therest period 130. Theearliest stimulation boundary 140 may be selected on a patient by patient basis and is the earliest time at which the innate respiratory drive is captured by a particular stimulation. The stimulation boundary may be determined, e.g., on a patient by patient basis by optimizing stimulation response prior to implanting the device. Accordingly stimulation is provided and observed at different times near the beginning of the rest period to identify when the respiratory drive is captured for a particular stimulation waveform. In general, it is believed that suchearliest stimulation boundary 140 is after the end of the exhalation period 120 and at or near the beginning of therest cycle 130. As an alternative to optimizing on a patient by patient basis an earliest time may be selected for example as the end of the exhalation period 120 or a given time after the end of the exhalation cycle. It may also be selected as a predetermined fraction of the respiratory interval or its various components based on a baseline respiratory interval or interval component. - The
latest stimulation boundary 150 may be similarly selected on a patient by patient basis or using a predetermined value or a value based on a baseline. In general, in order to capture respiration with stimulation for a subject's given minute ventilation, according to one embodiment, thelatest stimulation boundary 150 is selected to occur at a time prior to the generation of an inspiration signal from the dorsal respiratory group. Accordingly, thelatest stimulation boundary 150 is typically at time substantially before the expected onset of the next breath, before the end of the rest period. In particular, according to one variation, thelatest stimulation boundary 150 is at about 0.9 of the totalrest cycle length 130. According to another variation, the latest stimulation boundary is a predetermined time prior to the end of the rest cycle 160, more preferably at about 100 to 500 milliseconds prior to the end 160 of therest cycle 130. - The identification of the inspiration cycle, exhalation cycle rest period, tidal volume and respiratory rate may be accomplished by sensing the respiration waveform, e.g., with a pneumotachometer, movement sensor or using EMG. An example of such determination is described, for example in related U.S. application Ser. No. 10/686,891 incorporated herein by reference. Various methods and devices that may be used to map ideal electrode placement for a desired result or to optimize stimulation to achieve such result are described in related U.S. application Ser. No. 10/966,484 filed Oct. 15, 2004, now abandoned, entitled “SYSTEM AND METHOD FOR MAPPING DIAPHRAGM ELECTRODE SITES” and is incorporated herein by reference.
-
FIG. 2 is a flow chart illustrating a baseline determination in accordance with the invention. The device identifies the phase in which stimulation may be applied by sensing the respiratory phase length. This may be used during patient set up to establish patient baseline breathing. The baseline may be determined for several tidal volume levels or for one patient tidal volume, typically in a resting state. Baselines are established on a patient to patient basis because, e.g., each patient may have unique chest/lung compliance that could affect exhalation characteristics. - In
step 210, a patient is connected to a flow sensor (e.g., a pneumotachometer). - In step 220 a patient is instructed to breathe at a resting respiratory rate and tidal volume. The respiration waveform is used as a baseline. From the respiration waveform, respiration parameters are measured, e.g., tidal volume, inspiration duration, exhalation duration, rest period, and respiratory rate. Thus the length of each segment of the inspiration cycle is determined, for a given tidal volume. The minute ventilation may also be determined from the tidal volume and respiratory rate.
- At
step 230 which occurs withstep 220, the EMG is sensed and the EMG is correlated with the information sensed by the pneumotachometer instep 220. The correlation is useful when the patient is no longer connected to the pneumotachometer. From the EMG and measured tidal volume the tidal volume for a subsequently observed EMG may be estimated or determined. At rest, exhalation is correlated to tidal volume. As tidal volume increases, so does the duration of exhalation. Thus, the exhalation phase for a given title volume can be generally determined as the exhalation phase is generally the same for a given tidal volume. - In
step 240 which occurs withsteps - At
step 250 the respiration parameters are stored, i.e. the measured tidal volume and other sensed measured or calculated parameter, and correlated EMG, pneumotachometer and motion sensor data. - At
step 260,steps 220 through 250 are repeated for a decreased tidal volume. A patient may be coached or instructed by a provider or programmer via telemetry to breathe at a lower tidal volume and the same measurements are then made as were made for a resting tidal volume. - At
step 270,steps 220 through 250 are repeated for an increased tidal volume. A patient may be coached or instructed by a provider or programmer to breathe at a higher tidal volume and the same measurements are then made as were made for a resting tidal volume. - Once the initial baseline data and waveforms are stored, the implanted device may be programmed accordingly and the device turned on.
-
FIG. 3 illustrates the identification of phase boundaries when the device is in operation. - As illustrated in
step 310, the device senses EMG. - In
step 320 the EMG is stored along with respiratory parameters that may be ascertained from EMG. This includes the inspiration period where EMG is active, the exhalation and rest period combined where EMG is inactive. - At
step 330 if a motion sensor is in use on the diaphragm, then atstep 340 the motion detector is used to differentiate between the exhalation phase in which there is diaphragm movement and the rest phase in which there is minimal diaphragm movement. - At
step 330, if the motion sensor is not in use on the diaphragm, then atstep 350, the data points stored instep 230 ofFIG. 2 are used to extrapolate the tidal volume for a given EMG. For a given tidal volume, the exhalation period is generally known, thus the rest period may be determined by subtracting the exhalation period from the combined sensed exhalation and rest periods. - At
step 360, following either step 340 or step 350, the stimulation delivery boundaries are determined, i.e. theearliest stimulation boundary 140 andlatest stimulation boundary 150 are determined. The stimulation may occur in the same cycle as the EMG or in a subsequent cycle assuming the previous cycle would be approximately the same. In one example, the earliest stimulation boundary is at a predetermined time after the end of the exhalation period. The latest stimulation boundary is a predetermined time before the end of the rest period. In another example the earliest stimulation boundary is after a predetermined fraction of the expected rest cycle has passed. And, the latest stimulation boundary is before a predetermined fraction of the expected rest cycle has passed. Other ways of determining the stimulation phase may be used in accordance with the invention, including but not limited to using optimization as described above with reference toFIG. 1 . - At
step 370, if treatment is desirable, then atstep 380, stimulation is provided during the stimulation phase as programmed. Subsequently, or if no treatment is required, the system resumes monitoring EMG. - According to one aspect of the invention, stimulation is provided that inhibits central respiratory drive for a sufficient duration so that therapeutic stimulation and breathing control may be applied. The therapeutic stimulation breathing is configured to provide a therapeutic benefit at the same time that it acts to inhibit central respiratory drive. According to one aspect the stimulation intensity, duration and respiratory rate are manipulated to inhibit respiratory drive while providing desired stimulation to the diaphragm. For example, at a given respiratory rate and tidal volume during diaphragm stimulation, extending the inspiration or expiration duration (among other things, by increasing stimulation duration and decreasing intensity) effectively shortens the resting period compared to spontaneous breathing and decreases the likelihood of a spontaneous breath between stimulations.
- One factor in inhibiting respiratory drive is to stimulate an inspiration between the rest phase boundaries and thereby activate the mechanoreceptors such as the stretch receptors and the proprioreceptors to provide feed back that an individual is actively inspiring. The stretch receptors activate when the airways/lungs stretch and the proprioreceptors activate when respiratory muscles of the diaphragm and/or chest wall contract. Typically output from the respiratory center conducted by efferent nerves to the respiratory muscles are temporarily inhibited by the mechanoreceptor signals until the individual has exhaled.
- Another factor that affects respiratory drive is the blood oxygen concentration levels and the partial pressure of carbon dioxide in the blood. A decrease in carbon dioxide levels tends to create a decrease in respiratory drive whereas a decrease in oxygen saturation levels may increase respiratory drive. These levels and thus the chemoreceptors and respiratory drive may be influenced by controlling minute ventilation as is described in related U.S. patent application Ser. No. 10/966,472 filed Oct. 15, 2004, now. U.S. Pat. No. 8,200,336, entitled “SYSTEM AND METHOD FOR DIAPHRAGM STIMULATION” and is incorporated herein by reference. Accordingly, parameters that effect minute ventilation e.g., tidal volume and respiratory rate, may be manipulated to control respiratory drive.
-
FIGS. 4A-4B and 4D illustrate various stimulation schemes in accordance with the invention, for controlling breathing while maintaining central respiratory drive inhibition.FIG. 4C illustratesspontaneous breathing 450 with the dotted line showing what spontaneous breathing would continue to look like without stimulated breathing. - According to one aspect stimulation is provided within the defined stimulation phase (See
FIGS. 1 and 3 ) of the rest phase before the effect of the lack of mechanoreceptor activation allows the brain to initiate inspiration. In addition, tidal volume is maintained which is believed to help prevent other brain receptor functions from causing the initiation of inspiration. - As noted previously, in setting up and programming the device for a specific patient, various stimulation responses may be tested until a desired response (e.g., tidal volume an respiratory rate) is obtained.
- Referring to
FIG. 4A a set or a series ofstimulation pulses spontaneous breath 400. Each of the series ofpulses response spontaneous breaths spontaneous breaths FIG. 4C ). Each of the initiation points 402, 404, 406 fall within a stimulation phase that is a less than or is a fraction of the spontaneous breath rest phase 495 (FIG. 4C ). The rest phases 403, 405, 407 are shorter. Accordingly, spontaneous breathing is inhibited. - Similarly in
FIG. 4B a set of a series ofstimulation pulses spontaneous breath 430. Each of the series ofpulses shallow breathing response spontaneous breaths spontaneous breaths FIG. 4C ). Each of the initiation points 432, 434, 436 fall within a stimulation phase that is a less than or is a traction of the spontaneous breath rest phase 495 (FIG. 4C ). The rest phases 433, 435, 437 are shorter than therest phase 495 while somewhat longer than the rest phases 403, 405, and 407 ofFIG. 4A . Accordingly, spontaneous breathing is inhibited. -
FIG. 4D illustrates a set of a series ofstimulation pulses spontaneous breath 460. Each of the series ofpulses similar breathing response spontaneous breaths spontaneous breaths FIG. 4C ). While thebreathing responses - The stimulation scheme of the invention may be used in a number of applications. In general, a patient's breathing is captured by the stimulator and breathing stimulation is applied to control breathing for a period of time.
- In one application, breathing is stimulated to increase oxygen saturation levels for a period of time. It is believed that this scheme will allow positive remodeling of the heart by reducing the load on the heart for a period of time e.g., for one or more time intervals during sleep. Reduced contractility and cardiac output for a period of time provides an opportunity for an overloaded heart to rest. The oxygen saturation levels can be increased by increasing minute ventilation. Therefore one aspect of the invention is a device and method for treating heart failure patients by providing breathing stimulation for periods of time that increase oxygen saturation levels.
- Examples of a breathing therapy schemes are shown in
FIGS. 5-8 . As shown inFIG. 5 , during normal breathing tidal volume respiratory rate and minute ventilation are observed as described with respect toFIGS. 1-3 herein. Tidal volume is maintained at the normal level while respiratory rate is increased, thus increasing minute ventilation and SaO2 levels, decreasing PCO2 levels, and therefore maintaining central respiratory drive inhibition. This therapy mode is maintained for a programmable amount of time, e.g., for one or more intervals of time during the night or during the day. After the breathing therapy mode, breathing is normalized to allow PCO2 to slowly increase so spontaneous breathing can be restored. This may be accomplished by returning respiratory rate back to normal and maintaining normal tidal volume to increase PCO2 and thereby encourage the return of intrinsic breathing and respiratory drive. If after the stimulator stimulates breathing at a normal rate for a period of dine and spontaneous breathing has not returned, the patient is weaned from the stimulator by further decreasing the respiratory rate and therefore minute ventilation. This will allow intrinsic breathing and respiratory drive to return by allowing an increase in PCO2. -
FIG. 6 is a flow chart illustrating the scheme set forth inFIG. 5 . Atstep 610 the breathing therapy scheme is activated, e.g. at a programmed time. - At
step 620, control of breathing is taken over either immediately as described with respect toFIG. 7 , or gradually as described with respect toFIG. 8 . - At step 630 the stimulation delivery boundaries identified as described in
FIG. 2 are recalled (which have been dynamically observed and recorded). - At
step 640 the diaphragm is stimulated at an increased minute ventilation for a given or programmed duration. - At
step 650 breathing stimulation is normalized and the normalization mode is activated. Stimulation at a normal minute ventilation is provided for a given duration or until spontaneous breathing returns. - At
step 660, the weaning mode is activated and minute ventilation is decreased for a given duration or until spontaneous breathing returns. - Referring to
FIG. 7 , immediate control begins after a period of normal breathing 700 by taking over breathing at apoint 705 within an identified stimulation phase. Stimulation of breathing at the increased respiratory rate is continuously applied for thebreathing therapy portion 710. Stimulation is then normalized for a period ofnormalization 720 and the patient is weaned for a period of weaning 730. While not specifically shown inFIG. 7 , stimulation continues until the return of spontaneous breathing. -
FIG. 8 illustrates a gradual control mode. In thefirst portion 810 of the gradual control mode stimulatedbreaths 801 are induced betweenspontaneous breaths 800. The effective minute ventilation is gradually increased as therest period 812 between thespontaneous breath 800 and the subsequent stimulatedbreath 801 are shorter than the intrinsic rest period 811. Over time in thisfirst portion 810 of the gradual mode, SaO2 will increase and PCO2 will decrease gradually decreasing the respiratory drive. The length of the rest period is determined, e.g., using a motion sensor, until it reaches a critical length that has increased due to decreased respiratory drive (e.g. atrest period 820 ending at 802). At that point breathing is controlled by the stimulator as it has transitioned to the immediate control mode for a period oftime 830. Then breathing is normalized 840 and finally the patient is weaned 850. - Another aspect of the invention provides for breathing therapy in treating apnea. It is believed that stimulated breathing prior to or during apnea may stabilize the broad swings of blood gas concentrations that occur during cycles of Cheyne-Stokes and apnea. Further it is believed that diaphragmatic stimulation during apnea may stimulate vagal afferent signals to the respiratory center and thus may maintain vagal tone associated with restful sleeping. Vagal tone has a calming effect on heart rate, blood pressure and cardiac output during restful sleep stages. Furthermore, diaphragmatic stimulation may prevent a fall in oxygen saturation that would typically initiate an arousal episode during apnea. Arousal episodes are associated with increases of sympathetic nerve activity which increases ventilation rate, heart rate and blood pressure. If oxygen saturation falls below a threshold, it is believed that hyperventilation will attempt to compensate for the falling oxygen saturation and also create arousal. Accordingly the invention provides a device and method for preventing apnea arousals. The invention also provides a device and method for providing greater periods of restful sleep particularly in patients suffering from ongoing bouts of apnea and resulting arousal from sleep.
- Referring to
FIG. 9 atstep 910 apnea is detected and an episode is initiated. Apnea may be detected e.g., by a lack of EMG for a given period of time. - At
step 920, stimulation is provided. If stimulation is provided during an apnea interval, (preferably at the beginning of the apnea level before SaO2 levels are depleted) stimulation is provided at a predetermined rate and tidal volume based on previous baseline determinations. In particular stimulation is provided at lower minute ventilation than normal. This is to gradually allow for more oxygenation than will occur during apnea while also allowing an increase in the PCO2 levels until the respiratory drive increases at least above the apneac threshold, and spontaneous breathing at a desired level returns. Cheyne-Stokes and apnea tend to occur in repeated cycles in heart failure patients. This is believed to occur in part due to the delay in the feedback or chemoreceptor sensing due to circulatory delay which is common in heart failure patients. The purpose of the apnea therapy described herein is to stabilize the blood gas levels more gradually and to reduce the extreme fluctuations between Cheyne-Stokes hyperventilation and apnea. - At
step 930, the stimulation rate is set and may gradually be reduced by increasing the intervals between successive breaths or stimulations. If noEMG 940 is sensed withininterval 930 or a sensed EMG does not meet the amplitude criterion and the interval length has not reached a maximum length, then the stimulation is delivered atstep 920 and thecycle 930 & 940 repeated. If an EMG is sensed 940 within the 930 interval and meets amplitude criterion then the stimulation will be inhibited atstep 950. If a defined number of successive sensedEMGs meeting step 940 criterion are not met then the interval is again set atstep 930. If a defined number of successive sensedEMGs meeting step 940 criterion are met instep 960 then the episode is over and the device returns toapnea detection mode 910. -
FIG. 10 illustrates apnea treatment as described with respect toFIG. 9 . The waveform at 1000 may be a normal intrinsic breath. At 1010 a breath with an increased amplitude may be a precursor to Cheyne-Stokes hyperventilation that may indicate the imminent onset of Cheyne-Stokes. At 1020 Cheyne-Stokes hyperventilation is at a peak amplitude. At 1030 the amplitude is decreasing indication the imminent onset of apnea. At 1040, apnea has occurred. At 1010, 1020, or 1030, a precursor to apnea may be sensed and stimulation may be provided to take over breathing in a manner similar to that described with reference toFIGS. 5-8 . The stimulation may be adjusted to increase or decrease minute ventilation to stabilize blood gas fluctuations and avoid further episodes of Cheyne-Stokes and/or apnea. Maintaining stable blood gas levels with stimulation may prevent Cheyne-Stokes hyperventilation and hence avoid arousal events otherwise associated with large swings of these gases. - If detection of apnea occurs, e.g., at point 1040, then stimulation begins at 1050. As described with respect to
FIG. 9 , stimulation is at minute ventilation that is reduced from a normal baseline. At 1060 the intervals between stimulation cycles increase. At 1070 an EMG is sensed but it is not at a desired level and the stimulation continues. At 1080 an EMG is sensed and stimulation is inhibited until an interval passes. At 1090 a set interval has passed without spontaneous breathing and stimulation then resumes. At 1095 spontaneous breathing has resumed and continues for a requisite number of cycles (until point 1099 is reached). It is then determined that the episode is over and the system returns to apnea sensing mode. - As an alternative to detecting apnea as an episode is occurring, precursors to apnea or to Cheyne-Stokes may be sensed and treated. A precursor to apnea may be detected in a number of ways, for example, by detecting Cheyne-Stokes hyperventilation or a precursor to Cheyne-Stokes hyperventilation. Also as precursor to apnea may be detected by detecting periodic breathing throughout a day prior to night time. If this is the case stimulation is delivered throughout the night, in intervals as described, with respect to
FIGS. 5-8 . In addition, the device may be set to detect actual apnea events if they occur in spite of administering breathing therapy as described with respect toFIGS. 9 and 10 herein. Detection of precursors s described in more detail in related U.S. Ser. No. 10/966,421 filed Oct. 15, 2004, now U.S. Pat. No. 8,255,056, entitled: “BREATHING DISORDER AND PRECURSOR PREDICTOR AND THERAPY DELIVERY DEVICE AND METHOD” and is incorporated herein by reference. - In accordance with another aspect of the invention, provides for treatment of hypertension. Studies have shown that patients coached to breath at about 6 breaths per minute have a reduction in blood pressure and resting oxygen saturation is improved.
-
FIGS. 11A-B illustrate an example of a hypertension breathing therapy device. According to the example, capture of breathing as described inFIGS. 5-8 may occur on a nightly basis for specific preprogrammed durations. In addition stimulation may also be provided during an exhalation cycle to further extend the length of the active breathing portion (inspiration and exhalation) of the respiration cycle. The duration of the rest period is greatly reduced so that the central respiratory drive may remain inhibited. The minute ventilation is maintained in accordance with a baseline determined as described with reference toFIG. 2 . The goal is to create long slow breathing, e.g., at about 6 cycles per minute or at another rate that provides desired therapy. -
FIGS. 11A-B illustrates an example of inducing slow controlled breathing therapy.FIG. 11A illustrates the breathing morphology whileFIG. 11B illustrates the corresponding stimulation bursts or series of pulses. During thefirst period 1100 spontaneous breathing is occurring which can be used as a baseline. During asecond period 1110, breathing is captured and the breathing rate is slowed. Duringperiod 1110, stimulation induces an inspiration cycle with a passive exhalation and a rest period as in spontaneous breathing. - Subsequently during
period 1120 stimulation ramps up to induce an inspiration cycle, as inperiod 1110, and gradually ramps down during exhalation to extend the length of the exhalation cycle. Thus, the normally passive exhalation phase is now influenced with active stimulation. The increase in the duration of the active breathing portion of the respiration cycle decreases the rest phase duration which tends to inhibit the occurrence of spontaneous breathing. Duringperiod 1120 minute ventilation is approximately equal to minute ventilation duringperiod 1110 which is achieved by increasing the tidal volume and decreasing the rate. In the period 1120 (the therapy cycle), thestimulation 1131 becomes longer in duration thanstimulation 1130, further extending the duration of the breaths and decreasing the rest phase, which inhibits spontaneous breathing and maintains a decreased respiration rate. Then thestimulation 1132 decreases in duration and stimulation is inhibited. After breathing therapy is complete, the stimulation is turned off or stimulation is gradually returned to normal breathing in a manner similar to that described in examples above. Spontaneous breathing will then resume. In accordance with this aspect of the invention preferably the breathing rate is reduced to 20 breaths per minute or less, more preferably about 10 breaths per minute or less and most preferably between about 4 and 8 breaths per minute. - The respiratory drive inhibition may also be used in treating COPD patients. COPD patients have difficulties exhaling CO2 and therefore typically retain high levels of CO2 in their blood. Low levels of inspiration with high levels of exhalation may be induced by inducing longer periods of exhalation in a manner similar to that described with respect to
FIGS. 11A-11B where the exhalation period is extended. - While the invention has been described in detail with reference to preferred embodiments thereof, it will be apparent to one skilled in the art that various changes can be made, and equivalents employed, without departing from the scope of the invention.
Claims (15)
1. A medical device for use in patients comprising:
a stimulation lead, said lead having at least one stimulation electrode placed adjacent to at least one phrenic nerve of the patient;
a control unit implanted in the body of the patient, said control unit being electrically connected said stimulation electrode;
a respiration sensor implanted in the patient, said respiration sensor being in communication with said control unit; and
a control logic incorporated within said control unit, said control logic capable of reading said respiration sensor, analyzing said respiration signal and delivering stimulation pulses to maintain activation of at least a portion of a diaphragm to said stimulation electrode at a time proximate the transition from an inhalation phase to an exhalation phase of a respiration, retaining air in at least one lung and preventing exhalation of the retained air for a period of time, and Men after the period of time has lapsed, allowing a delayed exhalation outflow of the retained air.
2. The medical device of claim 1 further characterized by said control logic being capable of analyzing breath and delivering stimulation signal at the end of natural inspiration for a duration that exceeds natural exhalation.
3. The medical device of claim 1 further comprising: at least one sensing electrode in electrical communication with said control unit, said sensing electrode being capable of sensing cardiac electrical activity and transthoracic impedance.
4. The medical device of claim 1 further comprising: an implanted motion sensor capable of sensing motion of the patient; and said control logic being capable of sensing and analyzing motion signals.
5. The medical device of claim 4 further characterized by said control logic delivering phrenic nerve stimulation based on said respiratory sensor and disabling phrenic nerve stimulation based on said motion sensor.
6. The medical device of claim 4 wherein said motion sensor is correlated with EMG information.
7. The medical device of claim 1 further characterized by said control logic being capable of rejecting respiratory signals that appear during a refractory period.
8. The medical device of claim 4 further characterized by said control logic being capable of rejecting respiratory signals indicative of cough, arousal and movement.
9. The medical device of claim 1 further characterized by said lead having a plurality of stimulation electrodes.
10. The medical device of claim 1 further comprising a flow sensor in communication with the control unit.
11. The medical device of claim 1 further comprising an EMG sensor in communication with the control unit.
12. The medical device of claim 1 further characterized by said lead having at least one anchoring mechanism.
13. The medical device of claim 1 further comprising an external communications device in communication with the control unit.
14. The medical device of claim 1 further characterized by the shape of said stimulation pulses being selected from the group consisting of consistent amplitudes, progressively increasing amplitudes, progressively decreasing amplitudes, and a combination of progressively increasing amplitudes following by consistent amplitude followed by progressively decreasing amplitude.
15.-31. (canceled)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/851,003 US20130296973A1 (en) | 2003-10-15 | 2013-03-26 | Breathing therapy device and method |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/686,891 US8467876B2 (en) | 2003-10-15 | 2003-10-15 | Breathing disorder detection and therapy delivery device and method |
US10/966,474 US8412331B2 (en) | 2003-10-15 | 2004-10-15 | Breathing therapy device and method |
US13/851,003 US20130296973A1 (en) | 2003-10-15 | 2013-03-26 | Breathing therapy device and method |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/966,474 Continuation US8412331B2 (en) | 2003-10-15 | 2004-10-15 | Breathing therapy device and method |
Publications (1)
Publication Number | Publication Date |
---|---|
US20130296973A1 true US20130296973A1 (en) | 2013-11-07 |
Family
ID=34465515
Family Applications (15)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/686,891 Active 2026-09-30 US8467876B2 (en) | 2003-10-15 | 2003-10-15 | Breathing disorder detection and therapy delivery device and method |
US10/966,474 Active 2025-11-29 US8412331B2 (en) | 2003-10-15 | 2004-10-15 | Breathing therapy device and method |
US10/966,472 Active 2026-12-07 US8200336B2 (en) | 2003-10-15 | 2004-10-15 | System and method for diaphragm stimulation |
US10/966,484 Abandoned US20050085869A1 (en) | 2003-10-15 | 2004-10-15 | System and method for mapping diaphragm electrode sites |
US10/966,421 Active 2026-02-19 US8255056B2 (en) | 2003-10-15 | 2004-10-15 | Breathing disorder and precursor predictor and therapy delivery device and method |
US10/966,487 Abandoned US20050085734A1 (en) | 2003-10-15 | 2004-10-15 | Heart failure patient treatment and management device |
US11/246,439 Abandoned US20060030894A1 (en) | 2003-10-15 | 2005-10-11 | Breathing disorder detection and therapy device for providing intrinsic breathing |
US11/249,718 Active 2024-09-20 US8348941B2 (en) | 2003-10-15 | 2005-10-13 | Demand-based system for treating breathing disorders |
US11/526,949 Expired - Fee Related US8509901B2 (en) | 2003-10-15 | 2006-09-25 | Device and method for adding to breathing |
US11/981,800 Active 2024-12-08 US8116872B2 (en) | 2003-10-15 | 2007-10-31 | Device and method for biasing and stimulating respiration |
US11/981,727 Abandoned US20080183239A1 (en) | 2003-10-15 | 2007-10-31 | Breathing therapy device and method |
US11/981,831 Abandoned US20080183240A1 (en) | 2003-10-15 | 2007-10-31 | Device and method for manipulating minute ventilation |
US12/080,133 Abandoned US20080188903A1 (en) | 2003-10-15 | 2008-04-01 | Device and method for biasing and stimulating respiration |
US13/851,003 Abandoned US20130296973A1 (en) | 2003-10-15 | 2013-03-26 | Breathing therapy device and method |
US13/915,316 Abandoned US20130296964A1 (en) | 2003-10-15 | 2013-06-11 | Breathing disorder detection and therapy delivery device and method |
Family Applications Before (13)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/686,891 Active 2026-09-30 US8467876B2 (en) | 2003-10-15 | 2003-10-15 | Breathing disorder detection and therapy delivery device and method |
US10/966,474 Active 2025-11-29 US8412331B2 (en) | 2003-10-15 | 2004-10-15 | Breathing therapy device and method |
US10/966,472 Active 2026-12-07 US8200336B2 (en) | 2003-10-15 | 2004-10-15 | System and method for diaphragm stimulation |
US10/966,484 Abandoned US20050085869A1 (en) | 2003-10-15 | 2004-10-15 | System and method for mapping diaphragm electrode sites |
US10/966,421 Active 2026-02-19 US8255056B2 (en) | 2003-10-15 | 2004-10-15 | Breathing disorder and precursor predictor and therapy delivery device and method |
US10/966,487 Abandoned US20050085734A1 (en) | 2003-10-15 | 2004-10-15 | Heart failure patient treatment and management device |
US11/246,439 Abandoned US20060030894A1 (en) | 2003-10-15 | 2005-10-11 | Breathing disorder detection and therapy device for providing intrinsic breathing |
US11/249,718 Active 2024-09-20 US8348941B2 (en) | 2003-10-15 | 2005-10-13 | Demand-based system for treating breathing disorders |
US11/526,949 Expired - Fee Related US8509901B2 (en) | 2003-10-15 | 2006-09-25 | Device and method for adding to breathing |
US11/981,800 Active 2024-12-08 US8116872B2 (en) | 2003-10-15 | 2007-10-31 | Device and method for biasing and stimulating respiration |
US11/981,727 Abandoned US20080183239A1 (en) | 2003-10-15 | 2007-10-31 | Breathing therapy device and method |
US11/981,831 Abandoned US20080183240A1 (en) | 2003-10-15 | 2007-10-31 | Device and method for manipulating minute ventilation |
US12/080,133 Abandoned US20080188903A1 (en) | 2003-10-15 | 2008-04-01 | Device and method for biasing and stimulating respiration |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/915,316 Abandoned US20130296964A1 (en) | 2003-10-15 | 2013-06-11 | Breathing disorder detection and therapy delivery device and method |
Country Status (3)
Country | Link |
---|---|
US (15) | US8467876B2 (en) |
DE (3) | DE112004001953T5 (en) |
WO (6) | WO2005037172A2 (en) |
Cited By (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9545511B2 (en) | 2013-11-22 | 2017-01-17 | Simon Fraser University | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US9566436B2 (en) | 2007-01-29 | 2017-02-14 | Simon Fraser University | Transvascular nerve stimulation apparatus and methods |
US9597509B2 (en) | 2014-01-21 | 2017-03-21 | Simon Fraser University | Systems and related methods for optimization of multi-electrode nerve pacing |
US9776005B2 (en) | 2012-06-21 | 2017-10-03 | Lungpacer Medical Inc. | Transvascular diaphragm pacing systems and methods of use |
US10039920B1 (en) | 2017-08-02 | 2018-08-07 | Lungpacer Medical, Inc. | Systems and methods for intravascular catheter positioning and/or nerve stimulation |
US10293164B2 (en) | 2017-05-26 | 2019-05-21 | Lungpacer Medical Inc. | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US10512772B2 (en) | 2012-03-05 | 2019-12-24 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US10857363B2 (en) | 2014-08-26 | 2020-12-08 | Rmx, Llc | Devices and methods for reducing intrathoracic pressure |
US10940308B2 (en) | 2017-08-04 | 2021-03-09 | Lungpacer Medical Inc. | Systems and methods for trans-esophageal sympathetic ganglion recruitment |
WO2021061793A1 (en) * | 2019-09-26 | 2021-04-01 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US10987511B2 (en) | 2018-11-08 | 2021-04-27 | Lungpacer Medical Inc. | Stimulation systems and related user interfaces |
US11266838B1 (en) | 2019-06-21 | 2022-03-08 | Rmx, Llc | Airway diagnostics utilizing phrenic nerve stimulation device and method |
US11357979B2 (en) | 2019-05-16 | 2022-06-14 | Lungpacer Medical Inc. | Systems and methods for sensing and stimulation |
US11400286B2 (en) | 2016-04-29 | 2022-08-02 | Viscardia, Inc. | Implantable medical devices, systems, and methods for selection of optimal diaphragmatic stimulation parameters to affect pressures within the intrathoracic cavity |
US11666757B2 (en) | 2012-12-19 | 2023-06-06 | Viscardia, Inc. | Systems, devices, and methods for improving hemodynamic performance through asymptomatic diaphragm stimulation |
US11684783B2 (en) | 2012-12-19 | 2023-06-27 | Viscardia, Inc. | Hemodynamic performance enhancement through asymptomatic diaphragm stimulation |
US11771900B2 (en) | 2019-06-12 | 2023-10-03 | Lungpacer Medical Inc. | Circuitry for medical stimulation systems |
US11883658B2 (en) | 2017-06-30 | 2024-01-30 | Lungpacer Medical Inc. | Devices and methods for prevention, moderation, and/or treatment of cognitive injury |
US11957914B2 (en) | 2020-03-27 | 2024-04-16 | Viscardia, Inc. | Implantable medical systems, devices and methods for delivering asymptomatic diaphragmatic stimulation |
Families Citing this family (288)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9468378B2 (en) | 1997-01-27 | 2016-10-18 | Lawrence A. Lynn | Airway instability detection system and method |
US9042952B2 (en) | 1997-01-27 | 2015-05-26 | Lawrence A. Lynn | System and method for automatic detection of a plurality of SPO2 time series pattern types |
US8932227B2 (en) | 2000-07-28 | 2015-01-13 | Lawrence A. Lynn | System and method for CO2 and oximetry integration |
US5881723A (en) | 1997-03-14 | 1999-03-16 | Nellcor Puritan Bennett Incorporated | Ventilator breath display and graphic user interface |
US9521971B2 (en) | 1997-07-14 | 2016-12-20 | Lawrence A. Lynn | System and method for automatic detection of a plurality of SPO2 time series pattern types |
US9053222B2 (en) | 2002-05-17 | 2015-06-09 | Lawrence A. Lynn | Patient safety processor |
US20060195041A1 (en) | 2002-05-17 | 2006-08-31 | Lynn Lawrence A | Centralized hospital monitoring system for automatically detecting upper airway instability and for preventing and aborting adverse drug reactions |
US7206635B2 (en) * | 2001-06-07 | 2007-04-17 | Medtronic, Inc. | Method and apparatus for modifying delivery of a therapy in response to onset of sleep |
US20080077192A1 (en) * | 2002-05-03 | 2008-03-27 | Afferent Corporation | System and method for neuro-stimulation |
DE10248590B4 (en) * | 2002-10-17 | 2016-10-27 | Resmed R&D Germany Gmbh | Method and device for carrying out a signal-processing observation of a measurement signal associated with the respiratory activity of a person |
US7477932B2 (en) | 2003-05-28 | 2009-01-13 | Cardiac Pacemakers, Inc. | Cardiac waveform template creation, maintenance and use |
WO2005009291A2 (en) | 2003-07-23 | 2005-02-03 | Synapse Biomedical, Inc. | System and method for conditioning a diaphragm of a patient |
US7887493B2 (en) | 2003-09-18 | 2011-02-15 | Cardiac Pacemakers, Inc. | Implantable device employing movement sensing for detecting sleep-related disorders |
US7575553B2 (en) * | 2003-09-18 | 2009-08-18 | Cardiac Pacemakers, Inc. | Methods and systems for assessing pulmonary disease |
US7396333B2 (en) | 2003-08-18 | 2008-07-08 | Cardiac Pacemakers, Inc. | Prediction of disordered breathing |
US20050107838A1 (en) * | 2003-09-18 | 2005-05-19 | Lovett Eric G. | Subcutaneous cardiac rhythm management with disordered breathing detection and treatment |
US8002553B2 (en) | 2003-08-18 | 2011-08-23 | Cardiac Pacemakers, Inc. | Sleep quality data collection and evaluation |
US7662101B2 (en) * | 2003-09-18 | 2010-02-16 | Cardiac Pacemakers, Inc. | Therapy control based on cardiopulmonary status |
EP2008581B1 (en) | 2003-08-18 | 2011-08-17 | Cardiac Pacemakers, Inc. | Patient monitoring, diagnosis, and/or therapy systems and methods |
US7510531B2 (en) * | 2003-09-18 | 2009-03-31 | Cardiac Pacemakers, Inc. | System and method for discrimination of central and obstructive disordered breathing events |
US9259573B2 (en) * | 2003-10-15 | 2016-02-16 | Rmx, Llc | Device and method for manipulating exhalation |
US7979128B2 (en) * | 2003-10-15 | 2011-07-12 | Rmx, Llc | Device and method for gradually controlling breathing |
US7970475B2 (en) | 2003-10-15 | 2011-06-28 | Rmx, Llc | Device and method for biasing lung volume |
US8140164B2 (en) * | 2003-10-15 | 2012-03-20 | Rmx, Llc | Therapeutic diaphragm stimulation device and method |
US8160711B2 (en) | 2003-10-15 | 2012-04-17 | Rmx, Llc | Multimode device and method for controlling breathing |
US8467876B2 (en) * | 2003-10-15 | 2013-06-18 | Rmx, Llc | Breathing disorder detection and therapy delivery device and method |
US8265759B2 (en) * | 2003-10-15 | 2012-09-11 | Rmx, Llc | Device and method for treating disorders of the cardiovascular system or heart |
US8244358B2 (en) | 2003-10-15 | 2012-08-14 | Rmx, Llc | Device and method for treating obstructive sleep apnea |
US20080161878A1 (en) * | 2003-10-15 | 2008-07-03 | Tehrani Amir J | Device and method to for independently stimulating hemidiaphragms |
US20060167523A1 (en) * | 2003-10-15 | 2006-07-27 | Tehrani Amir J | Device and method for improving upper airway functionality |
US20050085874A1 (en) * | 2003-10-17 | 2005-04-21 | Ross Davis | Method and system for treating sleep apnea |
US20060247693A1 (en) | 2005-04-28 | 2006-11-02 | Yanting Dong | Non-captured intrinsic discrimination in cardiac pacing response classification |
US7319900B2 (en) * | 2003-12-11 | 2008-01-15 | Cardiac Pacemakers, Inc. | Cardiac response classification using multiple classification windows |
US8521284B2 (en) | 2003-12-12 | 2013-08-27 | Cardiac Pacemakers, Inc. | Cardiac response classification using multisite sensing and pacing |
US7774064B2 (en) | 2003-12-12 | 2010-08-10 | Cardiac Pacemakers, Inc. | Cardiac response classification using retriggerable classification windows |
US7421296B1 (en) * | 2004-01-26 | 2008-09-02 | Pacesetter, Inc. | Termination of respiratory oscillations characteristic of Cheyne-Stokes respiration |
US7363085B1 (en) * | 2004-01-26 | 2008-04-22 | Pacesetters, Inc. | Augmenting hypoventilation |
US8942779B2 (en) | 2004-02-05 | 2015-01-27 | Early Sense Ltd. | Monitoring a condition of a subject |
US20070118054A1 (en) * | 2005-11-01 | 2007-05-24 | Earlysense Ltd. | Methods and systems for monitoring patients for clinical episodes |
US7314451B2 (en) * | 2005-04-25 | 2008-01-01 | Earlysense Ltd. | Techniques for prediction and monitoring of clinical episodes |
US7077810B2 (en) | 2004-02-05 | 2006-07-18 | Earlysense Ltd. | Techniques for prediction and monitoring of respiration-manifested clinical episodes |
US8403865B2 (en) | 2004-02-05 | 2013-03-26 | Earlysense Ltd. | Prediction and monitoring of clinical episodes |
US8491492B2 (en) | 2004-02-05 | 2013-07-23 | Earlysense Ltd. | Monitoring a condition of a subject |
US20050197588A1 (en) * | 2004-03-04 | 2005-09-08 | Scott Freeberg | Sleep disordered breathing alert system |
US7751894B1 (en) * | 2004-03-04 | 2010-07-06 | Cardiac Pacemakers, Inc. | Systems and methods for indicating aberrant behavior detected by an implanted medical device |
US7371220B1 (en) * | 2004-06-30 | 2008-05-13 | Pacesetter, Inc. | System and method for real-time apnea/hypopnea detection using an implantable medical system |
US7269458B2 (en) * | 2004-08-09 | 2007-09-11 | Cardiac Pacemakers, Inc. | Cardiopulmonary functional status assessment via heart rate response detection by implantable cardiac device |
US7389143B2 (en) | 2004-08-12 | 2008-06-17 | Cardiac Pacemakers, Inc. | Cardiopulmonary functional status assessment via metabolic response detection by implantable cardiac device |
JP2006136511A (en) * | 2004-11-12 | 2006-06-01 | Matsushita Electric Ind Co Ltd | Drum type washing/drying machine |
US8473058B2 (en) * | 2004-11-22 | 2013-06-25 | Mitsuru Sasaki | Apnea preventing stimulation apparatus |
KR101133807B1 (en) * | 2004-11-22 | 2012-04-05 | 테크노 링크 컴파니 리미티드 | Simulator for preventing apnea |
US20060122661A1 (en) * | 2004-12-03 | 2006-06-08 | Mandell Lee J | Diaphragmatic pacing with activity monitor adjustment |
US7966072B2 (en) * | 2005-02-18 | 2011-06-21 | Palo Alto Investors | Methods and compositions for treating obesity-hypoventilation syndrome |
US7680534B2 (en) | 2005-02-28 | 2010-03-16 | Cardiac Pacemakers, Inc. | Implantable cardiac device with dyspnea measurement |
US7704211B1 (en) * | 2005-03-21 | 2010-04-27 | Pacesetter, Inc. | Method and apparatus for assessing fluid level in lungs |
US7404799B1 (en) * | 2005-04-05 | 2008-07-29 | Pacesetter, Inc. | System and method for detection of respiration patterns via integration of intracardiac electrogram signals |
US7630763B2 (en) * | 2005-04-20 | 2009-12-08 | Cardiac Pacemakers, Inc. | Thoracic or intracardiac impedance detection with automatic vector selection |
US7392086B2 (en) | 2005-04-26 | 2008-06-24 | Cardiac Pacemakers, Inc. | Implantable cardiac device and method for reduced phrenic nerve stimulation |
US7499751B2 (en) * | 2005-04-28 | 2009-03-03 | Cardiac Pacemakers, Inc. | Cardiac signal template generation using waveform clustering |
US8900154B2 (en) * | 2005-05-24 | 2014-12-02 | Cardiac Pacemakers, Inc. | Prediction of thoracic fluid accumulation |
US20060271121A1 (en) | 2005-05-25 | 2006-11-30 | Cardiac Pacemakers, Inc. | Closed loop impedance-based cardiac resynchronization therapy systems, devices, and methods |
US7644714B2 (en) | 2005-05-27 | 2010-01-12 | Apnex Medical, Inc. | Devices and methods for treating sleep disorders |
US8364455B2 (en) * | 2005-06-09 | 2013-01-29 | Maquet Critical Care Ab | Simulator for use with a breathing-assist device |
US8036750B2 (en) * | 2005-06-13 | 2011-10-11 | Cardiac Pacemakers, Inc. | System for neural control of respiration |
US20070021678A1 (en) * | 2005-07-19 | 2007-01-25 | Cardiac Pacemakers, Inc. | Methods and apparatus for monitoring physiological responses to steady state activity |
US8494618B2 (en) * | 2005-08-22 | 2013-07-23 | Cardiac Pacemakers, Inc. | Intracardiac impedance and its applications |
US9839781B2 (en) | 2005-08-22 | 2017-12-12 | Cardiac Pacemakers, Inc. | Intracardiac impedance and its applications |
US20070044669A1 (en) * | 2005-08-24 | 2007-03-01 | Geise Gregory D | Aluminum can compacting mechanism with improved actuation handle assembly |
US9050005B2 (en) * | 2005-08-25 | 2015-06-09 | Synapse Biomedical, Inc. | Method and apparatus for transgastric neurostimulation |
US7731663B2 (en) * | 2005-09-16 | 2010-06-08 | Cardiac Pacemakers, Inc. | System and method for generating a trend parameter based on respiration rate distribution |
US7974691B2 (en) | 2005-09-21 | 2011-07-05 | Cardiac Pacemakers, Inc. | Method and apparatus for controlling cardiac resynchronization therapy using cardiac impedance |
WO2007051258A1 (en) * | 2005-11-04 | 2007-05-10 | Resmed Ltd | Blood protein markers in methods and apparatuses to aid diagnosis and management of sleep disordered breathing |
US10406366B2 (en) | 2006-11-17 | 2019-09-10 | Respicardia, Inc. | Transvenous phrenic nerve stimulation system |
JP2009515670A (en) * | 2005-11-18 | 2009-04-16 | カーディアック コンセプツ | Apparatus and method for stimulating the phrenic nerve to prevent sleep apnea |
US7766840B2 (en) * | 2005-12-01 | 2010-08-03 | Cardiac Pacemakers, Inc. | Method and system for heart failure status evaluation based on a disordered breathing index |
WO2007064916A2 (en) * | 2005-12-01 | 2007-06-07 | Second Sight Medical Products, Inc. | Fitting a neural prosthesis using impedance and electrode height |
CA2631915A1 (en) * | 2005-12-02 | 2007-06-07 | Synapse Biomedical, Inc. | Transvisceral neurostimulation mapping device and method |
US8281792B2 (en) * | 2005-12-31 | 2012-10-09 | John W Royalty | Electromagnetic diaphragm assist device and method for assisting a diaphragm function |
EP1996284A2 (en) * | 2006-03-09 | 2008-12-03 | Synapse Biomedical, Inc. | Ventilatory assist system and method to improve respiratory function |
CA2653110C (en) * | 2006-03-29 | 2018-07-31 | Catholic Healthcare West | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US8021310B2 (en) * | 2006-04-21 | 2011-09-20 | Nellcor Puritan Bennett Llc | Work of breathing display for a ventilation system |
ES2402426T3 (en) * | 2006-05-23 | 2013-05-03 | Publiekrechtelijke Rechtspersoon Academisch Ziekenhuis Leiden H.O.D.N. Leids Universitair Medisch | Medical probe |
KR100845464B1 (en) * | 2006-06-14 | 2008-07-10 | (주)머티리얼솔루션테크놀로지 | Implantable diaphragm stimulator and breathing pacemaker using the same |
US8226570B2 (en) | 2006-08-08 | 2012-07-24 | Cardiac Pacemakers, Inc. | Respiration monitoring for heart failure using implantable device |
US20080071185A1 (en) * | 2006-08-08 | 2008-03-20 | Cardiac Pacemakers, Inc. | Periodic breathing during activity |
US8103341B2 (en) | 2006-08-25 | 2012-01-24 | Cardiac Pacemakers, Inc. | System for abating neural stimulation side effects |
US8050765B2 (en) | 2006-08-30 | 2011-11-01 | Cardiac Pacemakers, Inc. | Method and apparatus for controlling neural stimulation during disordered breathing |
US8121692B2 (en) * | 2006-08-30 | 2012-02-21 | Cardiac Pacemakers, Inc. | Method and apparatus for neural stimulation with respiratory feedback |
ATE479398T1 (en) * | 2006-09-11 | 2010-09-15 | Koninkl Philips Electronics Nv | SYSTEM AND METHOD FOR POSITIONING ELECTRODES ON A PATIENT'S BODY |
US8209013B2 (en) | 2006-09-14 | 2012-06-26 | Cardiac Pacemakers, Inc. | Therapeutic electrical stimulation that avoids undesirable activation |
US7784461B2 (en) | 2006-09-26 | 2010-08-31 | Nellcor Puritan Bennett Llc | Three-dimensional waveform display for a breathing assistance system |
US20080072902A1 (en) * | 2006-09-27 | 2008-03-27 | Nellcor Puritan Bennett Incorporated | Preset breath delivery therapies for a breathing assistance system |
US9913982B2 (en) | 2011-01-28 | 2018-03-13 | Cyberonics, Inc. | Obstructive sleep apnea treatment devices, systems and methods |
US9186511B2 (en) | 2006-10-13 | 2015-11-17 | Cyberonics, Inc. | Obstructive sleep apnea treatment devices, systems and methods |
US8855771B2 (en) | 2011-01-28 | 2014-10-07 | Cyberonics, Inc. | Screening devices and methods for obstructive sleep apnea therapy |
US9205262B2 (en) | 2011-05-12 | 2015-12-08 | Cyberonics, Inc. | Devices and methods for sleep apnea treatment |
US7809442B2 (en) | 2006-10-13 | 2010-10-05 | Apnex Medical, Inc. | Obstructive sleep apnea treatment devices, systems and methods |
US9744354B2 (en) | 2008-12-31 | 2017-08-29 | Cyberonics, Inc. | Obstructive sleep apnea treatment devices, systems and methods |
US20080109047A1 (en) * | 2006-10-26 | 2008-05-08 | Pless Benjamin D | Apnea treatment device |
US7917194B1 (en) * | 2006-11-15 | 2011-03-29 | Pacesetter, Inc. | Method and apparatus for detecting pulmonary edema |
US8280513B2 (en) * | 2006-12-22 | 2012-10-02 | Rmx, Llc | Device and method to treat flow limitations |
US9968266B2 (en) | 2006-12-27 | 2018-05-15 | Cardiac Pacemakers, Inc. | Risk stratification based heart failure detection algorithm |
US8909341B2 (en) * | 2007-01-22 | 2014-12-09 | Respicardia, Inc. | Device and method for the treatment of breathing disorders and cardiac disorders |
WO2008095075A1 (en) * | 2007-02-01 | 2008-08-07 | Ls Biopath, Inc. | Optical system for identification and characterization of abnormal tissue and cells |
EP2165187B1 (en) * | 2007-02-01 | 2018-05-16 | LS Biopath, Inc. | Apparatus and method for detection and characterization of abnormal tissue and cells |
US9079016B2 (en) * | 2007-02-05 | 2015-07-14 | Synapse Biomedical, Inc. | Removable intramuscular electrode |
US8417351B2 (en) * | 2007-02-09 | 2013-04-09 | Mayo Foundation For Medical Education And Research | Peripheral oxistimulator apparatus and methods |
US20080228093A1 (en) * | 2007-03-13 | 2008-09-18 | Yanting Dong | Systems and methods for enhancing cardiac signal features used in morphology discrimination |
US20080234556A1 (en) * | 2007-03-20 | 2008-09-25 | Cardiac Pacemakers, Inc. | Method and apparatus for sensing respiratory activities using sensor in lymphatic system |
US20080243016A1 (en) * | 2007-03-28 | 2008-10-02 | Cardiac Pacemakers, Inc. | Pulmonary Artery Pressure Signals And Methods of Using |
US7950560B2 (en) * | 2007-04-13 | 2011-05-31 | Tyco Healthcare Group Lp | Powered surgical instrument |
US11259801B2 (en) * | 2007-04-13 | 2022-03-01 | Covidien Lp | Powered surgical instrument |
US8585607B2 (en) | 2007-05-02 | 2013-11-19 | Earlysense Ltd. | Monitoring, predicting and treating clinical episodes |
WO2008144578A1 (en) * | 2007-05-17 | 2008-11-27 | Synapse Biomedical, Inc. | Devices and methods for assessing motor point electromyogram as a biomarker |
WO2008147253A1 (en) * | 2007-05-28 | 2008-12-04 | St. Jude Medical Ab | Implantable medical device for monitoring lung deficiency |
US8983609B2 (en) | 2007-05-30 | 2015-03-17 | The Cleveland Clinic Foundation | Apparatus and method for treating pulmonary conditions |
US9987488B1 (en) | 2007-06-27 | 2018-06-05 | Respicardia, Inc. | Detecting and treating disordered breathing |
US20090024176A1 (en) * | 2007-07-17 | 2009-01-22 | Joonkyoo Anthony Yun | Methods and devices for producing respiratory sinus arrhythmia |
US20090024047A1 (en) * | 2007-07-20 | 2009-01-22 | Cardiac Pacemakers, Inc. | Devices and methods for respiration therapy |
US8265736B2 (en) | 2007-08-07 | 2012-09-11 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
US9037239B2 (en) | 2007-08-07 | 2015-05-19 | Cardiac Pacemakers, Inc. | Method and apparatus to perform electrode combination selection |
CN102727975B (en) * | 2007-08-22 | 2016-03-30 | 纽约州立大学研究基金会 | Breathing gas supply and shared system and method thereof |
US8135471B2 (en) * | 2007-08-28 | 2012-03-13 | Cardiac Pacemakers, Inc. | Method and apparatus for inspiratory muscle stimulation using implantable device |
US8460189B2 (en) | 2007-09-14 | 2013-06-11 | Corventis, Inc. | Adherent cardiac monitor with advanced sensing capabilities |
EP2200499B1 (en) | 2007-09-14 | 2019-05-01 | Medtronic Monitoring, Inc. | Multi-sensor patient monitor to detect impending cardiac decompensation |
WO2009036256A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Injectable physiological monitoring system |
EP2194847A1 (en) | 2007-09-14 | 2010-06-16 | Corventis, Inc. | Adherent device with multiple physiological sensors |
WO2009036348A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Medical device automatic start-up upon contact to patient tissue |
WO2009036333A1 (en) | 2007-09-14 | 2009-03-19 | Corventis, Inc. | Dynamic pairing of patients to data collection gateways |
US8249686B2 (en) | 2007-09-14 | 2012-08-21 | Corventis, Inc. | Adherent device for sleep disordered breathing |
WO2009048610A1 (en) | 2007-10-10 | 2009-04-16 | Cardiac Pacemakers, Inc. | Respiratory stimulation for treating periodic breathing |
AU2008310577A1 (en) | 2007-10-12 | 2009-04-16 | Patientslikeme, Inc. | Self-improving method of using online communities to predict health-related outcomes |
US8428726B2 (en) | 2007-10-30 | 2013-04-23 | Synapse Biomedical, Inc. | Device and method of neuromodulation to effect a functionally restorative adaption of the neuromuscular system |
WO2009059033A1 (en) * | 2007-10-30 | 2009-05-07 | Synapse Biomedical, Inc. | Method of improving sleep disordered breathing |
US20170188940A9 (en) | 2007-11-26 | 2017-07-06 | Whispersom Corporation | Device to detect and treat Apneas and Hypopnea |
US8155744B2 (en) | 2007-12-13 | 2012-04-10 | The Cleveland Clinic Foundation | Neuromodulatory methods for treating pulmonary disorders |
US8346349B2 (en) | 2008-01-16 | 2013-01-01 | Massachusetts Institute Of Technology | Method and apparatus for predicting patient outcomes from a physiological segmentable patient signal |
US9199075B1 (en) | 2008-02-07 | 2015-12-01 | Respicardia, Inc. | Transvascular medical lead |
JP5276119B2 (en) | 2008-02-14 | 2013-08-28 | カーディアック ペースメイカーズ, インコーポレイテッド | Method and apparatus for detection of phrenic stimulation |
EP2257216B1 (en) * | 2008-03-12 | 2021-04-28 | Medtronic Monitoring, Inc. | Heart failure decompensation prediction based on cardiac rhythm |
WO2009118737A2 (en) * | 2008-03-27 | 2009-10-01 | Widemed Ltd. | Diagnosis of periodic breathing |
WO2009146214A1 (en) | 2008-04-18 | 2009-12-03 | Corventis, Inc. | Method and apparatus to measure bioelectric impedance of patient tissue |
US9883809B2 (en) | 2008-05-01 | 2018-02-06 | Earlysense Ltd. | Monitoring, predicting and treating clinical episodes |
US8882684B2 (en) | 2008-05-12 | 2014-11-11 | Earlysense Ltd. | Monitoring, predicting and treating clinical episodes |
JP5474937B2 (en) | 2008-05-07 | 2014-04-16 | ローレンス エー. リン, | Medical disorder pattern search engine |
EP2286395A4 (en) | 2008-05-12 | 2013-05-08 | Earlysense Ltd | Monitoring, predicting and treating clinical episodes |
CA2724335A1 (en) * | 2008-05-15 | 2009-11-19 | Inspire Medical Systems, Inc. | Method and apparatus for sensing respiratory pressure in an implantable stimulation system |
US8229566B2 (en) * | 2008-06-25 | 2012-07-24 | Sheng Li | Method and apparatus of breathing-controlled electrical stimulation for skeletal muscles |
US8340746B2 (en) * | 2008-07-17 | 2012-12-25 | Massachusetts Institute Of Technology | Motif discovery in physiological datasets: a methodology for inferring predictive elements |
US8202223B2 (en) * | 2008-09-19 | 2012-06-19 | Medtronic, Inc. | Method and apparatus for determining respiratory effort in a medical device |
US8302602B2 (en) | 2008-09-30 | 2012-11-06 | Nellcor Puritan Bennett Llc | Breathing assistance system with multiple pressure sensors |
EP2331201B1 (en) | 2008-10-01 | 2020-04-29 | Inspire Medical Systems, Inc. | System for treating sleep apnea transvenously |
US20100087893A1 (en) * | 2008-10-03 | 2010-04-08 | Solange Pasquet | Operant Conditioning-Based Device for Snoring and Obstructive Sleep Apnea and Method of Use |
US8644939B2 (en) * | 2008-11-18 | 2014-02-04 | Neurostream Technologies General Partnership | Method and device for the detection, identification and treatment of sleep apnea/hypopnea |
JP5575789B2 (en) * | 2008-11-19 | 2014-08-20 | インスパイア・メディカル・システムズ・インコーポレイテッド | How to treat sleep-disordered breathing |
US8823490B2 (en) | 2008-12-15 | 2014-09-02 | Corventis, Inc. | Patient monitoring systems and methods |
EP2198779B1 (en) * | 2008-12-22 | 2018-09-19 | Sendsor GmbH | Device and method for early detection of exacerbations |
US20100204567A1 (en) * | 2009-02-09 | 2010-08-12 | The Cleveland Clinic Foundation | Ultrasound-guided delivery of a therapy delivery device to a phrenic nerve |
US8870773B2 (en) * | 2009-02-09 | 2014-10-28 | The Cleveland Clinic Foundation | Ultrasound-guided delivery of a therapy delivery device to a nerve target |
EP2416845B1 (en) | 2009-03-31 | 2015-03-18 | Inspire Medical Systems, Inc. | Percutaneous access for systems of treating sleep-related disordered breathing |
WO2010126577A1 (en) | 2009-04-30 | 2010-11-04 | Patientslikeme, Inc. | Systems and methods for encouragement of data submission in online communities |
US8378832B2 (en) * | 2009-07-09 | 2013-02-19 | Harry J. Cassidy | Breathing disorder treatment system and method |
CN102481453B (en) | 2009-07-15 | 2014-10-08 | 心脏起搏器股份公司 | Physiologicl vibration detection in an implanted medical device |
EP2454697B1 (en) | 2009-07-15 | 2019-05-01 | Cardiac Pacemakers, Inc. | Remote pace detection in an implantable medical device |
US8285373B2 (en) | 2009-07-15 | 2012-10-09 | Cardiac Pacemakers, Inc. | Remote sensing in an implantable medical device |
WO2011023961A1 (en) * | 2009-08-28 | 2011-03-03 | Naylor, Matthew J. | Relational thermorespirometer spot vitals monitor |
US9072899B1 (en) * | 2009-09-04 | 2015-07-07 | Todd Nickloes | Diaphragm pacemaker |
US8233987B2 (en) | 2009-09-10 | 2012-07-31 | Respicardia, Inc. | Respiratory rectification |
CA2775466C (en) * | 2009-09-14 | 2018-03-27 | Sleep Methods, Inc. | System and method for training and promoting a conditioned reflex intervention during sleep |
US8790259B2 (en) | 2009-10-22 | 2014-07-29 | Corventis, Inc. | Method and apparatus for remote detection and monitoring of functional chronotropic incompetence |
US9675268B2 (en) * | 2009-11-05 | 2017-06-13 | Inovise Medical, Inc. | Detection and differentiation of sleep disordered breathing |
USD649157S1 (en) | 2009-12-04 | 2011-11-22 | Nellcor Puritan Bennett Llc | Ventilator display screen with a user interface |
USD638852S1 (en) | 2009-12-04 | 2011-05-31 | Nellcor Puritan Bennett Llc | Ventilator display screen with an alarm icon |
US8924878B2 (en) | 2009-12-04 | 2014-12-30 | Covidien Lp | Display and access to settings on a ventilator graphical user interface |
US9119925B2 (en) | 2009-12-04 | 2015-09-01 | Covidien Lp | Quick initiation of respiratory support via a ventilator user interface |
US8335992B2 (en) | 2009-12-04 | 2012-12-18 | Nellcor Puritan Bennett Llc | Visual indication of settings changes on a ventilator graphical user interface |
US9451897B2 (en) | 2009-12-14 | 2016-09-27 | Medtronic Monitoring, Inc. | Body adherent patch with electronics for physiologic monitoring |
US8499252B2 (en) | 2009-12-18 | 2013-07-30 | Covidien Lp | Display of respiratory data graphs on a ventilator graphical user interface |
US9262588B2 (en) | 2009-12-18 | 2016-02-16 | Covidien Lp | Display of respiratory data graphs on a ventilator graphical user interface |
JP2011213096A (en) * | 2010-03-19 | 2011-10-27 | Makita Corp | Power tool |
US8965498B2 (en) | 2010-04-05 | 2015-02-24 | Corventis, Inc. | Method and apparatus for personalized physiologic parameters |
US11723542B2 (en) * | 2010-08-13 | 2023-08-15 | Respiratory Motion, Inc. | Advanced respiratory monitor and system |
US8983572B2 (en) | 2010-10-29 | 2015-03-17 | Inspire Medical Systems, Inc. | System and method for patient selection in treating sleep disordered breathing |
US8585604B2 (en) | 2010-10-29 | 2013-11-19 | Medtronic, Inc. | Integrated patient care |
KR20120046554A (en) * | 2010-11-02 | 2012-05-10 | 연세대학교 산학협력단 | Sensor for detecting cancer tissue and manufacturing method of the same |
US9457186B2 (en) | 2010-11-15 | 2016-10-04 | Bluewind Medical Ltd. | Bilateral feedback |
US9186504B2 (en) | 2010-11-15 | 2015-11-17 | Rainbow Medical Ltd | Sleep apnea treatment |
WO2012069957A1 (en) * | 2010-11-23 | 2012-05-31 | Koninklijke Philips Electronics N.V. | Obesity hypoventilation syndrome treatment system and method |
US10292625B2 (en) | 2010-12-07 | 2019-05-21 | Earlysense Ltd. | Monitoring a sleeping subject |
US20120157799A1 (en) * | 2010-12-20 | 2012-06-21 | Abhilash Patangay | Using device based sensors to classify events and generate alerts |
US8827930B2 (en) * | 2011-01-10 | 2014-09-09 | Bioguidance Llc | System and method for patient monitoring |
US9744349B2 (en) | 2011-02-10 | 2017-08-29 | Respicardia, Inc. | Medical lead and implantation |
CN103501690B (en) * | 2011-03-23 | 2016-10-26 | 瑞思迈有限公司 | The detection of ventilation sufficiency |
WO2012167266A1 (en) * | 2011-06-03 | 2012-12-06 | Children's Hospital Los Angeles | Electrophysiological diagnosis and treatment for asthma |
US8478413B2 (en) | 2011-07-27 | 2013-07-02 | Medtronic, Inc. | Bilateral phrenic nerve stimulation with reduced dyssynchrony |
US8706235B2 (en) | 2011-07-27 | 2014-04-22 | Medtronic, Inc. | Transvenous method to induce respiration |
US8509902B2 (en) | 2011-07-28 | 2013-08-13 | Medtronic, Inc. | Medical device to provide breathing therapy |
US9861817B2 (en) | 2011-07-28 | 2018-01-09 | Medtronic, Inc. | Medical device to provide breathing therapy |
JP6092212B2 (en) | 2011-08-11 | 2017-03-08 | インスパイア・メディカル・システムズ・インコーポレイテッドInspire Medical Systems, Inc. | System for selecting a stimulation protocol based on detection results of respiratory effort |
US20130053717A1 (en) * | 2011-08-30 | 2013-02-28 | Nellcor Puritan Bennett Llc | Automatic ventilator challenge to induce spontaneous breathing efforts |
US8934992B2 (en) | 2011-09-01 | 2015-01-13 | Inspire Medical Systems, Inc. | Nerve cuff |
US8855783B2 (en) | 2011-09-09 | 2014-10-07 | Enopace Biomedical Ltd. | Detector-based arterial stimulation |
GB201116860D0 (en) * | 2011-09-30 | 2011-11-09 | Guy S And St Thomas Nhs Foundation Trust | Patent monitoring method and monitoring device |
US9364624B2 (en) | 2011-12-07 | 2016-06-14 | Covidien Lp | Methods and systems for adaptive base flow |
US9498589B2 (en) | 2011-12-31 | 2016-11-22 | Covidien Lp | Methods and systems for adaptive base flow and leak compensation |
CA2863049C (en) * | 2012-01-26 | 2017-08-29 | Willard Wilson | Neural monitoring methods and systems for treating pharyngeal disorders |
EP2806794A1 (en) * | 2012-01-27 | 2014-12-03 | T4 Analytics LLC | Anesthesia monitoring systems and methods of monitoring anesthesia |
US20130197385A1 (en) * | 2012-01-31 | 2013-08-01 | Medtronic, Inc. | Respiratory function detection |
US8844526B2 (en) | 2012-03-30 | 2014-09-30 | Covidien Lp | Methods and systems for triggering with unknown base flow |
CA2872012C (en) | 2012-05-08 | 2017-06-20 | Aeromics, Llc | New methods |
WO2014008171A1 (en) * | 2012-07-02 | 2014-01-09 | Medisci L.L.C. | Method and device for respiratory and cardiorespiratory support |
US10362967B2 (en) | 2012-07-09 | 2019-07-30 | Covidien Lp | Systems and methods for missed breath detection and indication |
US20140031643A1 (en) * | 2012-07-27 | 2014-01-30 | Cardiac Pacemakers, Inc. | Heart failure patients stratification |
CN102949770B (en) * | 2012-11-09 | 2015-04-22 | 张红璇 | External diaphragm pacing and breathing machine synergistic air supply method and device thereof |
CN103055417B (en) * | 2012-12-31 | 2015-09-09 | 中国人民解放军第三军医大学第一附属医院 | A kind of noinvasive transcutaneous electrostimulation instrument |
US20170112409A1 (en) * | 2013-02-06 | 2017-04-27 | BTS S.p.A. | Wireless probe for dental electromyography |
US9981096B2 (en) | 2013-03-13 | 2018-05-29 | Covidien Lp | Methods and systems for triggering with unknown inspiratory flow |
TWI505812B (en) * | 2013-04-15 | 2015-11-01 | Chi Mei Comm Systems Inc | System and method for displaying analysis of breath |
US9295397B2 (en) | 2013-06-14 | 2016-03-29 | Massachusetts Institute Of Technology | Method and apparatus for beat-space frequency domain prediction of cardiovascular death after acute coronary event |
EP3030143A1 (en) | 2013-08-05 | 2016-06-15 | Cardiac Pacemakers, Inc. | System and method for detecting worsening of heart failure based on rapid shallow breathing index |
JP6640084B2 (en) | 2013-08-09 | 2020-02-05 | インスパイア・メディカル・システムズ・インコーポレイテッドInspire Medical Systems, Inc. | Patient management system |
EP2839859B1 (en) * | 2013-08-20 | 2016-04-27 | Sorin CRM SAS | Active medical device, in particular a CRT resynchroniser, including predictive warning means for cardiac decompensation in the presence of central sleep apnoea |
JP6561363B2 (en) * | 2013-10-02 | 2019-08-21 | ザ ボード オブ トラスティーズ オブ ザ ユニヴァーシティー オブ イリノイ | Organ-mounted electronic device |
EP3065728A4 (en) | 2013-11-06 | 2017-06-07 | Aeromics, Inc. | Novel methods |
WO2015077283A1 (en) | 2013-11-19 | 2015-05-28 | The Cleveland Clinic Foundation | System for treating obstructive sleep apnea |
EP3086831B1 (en) * | 2013-12-27 | 2020-09-23 | St. Michael's Hospital | System for providing ventilatory assist to a patient |
EP4241662A1 (en) | 2014-02-11 | 2023-09-13 | Cyberonics, Inc. | Systems for detecting and treating obstructive sleep apnea |
CN103800999A (en) * | 2014-02-25 | 2014-05-21 | 郑州雅晨生物科技有限公司 | Obstructive sleep apnea hypopnea syndrome therapeutic apparatus |
US10638971B2 (en) | 2014-02-25 | 2020-05-05 | Somnics, Inc. (Usa) | Methods and applications for detection of breath flow and the system thereof |
MX366801B (en) * | 2014-02-28 | 2019-07-24 | Powell Mansfield Inc | Systems, methods and devices for sensing emg activity. |
US20150283382A1 (en) * | 2014-04-04 | 2015-10-08 | Med-El Elektromedizinische Geraete Gmbh | Respiration Sensors For Recording Of Triggered Respiratory Signals In Neurostimulators |
EP3173027B1 (en) * | 2014-07-22 | 2021-01-06 | Teijin Pharma Limited | Heart failure diagnosis device |
US9659159B2 (en) | 2014-08-14 | 2017-05-23 | Sleep Data Services, Llc | Sleep data chain of custody |
US9808591B2 (en) | 2014-08-15 | 2017-11-07 | Covidien Lp | Methods and systems for breath delivery synchronization |
US10172593B2 (en) | 2014-09-03 | 2019-01-08 | Earlysense Ltd. | Pregnancy state monitoring |
US10802780B2 (en) * | 2014-10-08 | 2020-10-13 | Lg Electronics Inc. | Digital device and method for controlling same |
CN106999118B (en) | 2014-10-13 | 2020-07-17 | 葡萄糖传感器公司 | Analyte sensing device |
US9950129B2 (en) | 2014-10-27 | 2018-04-24 | Covidien Lp | Ventilation triggering using change-point detection |
EP3212277B1 (en) | 2014-10-31 | 2020-12-16 | Avent, Inc. | Non-invasive nerve stimulation system |
US9925346B2 (en) | 2015-01-20 | 2018-03-27 | Covidien Lp | Systems and methods for ventilation with unknown exhalation flow |
EP3064131A1 (en) | 2015-03-03 | 2016-09-07 | BIOTRONIK SE & Co. KG | Combined vagus-phrenic nerve stimulation apparatus |
CN113908438A (en) | 2015-03-19 | 2022-01-11 | 启迪医疗仪器公司 | Stimulation for treating sleep disordered breathing |
US9839786B2 (en) * | 2015-04-17 | 2017-12-12 | Inspire Medical Systems, Inc. | System and method of monitoring for and reporting on patient-made stimulation therapy programming changes |
US10945628B2 (en) * | 2015-08-11 | 2021-03-16 | Koninklijke Philips N.V. | Apparatus and method for processing electromyography signals related to respiratory activity |
EP3405103B1 (en) | 2016-01-20 | 2021-10-27 | Soniphi LLC | Frequency analysis feedback system |
WO2017183030A1 (en) | 2016-04-20 | 2017-10-26 | Glusense Ltd. | Fret-based glucose-detection molecules |
CN105748069B (en) * | 2016-04-21 | 2018-10-23 | 罗远明 | A kind of centric sleep apnea carbon dioxide inhalation therapy device |
CN105879223B (en) * | 2016-04-22 | 2017-02-08 | 广州雪利昂生物科技有限公司 | Method and apparatus for triggering external diaphragm pacemaker by using surface electromyogram signal as synchronization signal |
US11247039B2 (en) | 2016-05-03 | 2022-02-15 | Btl Healthcare Technologies A.S. | Device including RF source of energy and vacuum system |
US10583287B2 (en) | 2016-05-23 | 2020-03-10 | Btl Medical Technologies S.R.O. | Systems and methods for tissue treatment |
US10556122B1 (en) | 2016-07-01 | 2020-02-11 | Btl Medical Technologies S.R.O. | Aesthetic method of biological structure treatment by magnetic field |
US11000211B2 (en) * | 2016-07-25 | 2021-05-11 | Facebook Technologies, Llc | Adaptive system for deriving control signals from measurements of neuromuscular activity |
AU2016418245B2 (en) | 2016-08-01 | 2020-07-16 | Med-El Elektromedizinische Geraete Gmbh | Respiratory triggered parasternal electromyographic recording in neurostimulators |
US11052241B2 (en) * | 2016-11-03 | 2021-07-06 | West Affum Holdings Corp. | Wearable cardioverter defibrillator (WCD) system measuring patient's respiration |
EP3537961A1 (en) | 2016-11-10 | 2019-09-18 | The Research Foundation for The State University of New York | System, method and biomarkers for airway obstruction |
US11426513B2 (en) * | 2016-11-29 | 2022-08-30 | Geoffrey Louis Tyson | Implantable devices for drug delivery in response to detected biometric parameters associated with an opioid drug overdose and associated systems and methods |
CN107019495B (en) * | 2017-03-13 | 2019-11-29 | 北京航空航天大学 | Apnea detection and prior-warning device and method based on smart phone and the mounted respiration transducer of nose |
WO2018200470A1 (en) | 2017-04-29 | 2018-11-01 | Cardiac Pacemakers, Inc. | Heart failure event rate assessment |
CN110997059B (en) * | 2017-06-16 | 2023-09-19 | 阿尔法泰克脊椎有限公司 | System for detecting neuromuscular response threshold using variable frequency stimulation |
JP7162050B2 (en) | 2017-08-11 | 2022-10-27 | インスパイア・メディカル・システムズ・インコーポレイテッド | cuff electrode |
US11291838B2 (en) | 2017-08-31 | 2022-04-05 | Mayo Foundation For Medical Education And Research | Systems and methods for controlling breathing |
CN108174034A (en) * | 2017-12-27 | 2018-06-15 | 苏鹏霄 | Using the system and method for APP real time monitoring sacral nerve neuromodulation devices |
US11031134B2 (en) * | 2018-02-05 | 2021-06-08 | International Business Machines Corporation | Monitoring individuals for water retention management |
US10722710B2 (en) | 2018-03-24 | 2020-07-28 | Moshe Hayik | Secretion clearance and cough assist |
US11058349B2 (en) | 2018-03-24 | 2021-07-13 | Ovadia Sagiv | Non-invasive handling of sleep apnea, snoring and emergency situations |
WO2019189153A1 (en) * | 2018-03-26 | 2019-10-03 | テルモ株式会社 | Support system, support method, support program, and recording medium on which support program is recorded |
US11109787B2 (en) * | 2018-05-21 | 2021-09-07 | Vine Medical LLC | Multi-tip probe for obtaining bioelectrical measurements |
US11771899B2 (en) | 2018-07-10 | 2023-10-03 | The Cleveland Clinic Foundation | System and method for treating obstructive sleep apnea |
US11633560B2 (en) | 2018-11-10 | 2023-04-25 | Novaresp Technologies Inc. | Method and apparatus for continuous management of airway pressure for detection and/or prediction of respiratory failure |
US11894139B1 (en) | 2018-12-03 | 2024-02-06 | Patientslikeme Llc | Disease spectrum classification |
US11471683B2 (en) | 2019-01-29 | 2022-10-18 | Synapse Biomedical, Inc. | Systems and methods for treating sleep apnea using neuromodulation |
US11382563B2 (en) | 2019-03-01 | 2022-07-12 | Respiration AI, LLC | System and method for detecting ventilatory depression and for prompting a patient to breathe |
US11547307B2 (en) * | 2019-04-29 | 2023-01-10 | Technion Research And Development Foundation Ltd. | Quantification of the respiratory effort from hemodynamic measurements |
EP3962592B1 (en) | 2019-05-02 | 2023-08-09 | XII Medical, Inc. | Implantable stimulation power receiver and systems |
US20200375665A1 (en) * | 2019-05-31 | 2020-12-03 | Canon U.S.A., Inc. | Medical continuum robot and methods thereof |
US11324954B2 (en) | 2019-06-28 | 2022-05-10 | Covidien Lp | Achieving smooth breathing by modified bilateral phrenic nerve pacing |
KR20210024874A (en) | 2019-08-26 | 2021-03-08 | 삼성전자주식회사 | Monitoring device inserted into human body and operating method thereof |
US11420061B2 (en) | 2019-10-15 | 2022-08-23 | Xii Medical, Inc. | Biased neuromodulation lead and method of using same |
WO2021141950A1 (en) * | 2020-01-06 | 2021-07-15 | W. L. Gore & Associates, Inc. | Conditioning algorithms for biomarker sensor measurements |
EP4069343A4 (en) * | 2020-02-26 | 2024-02-21 | Novaresp Tech Inc | Method and apparatus for determining and/or predicting sleep and respiratory behaviours for management of airway pressure |
US11878167B2 (en) | 2020-05-04 | 2024-01-23 | Btl Healthcare Technologies A.S. | Device and method for unattended treatment of a patient |
BR112022022112A2 (en) | 2020-05-04 | 2022-12-13 | Btl Healthcare Tech A S | DEVICE FOR UNASSISTED PATIENT TREATMENT |
US11672934B2 (en) | 2020-05-12 | 2023-06-13 | Covidien Lp | Remote ventilator adjustment |
US11691010B2 (en) | 2021-01-13 | 2023-07-04 | Xii Medical, Inc. | Systems and methods for improving sleep disordered breathing |
AU2022227086A1 (en) * | 2021-02-24 | 2023-09-28 | Medtronic, Inc. | Electrode selection based on impedance for sensing or stimulation |
US11896816B2 (en) | 2021-11-03 | 2024-02-13 | Btl Healthcare Technologies A.S. | Device and method for unattended treatment of a patient |
CN114376559B (en) * | 2022-01-18 | 2023-09-19 | 高昌生医股份有限公司 | Respiratory datum line tracking acceleration method |
US20240050743A1 (en) * | 2022-08-11 | 2024-02-15 | Stimdia Medical, Inc. | Apparatus and method for diaphragm stimulation |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6357438B1 (en) * | 2000-10-19 | 2002-03-19 | Mallinckrodt Inc. | Implantable sensor for proportional assist ventilation |
US20050021102A1 (en) * | 2003-07-23 | 2005-01-27 | Ignagni Anthony R. | System and method for conditioning a diaphragm of a patient |
Family Cites Families (197)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US85866A (en) * | 1869-01-12 | Improved bed-bottom | ||
US65567A (en) * | 1867-06-11 | Improved soeew machine | ||
US345202A (en) * | 1886-07-06 | Treating lac | ||
US540732A (en) * | 1895-06-11 | Martin freund | ||
US300094A (en) * | 1884-06-10 | Machine | ||
US247729A (en) * | 1881-09-27 | Corset-stay | ||
US215082A (en) * | 1879-05-06 | Improvement in type-writing machines | ||
US99479A (en) * | 1870-02-01 | Edwin r | ||
US522862A (en) * | 1894-07-10 | Sawhorse | ||
US36294A (en) * | 1862-08-26 | Improved portable sugar-evaporatx | ||
US167523A (en) * | 1875-09-07 | Improvement in sole-channeling machines | ||
US61315A (en) * | 1867-01-22 | Improved apparatus for decomposing animal and vegetable substances | ||
US146918A (en) * | 1874-01-27 | Improvement in car-couplings | ||
US59240A (en) * | 1866-10-30 | Maeshall t | ||
US85865A (en) * | 1869-01-12 | Improvement in threshing-knives | ||
US85868A (en) * | 1869-01-12 | Improvement in steam water-elevators | ||
US101833A (en) * | 1870-04-12 | Improved coal-box | ||
US88015A (en) * | 1869-03-23 | Improvement in lifting-jacks | ||
US55060A (en) * | 1866-05-29 | Improvement in harvester-rakes | ||
US211173A (en) * | 1879-01-07 | Improvement in wagon-tracks for roads | ||
US138719A (en) * | 1873-05-06 | Improvement in fly-switches | ||
US540731A (en) * | 1895-06-11 | Wire-reel | ||
US574507A (en) * | 1897-01-05 | Account-keeping book | ||
US174287A (en) * | 1876-02-29 | Improvement in tool-holders | ||
US281219A (en) * | 1883-07-10 | Half to alonzo e | ||
US149334A (en) * | 1874-04-07 | Improvement in railroad-frogs | ||
US193697A (en) * | 1877-07-31 | Improvement in mowers | ||
US119711A (en) * | 1871-10-10 | Improvement in staple-machines | ||
US155341A (en) * | 1874-09-22 | Improvement in fertilizers | ||
US85734A (en) * | 1869-01-12 | Improvement in gr | ||
US225226A (en) * | 1880-03-09 | Rotary engine | ||
US122622A (en) * | 1872-01-09 | Improvement in compartment-cars for railways | ||
US56519A (en) * | 1866-07-24 | Improvement in clamps for holding saws | ||
US142815A (en) * | 1873-09-16 | Improvement in car-couplings | ||
US127091A (en) * | 1872-05-21 | Improvement in spark-arresters | ||
US115561A (en) * | 1871-06-06 | Improvement in electro-sviagnetic separators | ||
US237963A (en) * | 1881-02-22 | Manufacture of sheet-iron | ||
US204213A (en) * | 1878-05-28 | Improvement in loom-pickers | ||
US77953A (en) * | 1868-05-19 | b i c k e | ||
US176809A (en) * | 1876-05-02 | Improvement in machinery for cutting waved edges on leather | ||
US85867A (en) * | 1869-01-12 | Improvement in blind-fastener | ||
US39745A (en) * | 1863-09-01 | Improvement in hoisting apparatus | ||
US540733A (en) * | 1895-06-11 | Ernst gerstenberg and herman barghausen | ||
US61320A (en) * | 1867-01-22 | of lewiston | ||
US148897A (en) * | 1874-03-24 | Improvement in machines for pressing pantaloons | ||
US21795A (en) * | 1858-10-12 | Improvement in cotton-gins | ||
US61319A (en) * | 1867-01-22 | Improvement in pumps | ||
US85869A (en) * | 1869-01-12 | Improvement in horse-rakes | ||
US74741A (en) * | 1868-02-18 | George w | ||
US240240A (en) * | 1881-04-19 | Beer-faucet | ||
US65563A (en) * | 1867-06-11 | Julius hackert | ||
US111040A (en) * | 1871-01-17 | Improvement in fluid-meters | ||
US681192A (en) * | 1900-11-19 | 1901-08-27 | Natural Food Company | Marking-machine. |
US678535A (en) * | 1901-02-02 | 1901-07-16 | Austen Bigg | Hoe. |
US911218A (en) * | 1908-02-17 | 1909-02-02 | Elias B Wrenn | Trace-holder. |
US1496918A (en) * | 1922-08-23 | 1924-06-10 | Frederick M Baldwin | Signaling device for vehicles |
US3773051A (en) | 1972-03-01 | 1973-11-20 | Research Corp | Method and apparatus for stimulation of body tissue |
US4146918A (en) * | 1978-01-18 | 1979-03-27 | Albert Tureck | Photographic flash reflector and diffuser system |
US4827935A (en) * | 1986-04-24 | 1989-05-09 | Purdue Research Foundation | Demand electroventilator |
US4830008A (en) * | 1987-04-24 | 1989-05-16 | Meer Jeffrey A | Method and system for treatment of sleep apnea |
US5329931A (en) * | 1989-02-21 | 1994-07-19 | William L. Clauson | Apparatus and method for automatic stimulation of mammals in response to blood gas analysis |
US5265604A (en) | 1990-05-14 | 1993-11-30 | Vince Dennis J | Demand - diaphragmatic pacing (skeletal muscle pressure modified) |
US5056519A (en) | 1990-05-14 | 1991-10-15 | Vince Dennis J | Unilateral diaphragmatic pacer |
US5281219A (en) | 1990-11-23 | 1994-01-25 | Medtronic, Inc. | Multiple stimulation electrodes |
US5211173A (en) | 1991-01-09 | 1993-05-18 | Medtronic, Inc. | Servo muscle control |
DE69209324T2 (en) | 1991-01-09 | 1996-11-21 | Medtronic Inc | Servo control for muscles |
US5190036A (en) * | 1991-02-28 | 1993-03-02 | Linder Steven H | Abdominal binder for effectuating cough stimulation |
US5146918A (en) * | 1991-03-19 | 1992-09-15 | Medtronic, Inc. | Demand apnea control of central and obstructive sleep apnea |
US5215082A (en) | 1991-04-02 | 1993-06-01 | Medtronic, Inc. | Implantable apnea generator with ramp on generator |
US5174287A (en) | 1991-05-28 | 1992-12-29 | Medtronic, Inc. | Airway feedback measurement system responsive to detected inspiration and obstructive apnea event |
US5233983A (en) | 1991-09-03 | 1993-08-10 | Medtronic, Inc. | Method and apparatus for apnea patient screening |
US5572543A (en) | 1992-04-09 | 1996-11-05 | Deutsch Aerospace Ag | Laser system with a micro-mechanically moved mirror |
US5423372A (en) * | 1993-12-27 | 1995-06-13 | Ford Motor Company | Joining sand cores for making castings |
US5800470A (en) | 1994-01-07 | 1998-09-01 | Medtronic, Inc. | Respiratory muscle electromyographic rate responsive pacemaker |
US5524632A (en) | 1994-01-07 | 1996-06-11 | Medtronic, Inc. | Method for implanting electromyographic sensing electrodes |
US5485851A (en) | 1994-09-21 | 1996-01-23 | Medtronic, Inc. | Method and apparatus for arousal detection |
US5483969A (en) * | 1994-09-21 | 1996-01-16 | Medtronic, Inc. | Method and apparatus for providing a respiratory effort waveform for the treatment of obstructive sleep apnea |
US5546952A (en) | 1994-09-21 | 1996-08-20 | Medtronic, Inc. | Method and apparatus for detection of a respiratory waveform |
US5540733A (en) | 1994-09-21 | 1996-07-30 | Medtronic, Inc. | Method and apparatus for detecting and treating obstructive sleep apnea |
US5540731A (en) | 1994-09-21 | 1996-07-30 | Medtronic, Inc. | Method and apparatus for pressure detecting and treating obstructive airway disorders |
US5549655A (en) | 1994-09-21 | 1996-08-27 | Medtronic, Inc. | Method and apparatus for synchronized treatment of obstructive sleep apnea |
US5540732A (en) | 1994-09-21 | 1996-07-30 | Medtronic, Inc. | Method and apparatus for impedance detecting and treating obstructive airway disorders |
US5522862A (en) * | 1994-09-21 | 1996-06-04 | Medtronic, Inc. | Method and apparatus for treating obstructive sleep apnea |
US5678535A (en) | 1995-04-21 | 1997-10-21 | Dimarco; Anthony Fortunato | Method and apparatus for electrical stimulation of the respiratory muscles to achieve artificial ventilation in a patient |
FR2739760B1 (en) * | 1995-10-11 | 1997-12-12 | Salomon Sa | METHOD AND DEVICE FOR HEATING AN INTERIOR SHOE LINING |
FR2739782B1 (en) * | 1995-10-13 | 1997-12-19 | Ela Medical Sa | ACTIVE IMPLANTABLE MEDICAL DEVICE, IN PARTICULAR HEART STIMULATOR, WITH CONTROLLED OPERATION AND REDUCED CONSUMPTION |
US6006134A (en) * | 1998-04-30 | 1999-12-21 | Medtronic, Inc. | Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers |
US5895360A (en) * | 1996-06-26 | 1999-04-20 | Medtronic, Inc. | Gain control for a periodic signal and method regarding same |
US6132384A (en) | 1996-06-26 | 2000-10-17 | Medtronic, Inc. | Sensor, method of sensor implant and system for treatment of respiratory disorders |
US6021352A (en) | 1996-06-26 | 2000-02-01 | Medtronic, Inc, | Diagnostic testing methods and apparatus for implantable therapy devices |
US6099479A (en) | 1996-06-26 | 2000-08-08 | Medtronic, Inc. | Method and apparatus for operating therapy system |
US5944680A (en) | 1996-06-26 | 1999-08-31 | Medtronic, Inc. | Respiratory effort detection method and apparatus |
SE9603841D0 (en) | 1996-10-18 | 1996-10-18 | Pacesetter Ab | A tissue stimulating apparatus |
US5830008A (en) | 1996-12-17 | 1998-11-03 | The Whitaker Corporation | Panel mountable connector |
US5876353A (en) * | 1997-01-31 | 1999-03-02 | Medtronic, Inc. | Impedance monitor for discerning edema through evaluation of respiratory rate |
US5797923A (en) | 1997-05-12 | 1998-08-25 | Aiyar; Harish | Electrode delivery instrument |
WO1999020339A1 (en) | 1997-10-17 | 1999-04-29 | Respironics, Inc. | Muscle stimulating device and method for diagnosing and treating a breathing disorder |
US6021362A (en) * | 1998-02-17 | 2000-02-01 | Maggard; Karl J. | Method and apparatus for dispensing samples and premiums |
US6251126B1 (en) * | 1998-04-23 | 2001-06-26 | Medtronic Inc | Method and apparatus for synchronized treatment of obstructive sleep apnea |
US6269269B1 (en) | 1998-04-23 | 2001-07-31 | Medtronic Inc. | Method and apparatus for synchronized treatment of obstructive sleep apnea |
ES2261589T3 (en) | 1998-05-06 | 2006-11-16 | Genentech, Inc. | ANTI-HER2 ANTIBODY COMPOSITION. |
AUPP366398A0 (en) | 1998-05-22 | 1998-06-18 | Resmed Limited | Ventilatory assistance for treatment of cardiac failure and cheyne-stokes breathing |
US6312399B1 (en) | 1998-06-11 | 2001-11-06 | Cprx, Llc | Stimulatory device and methods to enhance venous blood return during cardiopulmonary resuscitation |
US6234985B1 (en) * | 1998-06-11 | 2001-05-22 | Cprx Llc | Device and method for performing cardiopulmonary resuscitation |
US6463327B1 (en) * | 1998-06-11 | 2002-10-08 | Cprx Llc | Stimulatory device and methods to electrically stimulate the phrenic nerve |
SE9802335D0 (en) | 1998-06-30 | 1998-06-30 | Siemens Elema Ab | Breathing Help System |
FR2780654B1 (en) | 1998-07-06 | 2000-12-01 | Ela Medical Sa | ACTIVE IMPLANTABLE MEDICAL DEVICE FOR ELECTROSTIMULATION TREATMENT OF SLEEP APNEA SYNDROME |
US6587725B1 (en) * | 1998-07-27 | 2003-07-01 | Dominique Durand | Method and apparatus for closed-loop stimulation of the hypoglossal nerve in human patients to treat obstructive sleep apnea |
US6240316B1 (en) | 1998-08-14 | 2001-05-29 | Advanced Bionics Corporation | Implantable microstimulation system for treatment of sleep apnea |
US6212435B1 (en) * | 1998-11-13 | 2001-04-03 | Respironics, Inc. | Intraoral electromuscular stimulation device and method |
US7117032B2 (en) | 1999-03-01 | 2006-10-03 | Quantum Intech, Inc. | Systems and methods for facilitating physiological coherence using respiration training |
US7577475B2 (en) * | 1999-04-16 | 2009-08-18 | Cardiocom | System, method, and apparatus for combining information from an implanted device with information from a patient monitoring apparatus |
US6314324B1 (en) | 1999-05-05 | 2001-11-06 | Respironics, Inc. | Vestibular stimulation system and method |
US6512949B1 (en) * | 1999-07-12 | 2003-01-28 | Medtronic, Inc. | Implantable medical device for measuring time varying physiologic conditions especially edema and for responding thereto |
US6600949B1 (en) * | 1999-11-10 | 2003-07-29 | Pacesetter, Inc. | Method for monitoring heart failure via respiratory patterns |
US6527729B1 (en) * | 1999-11-10 | 2003-03-04 | Pacesetter, Inc. | Method for monitoring patient using acoustic sensor |
US6480733B1 (en) | 1999-11-10 | 2002-11-12 | Pacesetter, Inc. | Method for monitoring heart failure |
US6336903B1 (en) | 1999-11-16 | 2002-01-08 | Cardiac Intelligence Corp. | Automated collection and analysis patient care system and method for diagnosing and monitoring congestive heart failure and outcomes thereof |
US6752765B1 (en) * | 1999-12-01 | 2004-06-22 | Medtronic, Inc. | Method and apparatus for monitoring heart rate and abnormal respiration |
US6415183B1 (en) * | 1999-12-09 | 2002-07-02 | Cardiac Pacemakers, Inc. | Method and apparatus for diaphragmatic pacing |
US6418346B1 (en) * | 1999-12-14 | 2002-07-09 | Medtronic, Inc. | Apparatus and method for remote therapy and diagnosis in medical devices via interface systems |
US20030127091A1 (en) * | 1999-12-15 | 2003-07-10 | Chang Yung Chi | Scientific respiration for self-health-care |
US6710094B2 (en) * | 1999-12-29 | 2004-03-23 | Styrochem Delaware, Inc. | Processes for preparing patterns for use in metal castings |
US6589188B1 (en) * | 2000-05-05 | 2003-07-08 | Pacesetter, Inc. | Method for monitoring heart failure via respiratory patterns |
US6735479B2 (en) | 2000-06-14 | 2004-05-11 | Medtronic, Inc. | Lifestyle management system |
US6666830B1 (en) | 2000-08-17 | 2003-12-23 | East River Ventures, Lp | System and method for detecting the onset of an obstructive sleep apnea event |
US6633779B1 (en) | 2000-11-27 | 2003-10-14 | Science Medicus, Inc. | Treatment of asthma and respiratory disease by means of electrical neuro-receptive waveforms |
US6641542B2 (en) | 2001-04-30 | 2003-11-04 | Medtronic, Inc. | Method and apparatus to detect and treat sleep respiratory events |
US6731984B2 (en) * | 2001-06-07 | 2004-05-04 | Medtronic, Inc. | Method for providing a therapy to a patient involving modifying the therapy after detecting an onset of sleep in the patient, and implantable medical device embodying same |
US7206635B2 (en) | 2001-06-07 | 2007-04-17 | Medtronic, Inc. | Method and apparatus for modifying delivery of a therapy in response to onset of sleep |
US6572949B1 (en) * | 2001-08-30 | 2003-06-03 | Carlton Paul Lewis | Paint mask and method of using |
FR2829917B1 (en) | 2001-09-24 | 2004-06-11 | Ela Medical Sa | ACTIVE MEDICAL DEVICE INCLUDING MEANS FOR DIAGNOSING THE RESPIRATORY PROFILE |
US6904320B2 (en) * | 2002-02-14 | 2005-06-07 | Pacesetter, Inc. | Sleep apnea therapy device using dynamic overdrive pacing |
US6928324B2 (en) | 2002-02-14 | 2005-08-09 | Pacesetter, Inc. | Stimulation device for sleep apnea prevention, detection and treatment |
US6999817B2 (en) | 2002-02-14 | 2006-02-14 | Packsetter, Inc. | Cardiac stimulation device including sleep apnea prevention and treatment |
US8391989B2 (en) * | 2002-12-18 | 2013-03-05 | Cardiac Pacemakers, Inc. | Advanced patient management for defining, identifying and using predetermined health-related events |
US20030195571A1 (en) | 2002-04-12 | 2003-10-16 | Burnes John E. | Method and apparatus for the treatment of central sleep apnea using biventricular pacing |
US20030204213A1 (en) | 2002-04-30 | 2003-10-30 | Jensen Donald N. | Method and apparatus to detect and monitor the frequency of obstructive sleep apnea |
US20030225339A1 (en) | 2002-05-06 | 2003-12-04 | Respironics Novametrix | Methods for inducing temporary changes in ventilation for estimation of hemodynamic performance |
US6881192B1 (en) * | 2002-06-12 | 2005-04-19 | Pacesetter, Inc. | Measurement of sleep apnea duration and evaluation of response therapies using duration metrics |
SE0202537D0 (en) * | 2002-08-28 | 2002-08-28 | Siemens Elema Ab | Nerve stimulation apparatus |
JP4095391B2 (en) * | 2002-09-24 | 2008-06-04 | キヤノン株式会社 | Position detection method |
JP4309111B2 (en) * | 2002-10-02 | 2009-08-05 | 株式会社スズケン | Health management system, activity state measuring device and data processing device |
US6945939B2 (en) * | 2002-10-18 | 2005-09-20 | Pacesetter, Inc. | Hemodynamic analysis |
US7277757B2 (en) * | 2002-10-31 | 2007-10-02 | Medtronic, Inc. | Respiratory nerve stimulation |
US7252640B2 (en) * | 2002-12-04 | 2007-08-07 | Cardiac Pacemakers, Inc. | Detection of disordered breathing |
US8672852B2 (en) * | 2002-12-13 | 2014-03-18 | Intercure Ltd. | Apparatus and method for beneficial modification of biorhythmic activity |
US7160252B2 (en) * | 2003-01-10 | 2007-01-09 | Medtronic, Inc. | Method and apparatus for detecting respiratory disturbances |
US7025730B2 (en) * | 2003-01-10 | 2006-04-11 | Medtronic, Inc. | System and method for automatically monitoring and delivering therapy for sleep-related disordered breathing |
US7438686B2 (en) * | 2003-01-10 | 2008-10-21 | Medtronic, Inc. | Apparatus and method for monitoring for disordered breathing |
US20050020240A1 (en) * | 2003-02-07 | 2005-01-27 | Darin Minter | Private wireless network |
US20050261747A1 (en) | 2003-05-16 | 2005-11-24 | Schuler Eleanor L | Method and system to control respiration by means of neuro-electrical coded signals |
WO2005009531A1 (en) * | 2003-07-23 | 2005-02-03 | University Hospitals Of Cleveland | Mapping probe system for neuromuscular electrical stimulation apparatus |
US7664546B2 (en) * | 2003-09-18 | 2010-02-16 | Cardiac Pacemakers, Inc. | Posture detection system and method |
US7591265B2 (en) * | 2003-09-18 | 2009-09-22 | Cardiac Pacemakers, Inc. | Coordinated use of respiratory and cardiac therapies for sleep disordered breathing |
US7680537B2 (en) * | 2003-08-18 | 2010-03-16 | Cardiac Pacemakers, Inc. | Therapy triggered by prediction of disordered breathing |
US7469697B2 (en) * | 2003-09-18 | 2008-12-30 | Cardiac Pacemakers, Inc. | Feedback system and method for sleep disordered breathing therapy |
US7610094B2 (en) * | 2003-09-18 | 2009-10-27 | Cardiac Pacemakers, Inc. | Synergistic use of medical devices for detecting medical disorders |
US7510531B2 (en) * | 2003-09-18 | 2009-03-31 | Cardiac Pacemakers, Inc. | System and method for discrimination of central and obstructive disordered breathing events |
EP2008581B1 (en) * | 2003-08-18 | 2011-08-17 | Cardiac Pacemakers, Inc. | Patient monitoring, diagnosis, and/or therapy systems and methods |
US7396333B2 (en) * | 2003-08-18 | 2008-07-08 | Cardiac Pacemakers, Inc. | Prediction of disordered breathing |
US7468040B2 (en) * | 2003-09-18 | 2008-12-23 | Cardiac Pacemakers, Inc. | Methods and systems for implantably monitoring external breathing therapy |
US7662101B2 (en) * | 2003-09-18 | 2010-02-16 | Cardiac Pacemakers, Inc. | Therapy control based on cardiopulmonary status |
US7532934B2 (en) * | 2003-09-18 | 2009-05-12 | Cardiac Pacemakers, Inc. | Snoring detection system and method |
US7720541B2 (en) * | 2003-08-18 | 2010-05-18 | Cardiac Pacemakers, Inc. | Adaptive therapy for disordered breathing |
US7757690B2 (en) * | 2003-09-18 | 2010-07-20 | Cardiac Pacemakers, Inc. | System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep |
DE502004006169D1 (en) * | 2003-09-02 | 2008-03-27 | Biotronik Gmbh & Co Kg | Device for the treatment of sleep apnea |
US20050055060A1 (en) * | 2003-09-05 | 2005-03-10 | Steve Koh | Determination of respiratory characteristics from AV conduction intervals |
US6905788B2 (en) * | 2003-09-12 | 2005-06-14 | Eastman Kodak Company | Stabilized OLED device |
US20050065563A1 (en) * | 2003-09-23 | 2005-03-24 | Avram Scheiner | Paced ventilation therapy by an implantable cardiac device |
US8244358B2 (en) * | 2003-10-15 | 2012-08-14 | Rmx, Llc | Device and method for treating obstructive sleep apnea |
US8140164B2 (en) * | 2003-10-15 | 2012-03-20 | Rmx, Llc | Therapeutic diaphragm stimulation device and method |
US7979128B2 (en) * | 2003-10-15 | 2011-07-12 | Rmx, Llc | Device and method for gradually controlling breathing |
US20060167523A1 (en) * | 2003-10-15 | 2006-07-27 | Tehrani Amir J | Device and method for improving upper airway functionality |
US7970475B2 (en) * | 2003-10-15 | 2011-06-28 | Rmx, Llc | Device and method for biasing lung volume |
US8265759B2 (en) | 2003-10-15 | 2012-09-11 | Rmx, Llc | Device and method for treating disorders of the cardiovascular system or heart |
US8467876B2 (en) | 2003-10-15 | 2013-06-18 | Rmx, Llc | Breathing disorder detection and therapy delivery device and method |
US9259573B2 (en) * | 2003-10-15 | 2016-02-16 | Rmx, Llc | Device and method for manipulating exhalation |
US8160711B2 (en) | 2003-10-15 | 2012-04-17 | Rmx, Llc | Multimode device and method for controlling breathing |
US20080161878A1 (en) | 2003-10-15 | 2008-07-03 | Tehrani Amir J | Device and method to for independently stimulating hemidiaphragms |
US20120158091A1 (en) * | 2003-10-15 | 2012-06-21 | Rmx, Llc | Therapeutic diaphragm stimulation device and method |
US6964641B2 (en) * | 2003-12-24 | 2005-11-15 | Medtronic, Inc. | Implantable medical device with sleep disordered breathing monitoring |
US7519425B2 (en) * | 2004-01-26 | 2009-04-14 | Pacesetter, Inc. | Tiered therapy for respiratory oscillations characteristic of Cheyne-Stokes respiration |
US7077810B2 (en) | 2004-02-05 | 2006-07-18 | Earlysense Ltd. | Techniques for prediction and monitoring of respiration-manifested clinical episodes |
US7070568B1 (en) * | 2004-03-02 | 2006-07-04 | Pacesetter, Inc. | System and method for diagnosing and tracking congestive heart failure based on the periodicity of Cheyne-Stokes Respiration using an implantable medical device |
DE102004016985B4 (en) | 2004-04-07 | 2010-07-22 | Pari Pharma Gmbh | Aerosol generating device and inhalation device |
US7245971B2 (en) | 2004-04-21 | 2007-07-17 | Pacesetter, Inc. | System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device |
US7082331B1 (en) * | 2004-04-21 | 2006-07-25 | Pacesetter, Inc. | System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device |
JP4396380B2 (en) | 2004-04-26 | 2010-01-13 | アイシン・エィ・ダブリュ株式会社 | Traffic information transmission device and transmission method |
US7153271B2 (en) | 2004-05-20 | 2006-12-26 | Airmatrix Technologies, Inc. | Method and system for diagnosing central versus obstructive apnea |
US20060058852A1 (en) * | 2004-09-10 | 2006-03-16 | Steve Koh | Multi-variable feedback control of stimulation for inspiratory facilitation |
US7678116B2 (en) * | 2004-12-06 | 2010-03-16 | Dfine, Inc. | Bone treatment systems and methods |
US20060122661A1 (en) * | 2004-12-03 | 2006-06-08 | Mandell Lee J | Diaphragmatic pacing with activity monitor adjustment |
US7680538B2 (en) | 2005-03-31 | 2010-03-16 | Case Western Reserve University | Method of treating obstructive sleep apnea using electrical nerve stimulation |
US8036750B2 (en) | 2005-06-13 | 2011-10-11 | Cardiac Pacemakers, Inc. | System for neural control of respiration |
US20080021506A1 (en) * | 2006-05-09 | 2008-01-24 | Massachusetts General Hospital | Method and device for the electrical treatment of sleep apnea and snoring |
US8280513B2 (en) | 2006-12-22 | 2012-10-02 | Rmx, Llc | Device and method to treat flow limitations |
-
2003
- 2003-10-15 US US10/686,891 patent/US8467876B2/en active Active
-
2004
- 2004-10-15 WO PCT/US2004/033850 patent/WO2005037172A2/en active Application Filing
- 2004-10-15 DE DE112004001953T patent/DE112004001953T5/en not_active Withdrawn
- 2004-10-15 WO PCT/US2004/034103 patent/WO2005037366A1/en active Application Filing
- 2004-10-15 US US10/966,474 patent/US8412331B2/en active Active
- 2004-10-15 WO PCT/US2004/034170 patent/WO2005037220A2/en active Application Filing
- 2004-10-15 US US10/966,472 patent/US8200336B2/en active Active
- 2004-10-15 WO PCT/US2004/034211 patent/WO2005037077A2/en active Application Filing
- 2004-10-15 US US10/966,484 patent/US20050085869A1/en not_active Abandoned
- 2004-10-15 DE DE112004001957T patent/DE112004001957T5/en not_active Withdrawn
- 2004-10-15 DE DE112004001954.0T patent/DE112004001954B4/en not_active Expired - Fee Related
- 2004-10-15 US US10/966,421 patent/US8255056B2/en active Active
- 2004-10-15 US US10/966,487 patent/US20050085734A1/en not_active Abandoned
- 2004-10-15 WO PCT/US2004/034213 patent/WO2005037174A2/en active Application Filing
- 2004-10-15 WO PCT/US2004/034212 patent/WO2005037173A2/en active Application Filing
-
2005
- 2005-10-11 US US11/246,439 patent/US20060030894A1/en not_active Abandoned
- 2005-10-13 US US11/249,718 patent/US8348941B2/en active Active
-
2006
- 2006-09-25 US US11/526,949 patent/US8509901B2/en not_active Expired - Fee Related
-
2007
- 2007-10-31 US US11/981,800 patent/US8116872B2/en active Active
- 2007-10-31 US US11/981,727 patent/US20080183239A1/en not_active Abandoned
- 2007-10-31 US US11/981,831 patent/US20080183240A1/en not_active Abandoned
-
2008
- 2008-04-01 US US12/080,133 patent/US20080188903A1/en not_active Abandoned
-
2013
- 2013-03-26 US US13/851,003 patent/US20130296973A1/en not_active Abandoned
- 2013-06-11 US US13/915,316 patent/US20130296964A1/en not_active Abandoned
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6357438B1 (en) * | 2000-10-19 | 2002-03-19 | Mallinckrodt Inc. | Implantable sensor for proportional assist ventilation |
US20050021102A1 (en) * | 2003-07-23 | 2005-01-27 | Ignagni Anthony R. | System and method for conditioning a diaphragm of a patient |
Cited By (48)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10864374B2 (en) | 2007-01-29 | 2020-12-15 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US10765867B2 (en) | 2007-01-29 | 2020-09-08 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US10561843B2 (en) | 2007-01-29 | 2020-02-18 | Lungpacer Medical, Inc. | Transvascular nerve stimulation apparatus and methods |
US10792499B2 (en) | 2007-01-29 | 2020-10-06 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US11027130B2 (en) | 2007-01-29 | 2021-06-08 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US9950167B2 (en) | 2007-01-29 | 2018-04-24 | Lungpacer Medical, Inc. | Transvascular nerve stimulation apparatus and methods |
US9968785B2 (en) | 2007-01-29 | 2018-05-15 | Lungpacer Medical, Inc. | Transvascular nerve stimulation apparatus and methods |
US10022546B2 (en) | 2007-01-29 | 2018-07-17 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US9566436B2 (en) | 2007-01-29 | 2017-02-14 | Simon Fraser University | Transvascular nerve stimulation apparatus and methods |
US11369787B2 (en) | 2012-03-05 | 2022-06-28 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US10512772B2 (en) | 2012-03-05 | 2019-12-24 | Lungpacer Medical Inc. | Transvascular nerve stimulation apparatus and methods |
US10406367B2 (en) | 2012-06-21 | 2019-09-10 | Lungpacer Medical Inc. | Transvascular diaphragm pacing system and methods of use |
US11357985B2 (en) | 2012-06-21 | 2022-06-14 | Lungpacer Medical Inc. | Transvascular diaphragm pacing systems and methods of use |
US9776005B2 (en) | 2012-06-21 | 2017-10-03 | Lungpacer Medical Inc. | Transvascular diaphragm pacing systems and methods of use |
US10561844B2 (en) | 2012-06-21 | 2020-02-18 | Lungpacer Medical Inc. | Diaphragm pacing systems and methods of use |
US10589097B2 (en) | 2012-06-21 | 2020-03-17 | Lungpacer Medical Inc. | Transvascular diaphragm pacing systems and methods of use |
US11666757B2 (en) | 2012-12-19 | 2023-06-06 | Viscardia, Inc. | Systems, devices, and methods for improving hemodynamic performance through asymptomatic diaphragm stimulation |
US11684783B2 (en) | 2012-12-19 | 2023-06-27 | Viscardia, Inc. | Hemodynamic performance enhancement through asymptomatic diaphragm stimulation |
US10035017B2 (en) | 2013-11-22 | 2018-07-31 | Lungpacer Medical, Inc. | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US9545511B2 (en) | 2013-11-22 | 2017-01-17 | Simon Fraser University | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US11707619B2 (en) | 2013-11-22 | 2023-07-25 | Lungpacer Medical Inc. | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US9931504B2 (en) | 2013-11-22 | 2018-04-03 | Lungpacer Medical, Inc. | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US9597509B2 (en) | 2014-01-21 | 2017-03-21 | Simon Fraser University | Systems and related methods for optimization of multi-electrode nerve pacing |
US11311730B2 (en) | 2014-01-21 | 2022-04-26 | Lungpacer Medical Inc. | Systems and related methods for optimization of multi-electrode nerve pacing |
US10391314B2 (en) | 2014-01-21 | 2019-08-27 | Lungpacer Medical Inc. | Systems and related methods for optimization of multi-electrode nerve pacing |
US10857363B2 (en) | 2014-08-26 | 2020-12-08 | Rmx, Llc | Devices and methods for reducing intrathoracic pressure |
US11497915B2 (en) | 2014-08-26 | 2022-11-15 | Rmx, Llc | Devices and methods for reducing intrathoracic pressure |
US11400286B2 (en) | 2016-04-29 | 2022-08-02 | Viscardia, Inc. | Implantable medical devices, systems, and methods for selection of optimal diaphragmatic stimulation parameters to affect pressures within the intrathoracic cavity |
US10293164B2 (en) | 2017-05-26 | 2019-05-21 | Lungpacer Medical Inc. | Apparatus and methods for assisted breathing by transvascular nerve stimulation |
US11883658B2 (en) | 2017-06-30 | 2024-01-30 | Lungpacer Medical Inc. | Devices and methods for prevention, moderation, and/or treatment of cognitive injury |
US10195429B1 (en) | 2017-08-02 | 2019-02-05 | Lungpacer Medical Inc. | Systems and methods for intravascular catheter positioning and/or nerve stimulation |
US11090489B2 (en) | 2017-08-02 | 2021-08-17 | Lungpacer Medical, Inc. | Systems and methods for intravascular catheter positioning and/or nerve stimulation |
US10926087B2 (en) | 2017-08-02 | 2021-02-23 | Lungpacer Medical Inc. | Systems and methods for intravascular catheter positioning and/or nerve stimulation |
US10039920B1 (en) | 2017-08-02 | 2018-08-07 | Lungpacer Medical, Inc. | Systems and methods for intravascular catheter positioning and/or nerve stimulation |
US11944810B2 (en) | 2017-08-04 | 2024-04-02 | Lungpacer Medical Inc. | Systems and methods for trans-esophageal sympathetic ganglion recruitment |
US10940308B2 (en) | 2017-08-04 | 2021-03-09 | Lungpacer Medical Inc. | Systems and methods for trans-esophageal sympathetic ganglion recruitment |
US10987511B2 (en) | 2018-11-08 | 2021-04-27 | Lungpacer Medical Inc. | Stimulation systems and related user interfaces |
US11890462B2 (en) | 2018-11-08 | 2024-02-06 | Lungpacer Medical Inc. | Stimulation systems and related user interfaces |
US11717673B2 (en) | 2018-11-08 | 2023-08-08 | Lungpacer Medical Inc. | Stimulation systems and related user interfaces |
US11357979B2 (en) | 2019-05-16 | 2022-06-14 | Lungpacer Medical Inc. | Systems and methods for sensing and stimulation |
US11771900B2 (en) | 2019-06-12 | 2023-10-03 | Lungpacer Medical Inc. | Circuitry for medical stimulation systems |
US11266838B1 (en) | 2019-06-21 | 2022-03-08 | Rmx, Llc | Airway diagnostics utilizing phrenic nerve stimulation device and method |
WO2021061793A1 (en) * | 2019-09-26 | 2021-04-01 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US11524158B2 (en) | 2019-09-26 | 2022-12-13 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US11911616B2 (en) | 2019-09-26 | 2024-02-27 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US11925803B2 (en) | 2019-09-26 | 2024-03-12 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US11458312B2 (en) | 2019-09-26 | 2022-10-04 | Viscardia, Inc. | Implantable medical systems, devices, and methods for affecting cardiac function through diaphragm stimulation, and for monitoring diaphragmatic health |
US11957914B2 (en) | 2020-03-27 | 2024-04-16 | Viscardia, Inc. | Implantable medical systems, devices and methods for delivering asymptomatic diaphragmatic stimulation |
Also Published As
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8412331B2 (en) | Breathing therapy device and method | |
US20220176119A1 (en) | System and method to modulate phrenic nerve to prevent sleep apnea | |
JP5389650B2 (en) | A system for neural stimulation using feedback by respiration | |
US7596413B2 (en) | Coordinated therapy for disordered breathing including baroreflex modulation | |
US9872987B2 (en) | Method and system for treating congestive heart failure | |
US8140164B2 (en) | Therapeutic diaphragm stimulation device and method | |
JP5231418B2 (en) | System for neural stimulation during respiratory disorders | |
US8321022B2 (en) | Adaptive therapy for disordered breathing | |
JP3621348B2 (en) | Implantable active medical device for treating sleep apnea syndrome by electrical stimulation | |
US20090024176A1 (en) | Methods and devices for producing respiratory sinus arrhythmia | |
US20120158091A1 (en) | Therapeutic diaphragm stimulation device and method | |
US20220134101A1 (en) | Sleep apnea therapy | |
US11266838B1 (en) | Airway diagnostics utilizing phrenic nerve stimulation device and method | |
CA3147744C (en) | System and method to modulate phrenic nerve to prevent sleep apnea |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: RMX, LLC, CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:INSPIRATION MEDICAL, INC.;REEL/FRAME:030838/0273 Effective date: 20070831 Owner name: INSPIRATION MEDICAL, INC., CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:TEHRANI, AMIR J.;LIGON, DAVID;REEL/FRAME:030838/0069 Effective date: 20050110 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |