Tiered therapy for respiratory oscillations characteristic of Cheyne-Stokes respiration

• US 20050165457A1
• Filed: 10/18/2004
• Published: 07/28/2005
• Est. Priority Date: 01/26/2004
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Benser, Michael, Falkenberg, Eric
• Granted Patent: US 7,519,425 B2
• Time in Patent Office: Days
• US Class Current: 607/42
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585

Abstract

An exemplary method includes delivering a maintenance therapy that aims to prevent occurrence of apnea, sensing information, based at least in part on the information, determining if apnea exists and, if apnea exists, delivering a termination therapy that aims to terminate the apnea. An exemplary implantable device includes an input for information pertaining to respiration and control logic to call for overdrive pacing at a first rate that aims to minimize occurrence of a respiratory condition, to analyze the information for occurrence of the respiratory condition and, upon occurrence of the respiratory condition, to call for overdrive pacing at a higher rate. Other exemplary methods, devices, systems, etc., are also disclosed.

Claims

1. A method comprising:

delivering a maintenance therapy that aims to prevent occurrence of apnea;

sensing information;

based at least in part on the information, determining if apnea exists; and

if apnea exists, delivering a termination therapy that aims to terminate the apnea.

2. The method of claim 1 wherein the maintenance therapy comprises overdrive pacing.

3. The method of claim 1 wherein the termination therapy comprises overdrive pacing.

4. The method of claim 1 wherein the maintenance therapy comprises overdrive pacing at a first overdrive rate and the termination therapy comprises overdrive pacing at a second overdrive rate wherein the second overdrive rate exceeds the first overdrive rate.

5. The method of claim 1 wherein the sensing information comprises sensing information related to airway patency.

6. The method of claim 1 further comprising classifying the apnea as being related to central apnea or obstructive apnea.

7. The method of claim 1 further comprising delivering diaphragm activation if the termination therapy fails to terminate the apnea.

8. The method of claim 1 wherein the maintenance therapy occurs according to a schedule.

9. The method of claim 1 wherein the maintenance therapy occurs in response to position information of a patient.

10. The method of claim 1 wherein the maintenance therapy occurs in response to activity information of a patient.

11. The method of claim 1 wherein the sensing information occurs during the delivering of the maintenance therapy.

12. The method of claim 1 wherein the determining occurs during the delivering of the maintenance therapy.

13. The method of claim 1 further comprising adjusting one or more parameters associated with the maintenance therapy in response to the determining.

14. The method of claim 1 wherein the termination therapy comprises diaphragm activation.

15. The method of claim 1 wherein the termination therapy comprises overdrive pacing and diaphragm activation.

16. A method comprising:

delivering a maintenance therapy that aims to prevent occurrence of hypopnea;

sensing information;

based at least in part on the information, determining if hypopnea exists; and

if hypopnea exists, delivering a termination therapy that aims to terminate the hypopnea.

17. The method of claim 16 wherein the maintenance therapy comprises overdrive pacing.

18. The method of claim 16 wherein the termination therapy comprises overdrive pacing.

19. The method of claim 16 wherein the maintenance therapy comprises overdrive pacing at a first overdrive rate and the termination therapy comprises overdrive pacing at a second overdrive rate wherein the second overdrive rate exceeds the first overdrive rate.

20. The method of claim 16 wherein the sensing information comprises sensing information related to airway patency.

21. The method of claim 16 further comprising delivering diaphragm activation if the termination therapy fails to terminate the hypopnea.

22. The method of claim 16 wherein the maintenance therapy occurs according to a schedule.

23. The method of claim 16 wherein the maintenance therapy occurs in response to position information of a patient.

24. The method of claim 16 wherein the maintenance therapy occurs in response to activity information of a patient.

25. The method of claim 16 wherein the sensing information occurs during the delivering of the maintenance therapy.

26. The method of claim 16 wherein the determining occurs during the delivering of the maintenance therapy.

27. The method of claim 16 further comprising adjusting one or more parameters associated with the maintenance therapy in response to the determining.

28. The method of claim 16 wherein the termination therapy comprises diaphragm activation.

29. The method of claim 16 wherein the termination therapy comprises overdrive pacing and diaphragm activation.

30. The method of claim 16 wherein the maintenance therapy comprises diaphragm activation.

31. An implantable apparatus comprising:

an input adapted to receive information pertaining to respiration; and

control logic to call for overdrive pacing at a first rate that aims to minimize occurrence of a respiratory condition, to analyze the information for occurrence of the respiratory condition and, upon occurrence of the respiratory condition, to call for overdrive pacing at a higher rate.

32. The apparatus of claim 31 further comprising control logic to call for diaphragm activation if the overdrive pacing at a higher rate does not terminate the respiratory condition.