System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device
First Claim
1. A method for delivering therapy in response to periodic breathing within a patient using an implantable medical system, the method comprising:
- detecting a period of hyperpnea; and
selectively delivering diaphragmatic stimulation during the period of hyperpnea.
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Abstract
Techniques are provided for treating periodic breathing, such as Cheyne-Stokes Respiration, using an implantable medical system. In one technique, diaphragmatic stimulation is delivered during a hyperpnea phase of periodic breathing via electrical stimulation of the phrenic nerves. Diaphragmatic stimulation is synchronized with intrinsic inspiration so as to increase the amplitude of diaphragmatic contraction during inspiration. This tends to decrease intrathoracic pressure leading to occlusion of the respiratory airway. Occlusion reduces actual ventilation during hyperpnea, thus reducing the cyclic blood chemistry imbalance that sustains periodic breathing so as to either mitigate periodic breathing or eliminate it completely. In another technique, respiration is instead inhibited during the hyperpnea phase of periodic breathing by blocking phrenic nerve signals to the extent necessary to reduce ventilation to terminate periodic breathing or at least mitigate its severity. Techniques are also described for controlling the type of therapy applied in response to periodic breathing.
79 Citations
16 Claims
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1. A method for delivering therapy in response to periodic breathing within a patient using an implantable medical system, the method comprising:
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detecting a period of hyperpnea; and
selectively delivering diaphragmatic stimulation during the period of hyperpnea. - View Dependent Claims (2, 3, 4, 5, 6)
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7. An implantable medical system for delivering therapy in response to periodic breathing within a patient, the system comprising:
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a periodic breathing detection system operative to detect episodes of periodic breathing and to identify periods of hyperpnea therein; and
a hyperpnea-based diaphragmatic stimulation system operative to selectively deliver diaphragmatic stimulation during the periods of hyperpnea. - View Dependent Claims (8, 9, 10, 11)
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12. An implantable medical system for delivering therapy in response to periodic breathing within a patient, the system comprising:
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a periodic breathing detection system operative to detect episodes of periodic breathing and to identify periods of hyperpnea and hypopnea therein;
a periodic breathing severity evaluation system operative to detect episodes of frank apnea, if any, occurring during the periods of hypopnea;
a hyperpnea-based diaphragmatic stimulation system operative to selectively deliver diaphragmatic stimulation during the periods of hyperpnea if frank apnea is found to occur during the periods of hypopnea; and
a hypopnea-based diaphragmatic stimulation system operative to selectively deliver diaphragmatic stimulation during the periods of hypopnea if frank apnea is not found to occur during the periods of hypopnea. - View Dependent Claims (13, 14, 15, 16)
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Specification