Method and apparatus for diaphragmatic pacing
First Claim
1. A method, comprising:
- delivering an electric stimulus from a lead situated within a body to a phrenic nerve at a controlled rate, wherein the electric stimulus is delivered in a region proximate a wall of a heart, wherein the electric stimulus is delivered from an electrode on the lead, the electrode being located on or within the heart.
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Accused Products
Abstract
A diaphragmatic pacing system and method. The method includes monitoring a signal representing a patient'"'"'s respiratory activity, and delivering an electric stimulus from a lead to the phrenic nerve when the signal indicates that the respiratory activity is below a predetermined level. Physiological state information, such as the respiration activity or minute ventilation, is sensed using the implanted lead and the method delivers an output based on such input. Another embodiment provides concurrent sensing and pacing of heart and diaphragm using a single implanted pulse generator. The implantable system includes at least one lead and a signal processing circuit coupled to the lead. The signal processing circuit processes a signal representative of a respiratory activity. A controller coupled to the signal processing circuit analyzes the signal and when the signal indicates a need for respiratory therapy the controller outputs a controller signal. An output circuit coupled to the controller, for delivering a pulse in response to the controller signal, the pulse having an amplitude high enough to stimulate a phrenic nerve.
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Citations
36 Claims
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1. A method, comprising:
delivering an electric stimulus from a lead situated within a body to a phrenic nerve at a controlled rate, wherein the electric stimulus is delivered in a region proximate a wall of a heart, wherein the electric stimulus is delivered from an electrode on the lead, the electrode being located on or within the heart. - View Dependent Claims (2, 3)
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4. A method, comprising:
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delivering an electric stimulus from a lead situated within a body to a phrenic nerve at a controlled rate, wherein the electric stimulus is delivered in a region proximate a wall of a heart, wherein the lead is situated along a lateral wall of a heart. - View Dependent Claims (5, 6, 7)
a cardiac rhythm management lead.
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6. The method of claim 4, wherein the controlled rate is determined by a method comprising:
analyzing whether a signal representing a respiratory state indicates a need for the electrical stimulus.
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7. The method of claim 6, wherein the respiratory state is a patient'"'"'s chest wall motion.
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8. A method, comprising:
delivering an electric stimulus from a lead situated within a body to a phrenic nerve at a controlled rate, wherein the electric stimulus is delivered in a region proximate a wall of a heart, wherein the controlled rate is a asynchronous mode rate.
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9. A method, comprising:
delivering an electric stimulus from a lead situated within a body to a phrenic nerve at a controlled rate, the electric stimulus being delivered in a region proximate a wall of a heart, wherein the controlled rate is determined by analyzing whether a signal representing a patient'"'"'s minute ventilation indicates a need for the electrical stimulus.
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10. A method, comprising:
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monitoring a signal representing a patient'"'"'s respiratory activity; and
delivering an electric stimulus from a lead to a phrenic nerve when the signal indicates that the respiratory activity is below a predetermined level, wherein the electric stimulus is delivered in a region proximate to where the phrenic nerve runs along a wall of a heart of the patient. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
rectifying the signal;
applying a low pass filter to the signal; and
calculating a decay time constant of the signal.
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14. The method of claim 13, further comprising
analyzing whether the decay time constant is below a preset level; - and
analyzing whether an amplitude of the signal is below a preset level.
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15. The method of claim 10, wherein the respiratory activity comprises a chest wall motion.
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16. The method of claim 10, wherein the respiratory activity comprises a minute ventilation.
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17. The method of claim 10, further comprising increasing the amplitude of the electric stimulus if the respiratory activity does not increase after the electric stimulus has been delivered.
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18. A method for pacing a heart and a diaphragm, comprising:
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analyzing a first signal which indicates whether the heart needs pacing and analyzing a second signal which indicates whether the diaphragm needs pacing;
delivering a first electric stimulus at a first controlled rate to pace the heart when the first signal indicates a need for heart pacing; and
delivering a second electric stimulus at a second controlled rate to pace the diaphragm when the second signal indicates a need for diaphragmatic pacing. - View Dependent Claims (19, 20, 21, 22)
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23. A method for heart and diaphragmatic pacing, comprising:
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monitoring a first signal representing a patient'"'"'s respiratory activity;
monitoring a second signal representing a patient'"'"'s heart activity;
delivering a first electric stimulus to the phrenic nerve at a first controlled rate when the signal indicates that the respiratory activity is below a predetermined level; and
delivering a second electric stimulus to the heart at a second controlled rate when the signal indicates that the heart activity is below a predetermined level. - View Dependent Claims (24, 25, 26)
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27. A system, comprising:
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at least one lead having a plurality of electrodes;
a signal processing circuit coupled to each of the at least one leads, the signal processing circuit processes a signal representative of a respiratory activity;
a controller coupled to the signal processing circuit, the controller analyzes the signal, when the signal indicates a need for respiratory therapy the controller outputs a controller signal; and
an output circuit coupled to the controller, the output circuit delivers a pulse in response to the controller signal, the pulse having an amplitude high enough to stimulate a phrenic nerve, wherein the pulse is in the constant voltage range 0.2 volts to 14 volts at a duration of approximately 0.2 to 12 milliseconds. - View Dependent Claims (28, 29, 30, 31)
a rectifying circuit for rectifying the signal;
a low pass filter circuit for applying a low pass filter to the signal; and
a circuit for calculating a decay time constant of the signal.
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31. The system of claim 30, wherein the controller comprises:
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a means for analyzing whether the decay time constant is below a preset level; and
a means for analyzing whether an amplitude of the signal is below a preset level.
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32. A system, comprising:
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at least one lead having a plurality of electrodes;
a signal processing circuit coupled to each of the at least one leads, the signal processing circuit processes a first signal representative of a respiratory activity, the signal processing circuit senses a second signal representative of a cardiac activity;
a controller coupled to the signal processing circuit, the controller analyzes the first signal and the second signal, when the first signal indicates a need for respiratory therapy the controller outputs a first controller signal, when the first signal does not indicate a need for respiratory therapy and the second signal indicates a need for cardiac therapy the controller outputs a second controller signal; and
an output circuit coupled to the controller, the output circuit delivers a first pulse in response to the first controller signal, the first pulse having an amplitude high enough to stimulate a phrenic nerve, the output circuit delivers a second pulse in response to the second controller signal, the second pulse having an amplitude high enough to pace a heart but not high enough to stimulate a phrenic nerve. - View Dependent Claims (33)
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34. A method for heart and diaphragmatic pacing, comprising:
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monitoring a first signal representing a patient'"'"'s respiratory activity;
monitoring a second signal representing a patient'"'"'s heart activity;
delivering a first electric stimulus to a phrenic nerve at a first controlled rate when the first signal indicates that the patient'"'"'s respiratory activity is below a predetermined level; and
delivering a second electric stimulus to a heart at a second controlled rate when the second signal indicates that the patient'"'"'s heart activity is below a predetermined level, wherein the first electric stimulus is in the constant voltage range 0.2 volts to 14 volts at a duration of 0.2 to 12 milliseconds, and the second stimulus is in the constant voltage range 0.1 volts to 4 volts at a duration of 0.1 to 2 milliseconds. - View Dependent Claims (35, 36)
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Specification