System and method of cardiac pacing during sleep apnea

• US 7,092,755 B2
• Filed: 03/18/2003
• Issued: 08/15/2006
• Est. Priority Date: 03/18/2003
• Status: Expired due to Fees

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Florio, Joseph J.
• Primary Examiner(s): Pezzuto, Robert
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US10/392,128
• Publication Number:
  US 20040186523A1
• Time in Patent Office: 1,246 Days
• Field of Search: 607/2, 607/9, 600/26, 128/898
• US Class Current: 607/9
• 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
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay

Abstract

An exemplary method for treating sleep apnea is described that includes determining parameters for a cardiac pacing pulse based, at least in part, on information characteristic of sleep apnea, wherein the cardiac pacing pulse aims to create a hemodynamic imbalance. An exemplary implantable cardiac device is programmable to perform such an exemplary method. Other exemplary methods, devices, and/or media are also disclosed.

Claims

1. A method for treating a patient experiencing sleep apnea, the method comprising:

detecting an episode of sleep apnea;

determining one or more parameters for a cardiac pacing pulse, wherein the one or more parameters are selected to create a hemodynamic imbalance within a patient'"'"'s cardiovascular system; and

delivering at least one of the cardiac pacing pulses to the patient'"'"'s heart.

2. The method as recited in claim 1, further comprising applying the cardiac pulse repetitively in sets during a sequence of cardiac cycles, wherein at least one of the cardiac pulses is applied during each cardiac cycle.

3. The method as recited in claim 2, further comprising applying an interval of physiologic pacing pulses between the sets, wherein a physiologic pacing pulse does not aim to create a hemodynamic imbalance.

4. The method as recited in claim 3, wherein each set comprises approximately 1 to approximately 20 cardiac cycles.

5. The method as recited in claim 3, wherein the interval of physiologic pacing pulses is between approximately 30 to approximately 120 seconds.

6. The method as recited in claim 3, wherein the interval of physiologic pacing pulses is approximately 20 to approximately 160 cardiac cycles.

7. The method as recited in claim 3, wherein each set includes between 1 to approximately 20 cardiac cycles and the interval of physiologic pacing is between approximately 30 to approximately 120 seconds.

8. The method as recited in claim 3, wherein each set includes from 1 to approximately 3 cardiac cycles and the interval of physiologic pacing is between approximately 5 to approximately 20 cardiac cycles.

9. The method as recited in claim 1, wherein the cardiac pulse creates a hemodynamic imbalance via a shortened AV delay.

10. The method as recited in claim 1, wherein the cardiac pulse causes an extra contraction of a ventricle in a cardiac cycle.

11. The method as recited in claim 10, wherein the cardiac pulse causes a ventricle to contract before an atrium contracts.

the means for generating non-physiologic pacing pulses comprises means for generating a ventricular stimulation pulse at an atrioventricular delay of less than approximately 25 milliseconds.

12. An implantable cardiac stimulation system comprising:

a pulse generator that generates cardiac pacing pulses for delivery to a patient'"'"'s heart;

a sleep apnea detector that is operative to detect an episode of sleep apnea; and

a sleep apnea therapy module that is responsive to the episode of sleep apnea to control the pulse generator to generate one or more non-physiologic pacing pulses, wherein the one or more non-physiologic pacing pulses are operative to cause a hemodynamic imbalance within the patient.

13. The system as recited in claim 12, wherein the sleep apnea therapy module applies the cardiac pacing pulse repetitively in sets.

14. The system as recited in claim 13, wherein the sleep apnea therapy module applies intervals of physiologic pulses between the sets, wherein a physiologic pulse does not aim to create a hemodynamic imbalance.

15. The system as recited in claim 14, wherein the sleep apnea therapy module receives feedback from the sleep apnea detector to vary the size of the sets and the size of the intervals.

16. The system as recited in 12, wherein the cardiac pacing pulse creates an abnormal cardiac electrical rhythm and the sleep apnea therapy module receives feedback from the sleep apnea detector to vary the morphology of the abnormal cardiac electrical rhythm.

17. A method for treating a patient experiencing sleep apnea, the method comprising:

detecting an episode of sleep apnea; and

in response to the episode of sleep apnea, delivering a ventricular stimulation pulse at an atrioventricular delay of less than about 25 milliseconds following an atrial event.

18. A method for treating a patient experiencing sleep apnea, the method comprising:

detecting an episode of sleep apnea in a patient; and

applying at least one cardiac pacing pulse to the patient'"'"'s heart to create a hemodynamic imbalance within the patient'"'"'s cardiovascular system in response to the detection of an episode of sleep apena.

19. An implantable cardiac stimulation system comprising:

means for detecting an episode of sleep apnea in a patient; and

means for applying at least one cardiac pacing pulse to the patient'"'"'s heart to create a hemodynamic imbalance within the patient'"'"'s cardiovascular system in response to the detection of an episode of sleep apena.

20. The implantable cardiac system of claim 19 wherein the cardiac pacing pulse emulates at least part of an abnormal cardiac rhythm.

21. The implantable cardiac system of claim 19 wherein the means for applying at least one cardiac pacing pulse to the patient'"'"'s heart to create a hemodynamic imbalance within the patient'"'"'s cardiovascular system comprise means for causing an extra contraction to occur within a subsequent cardiac cycle in response to the detection of the episode of sleep apnea.

22. The implantable cardiac system of claim 21, wherein causing an extra contraction comprises causing an extra ventricular contraction to occur within a subsequent cardiac cycle.