Treating sleep apnea in patients using phrenic nerve stimulation
First Claim
1. An implantable cardiac device comprising:
- a lead comprising at least one electrode, the lead being configured for advancement through a coronary sinus so that the electrode is positionable proximate the left ventricle;
pacing circuitry to apply pacing pulses to a patient'"'"'s heart via the electrode; and
a sleep apnea therapy module to occasionally apply one or more phrenic nerve stimulation pulses to the patient'"'"'s heart and phrenic nerve via the electrode, the phrenic nerve stimulation pulse having a voltage amplitude exceeding a pacing pulse voltage amplitude and delivered at a time when a pacing pulse is needed.
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Accused Products
Abstract
An exemplary implantable cardiac device is programmed to administer pacing therapy that treats both congestive heart failure (CHF) and sleep apnea. To treat CHF, the exemplary device delivers pacing pulses of a first voltage level via a lead in the left-sided veins of the heart. During periods of apnea, the device occasionally increases the pulse voltage and delivers one or more phrenic nerve stimulation pulses via the same lead to stimulate the phrenic nerve. This awakens the respiratory system to minimize or prevent episodes of sleep apnea. In an exemplary method, one or more phrenic nerve stimulation pulses are applied in synchronization with the pacing frequency so that the sleep apnea therapy does not disturb the normal cardiac rhythm. Other exemplary devices and methods are also disclosed.
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Citations
34 Claims
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1. An implantable cardiac device comprising:
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a lead comprising at least one electrode, the lead being configured for advancement through a coronary sinus so that the electrode is positionable proximate the left ventricle; pacing circuitry to apply pacing pulses to a patient'"'"'s heart via the electrode; and a sleep apnea therapy module to occasionally apply one or more phrenic nerve stimulation pulses to the patient'"'"'s heart and phrenic nerve via the electrode, the phrenic nerve stimulation pulse having a voltage amplitude exceeding a pacing pulse voltage amplitude and delivered at a time when a pacing pulse is needed. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. An implantable cardiac device comprising:
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a pulse generator to generate pacing pulses and pacing pulse trains for pacing a patient'"'"'s heart; and a therapy module to alter the pacing pulses such that the pacing pulses are effective to stimulate the patient'"'"'s heart without stimulating the patient'"'"'s phrenic nerve and the pacing pulse trains are effective to stimulate both the patient'"'"'s heart and the patient'"'"'s phrenic nerve wherein the pacing pulse trains have pulses with pulse widths of less than approximately 100 microseconds. - View Dependent Claims (10, 11, 12, 13, 14)
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15. An implantable cardiac device comprising:
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an electrode adapted for placement on a patient'"'"'s heart; implantable means for generating pulses to be applied via the electrode to the patient'"'"'s heart; and implantable means for altering pulse widths of the pulses to produce first pulses, which when applied via the electrode, stimulate the patient'"'"'s heart without stimulating the phrenic nerve, and to produce second pulses different from the first pulses, which when applied via the electrode, stimulate the patient'"'"'s heart and phrenic nerve. - View Dependent Claims (16)
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17. An implantable and programmable cardiac device having a memory and a processor, the cardiac device being programmed to perform tasks comprising:
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applying pacing pulses to pace a patient'"'"'s heart; detecting when the patient is experiencing an episode of central sleep apnea; determining when the patient is in an inspiration phase of a respiratory cycle; and in response to the detecting and to the determining, selectively applying a phrenic nerve stimulation pulse to the patient'"'"'s phrenic nerve to stimulate the patient'"'"'s phrenic nerve to provoke respiration. - View Dependent Claims (18, 19, 20, 21, 22)
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23. A method implemented by an implantable cardiac device, comprising:
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administering pacing pulses to a patient'"'"'s heart; detecting when the patient is experiencing central sleep apnea; and in response to detecting the central sleep apnea, selectively applying phrenic nerve stimulation pulses to the patient'"'"'s phrenic nerve, the phrenic nerve stimulation pulses having comparatively higher voltage and having comparatively shorter pulse widths than the pacing pulses. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30)
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31. A method comprising:
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generating pulses to be applied via an electrode to a patient'"'"'s heart; and altering pulse widths of the pulses to produce first pulses, which when applied via the electrode, stimulate either the patient'"'"'s heart without stimulating the phrenic nerve, and to produce second pulses different from the first pulses, which when applied via the electrode, stimulate the patient'"'"'s phrenic nerve and the patient'"'"'s heart. - View Dependent Claims (32)
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33. A method comprising:
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determining that a patient is at rest; and while the patient is at rest, administering a rest mode pacing therapy of comparatively lower voltage pacing pulses effective to stimulate the patient'"'"'s heart; detecting when the patient is experiencing an episode of sleep apnea; and in response to detecting the sleep apnea, administering sleep apnea pacing therapy of comparatively higher voltage phrenic nerve stimulation pulses that are effective to stimulate the patient'"'"'s phrenic nerve to provoke respiration. - View Dependent Claims (34)
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Specification