Multimode device and method for controlling breathing
First Claim
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1. A device for manipulating breathing of a subject, comprising:
- a phrenic nerve and/or diaphragm tissue stimulation element comprising at least a first electrode;
an upper airway stimulation element comprising at least a second electrode, where the first electrode or second electrode are configured for transvenous placement;
a controller in communication with the first and second electrodes and programmed to supply a first stimulation signal through the first electrode during at least one existing breath to a phrenic nerve and/or diaphragm tissue to elicit a diaphragm response without initiating a new breath during a respiratory cycle of the subject having intrinsic respiration and to further supply a second stimulation signal through the second electrode during at least one existing breath to tissue associated with an upper airway of the subject during said respiratory cycle to elicit a response of an upper airway musculature; and
,a sensor in communication with the controller, wherein the sensor is configured to detect at least one parameter of the respiratory cycle,wherein the controller is further programmed to coordinate the first and second stimulation signals provided by the phrenic nerve and/or diaphragm tissue stimulation element and upper airway stimulation element with respect to each other to supply diaphragm stimulation and upper airway stimulation such that the breath is supplemented, andwherein the controller is also programmed to adjust a waveform of the first stimulation signal in response to the sensed parameter of the respiratory cycle.
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Abstract
A device and method is provided for therapeutic stimulating, augmenting, manipulating and/or controlling breathing, in combination with stimulation of auxiliary respiratory nerves or muscles including the upper airway tract, chest wall muscles or abdominal muscles. Stimulation may be provided, for example, to augment breathing or to prevent closing of the upper airway during therapeutic stimulation. Stimulation may be also provided to the Hypoglossal nerve during exhalation.
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Citations
17 Claims
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1. A device for manipulating breathing of a subject, comprising:
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a phrenic nerve and/or diaphragm tissue stimulation element comprising at least a first electrode; an upper airway stimulation element comprising at least a second electrode, where the first electrode or second electrode are configured for transvenous placement; a controller in communication with the first and second electrodes and programmed to supply a first stimulation signal through the first electrode during at least one existing breath to a phrenic nerve and/or diaphragm tissue to elicit a diaphragm response without initiating a new breath during a respiratory cycle of the subject having intrinsic respiration and to further supply a second stimulation signal through the second electrode during at least one existing breath to tissue associated with an upper airway of the subject during said respiratory cycle to elicit a response of an upper airway musculature; and
,a sensor in communication with the controller, wherein the sensor is configured to detect at least one parameter of the respiratory cycle, wherein the controller is further programmed to coordinate the first and second stimulation signals provided by the phrenic nerve and/or diaphragm tissue stimulation element and upper airway stimulation element with respect to each other to supply diaphragm stimulation and upper airway stimulation such that the breath is supplemented, and wherein the controller is also programmed to adjust a waveform of the first stimulation signal in response to the sensed parameter of the respiratory cycle. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method for manipulating breathing of a subject, comprising:
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providing a phrenic nerve and/or diaphragm tissue stimulation element comprising at least a first electrode and an upper airway stimulation element comprising at least a second electrode; positioning the first electrode and/or second electrode transvenously; monitoring a respiratory parameter of the subject; supplying a first stimulation signal through the first electrode during an existing breath to a phrenic nerve and/or diaphragm tissue of the subject to elicit a diaphragm response without initiating a new breath during intrinsic respiration of the subject, wherein the first stimulation signal has a waveform which elicits the diaphragm response and which is adjusted in response to the monitored respiratory parameter; supplying a second stimulation signal through the second electrode during the existing breath to tissue associated with an upper airway of the subject to elicit a response of an upper airway musculature; and stimulating the upper airway musculature during an exhalation cycle of a first respiratory cycle prior to an inspiration portion of a next respiratory cycle. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17)
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Specification