Techniques for modifying breathing rate using cardiac pacing

• US 8,467,870 B2
• Filed: 05/09/2011
• Issued: 06/18/2013
• Est. Priority Date: 05/09/2011
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cho, Yong Kyun, Erickson, Mark K., Bennett, Tommy D.
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): EDWARDS, PHILIP CHARLES
• Application Number:
  US13/103,839
• Publication Number:
  US 20120290032A1
• Time in Patent Office: 771 Days
• Field of Search: 607/20, 607/42
• US Class Current: 607/20
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A method includes controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient and determining that the patient is in a resting state. The method further includes modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state. N is an integer greater than 1. Modifying the pacing rate includes incrementally increasing the pacing rate for a first portion of the N cardiac cycles, and incrementally decreasing the pacing rate for a second portion of the N cardiac cycles.

Claims

1. A method comprising:

controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient;

determining that the patient is in a resting state; and

modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles; and

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles; and

discontinuing modification of the pacing rate when at least one of a predetermined amount of time has passed since determining that the patient is in the resting state and a predetermined number of cardiac cycles have passed since determining that the patient is in the resting state.

2. The method of claim 1, further comprising, before modifying the pacing rate of the IMD for N cardiac cycles, determining amounts by which to incrementally increase and incrementally decrease the pacing rate based on at least one of a current heart rate of the patient and a breathing rate of the patient.

3. A method comprising:

controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient;

determining that the patient is in a resting state; and

modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles;

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles; and

determining, based on a target breathing rate of the patient, at least one of an amount by which to incrementally increase the pacing rate for each cardiac cycle of the first portion, an amount by which to incrementally decrease the pacing rate for each cardiac cycle of the second portion, and the number of cardiac cycles, N.

4. The method of claim 3, further comprising determining that the patient is in the resting state based on at least one of a sensed activity level of the patient and a posture of the patient.

5. The method of claim 3, wherein the first and second portions comprise all of the N cardiac cycles, and wherein the second portion occurs after the first portion.

6. The method of claim 3, wherein N is an integer that is less than or equal to 12.

7. A method comprising:

controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient;

determining that the patient is in a resting state; and

modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles;

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles; and

determining a breathing rate of the patient; and

determining the number of cardiac cycles, N, for which to modify the pacing rate based on the determined breathing rate.

8. The method of claim 7, further comprising determining that the patient is in the resting state based on at least one of a sensed activity level of the patient and a posture of the patient.

9. The method of claim 7, wherein the first and second portions comprise all of the N cardiac cycles, and wherein the second portion occurs after the first portion.

10. The method of claim 7, wherein N is an integer that is less than or equal to 12.

11. A device comprising:

one or more electrodes configured for implantation in a patient;

a stimulation module configured to generate stimulation for delivery to the one or more electrodes; and

a processing module configured to;

control a cardiac pacing rate of the stimulation delivered to the one or more electrodes to control a heart rate of the patient;

determine that the patient is in a resting state; and

modify the pacing rate for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles; and

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles; and

wherein the processing module discontinues modification of the pacing rate when at least one of a predetermined amount of time has passed since determining that the patient is in the resting state and a predetermined number of cardiac cycles have passed since determining that the patient is in the resting state.

12. The device of claim 11, wherein the processing module incrementally decreases the pacing rate to a value that is less than approximately 75% of the threshold heart rate.

13. The device of claim 11, wherein the processing module, before modifying the pacing rate of the IMD for N cardiac cycles, determines amounts by which to incrementally increase and incrementally decrease the pacing rate based on at least one of a current heart rate of the patient and a breathing rate of the patient.

14. The device of claim 11, wherein the processing module determines a breathing rate of the patient and determines the number of cardiac cycles, N, for which to modify the pacing rate based on the determined breathing rate.

15. A device comprising:

one or more electrodes configured for implantation in a patient;

a stimulation module configured to generate stimulation for delivery to the one or more electrodes; and

a processing module configured to;

control a cardiac pacing rate of the stimulation delivered to the one or more electrodes to control a heart rate of the patient;

determine that the patient is in a resting state; and

modify the pacing rate for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles; and

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles; and

wherein the processing module determines, based on a target breathing rate of the patient, at least one of an amount by which to incrementally increase the pacing rate for each cardiac cycle of the first portion, an amount by which to incrementally decrease the pacing rate for each cardiac cycle of the second portion, and the number of cardiac cycles, N.

16. The device of claim 15, wherein the processing module determines that the patient is in the resting state based on at least one of a sensed activity level of the patient and a posture of the patient.

17. The device of claim 15, wherein the first and second portions comprise all of the N cardiac cycles, and wherein the second portion occurs after the first portion.

18. The device of claim 15, wherein N is an integer that is less than or equal to 12.

19. A device comprising:

one or more electrodes configured for implantation in a patient;

a stimulation module configured to generate stimulation for delivery to the one or more electrodes; and

a processing module configured to;

control a cardiac pacing rate of the stimulation delivered to the one or more electrodes to control a heart rate of the patient;

determine a breathing rate of the patient; and

determine the number of cardiac cycles, N, for which to modify the pacing rate based on the determined breathing rate

determine that the patient is in a resting state; and

modify the pacing rate for N cardiac cycles in response to determining that the patient is in the resting state, wherein N is an integer greater than 1, and wherein modifying the pacing rate comprises;

incrementally increasing the pacing rate for a first portion of the N cardiac cycles; and

incrementally decreasing the pacing rate for a second portion of the N cardiac cycles.

20. The device of claim 19, wherein the processing module determines that the patient is in the resting state based on at least one of a sensed activity level of the patient and a posture of the patient.

21. The device of claim 19, wherein the first and second portions comprise all of the N cardiac cycles, and wherein the second portion occurs after the first portion.

22. The device of claim 19, wherein N is an integer that is less than or equal to 12.