Techniques for modifying breathing rate using cardiac pacing

• US 8,483,833 B2
• Filed: 05/09/2011
• Issued: 07/09/2013
• 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:
  US13/103,861
• Publication Number:
  US 20120290033A1
• Time in Patent Office: 792 Days
• Field of Search: 607/20, 607/42
• US Class Current: 607/42
• 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 to control a heart rate of a patient and detecting inhalation and exhalation of the patient. The method further includes determining that the patient is in a resting state, and, in response to determining that the patient is in the resting state, incrementally increasing the pacing rate while exhalation of the patient is detected and incrementally decreasing the pacing rate while inhalation of the patient is detected.

Claims

1. A method comprising:

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

detecting inhalation and exhalation of the patient;

determining that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increasing the pacing rate while exhalation of the patient is detected; and

incrementally decreasing the pacing rate while inhalation of the patient is detected.

2. 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 pacing rate delivered to the one or more electrodes to control a heart rate of the patient;

detect inhalation and exhalation of the patient;

determine that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increase the pacing rate while exhalation of the patient is detected; and

incrementally decrease the pacing rate while inhalation of the patient is detected.

3. A system comprising:

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

means for detecting inhalation and exhalation of the patient;

means for determining that the patient is in a resting state; and

in response to determining that the patient is in the resting state, means for;

incrementally increasing the pacing rate while exhalation of the patient is detected; and

incrementally decreasing the pacing rate while inhalation of the patient is detected.

4. A non-transitory computer-readable storage medium comprising instructions that cause a programmable processor to:

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

detect inhalation and exhalation of the patient;

determine that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increase the pacing rate while exhalation of the patient is detected; and

incrementally decrease the pacing rate while inhalation of the patient is detected.

5. A method comprising:

controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient by delivering pacing pulses during both inhalation and exhalation of the patient;

detecting inhalation and exhalation of the patient;

determining that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increasing the pacing rate while exhalation of the patient is detected; and

incrementally decreasing the pacing rate while inhalation of the patient is detected.

6. The method of claim 5, further comprising determining that the patient is in the resting state when the heart rate of the patient has been less than a threshold heart rate for a predetermined period of time.

7. The method of claim 5, further comprising incrementally decreasing the pacing rate to a value that is less than 75% of the threshold heart rate.

8. The method of claim 5, 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 5, wherein detecting inhalation and exhalation of the patient comprises:

measuring an impedance between electrodes of the IMD; and

detecting inhalation and exhalation of the patient based on the measured impedance.

10. The method of claim 9, further comprising:

detecting inhalation of the patient based on an increase in the measured impedance; and

detecting exhalation of the patient based on a decrease in the measured impedance.

11. The method of claim 5, further comprising determining an amount by which to incrementally increase and decrease the pacing rate based on a heart rate of the patient measured prior to incrementally increasing and decreasing the pacing rate.

12. The method of claim 5, further comprising discontinuing incrementally increasing and decreasing the pacing rate when a breathing rate of the patient is greater than a threshold breathing rate.

13. 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 pacing rate delivered to the one or more electrodes to control a heart rate of the patient by delivering pacing pulses during both inhalation and exhalation of the patient;

detect inhalation and exhalation of the patient;

determine that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increase the pacing rate while exhalation of the patient is detected; and

incrementally decrease the pacing rate while inhalation of the patient is detected.

14. The device of claim 13, wherein the processing module determines that the patient is in the resting state when the heart rate of the patient has been less than a threshold heart rate for a predetermined period of time.

15. The device of claim 14, wherein the processing module incrementally decreases the pacing rate to a value that is less than 75% of the threshold heart rate.

16. The device of claim 13, 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 13, wherein the processing module:

measures an impedance between the one or more electrodes; and

detects inhalation and exhalation of the patient based on the measured impedance.

18. The device of claim 17, wherein the processing module:

detects inhalation of the patient based on an increase in the measured impedance; and

detects exhalation of the patient based on a decrease in the measured impedance.

19. The device of claim 13, wherein the processing module determines an amount by which to incrementally increase and decrease the pacing rate based on a heart rate of the patient measured prior to incrementally increasing and decreasing the pacing rate.

20. The device of claim 13, wherein the processing module discontinues incrementally increasing and decreasing the pacing rate when a breathing rate of the patient is greater than a threshold breathing rate.

21. A system comprising:

means for controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient by delivering pacing pulses during both inhalation and exhalation of the patient;

means for detecting inhalation and exhalation of the patient;

means for determining that the patient is in a resting state; and

in response to determining that the patient is in the resting state, means for;

incrementally increasing the pacing rate while exhalation of the patient is detected; and

incrementally decreasing the pacing rate while inhalation of the patient is detected.

22. The system of claim 21, further comprising means for determining that the patient is in the resting state when the heart rate of the patient has been less than a threshold heart rate for a predetermined period of time.

23. The system of claim 21, wherein means for detecting inhalation and exhalation of the patient comprises means for:

measuring an impedance between electrodes of the IMD; and

detecting inhalation and exhalation of the patient based on the measured impedance.

24. The system of claim 21, further comprising means for determining an amount by which to incrementally increase and decrease the pacing rate based on a heart rate of the patient measured prior to incrementally increasing and decreasing the pacing rate.

25. The system of claim 21, further comprising means for discontinuing incrementally increasing and decreasing the pacing rate when a breathing rate of the patient is greater than a threshold breathing rate.

26. A non-transitory computer-readable storage medium comprising instructions that cause a programmable processor to:

control a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient by delivering pacing pulses during both inhalation and exhalation of the patient;

detect inhalation and exhalation of the patient;

determine that the patient is in a resting state; and

in response to determining that the patient is in the resting state;

incrementally increase the pacing rate while exhalation of the patient is detected; and

incrementally decrease the pacing rate while inhalation of the patient is detected.

27. The computer-readable storage medium of claim 26, further comprising instructions that cause the programmable processor to determine that the patient is in the resting state when the heart rate of the patient has been less than a threshold heart rate for a predetermined period of time.

28. The computer-readable storage medium of claim 26, wherein the instructions that cause the programmable processor to detect inhalation and exhalation of the patient comprises instructions that cause the programmable processor to:

measure an impedance between electrodes of the IMD; and

detect inhalation and exhalation of the patient based on the measured impedance.

29. The computer-readable storage medium of claim 26, further comprising instructions that cause the programmable processor to determine an amount by which to incrementally increase and decrease the pacing rate based on a heart rate of the patient measured prior to incrementally increasing and decreasing the pacing rate.

30. The computer-readable storage medium of claim 26, further comprising instructions that cause the programmable processor to discontinue incrementally increasing and decreasing the pacing rate when a breathing rate of the patient is greater than a threshold breathing rate.