Transvenous phrenic nerve stimulation system
A lead system and method of use for treating breathing disorders by the transvenous stimulation of the phrenic nerve. The lead is implanted in a vein near one portion of the phrenic nerve.
1. A method of treating a patient comprising:
placing a lead in a brachiocephalic vein and proximate a left pericardiophrenic vein, the lead having at least one electrode;
positioning the at least one electrode within the left pericardiophrenic vein and adjacent a left phrenic nerve;
implanting a pulse generator for supplying electrical stimulation energy to said phrenic nerve;
delivering the electrical stimulation energy at a time after an onset of a breath, whereby the electrical stimulation energy delivered is configured to:
arrest motion of a hemidiaphragm innervated by said phrenic nerve; and
extend a duration of the stimulated breath.
2. The method of claim 1 , wherein the electrical stimulation energy is delivered such that a right phrenic nerve remains under normal physiologic control.
3. The method of claim 1 , wherein the electrical stimulation energy is delivered via a stimulation pulse having a shape wherein an amplitude of the electrical stimulation energy increases over time within the pulse.
4. The method of claim 1 , wherein the electrical stimulation energy is delivered via a stimulation pulse having a shape wherein an amplitude increases over time and then decreases over time within the pulse.
5. The method of claim 1 , wherein the electrical stimulation energy is delivered via a series of stimulation pulses that have increasing amplitudes over a period of time.
6. The method of claim 1 , wherein the electrical stimulation energy is delivered episodically without regard to sensed conditions.
7. The method of claim 1 , wherein the lead comprises a tapered distal tip.
8. The method of claim 1 , wherein the lead comprises a lead body and the lead body forms a guidewire lumen.
9. The method of claim 1 , wherein the lead comprises a drug eluting coating.
10. The method of claim 1 further comprising a step of inserting a guidewire at least one centimeter into the left pericardiophrenic vein and advancing the lead over the guidewire.
11. The method of claim 1 , comprising positioning a bend of the lead in contact with an ostium of the left pericardiophrenic vein.
12. The method of claim 1 , comprising positioning a first bend of the lead in contact with a wall of the brachiocephalic vein.
13. The method of claim 12 , comprising positioning a second bend of the lead in contact with a wall of the left pericardiophrenic vein.
14. The method of claim 1 comprising:
delivering the electrical stimulation energy at a magnitude of stimulation to
avoid incidental stimulation of cardiac tissue.
15. The method of claim 14 , wherein the lead exerts a bias force to retain a distal tip of the lead substantially immobile.
16. The method of claim 14 , comprising positioning a first bend of the lead in contact with a wall of the brachiocephalic vein.
17. The method of claim 16 , comprising positioning a second bend of the lead in contact with a wall of the left pericardiophrenic vein.
18. The method of claim 14 , comprising positioning a bend of the lead in contact with an ostium of the left pericardiophrenic vein.