COMBINED VAGUS-PHRENIC NERVE STIMULATION DEVICE

1 . An implantable pulse generator ( 106 ) connected or connectable to a stimulation lead ( 100 ) having a stimulation electrode ( 107 ), the implantable pulse generator ( 106 ) including:

a. a respiration activity sensing unit ( 54 , 60 ) configured to generate a signal representing respiration activity,

b. a control unit ( 50 ) configured to trigger delivery of nerve stimulation electrical pulses via the stimulation electrode ( 107 ), wherein triggering of delivery depends on the signal representing respiration activity.

2 . The implantable pulse generator ( 106 ) of claim 1 wherein the control unit ( 50 ) is configured to:

a. generate a predictive respiration pattern from the signal representing respiration activity, and

b. trigger the stimulation pulses in dependence on the predictive respiration pattern.

3 . The implantable pulse generator ( 106 ) of claim 1 :

a. further including the stimulation lead ( 100 ), wherein the stimulation lead ( 100 ) has several stimulation electrodes ( 107 ),

b. the control unit ( 50 ) is configured to:

(1) select one or more of the stimulation electrodes ( 107 ), and

(2) trigger delivery of nerve stimulation electrical pulses via the selected electrodes ( 107 ).

4 . The implantable pulse generator ( 106 ) of claim 3 wherein at least some of the stimulation electrodes ( 107 ) are situated in a left superior intercostal vein ( 101 ) between a phrenic nerve ( 103 ) and a vagus nerve ( 104 ).

5 . The implantable pulse generator ( 106 ) of claim 3 wherein one or more of the stimulation electrodes ( 107 ) extend about no more than half of the outer circumference of the stimulation lead ( 100 ).

6 . The implantable pulse generator ( 106 ) of claim 1 wherein the control unit ( 50 ) is configured to trigger delivery of nerve stimulation electrical pulses when the signal representing respiration activity indicates a breathing pause.

7 . The implantable pulse generator ( 106 ) of claim 1 wherein the control unit ( 50 ) is configured to trigger delivery of nerve stimulation electrical pulses when the signal representing respiration activity indicates decreased inspiration and expiration amplitudes.

8 . The implantable pulse generator ( 106 ) of claim 1 wherein the signal representing respiration activity is a chest Respiration Effort Signal (REFFS).

9 . The implantable pulse generator ( 106 ) of claim 8 wherein the respiration activity sensing unit ( 54 ):

a. includes or is connected to an accelerometer, and

b. is configured to generate the chest Respiration Effort Signal (REFFS) from a signal from the accelerometer.

10 . The implantable pulse generator ( 106 ) of claim 1 wherein the respiration activity sensing unit ( 60 ):

a. includes or is connected to an impedance measurement unit ( 60 ) configured to generate an impedance signal representing intrathoracic impedance, and

b. is configured to generate the chest Respiration Effort Signal (REFFS) from the impedance signal.

11 . The implantable pulse generator ( 106 ) of claim 1 further including a telemetry unit ( 72 ) configured to:

a. receive programming, and/or

b. transmit recorded data and/or status information.

12 . The implantable pulse generator ( 106 ) of claim 1 further including a heart monitoring unit that is configured to determine at least a heart rate.

13 . The implantable pulse generator ( 106 ) of claim 1 further including:

a. a case ( 20 ) enclosing at least a portion of the implantable pulse generator ( 106 ), wherein at least a portion of the case is electrically conductive;

b. a far-field electrogram (ff-EGM) sensing unit ( 56 ) connected to:

(1) the case ( 20 ), and

(2) a stimulation electrode ( 107 ) of the stimulation lead ( 100 ), the far-field electrogram (ff-EGM) sensing unit ( 56 ) being configured to sense ff-EGM ( 600 ) signals.

14 . The implantable pulse generator ( 106 ) of claim 1 :

a. further including the stimulation lead ( 100 ),

b. wherein the stimulation lead ( 100 ) is a multi-electrode lead configured for placement in a left superior intercostal vein.

15 . A method for nerve stimulation including the steps of:

a. sensing respiration activity,

b. delivering nerve stimulation electrical pulses via a stimulation electrode ( 107 ), wherein delivery is dependent on the sensed respiration activity.

16 . The method of claim 15 :

a. further including the step of determining a predictive respiration pattern based on the sensed respiration activity, and

b. wherein the delivery of the nerve stimulation electrical pulses is also dependent on the predictive respiration pattern.

17 . The method of claim 15 wherein the nerve stimulation electrical pulses are delivered to a vagus nerve and/or a phrenic nerve.

18 . The method of claim 15 wherein the nerve stimulation electrical pulses are delivered during a breathing pause ( 504 ).

19 . The method of claim 15 wherein:

a. the nerve stimulation electrical pulses are delivered via several stimulation electrodes ( 107 ) on a stimulation lead ( 100 ),

b. the several stimulation electrodes ( 107 ) are situated:

(1) in a left superior intercostal vein ( 101 ),

(2) between a phrenic nerve ( 103 ) and a vagus nerve ( 104 ).

20 . An implantable pulse generator ( 106 )

a. a respiration activity sensing unit ( 54 , 60 ) configured to generate a signal representing respiration activity;

b. a stimulation lead ( 100 ) having a stimulation electrode ( 107 ) situated within a left superior intercostal vein between a phrenic nerve ( 103 ) and a vagus nerve ( 104 );

d. a control unit ( 50 ) configured to trigger delivery of electric stimulation pulses via the stimulation electrode ( 107 ) when the signal representing respiration activity indicates a breathing pause.