Systems for treating disordered breathing by comparing stimulated and unstimulated breathing
A means for treating breathing disorders by stimulating respiratory muscles or nerves to entrain respiratory systems while leaving respiratory drive intact. Embodiments of the invention employ frequency analysis to determine if appropriate stimulation energy is being applied.
1. A system for treating disordered breathing comprising:
an electrode lead to be disposed intravenously proximate a phrenic nerve of a patient, the electrode lead including one or more electrodes;
a respiration sensor to sense a signal representative of respiration of the patient;
an electrical pulse generator to provide, via the electrode lead, electrical stimulation signals to the phrenic nerve or diaphragm of the patient at a predetermined signal frequency, the electrical stimulation signals comprising a pulse train including a series of individual pulses; and
a comparator to compare a spectrum of the sensed respiration signals corresponding to unstimulated breathing to a spectrum of the sensed respiration signals corresponding to stimulated breathing to determine a value indicative of capture.
2. The system of claim 1 , wherein each of the series of individual pulses has a pulse length between 100 and 500 μsec.
3. The system of claim 2 , wherein an electric current amplitude of the individual pulses within the pulse train is gradually increased.
4. The system of claim 2 , wherein an electric current amplitude of the individual pulses within the pulse train is gradually decreased.
5. The system of claim 2 , wherein an electric current amplitude of the individual pulses within the pulse train is gradually increased, held constant, or gradually decreased.
6. The system of claim 2 , wherein a stimulation current of each of the series of individual pulses may be increased or decreased in a range between 1 and 10 mA.
7. The system of claim 1 , further comprising:
power adjusting circuitry to adjust a power of the electrical stimulation signals provided by the electrical pulse generator based on the comparison.
8. The system of claim 7 , wherein the comparator compares a power spectrum of the sensed respiration signals over a stimulation frequency band corresponding to stimulated breathing to a power spectrum of the sensed respiration signals over a respiratory frequency band corresponding to unstimulated breathing.
9. The system of claim 8 , wherein the comparator compares a power density spectrum of the sensed respiration signals over the stimulation frequency band to a power density spectrum of the sensed respiration signals over the respiratory frequency band.
10. The system of claim 8 , wherein the comparator compares a magnitude spectrum of the sensed respiration signals over the stimulation frequency band to a magnitude spectrum of the sensed respiration signals over the respiratory frequency band.
11. The system of claim 8 , wherein the comparator compares the power spectrum of the sensed respiration signals over the stimulation frequency band to the power spectrum of the sensed respiration signals over the respiratory frequency band by dividing the power spectrum of the sensed respiration signals over the stimulation frequency band by the power spectrum of the sensed respiration signals over the respiratory frequency band to determine a capture index corresponding to the value indicative of capture.
12. The system of claim 11 , wherein the power of the electrical stimulation signals is increased in response to the capture index being below a certain threshold and is decreased in response to the capture index being below the certain threshold.
13. The system of claim 7 , wherein the power of the electrical stimulation signals is provided at an intensity sufficient to entrain respiration while leaving an intrinsic drive of the patient to breathe intact.
14. The system of claim 7 , wherein the power adjusting circuitry adjusts a stimulation current.
15. The system of claim 7 , wherein the power adjusting circuitry adjusts a stimulation voltage.
16. The system of claim 7 , wherein the power adjusting circuitry adjusts a frequency of the individual pulses in the pulse train.
17. The system of claim 7 , wherein the power adjusting circuitry adjusts a pulse duration of the individual pulses in the pulse train.
18. The system of claim 1 , wherein the respiration sensor is a thoracic impedance sensor.
19. The system of claim 1 , wherein the electrical stimulation signals are applied at a constant rate.
20. The system of claim 19 , wherein the constant rate is below an intrinsic breathing rate of the patient.