Adaptive baroreflex stimulation therapy for disordered breathing
An approach to providing disordered breathing therapy includes delivering electrical stimulation therapy modifying a patient's baroreflex response. Disordered breathing therapy may be delivered in response to prediction or detection of disordered breathing events. Various conditions affecting the patient may be evaluated and the baroreflex therapy modified. The therapy may be modified to improve therapy efficacy, to reduce an impact to the patient and/or to mitigate therapy interactions.
1. A method of providing disordered breathing therapy to a patient, comprising:
delivering a first therapy other than a disordered breathing therapy to the patient;
evaluating one or more conditions selected from the group of precursor conditions associated with an imminent onset of disordered breathing, and conditions predisposing the patient to disordered breathing;
predicting disordered breathing in the patient based on the evaluating;
in response to the predicting, delivering a preventative therapy modifying a baroreflex response to treat the predicted disordered breathing; and
coordinating delivery of the first therapy and the preventative therapy to enhance overall therapy efficacy.
2. The method of claim 1 , wherein coordinating delivery includes coordinating delivery of the first and preventative therapies to reduce interactions therebetween.
3. The method of claim 2 , wherein the first therapy includes a cardiac pacing therapy, and wherein coordinating delivery includes delivering the electrical stimulation of the preventative therapy during a refractory period of the patient's heart.
4. The method of claim 1 , wherein the preventative therapy includes electrical stimulation applied to at least one baroreceptor, and wherein coordinating delivery includes sending an alert when the electrical stimulation is to be applied.
5. The method of claim 4 , wherein the first therapy includes a cardiac pacing therapy that utilizes an event detection algorithm, and wherein the event detection algorithm is responsive to the alert so as to prevent the electrical stimulation from being misinterpreted.
6. The method of claim 1 , wherein the first therapy includes neurostimulation for anti-hypertensive therapy.
7. The method of claim 1 , further comprising:
sensing one or more conditions affecting the patient; and
wherein the predicting is based on the sensing.
8. The method of claim 7 , wherein the one or more conditions includes at least one physiological condition and at least one non-physiological (contextual) condition.
9. A therapy system for treating disordered breathing of a patient, comprising:
a sensing system configured to sense one or more conditions affecting the patient, the one or more conditions including one or more precursor conditions associated with an imminent onset of disordered breathing, and/or one or more predisposing conditions predisposing the patient to disordered breathing;
a disordered breathing predictor coupled to the sensing system and configured to evaluate the one or more precursor conditions and/or the one or more predisposing conditions, the disordered breathing predictor further configured to predict disordered breathing using the one or more sensed conditions and based on the evaluation;
a first therapy device configured to deliver a preventative therapy to the patient in response to the predicted disordered breathing, the preventative therapy including electrical stimulation that modulates the patient's baroreflex response to treat the predicted disordered breathing;
a second therapy device configured to deliver a second therapy other than a disordered breathing therapy to the patient; and
a therapy controller coupled to the first and second therapy devices and configured to coordinate delivery of the first and second therapies to enhance overall therapy efficacy.
10. The system of claim 9 , wherein first therapy device, the second therapy device, and the therapy controller are all adapted for implantation in the patient.
11. The system of claim 9 , wherein the therapy controller coordinates delivery of the first and second therapies to reduce interactions therebetween.
12. The system of claim 11 , wherein the second therapy device includes a cardiac pacing device, and wherein the therapy controller coordinates delivery by delivering the electrical stimulation of the preventative therapy during a refractory period of the patient's heart.
13. The system of claim 11 , wherein the first therapy device sends an alert when the electrical stimulation of the preventative therapy is to be applied.
14. The system of claim 13 , wherein the second therapy device includes a cardiac pacing device that utilizes an event detection algorithm, and wherein the event detection algorithm is responsive to the alert so as to prevent the electrical stimulation of the preventative therapy from being misinterpreted.
15. The system of claim 9 , wherein the second therapy device includes an anti-hypertensive therapy device that utilizes neurostimulation.
16. The system of claim 9 , wherein the disordered breathing predictor is configured to evaluate the one or more precursor conditions and to predict the disordered breathing based on the evaluation of the one or more precursor conditions.
17. The system of claim 9 , wherein the disordered breathing predictor is configured to evaluate the one or more predisposing conditions, and to predict the disordered breathing based on the evaluation of the one or more predisposing conditions.
18. A system providing disordered breathing therapy to a patient, comprising:
means for delivering a first therapy other than a disordered breathing therapy to the patient;
means for evaluating one or more conditions selected from the group of precursor conditions associated with an imminent onset of disordered breathing, and conditions predisposing the patient to disordered breathing;
means for predicting disordered breathing in the patient based on the evaluation;
means for delivering, in response to the predicted disordered breathing, a preventative therapy modifying a baroreflex response to treat the predicted disordered breathing; and
means for coordinating delivery of the first therapy and the preventative therapy to enhance overall therapy efficacy.
19. The system of claim 18 , wherein the means for delivering the first therapy, the predicting means, the means for delivering the preventative therapy, and the coordinating means are adapted for implantation in the patient.
20. The system of claim 18 , wherein the coordinating means coordinates delivery of the first therapy and the preventative therapy to reduce interactions therebetween.
21. The system of claim 20 , wherein the first therapy includes a cardiac pacing therapy, wherein the preventative therapy includes electrical stimulation applied to at least one baroreceptor, and wherein the coordinating means delivers the electrical stimulation during a refractory period of the patient's heart.
22. The system of claim 18 , wherein the preventative therapy includes electrical stimulation applied to at least one baroreceptor, and wherein the means for delivering the preventative therapy sends an alert when the electrical stimulation is to be applied.
23. The system of claim 22 , wherein the first therapy includes a cardiac pacing therapy that utilizes an event detection algorithm, and wherein the event detection algorithm is responsive to the alert so as to prevent the electrical stimulation from being misinterpreted.