Connect public, paid and private patent data with Google Patents Public Datasets

System and method for mapping diaphragm electrode sites

Download PDF

Info

Publication number
US20050085869A1
US20050085869A1 US10966484 US96648404A US2005085869A1 US 20050085869 A1 US20050085869 A1 US 20050085869A1 US 10966484 US10966484 US 10966484 US 96648404 A US96648404 A US 96648404A US 2005085869 A1 US2005085869 A1 US 2005085869A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
electrode
diaphragm
response
fig
electrodes
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10966484
Inventor
Amir Tehrani
Chang Lee
David Ligon
Mark Meltzer
Anthony Mo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
RMX LLC
Original Assignee
Inspiration Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36128Control systems
    • A61N1/36132Control systems using patient feedback
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3601Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of respiratory organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/04Detecting, measuring or recording bioelectric signals of the body or parts thereof
    • A61B5/0488Electromyography
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/08Detecting, measuring or recording devices for evaluating the respiratory organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4806Sleep evaluation
    • A61B5/4818Sleep apnoea
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235Details of waveform analysis
    • A61B5/7264Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems

Abstract

A signal source coupled to one or more electrodes in the vicinity of the diaphragm for mapping therapeutic electrode sites. A stimulus signal from the signal source may be applied to the one or more electrodes to produce activation of the diaphragm. Activation of the diaphragm is sensed to provide information that may be correlated with the stimulus signal. The correlated information may be used to identify a therapeutic locus for a therapeutic electrode. An electrical stimulus comprising a series of pulses may be applied to the one or more electrodes to elicit a desired breathing response. The electrical stimulus may be applied between intrinsic breathing cycles, or between regulated breathing cycles. More than one electrode may be supported on a single substrate. The substrate may configured to be positioned on the diaphragm. A hierarchy of stimuli may be applied to a set of electrodes.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application is a continuation-in-part to U.S. patent application Ser. No. 10/686,891, “BREATHING DISORDER DETECTION AND THERAPY DELIVERY DEVICE AND METHOD”, by Tehrani filed Oct. 15, 2003, and incorporated herein by reference.
  • FIELD OF THE INVENTION
  • [0002]
    The present invention relates to devices, systems, and methods useful for determining locations for therapeutic electrode placement on the diaphragm.
  • BACKGROUND
  • [0003]
    Electrical stimulation of the diaphragm has been performed by delivering a stimulus to the diaphragm through one or more electrodes. The location of the stimulation electrodes greatly affects the ability to obtain a desired response with a given stimulus and candidate electrode sites may be mapped in order to aid in selecting a location for electrode placement.
  • [0004]
    Diaphragm mapping is the process of correlating electrical stimuli applied at a set of points in the vicinity of the diaphragm muscle with the associated responses of the diaphragm muscle. When an electrical stimulus is applied, the diaphragm may respond directly or indirectly.
  • [0005]
    In a direct response, the diaphragm is activated by a signal that is received by muscle fibers without conduction along a nerve. In an indirect response, the muscle fibers respond to a signal that is conducted through a nerve. In general, activation of the diaphragm muscle involves both direct and indirect responses. The relative intensity of direct and indirect response will vary with electrode location.
  • [0006]
    The threshold for action potential initiation of nerves and muscle fibers is approximately the same. However, due to the signal attenuation of muscle tissue, direct stimulation is more localized with respect to an electrode than the response muscle tissue that is stimulated through nerve recruitment. Thus, changes in electrode location will typically affect the indirect and direct response differently.
  • [0007]
    A motor point mapping system is described in “Laparoscopic Placement of Electrodes for Diaphragm Pacing Using Stimulation to Locate the Phrenic Nerve Motor Points,” B. D. Schmit, T. A. Stellato, M. E. Miller, and J. T. Mortimer, IEEE Trans. Rehab. Eng., vol. 6, pp. 382-390, 1998. Mapping was done with the goal of finding a functional motor point on the surface of the diaphragm at which full hemidiaphragm activation could be achieved with a minimum stimulus current. Full activation of the diaphragm was correlated with a tidal volume or peak pressure value. Also, the anatomical motor point was determined to be substantially in the geometric center of a group of nerve branches.
  • [0008]
    Although electrode placement for obtaining full activation may be achieved by mapping a motor point, there are situations in which full activation may not be desirable, e.g., in the treatment of sleep apnea, because it may disturb the sleep of the subject.
  • [0009]
    U.S. Pat. No. 4,827,935 describes a demand electroventilator using a plurality of electrodes adapted for placement on the skin. It describes mapping locations on the skin for optimum electrode location. It also uses the tidal volume to determine the optimal placement. The optimum inspiratory points were located as the sites where the maximum volume of air was inspired per milliampere of current.
  • [0010]
    Since an activation level is characterized in each of these references by a peak or integrated value, a given activation level may be produced by many breathing patterns. Such peak or integrated value is not believed to be sufficient to determine proper placement of electrodes to achieve a desired breathing morphology because placement of electrodes influences the coordinated activation of various nerve and muscle fibers. Motor point mapping as performed in the prior art, for example, does not provide the information necessary for optimal placement of therapeutic electrodes intended to stimulate breathing patterns similar to those associated with certain activity levels such as, e.g., sleep. Such natural breathing patterns may be characterized by pressure or flow as a function of time. Also, tidal volume is not believed to provide sufficient information for optimal placement of electrodes to provide other desired inspiration morphologies that are characterized by flow properties.
  • [0011]
    Additionally, known mapping techniques have been done where the breathing of the subject is controlled by a ventilator, or by inducing a particular state (e.g., apnea induced by hyperventilation) and thus under artificial conditions. Threshold and full activation mapping have been done under these conditions, but it is not believed to be well suited for mapping that is directed to identifying optimal electrode placement for replicating intrinsic breathing patterns or for controlling or manipulating specific aspects of breathing morphology and related physiology.
  • [0012]
    Mapping has been done using a single electrode that is moved from one location to the next, with stimuli being applied and responses measured at each location. In this scheme there may be some placement error when the mapping electrode is removed and replaced with a permanent implanted electrode.
  • [0013]
    Thus, a need exists for a system and method of mapping sites on the diaphragm for therapeutic electrode placement that is more suitable to create intrinsic breathing or to control or manipulate specific aspects of breathing morphology and related physiology. A need also exists for a system and method that provides increased accuracy of electrode placement.
  • BRIEF SUMMARY OF THE INVENTION
  • [0014]
    The present invention provides a signal source for eliciting a desired respiration response that is coupled to one or more electrodes in the vicinity of the diaphragm. A stimulus signal from the source may be applied to the one or more electrodes to produce activation of the diaphragm. Respiration response is sensed to provide information that may be correlated with the stimulus signal. The correlated information may be used to identify a therapeutic locus for a therapeutic electrode.
  • [0015]
    Sensed respiration response may include, for example, parameters indicating diaphragm activation such as diaphragm movement or diaphragm EMG. Sensed respiration response may include parameters such as flow, tidal volume, intraabdominal, intrathoracic and airway pressure. Each of these parameters may be observed over time where they create a respiration or inspiration morphology.
  • [0016]
    In one embodiment of the invention an electrode is placed in the vicinity of the diaphragm and an electrical stimulus is applied between intrinsic breathing cycles, or regulated breathing cycles.
  • [0017]
    In a further embodiment an electrical stimulus comprising a series or burst of pulses is applied through one or more electrodes to the diaphragm to elicit a natural breathing response. The series of pulses may be varied in either or both amplitude and frequency.
  • [0018]
    In another embodiment a support structure supporting one or more electrodes is configured to be placed on the surface of the diaphragm. The support structure may be, e.g., a mesh or other flexible thin substrate. The support structure may comprise a variety of materials such as, e.g., silicone, PTFE, polyurethane, latex, polyester. The support structure may be a substrate with electrodes positioned on, attached to, or formed with the substrate. The substrate may be configured to be positioned on the diaphragm, e.g., by aiding proper locating, positioning and placement of the electrodes and/or by accommodating the movement of the diaphragm. The substrate may also be shaped to fit on the diaphragm and may also be keyed with anatomical structures to aid in ideal positioning. Electrical stimuli are applied sequentially and/or in combination through the electrodes to the diaphragm to elicit a natural breathing response from the diaphragm.
  • [0019]
    Another feature provides an array of electrodes configured to be laparoscopically delivered and to be positioned on the diaphragm. In addition to features that allow the device to be positioned on the diaphragm for stimulation, the substrate is foldable, deflatable and/or contractible so that it can be delivered through a small opening or cannula, and unfoldable, inflatable or expandable to be positioned on the diaphragm.
  • [0020]
    In yet another embodiment a hierarchy of stimuli are applied to a set of electrodes. At each level in the hierarchy the stimuli are more complex with a greater number of adjustable parameters. The set of electrodes may be reduced in number as each level in the hierarchy is reached.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0021]
    FIG. 1 shows a diagram of a system for mapping electrode sites on a diaphragm in accordance with an embodiment of the present invention.
  • [0022]
    FIG. 2A shows a guide grid on a diaphragm in accordance with an embodiment of the present invention.
  • [0023]
    FIG. 2B shows electrode arrays placed with respect to an anatomical feature in accordance with an embodiment of the present invention.
  • [0024]
    FIG. 2C shows a template corresponding to each of electrode arrays of FIG. 2B
  • [0025]
    FIG. 3A shows a top view of an array of electrodes on a single substrate in accordance with an embodiment of the present invention.
  • [0026]
    FIG. 3B shows a cross-section view of the electrode array of FIG. 3A in accordance with an embodiment of the present invention.
  • [0027]
    FIG. 4A shows an electrode array arranged on an inflatable member in accordance with an embodiment of the present invention.
  • [0028]
    FIG. 4B shows a diagram of an in situ electrode substrate in accordance with an embodiment of the present invention.
  • [0029]
    FIG. 5 shows a perspective view of an electrode array with a suction field surrounding the electrodes in accordance with an embodiment of the present invention.
  • [0030]
    FIG. 6A shows a view of the active surface of an electrode array with an inflatable member in accordance with an embodiment of the present invention.
  • [0031]
    FIG. 6B shows a side view of the electrode array of FIG. 6A.
  • [0032]
    FIG. 6C shows the electrode array of FIG. 6A in a folded configuration in accordance with an embodiment of the present invention.
  • [0033]
    FIG. 7A shows a perspective view of an electrode array with an inflatable member and suction field in accordance with an embodiment of the present invention.
  • [0034]
    FIG. 7B shows a side view of the electrode array of FIG. 7A.
  • [0035]
    FIG. 7C shows the electrode array of FIG. 7A in a folded configuration in accordance with an embodiment of the present invention.
  • [0036]
    FIG. 8 shows a stimulus waveform in accordance with an embodiment of the present invention.
  • [0037]
    FIG. 9A shows a natural breathing response waveform in accordance with an embodiment of the present invention.
  • [0038]
    FIGS. 9B1-9B4 shows target, acceptable and unacceptable breathing response waveforms in response to stimulation in accordance with an embodiment of the present invention.
  • [0039]
    FIGS. 9C1-9C4 shows target, acceptable and unacceptable breathing response waveforms in response to stimulation in accordance with an embodiment of the present invention.
  • [0040]
    FIGS. 9D1-9D4 shows target, acceptable and unacceptable breathing response waveforms in response to stimulation in accordance with an embodiment of the present invention.
  • [0041]
    FIGS. 9E1-9E4 shows target, acceptable and unacceptable breathing response waveforms in response to stimulation in accordance with an embodiment of the present invention.
  • [0042]
    FIGS. 10A and 10B show timing diagrams for a stimulus applied during intrinsic breathing in accordance with embodiments of the present invention.
  • [0043]
    FIG. 11 shows an electrode array and sensors placed on the diaphragm in accordance with an embodiment of the present invention.
  • [0044]
    FIG. 12 shows a flow chart of a coarse mapping method in accordance with an embodiment of the present invention.
  • [0045]
    FIG. 13A shows a flow chart of a method for intrinsic breathing evaluation in accordance with an embodiment of the present invention.
  • [0046]
    FIG. 13B shows a flow chart of a method for baseline acquisition for mapping performed on a subject with regulated breathing in accordance with an embodiment of the present invention.
  • [0047]
    FIG. 14A shows a flow chart of a preliminary array mapping method in accordance with an embodiment of the present invention.
  • [0048]
    FIG. 14B shows a flow chart of a preliminary array mapping method in accordance with an embodiment of the present invention.
  • [0049]
    FIG. 15A shows a flow chart of a single parameter mapping method in accordance with an embodiment of the present invention.
  • [0050]
    FIG. 15B shows a flow chart of a single parameter mapping method in accordance with an embodiment of the present invention.
  • [0051]
    FIG. 16A shows a flow chart of a multi-parameter mapping method in accordance with an embodiment of the present invention.
  • [0052]
    FIG. 16B shows a flow chart of a multi-parameter mapping method in accordance with an embodiment of the present invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0053]
    FIG. 1 shows a system 100 for mapping electrode sites on a diaphragm 155 of a subject 135. A laparoscopic imaging unit 130 is coupled to a laparoscope 145 for observing the surface of the diaphragm 155. The imaging unit 130 is coupled to a diaphragm mapping control module 105. The imaging unit 130 may provide analog or digital images to the control module 105. The control module 105 includes a monitor 110, processing unit 115 and an I/O module 120.
  • [0054]
    The monitor 110 may be used displaying a graphical user interface and may also be used for displaying images. Displayed images may be either real-time images from the imaging unit 130 or stored images. Stored images may be overlaid with real-time images to provide visual references for electrode placement.
  • [0055]
    The processing unit 115 includes a data processor, memory, and program storage for data and image acquisition and manipulation. The processing unit 115 is coupled to an input/output (I/O) module 120, and may be used to control the timing of stimuli delivered to mapping electrodes.
  • [0056]
    The I/O module 120 is coupled to the imaging unit 130, and to one or more electrodes 151 on the mapping electrode substrate 150. The electrodes 151 on the mapping electrode substrate are configured for electrical stimulation and/or sensing of the diaphragm. The I/O module may also be coupled to other sensing devices coupled to the subject 135, such as a respiratory sensor 125 (e.g., pneumotachometer) or electrical/mechanical sensors 140 and/or 152. Sensor 152 is shown positioned for sensing abdominal movement, whereas sensor 140 is positioned for sensing movement in the thoracic region 160. Sensors 140, 152 may also be used to sense movement of the subject which can provide information, such as, activity level of the subject. Alternatively other sensors may positioned or coupled to the body and in communication with the I/O module. The I/O module may also have a keyboard, mouse, or other device for operator input.
  • [0057]
    Respiratory sensor 125 may be, e.g., a flow meter, pneumotachometer, or pressure sensor used to measure tidal volume, respiratory flow, and/or respiratory pressure. Sensor 140 may be, e.g., a piezo-film sensor, multi-axis accelerometer, strain gauge, pressure sensor, and may be used to measure abdominal movement, diaphragmatic movement, other subject movement or activity, intrathoracic pressure, or intraabdominal pressure.
  • [0058]
    The system 100 may be used to develop a coordinate system on a per subject basis by capturing an image of the surface of the diaphragm 155, upon which the mapping electrode substrate 150 is attached. The image obtained by the imaging unit 130 is transferred to the control module 105. Each time the mapping electrode substrate 150 is moved, a new coordinate system is created. Once a desired therapeutic locus is determined on the surface of the diaphragm 155 as described in more detail below, the control unit may use the images acquired during the mapping process to provide guidance for placement of a permanent electrode, e.g. through real-time visual aid (video feed, laser grid), audible proximity indicator beeps, or haptic feedback.
  • [0059]
    FIG. 2A shows an abdominal view of a diaphragm 205 with a reference grid 210 applied to the right hemidiaphragm 215 and a reference grid 220 applied to the left hemidiaphragm 225. The reference grid may be applied with an ink or dye, or it may be an optical projection. The grids 210 and 220 may be used as a reference for electrode placement.
  • [0060]
    FIG. 2B shows an abdominal view of a diaphragm 205 with attached electrode substrates 230 and 235. The electrode substrates are configured to be positioned on the diaphragm. The electrode substrates 230, 235 include electrodes 233 located on the substrates in a predetermined configuration. Electrode substrate 230 has a keyed or curved portion 231 on its perimeter that matches the depression 245 on the central tendon 240. Similarly, electrode substrate 235 has a keyed or curved portion 232 on its perimeter that matches the depression 250 on the central tendon 240. The keyed configuration of the electrode substrate 235 allows a more precise locating, positioning and placement of the substrates on the diaphragm. The substrates 230, 235 further include template openings 234 for marking the position of the substrates 230, 235 after electrode selection has been made.
  • [0061]
    The electrode substrates 230 and 235 may be attached to the diaphragm 205 in a number of ways with laparoscopic instruments, for example with sutures, staples or clips, temporary adhesive (bio-adhesive), and suction.
  • [0062]
    To identify the precise location of the selected mapping electrode after the substrates 230, 235 have been removed, a mark is made through each of the template openings 234. A template 236 as illustrated in FIG. 2C includes matching template openings 237 that match the orientation of the template openings 234 of the substrates 230, 235. Electrode openings 238 in the template 236 also match the orientation of the electrodes 233 on the substrates 230, 235. Thus, using the marks made through template openings 234 in the substrates 230, 235, the template is positioned with openings 237 over the marks. The electrode opening that corresponds to the selected electrode on the array may then be used to mark the correct location for a subsequently implanted electrode. Permanently implanted electrodes may then be placed in position of the selected optimal mapping electrode or electrodes as they were positioned with the mapping substrate.
  • [0063]
    The electrode substrate may also include an adhesive dye (which can be radio-opaque) in a pattern where once the substrate is removed, the adhesive sticks to the diaphragm indicating key locations so that mapped positions may be visually or radiographically identified. The locations of the mapping substrate and electrodes may also be identified with a photo taken of the substrate in position on the diaphragm.
  • [0064]
    This and other electrode assemblies and/or substrates described herein may be temporarily implanted or permanently implanted and used for stimulation once the assembly or substrate has been optimally positioned.
  • [0065]
    FIG. 3A shows a top view of an array of electrodes (310,315) on a single substrate 305 in accordance with an embodiment of the present invention. Electrode 310 is a subsurface electrode that is intended to penetrate the peritoneum on the diaphragm, whereas electrode 315 is a surface electrode that is intended for contact with the surface of the peritoneum on the diaphragm. A subsurface electrode 310 will generally provide a greater electrical efficiency, whereas a surface electrode 315 will more easily couple to a larger region. A surface electrode may 315 be combined with a subsurface electrode 310 to form a single composite electrode. These electrodes may also be selected to elicit a desired observed response.
  • [0066]
    The substrate 305 is preferably fabricated from a flexible material such as silicone, and may or may not be reinforced (e.g., with a mesh). The substrate is configured to fit on the diaphragm. The perimeter of the substrate 305 may be round, elliptical, or a more complex shape that conforms to a specific feature on the diaphragm surface. A complex perimeter shape may be used to facilitate placement of the substrate 305 at a particular location on the surface of the diaphragm, such as one of the depressions separating the three leaflets of the diaphragm, or characteristics of the central tendon.
  • [0067]
    The electrode array on the substrate 305 may contain only surface or subsurface electrodes or a combination of surface and subsurface electrodes. The electrodes may be arranged in a regular array using polar or rectangular coordinates, or they may be arranged as an irregularly spaced array, e.g., that is correlated with nerve structure that innervates the diaphragm. The electrodes may be attached to the substrate a number of ways, e.g., glued, welded, etched on, or encased with the substrate material.
  • [0068]
    FIG. 3B shows a cross-section view A-A of the electrode array of FIG. 3A. The substrate is thicker in the central region and tapers at the perimeter. A reinforcement 325 is also shown. The taper at the perimeter 321 reduces the dynamic interfacial forces that are produced between substrate and diaphragm during activation of the diaphragm. The enhanced peripheral flexibility reduces mechanical loading of the diaphragm and reduces the stress on the attachment (e.g., sutures or suction). The substrate surface 320 upon which the electrodes reside may be flat, or it may be curved to accommodate the surface of the diaphragm.
  • [0069]
    Electrodes 310 and 315 may be used individually as monopolar electrodes for sensing and/or stimulation, or any two electrodes may be select as a pair for bipolar sensing and/or stimulation.
  • [0070]
    The electrode assembly may also be in the form of a flexible wire member such as a flexible loop. The flexibility of the loops permits the ability to form the loops in the shape most ideally suited for a particular patient. Other shapes may be used as well, e.g. a loop with a branch that extends to the region adjacent the anterior branches of the phrenic nerve. The control unit may be programmed to activate the electrodes in a sequence that is determined to elicit the desired response from the diaphragm.
  • [0071]
    The electrodes of the electrode assemblies once implanted, may be selected to form bipolar or multipolar electrode pairs or groups that optimize the stimulation response.
  • [0072]
    FIG. 4A shows an electrode array 400 coupled to an inflatable member 405 defining an inflation chamber 406. In this embodiment, the inflatable member 405 may be inflated to contact a surface opposite the diaphragm to provide the force necessary to hold the electrode array 400 against the surface of the diaphragm. The electrodes may be coupled to an external I/O device with lead wires extending inside of, outside of or within the walls of the inflation tube. The inflation chamber 406 is coupled to a tube 420 that delivers an inflation medium to or from the chamber 407. The tube 420 may also serve to couple the pressure within the inflation chamber 407 to an external pressure transducer. Alternatively pressure within the inflation chamber 407 may be sensed by a local pressure transducer 425 which is coupled to an I/O port with a lead or in a similar manner as the electrodes. The inflation chamber 407 may be evacuated in order to reduce the volume of the inflation member 405 and electrode array 400 during an insertion or removal procedure.
  • [0073]
    FIG. 4B shows a diagram of an in situ electrode substrate 406. In this example, the electrode substrate 406 is coupled to a flexible tube 435 that penetrates the abdominal wall 440. A switching network 450 couples lines 441 and 442 from the control unit 430 to an array of nine electrodes. The switching network 450 allows any one or two of the nine electrodes to be selected, and reduces the number of leads that must be connected directly to the control unit 430. Electrode selection may be done either for monopolar/bipolar sensing, or stimulus delivery.
  • [0074]
    The electrode substrate 406 may support one or more sensors 445 for sensing electrical or mechanical activity of the diaphragm. Sensor 445 is coupled to the control unit 430 by lead 443. Examples of electrical sensors are monopolar and bipolar electrodes for electromyogram (EMG) sensing. Examples of mechanical activity sensors are: strain gauges, pressure sensors, piezo-electric devices, accelerometers, and position sensors.
  • [0075]
    FIG. 5 shows a perspective view of an electrode array structure 505 with a suction field surrounding the electrodes 515 in accordance with an embodiment of the present invention. The electrodes 515 are supported on a mesh 510 that is circumferentially enclosed by a seal surface 520 that interfaces with the diaphragm surface. A port 525 is used to connect a vacuum source to the electrode array structure 505. Vacuum is applied after the seal surface is placed on or mated to the surface of the diaphragm.
  • [0076]
    FIG. 6A shows a view of the active surface of an electrode array structure 605 with an inflation member 620 having an inflation chamber 621 in accordance with an embodiment of the present invention. Individual suction cups 615 are used to provide the attaching force to the diaphragm. Electrodes 610 are distributed on the surface between the suction cups 615. FIG. 6B shows a side view 601 of the electrode array structure of FIG. 6A. Vacuum ports 625 are shown connected to the suction cups 615, and a fill/evacuation port 630 is shown coupled to the inflation chamber 621.
  • [0077]
    FIG. 6C shows the electrode array of FIG. 6A in a folded configuration that is produced in conjunction with deflation of the inflation member 620. The deflation of the inflation chamber 621 of the inflation member 620 produces a reduction in volume and an elongated shape that facilitates the introduction and removal of the electrode array structure 605 through a cannula or a narrow opening.
  • [0078]
    FIG. 7A shows a perspective view of an electrode array 705 on an inflation member 740 with an inflation chamber 741 and a suction field mesh 710 in accordance with an embodiment of the present invention. Electrodes 715 are supported on the mesh 710. The mesh 710 is surrounded by a seal surface 720. The inflation chamber 741 is coupled to a fill/evacuation port 730. An evacuation port 725 is used provide to provide vacuum to the electrode array 705. Having the mesh 710 with electrodes 715 inside the suction field allows stabilization of the tissue via vacuum and provides intimate contact between the tissue and the electrodes 715 during contraction of the diaphragm. FIG. 7B shows a side view of the electrode array of FIG. 7A. The inflation member 740 has a radial symmetry (e.g., toroidal) with respect to the evacuation port 725.
  • [0079]
    FIG. 7C shows the electrode array of FIG. 7A in a folded configuration that is produced in conjunction with deflation of the inflation member 740. The deflation of the inflation member 740 produces a reduction in volume and an elongated shape that facilitates the introduction and removal of the electrode array structure 705 through a cannula or a narrow opening.
  • [0080]
    The electrode arrays described herein may be configured to be laparoscopically delivered to the diaphragm. They may be compressed to a smaller configuration and then expanded to be positioned on the diaphragm. They may also be delivered as individual components and assembled at the diaphragm. They may also be delivered as individual components and assembled at the diaphragm.
  • [0081]
    FIG. 8 shows an example of a stimulus waveform 800 that may be applied to the diaphragm through an electrode. Waveform 800 is a biphasic pulse train; however, in other embodiments a monophasic or other multiphasic pulse train may be used. The individual pulses within the pulse train 800 may have variable amplitudes. For example, pulse 805 has an amplitude A1 that is smaller than the amplitude A2 of pulse 810. The pulse train 800 may also have a variable frequency, with the period P1 between pulses 813 and 815 being greater than the period P2 between succeeding pulses 820 and 825. The first pulse amplitude A1 may be selected to on the basis of an observed or measured threshold value associated with the response of the diaphragm to an applied stimulus (e.g., an observed muscle twitch).
  • [0082]
    The stimulus waveform or pulse train 800 may incorporate a delay D between positive and negative pulses, as shown between positive pulse 810 and negative pulse 811.
  • [0083]
    FIG. 9A shows an example of a natural breathing flow response waveform 905 associated with a stimulation waveform 910 delivered to a therapeutic locus on the diaphragm. For purposes of this disclosure, “intrinsic breathing” refers to breathing that is not induced by an applied stimulus, and “natural breathing” refers to breathing that is similar or identical to intrinsic breathing, but is induced by an applied stimulus. The natural breathing flow response waveform 905 is similar to intrinsic respiration waveforms observed in humans. Flow increases gradually during most of the inspiration phase to a peak value, followed by a relatively sharp decline in flow to the onset of the expiration phase. In this example, the first pulse in the stimulation waveform 910 has an amplitude At, that is equal to a measured or observed threshold value for the therapeutic locus. FIG. 9A similarly illustrates a natural breathing EMG response waveform 906 and envelope 907 associated with the stimulation waveform 910.
  • [0084]
    FIG. 9B 1 illustrates a stimulation waveform 925 delivered to candidate therapeutic loci on the diaphragm. The various loci of stimulation correspond to resulting response waveforms 926, 927, 928 illustrated in FIGS. 9B2, 9B3, 9B4 respectively and each corresponding to a response resulting from stimulation at a different locus. Different waveforms may also result from variations in the stimulation pulses such as, e.g., in frequency pulse duration and amplitudes as well as by using different electrode firing sequences as described for example in parent application Ser. No. 10/686,891.
  • [0085]
    The waveform responses illustrated in FIGS. 9B1-9B2 are measured in airflow but may also be determined, from other respiration parameters, e.g. EMG or diaphragm movement. “Morphology” refers to the shape or form of the respiration waveform or waveform envelope and may include various aspects of the waveform including, e.g., length of various portions of the waveform, amplitude, frequency or slope. A desired response may be natural breathing as illustrated in FIG. 9A or another desired response.
  • [0086]
    FIG. 9B 2 illustrates a waveform response 926 in an ideal, preferred or target range. According to this target morphology, for a given portion of the inspiration cycle positive inhalation is sustained. A sustained inhalation period or portion of time is an inhalation period in which there is a positive airflow. The target range may be expressed as a portion, fraction or percentage of time of the inspiration cycle in which there is a positive or sustained inhalation. While this effect may be expressed in these terms, a percentage or fraction calculation is not required to achieve the effect of the invention or its equivalent. The target range is from about 75% to 100% sustained inhalation. The waveform illustrated in FIG. 9B 2 shows an inspiration cycle where 95% or 0.95 of the inspiration cycle is sustained positive inhalation.
  • [0087]
    FIG. 9B 3 illustrates a waveform response 927 in an acceptable range. The acceptable range is between about 50% and 100% sustained inhalation. The illustrated waveform is at 60% sustained positive inhalation.
  • [0088]
    FIG. 9B 4 illustrates a waveform 928 response in an unacceptable range. The unacceptable range is below about 50% sustained inhalation. The illustrated waveform is at 20% sustained positive inhalation. Less than about 50% suggests poor efficiency of the delivered stimulation pulse.
  • [0089]
    It is believed that long period of isometric diaphragm contraction can lead to diaphragm fatigue and patient discomfort. Staying within the target range suggests increased energy efficiency, likely responses similar to physiologic or natural conditions. Gradual contraction is also less likely to cause airway collapse or stretch receptor inhibition reflex and is likely to provide more comfortable breathing for patients.
  • [0090]
    FIG. 9C 1 illustrates a stimulation waveform 935 delivered to candidate therapeutic loci on the diaphragm. The various loci of stimulation correspond to resulting response waveforms 936, 937, 938 illustrated in FIGS. 9C2, 9C3, 9C4 respectively and each corresponding to a response resulting from stimulation at a different locus (or alternatively by varying stimulation parameters).
  • [0091]
    The waveform responses illustrated in FIGS. 9C1-9C2 are measured in airflow but may also be determined, from other respiration parameters, e.g. EMG or diaphragm movement.
  • [0092]
    FIG. 9C 2 illustrates a waveform response 936 in an ideal, preferred or target range. According to this target morphology, the ratio of peak flow over stimulation time for a given portion of the inspiration cycle is less than about 3.5. The ratio may also be expressed as a ratio of percentage of peak flow over a percentage of pacing time. While the effects herein may be expressed as a certain value, a specific calculation of the value is not required to achieve the invention or its equivalent.
  • [0093]
    FIG. 9C 3 illustrates a waveform response 937 in an acceptable range. The acceptable range ratio of peak flow over pacing time is about less than or equal to about 10.
  • [0094]
    FIG. 9C 4 illustrates a waveform response 938 in an unacceptable range. The unacceptable range ratio of peak flow over pacing time is above about 10. A ratio above 10 suggests an abrupt flow which may cause airway collapse, stretch receptor inhibition reflex, or pain for patients.
  • [0095]
    FIG. 9D 1 illustrates a stimulation waveform 945 delivered to candidate therapeutic loci on the diaphragm. The various loci of stimulation correspond to resulting response waveforms 946, 947, 948 illustrated in FIGS. 9D2, 9D3, 9D4 respectively and each corresponding to a response resulting from stimulation at a different locus (or alternatively by varying stimulation parameters).
  • [0096]
    The waveform responses illustrated in FIGS. 9D1-9D2 are measured in airflow but may also be determined, from other respiration parameters, e.g. EMG or diaphragm movement.
  • [0097]
    FIG. 9D 2 illustrates a waveform response 946 in an ideal, preferred or target range. According to this target morphology, the instantaneous slope of peak flow over stimulation time for a given portion of the inspiration cycle is less than about 0.75. The ratio may also be expressed as a ratio of percentage of peak flow per milliseconds. While the effects herein may be expressed as a certain value, a specific calculation of the value is not required to achieve the invention or its equivalent.
  • [0098]
    FIG. 9D 3 illustrates a waveform response 947 in an acceptable range. The acceptable range of instantaneous peak flow over time is about less than or equal to about 2.
  • [0099]
    FIG. 9D 4 illustrates a waveform response 948 in an unacceptable range. The unacceptable range of instantaneous peak flow over time is above about 2. A ratio above 2 suggests an abrupt flow which may cause airway collapse, stretch receptor inhibition reflex, or pain for patients.
  • [0100]
    FIG. 9E 1 illustrates a stimulation waveform 955 delivered to candidate therapeutic loci on the diaphragm. The various loci of stimulation correspond to resulting response waveforms 956, 957, 958 illustrated in FIGS. 9E2, 9E3, 9E4 respectively and each corresponding to a response resulting from stimulation at a different locus (or alternatively by varying stimulation parameters).
  • [0101]
    The waveform responses illustrated in FIGS. 9E1-9E2 are measured in airflow but may also be determined, from other respiration parameters, e.g. EMG or diaphragm movement.
  • [0102]
    FIG. 9E 2 illustrates a waveform response 956 in an ideal, preferred or target range. According to this target morphology, the minimum time elapsed before peak flow is achieved is greater than or equal to about 300 milliseconds or more.
  • [0103]
    FIG. 9E 3 illustrates a waveform response 957 in an acceptable range. The acceptable range of minimum time to reach peak flow is greater than or equal to about 100 milliseconds and more preferably between about 100 milliseconds and 300 milliseconds.
  • [0104]
    FIG. 9E 4 illustrates a waveform response 958 in an unacceptable range. The unacceptable range minimum time to reach peak flow is less than about 100 milliseconds. A time below about 100 ms suggests an abrupt flow which may cause airway collapse, stretch receptor inhibition reflex, or pain for patients.
  • [0105]
    Various desired responses may also include waveforms or morphologies that have a desired physiological outcome or effect such as desired blood oxygen saturation levels or PCO2 levels. Minute ventilation may be increased or decreased with respect to a baseline minute ventilation. This may be done by manipulation of one or more parameters affecting minute ventilation. Some of the parameters may include, for example, tidal volume, respiration rate, flow morphology, flow rate, inspiration duration, slope of the inspiration curve, and diaphragm created or intrathoracic pressure gradients. Increasing minute ventilation generally increases the partial pressure of O2 compared to a reference minute ventilation. Decreasing minute ventilation generally increases the partial pressure of CO2 compared to a reference minute ventilation.
  • [0106]
    As noted variations in stimulation parameters may be used to elicit different responses and therefore may also be used to determine optimal electrode location as well as optimal stimulus parameters. This stimulation may also be done with multiple electrodes simultaneously or in a sequence.
  • [0107]
    The system may adjust the pace, pulse, frequency and amplitude within a series of pulses to induce or control various portions of a respiratory cycle, inspiration, exhalation, tidal volume (area under waveform curve) slope of inspiration, fast exhalation and other parameters of the respiratory cycle. The system may also adjust the rate of the respiratory cycle.
  • [0108]
    The stimulation optimization may be used not only for mapping to identify electrode sites but may also be used to determine stimulation parameters for the ultimately implanted device. As such the ideal, preferred, target and acceptable waveform morphologies are not only for mapping but are also ideal, preferred, target and acceptable stimulation responses in the implanted device.
  • [0109]
    A breathing response depends upon both the electrode location and the applied stimulus waveform. Not all electrode locations may be capable of producing a desired response. Also, different stimulus waveforms may be required at those locations that are shown to be capable of producing a desired response.
  • [0110]
    FIG. 10A shows a timing diagram for a fixed stimulus 1000 applied during a rest period associated with intrinsic (or regulated) breathing. Regulated breathing refers to a predominantly regular breathing pattern that is produced by external assistance (e.g., a ventilator). Fixed stimulation may also be done during absence of breathing (e.g., in apnea) where stimulation is applied a certain period of time after apnea has begun. The fixed stimulus may be applied after a percentage (e.g., 30%) of the observed rest period has elapsed, or it may be applied after a fixed period of time has elapsed. The fixed period of time may be referenced to the beginning of inhalation 1005, end of inhalation 1010, or end of exhalation 1015. The fixed time period may also be referenced to a period of time after EMG waveform 1006 has stopped or after the EMG envelope 1007 has fallen off. Fixed stimulation is not necessarily in phase with intrinsic respiration, and rather, is offset from a previous cycle.
  • [0111]
    FIG. 10B shows a timing diagram for a dynamically synchronized stimulus 1020 applied during a rest period associated with intrinsic (or regulated) breathing. The dynamically synchronized stimulus is applied after a delay equal to the length of the inspiration phase, expiration phase, or the total respiratory cycle. The delay is indexed to the end of the respiration cycle 1035. In this example the delay at 1035 is approximately equal to or less than the total respiratory cycle. The delay may also be equal to the length of the EMG signal 1036 or to the length of the EGM envelope 1037. The delay may also be indexed to the end of the EMG envelope 1038. Dynamic synchronization may occur or be adjusted breath to breath.
  • [0112]
    While the stimulation may be fixed or dynamically synchronized, it may also switch between fixed and dynamically synchronized, for example depending on the rate of respiration. If a subject is hyperventilating, hypoventilating or apneaic, the stimulation may revert to a fixed stimulation mode.
  • [0113]
    FIG. 11 shows an abdominal view of a diaphragm 1105 with attached electrode substrates 1110 and 1120. Electrode substrates 1110, 1120 have keyed portions 1111, 1121 respectively for positioning the substrate 1110, 1120 on a conforming portions or surfaces of the central tendon 1106. Electrode substrate 1110 located on the right hemidiaphragm 1115 has a pair of extensions 1126 a-b. Electrode substrate 1120 located on the left hemidiaphragm 1125 has a single extension 1126 c. Each extension 1126 a-c supports a peripheral device 1130 that may be either an electrode (e.g., stimulation or sensing electrode) or a sensor (e.g., movement sensor). The extensions 1126 a-c are located adjacent specific portions of the diaphragm apart from the stimulation electrodes. The peripheral device or devices 1130 sense movement or EMG at a distal or radial location from the stimulation electrodes on the electrode substrates 1110, 1120. This sensed movement or EMG may be used to confirm activation or degree of activation of the diaphragm from stimulation by one or more electrodes on the substrates 1110, 1120.
  • [0114]
    FIGS. 12 through 16 show a series of flow charts for process sequences that may be combined to provide a hierarchical method for mapping diaphragm electrode sites. First, coarse mapping is done as described with reference to FIG. 12. Coarse mapping entails testing a wide area on the diaphragm which is typically greater than the are of the electrode assembly used in testing. Once an area for electrode array positioning is determined, specific electrode position testing is performed and then stimulation optimization as described in FIGS. 13A-16B. These process sequences may be performed using all or part of the system shown in FIG. 1.
  • [0115]
    FIGS. 13A, 14A, 15A and 16A are directed to patients who are breathing on their own. FIGS. 13B, 14B, 15B and 16B are directed to patients in artificial respiratory states (i.e.—ventilator dependent.
  • [0116]
    FIG. 12 shows a flow chart of a coarse mapping method in accordance with an embodiment of the present invention. This method may be used as a preliminary mapping process to determine the initial placement of an electrode array. Coarse mapping may be useful since physical land marks provided by the diaphragm might not be enough to identify an optimal positioning of the electrode array. In order to determine sections of the diaphragm that is more responsive to electrical stimulation course mapping may be performed. In step 1210 a coordinate system is established in a selected area. The selected area is typically larger than the foot print of the electrode array being placed. Selection of the area may be based upon visually observable features of the diaphragm, or may use information regarding the nerve structure of the diaphragm obtained by computer aided tomography (CAT), or other imaging technologies.
  • [0117]
    In step 1215 a single electrode probe is used to probe a series of points distributed across the area selected in step 1210. The locations may be marked, e.g. with ink, a laser grid, or on a monitor. The system depicted in FIG. 1 may be used, with the single electrode probe being substituted for the electrode substrate 150. A fixed waveform may be applied at each location and a response sensed, e.g., by one of the previously mentioned techniques.
  • [0118]
    In step 1220 the pattern of test locations obtained in step 1215 is evaluated to determine where within the selected area the electrode array should be placed. For example, the electrode array may be placed in the region of the selected area for which the underlying test points have the highest average response value. At step 1225 the process is done.
  • [0119]
    FIG. 13A shows a flow chart 1300 of a method for intrinsic breathing evaluation in accordance with an embodiment of the present invention. This process is typically used prior to applying mapping stimuli in order to establish a target response that may be subsequently updated during mapping.
  • [0120]
    In step 1310 the mapping electrode array is placed on the diaphragm. The mapping electrode array may be placed using the results of the coarse mapping procedure shown in FIG. 12, or may be placed using physical features of the diaphragm.
  • [0121]
    In step 1315 the intrinsic breathing pattern is sensed and recorded using respiratory flow sensors to determine time dependent characteristics such as flow rate, pressure and tidal volume.
  • [0122]
    In step 1320 the intrinsic breathing diaphragm movement and activity are sensed and recorded using electrical (e.g., EMG) and/or mechanical (e.g., accelerometer or strain gauge) sensors.
  • [0123]
    In step 1325 the intrinsic breathing parameters associated with the observed intrinsic breathing pattern are calculated to provide reference values for subsequent comparison to those calculated from observed responses to mapping stimuli. Examples of intrinsic (or desired) breathing parameters are inspiration length, exhalation length, rate, amplitude, rest length and cycle length, slope of the inspiration cycle, slope of the expiration cycle, peak flow per time, percent peak flow per percent of inspiration time, and sustaining positive flow as a time value or as a percent of inspiration cycle.
  • [0124]
    In step 1330 the optimum stimulation timing is determined. As previously discussed, the stimulation may be dynamically synchronized or fixed. At step 1335 the process is done.
  • [0125]
    FIG. 13B shows a flow chart of a method for baseline acquisition for mapping performed on a subject with regulated breathing in accordance with an embodiment of the present invention. Subjects with regulated breathing, such as those on a ventilator may lack the diaphragm activity associated with intrinsic breathing. In such cases, a baseline is developed during monitored intrinsic breathing prior to regulation. The baseline reference is a target response that is not updated during mapping.
  • [0126]
    In step 1340 a respiratory flow monitor (e.g., a pneumotachometer) is placed on the subject. In step 1345 the intrinsic breathing pattern is recorded.
  • [0127]
    In step 1350 the intrinsic breathing parameters are calculated. In contrast to the process of FIG. 13A, information regarding diaphragm activity is not used.
  • [0128]
    In step 1355 the baseline reference is stored. Since intrinsic breathing is absent during mapping performed on a subject with regulated breathing, the baseline reference will not change during mapping. At step 1360 the process is done.
  • [0129]
    FIG. 14A shows a flow chart of a preliminary array mapping method for intrinsic breathing (or desired breathing) in accordance with an embodiment of the present invention. In step 1410 an electrode is selected from the array. In step 1415 a locator wave is applied to the selected electrode (e.g., fixed or dynamically synchronized). A locator wave typically has fixed parameters and a low current and is a wave that will evoke an observable response for area close to the desired permanent electrode implantation site(or desired).
  • [0130]
    In step 1420 the response to the locator wave is sensed and stored. A desired or acceptable response may be with respect to any of the parameters set forth with respect to FIG. 13A. The response may be a particular parameter such as, e.g., the amplitude of the response.
  • [0131]
    In step 1425 the intrinsic breathing pattern is sensed and recorded. In step 1430 the intrinsic breathing parameters are recalculated. In step 1435 the stored response is compared to the intrinsic breathing parameters, and an accuracy score or figure of merit is determined for the response.
  • [0132]
    At step 1440 a check is made to see if all of the electrodes in the array have been evaluated. If not, steps 1410 through 1435 are repeated. If all electrodes have been evaluated, the process is done at step 1445.
  • [0133]
    FIG. 14B shows a flow chart of a preliminary array mapping method for regulated breathing in accordance with an embodiment of the present invention. In step 1450 an electrode is selected from the array. In step 1455 a locator wave is applied to the selected electrode (e.g., in a dynamic or fixed synchronized manner). A locator wave typically has fixed parameters and a low current.
  • [0134]
    In step 1460 the response to the locator wave is sensed and stored. In step 1465 the stored response is compared to a baseline reference (e.g., as obtained from the process of FIG. 13B), and an accuracy score or figure of merit is determined for the response.
  • [0135]
    At step 1470 a check is made to see if all of the electrodes in the array have been evaluated. If not, steps 1450 through 1465 are repeated. If all electrodes have been evaluated, the process is done at step 1475.
  • [0136]
    FIG. 15A shows a flow chart of a single parameter mapping method for intrinsic breathing in accordance with an embodiment of the present invention. In step 1510 a set of candidate electrodes is selected, i.e., electrodes that have given the best response. This set may be selected on the basis of accuracy scores determined by the process shown in FIG. 14A. In step 1515 a response parameter is selected for qualification. Examples of response parameters are: inspiration length, exhalation length, rate, amplitude, rest length and cycle length, slope of the inspiration cycle, slope of the expiration cycle, peak flow per time, percent peak flow per percent of inspiration time, and sustaining positive flow as a time value or as a percent of inspiration cycle.
  • [0137]
    In step 1520 a test wave is adjusted to match the intrinsic breath duration. Other parameters may subsequently be adjusted, for example: by lowering maximum current or lowering maximum frequency if peak flow/movement/EMG/volume/etc. are achieved too quickly; by increasing initial current amplitude or initial frequency if flow/EMG/pressure/etc initiation is delayed from delivery of initial pulse; or by changing (e.g., increasing) the ramp slope if flow/movement/EMG/volume/etc. has had more than one peak during an inspiration period. Other parameters that may also be adjusted are amplitude, frequency, shape, and timing. The test wave may also be adjusted to achieve a desired response, e.g., a percent of sustained positive airflow with respect to an inspiration cycle or other response.
  • [0138]
    In step 1525 an individual electrode is selected from the set of candidate electrodes selected in step 1510. In step 1530 the test wave constructed in step 1520 is delivered to the electrode (e.g., fixed or dynamically synchronized). In step 1535 the response to the test wave is sensed and stored.
  • [0139]
    In step 1540 the intrinsic breathing pattern is sensed and recorded. In step 1545 the intrinsic breathing parameters are recalculated. In step 1550 the stored response is compared to the intrinsic breathing parameters, and an accuracy score or figure of merit is determined for the response.
  • [0140]
    At step 1555 a check is made to see if all of the electrodes in the array have been evaluated. If not, steps 1510 through 1550 are repeated. If all electrodes have been evaluated, the process is done at step 1560.
  • [0141]
    FIG. 15B shows a flow chart of a single parameter mapping method for regulated breathing in accordance with an embodiment of the present invention. In step 1570 a set of candidate electrodes is selected. This set may be selected on the basis of accuracy scores determined by the process shown in FIG. 14B. In step 1572 a response parameter is selected for qualification. Examples of response parameters are: EMG, flow, tidal volume, movement and pressure.
  • [0142]
    In step 1574 a test wave is adjusted to match the intrinsic breath duration. Other parameters that may also be adjusted as well. In step 1576 an individual electrode is selected from the set of candidate electrodes selected in step 1570. In step 1578 the test wave constructed in step 1574 is delivered to the electrode (e.g., fixed or dynamically synchronized). In step 1580 the response to the test wave is sensed and stored.
  • [0143]
    In step 1582 the stored response is compared to a baseline reference, and an accuracy score or figure of merit is determined for the response.
  • [0144]
    At step 1584 a check is made to see if all of the electrodes in the array have been evaluated. If not, steps 1570 through 1582 are repeated. If all electrodes have been evaluated, the process is done at step 1586.
  • [0145]
    FIG. 16A shows a flow chart of a multi-parameter mapping method for intrinsic breathing in accordance with an embodiment of the present invention. In step 1610 an electrode is selected. The electrode may be selected on the basis of the accuracy score determined in the process shown in FIG. 14A or FIG. 15A.
  • [0146]
    In step 1615 a plurality of response parameters are selected for qualification. This may be done to refine the elelctorde choice or if a single parameter has not resulted in an electrode selection. Adjustments may be made where necessary in a manner similar as described with reference to FIG. 15A. Examples of response parameters are: EMG, flow, tidal volume, movement and pressure. An example of a pair of parameters are tidal volume and the measured parameter associated with diaphragm activation that shows the greatest dynamic range.
  • [0147]
    In step 1620 a therapy wave is adjusted to match the intrinsic breath duration. Other parameters may also be adjusted as described with reference to FIG. 15A. For example, the therapy wave may be adjusted to elicit an inspiration slope, a percentage peak value in a minimum percentage of the inspiration cycle, or a percentage of the peak inspiriaton in a minimum amount of time. In step 1625 the therapy wave constructed in step 1620 is delivered to the electrode (e.g., fixed or dynamically synchronized). In step 1630 the response to the therapy wave is sensed and stored.
  • [0148]
    In step 1635 the intrinsic breathing pattern is sensed and recorded. In step 1640 the intrinsic breathing parameters are recalculated. In step 1645 the stored response is compared to the intrinsic breathing parameters, and an accuracy score or figure of merit is determined for the response.
  • [0149]
    At step 1650 a check is made to see if the accuracy score or figure of merit determined in step 1645 is greater than a predetermined value. If not, steps 1610 through 1645 are repeated. If yes, the electrode location is qualified as a therapeutic locus and the process is done at step 1655.
  • [0150]
    FIG. 16B shows a flow chart of a multi-parameter mapping method for regulated breathing in accordance with an embodiment of the present invention. In step 1660 an electrode is selected. The electrode may be selected on the basis of the accuracy score determined in the process shown in FIG. 14B or FIG. 15B.
  • [0151]
    In step 1665 at least two response parameters are selected for qualification. Examples of response parameters are: EMG, flow, tidal volume, movement and pressure. An example of a pair of parameters are tidal volume and the measured parameter associated with diaphragm activation that shows the greatest dynamic range.
  • [0152]
    In step 1670 a therapy wave is adjusted to match the intrinsic breath duration. Other parameters may also be adjusted. In step 1675 the therapy wave constructed in step 1670 is delivered to the electrode (e.g., fixed or dynamically synchronized). In step 1680 the response to the therapy wave is sensed and stored.
  • [0153]
    In step 1685 the stored response is compared to a baseline reference, and an accuracy score or figure of merit is determined for the response.
  • [0154]
    At step 1690 a check is made to see if the accuracy score or figure of merit determined in step 1685 is greater than a predetermined value. If not, steps 1660 through 1685 are repeated. If yes, the electrode location is qualified as a therapeutic locus and the process is done at step 1695.
  • [0155]
    With respect to hierarchical optimization scheme described with reference to FIGS. 13-16, if one parameter does not give the user control over enough breathing parameters to match the intrinsic breathing characteristics, then another parameter is hierarchically added and adjusted that parameter until it provides sufficient control. If it does not, then again, another parameter is added until sufficient control over the breathing pattern or morphology is reached.
  • [0156]
    As an alternative, instead of using a natural breathing pattern as set for the with respect to FIGS. 12-16B, a desired breathing pattern, for example, to manipulate physiological responses or to treat disorders, may be selected or programmed into the device. The electrodes may the be selected as set forth with reference to FIGS. 14-16 using the desired breathing pattern instead of the natural breathing pattern for comparison.
  • [0157]
    The stimulation device may be used, for example in subjects with breathing disorders, heart failure patients and patients who cannot otherwise breathe on their own such as spinal cord injury patients.
  • [0158]
    Safety mechanisms may be incorporated into any stimulation device in accordance with the invention. The safety feature disables the device under certain conditions. Such safety features may include a patient or provider operated switch, e.g. a magnetic switch. In addition a safety mechanism may be included that determines when patient intervention is being provided. For example, the device will turn off if there is diaphragm movement sensed without an EMG as the case would be where a ventilator is being used.
  • [0159]
    While the invention has been described in detail with reference to preferred embodiments thereof, it will be apparent to one skilled in the art that various changes can be made, and equivalents employed, without departing from the scope of the invention.

Claims (54)

1. A system for mapping therapeutic electrode sites on a diaphragm comprising:
a signal source configured to provide a stimulus for eliciting a respiration response comprising an inspiration waveform having a morphology;
one or more implanted electrodes coupled to the signal source and configured to deliver the stimulus to body tissue within the body.
a sensor configured to sense a parameter corresponding to the respiration response; and,
a processor coupled to the sensor, configured to receive a signal from the sensor corresponding to the respiration response, and configured to determine a correlation between the morphology and a desired morphology.
2. The system for mapping therapeutic electrode sites of claim 1 wherein the desired morphology comprises a natural breathing pattern.
3. The system for mapping therapeutic electrode sites of claim 1 wherein the desired morphology is configured to elicit a desired physiological response.
4. The system for mapping therapeutic electrodes sites of claim 3 wherein the desired physiological response is to influence SaO2 levels.
5. The system for mapping therapeutic electrodes sites of claim 3 wherein the desired physiological response is to influence PCO2 levels.
6. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the electrodes are coupled to a substrate.
7. The system for mapping therapeutic electrode sites on a diaphragm of claim 6 wherein the sensor is coupled to the substrate.
8. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the waveform comprises information representative of inter-abdominal pressure over time.
9. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the waveform comprises information representative of thoracic pressure over time.
10. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the waveform comprises information representative of movement of the diaphragm over time.
11. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the waveform comprises information representative of at least a portion of a diaphragm EMG over time.
12. The system for mapping therapeutic electrode sites on a diaphragm of claim 1 wherein the waveform comprises information representative of airway flow over time.
13. A system for mapping therapeutic electrode sites on a diaphragm comprising:
a signal source configured to provide a stimulus configured to elicit a respiration response;
one or more electrodes coupled to the signal source and configured to deliver the stimulus to tissue of a body;
a sensor configured to sense a response to the stimulus wherein the sensor is configured to sense at least one parameter corresponding the respiration response; and,
a processor coupled to the sensor and configured to receive a signal corresponding to the at least one parameter, wherein the processor is configured to determine from the at least one parameter, a ratio of a portion of peak volume over a portion of stimulation time.
14. The system of claim 13 wherein the processor is configured to determine whether the percentage of peak volume per percentage of and inspiration cycle corresponds to an acceptable respiration response.
15. The system of claim 14 wherein the acceptable response is a ratio of less than or equal to about 10.
16. The system of claim 15 wherein the acceptable response is a ratio of less than or equal to about 3.5.
17. A system for mapping therapeutic electrode sites on a diaphragm comprising:
a signal source configured to provide a stimulus configured to elicit a respiration response;
one or more electrodes coupled to the signal source and configured to deliver the stimulus to tissue of a body;
a sensor configured to sense a response to the stimulus wherein the sensor is configured to sense at least one parameter corresponding the respiration response; and,
a processor coupled to the sensor and configured to receive a signal corresponding to the at least one parameter, wherein the processor is configured to determine from the at least one parameter whether a sustained inspiration portion of a stimulation duration for a cycle is at an acceptable level.
18. The system of claim 17 wherein an acceptable level is about 0.5 of the stimulation duration or more.
19. The system of claim 17 wherein an acceptable level is about 0.75 of the stimulation duration or more.
20. A system for mapping therapeutic electrode sites on a diaphragm comprising:
a signal source configured to provide a stimulus configured to elicit a respiration response;
one or more electrodes coupled to the signal source and configured to deliver the stimulus to tissue of a body;
a sensor configured to sense a response to the stimulus wherein the sensor is configured to sense at least one parameter corresponding the respiration response; and,
a processor coupled to the sensor and configured to receive a signal corresponding to the at least one parameter, wherein the processor is configured to determine from the at least one parameter whether an instantaneous slope of peak flow over stimulation time is at an acceptable level.
21. The system of claim 20 wherein an acceptable level of instantaneous slope of peak flow over stimulation time is about 2 or less.
22. The system of claim 20 wherein an acceptable level of the instantaneous slope of peak flow over stimulation time is about 0.75 or less.
23. A system for mapping therapeutic electrode sites on a diaphragm comprising:
a signal source configured to provide a stimulus configured to elicit a respiration response;
one or more electrodes coupled to the signal source and configured to deliver the stimulus to tissue of a body;
a sensor configured to sense a response to the stimulus wherein the sensor is configured to sense at least one parameter corresponding the respiration response; and,
a processor coupled to the sensor and configured to receive a signal corresponding to the at least one parameter, wherein the processor is configured to determine from the at least one parameter whether an instantaneous slope of peak flow over stimulation time is at an acceptable level.
24. The system of claim 23 wherein an acceptable level of minimum time to reach peak flow between about 100 milliseconds and 300 milliseconds.
25. The system of claim 23 wherein an acceptable level of minimum time to reach peak flow is greater than or equal to about 300 milliseconds.
26. An electrode assembly comprising:
an inflatable member comprising a substrate and an inflation chamber configured to receive an inflation medium; and
one or more electrodes configured to deliver or sense an electrical signal, coupled to the substrate.
27. The electrode assembly of claim 26 wherein the assembly is configured to be positioned on a diaphragm.
28. The electrode assembly of claim 26 further comprising a manipulation member coupled to the inflatable member, wherein the manipulation member is configured to position the inflatable member in a desired location adjacent a portion of a body.
29. An electrode assembly for stimulating sites on a diaphragm comprising:
a member configured to be positioned on a diaphragm during electrical stimulation of the diaphragm; and,
a plurality of electrodes coupled to the member and configured to deliver electrical stimulation to the diaphragm.
30. The electrode assembly of claim 29 wherein the member comprises a keyed portion configured to be positioned adjacent an anatomical structure of the diaphragm to aid in positioning of the member.
31. The electrode assembly of claim 29 wherein the member comprises a flexible portion configured to accommodate movement of the diaphragm during electrical stimulation.
32. The electrode assembly of claim 29 wherein the member comprises a perimeter having a shape that conforms to a specific feature on a surface of a diaphragm.
33. The electrode assembly of claim 29 wherein the member comprises an active surface configured to interface with a diaphragm surface, wherein the plurality of electrodes is coupled to the active surface of the member, and wherein the active surface is curved.
34. The electrode assembly of claim 29 wherein at least one of the plurality of electrodes comprises a subsurface electrode.
35. The electrode assembly of claim 29 wherein at least one of the plurality of electrodes comprises a composite electrode.
36. The electrode assembly of claim 29 further comprising a switching network coupled to the plurality of electrodes.
37. The electrode assembly of claim 29 wherein the member comprises a mesh.
38. A method for delivering an electrode array to a diaphragm comprising the steps of:
providing an electrode array configured to be compressed to a first configuration and to expand to a second configuration;
compressing the electrode array to the first configuration;
positioning the electrode array adjacent a diaphragm within a subject's body; and
expanding the electrode array to the second configuration.
39. The method of claim 38 wherein the step of compressing the electrode array comprises folding the electrode array; and wherein the step of expanding the electrode array comprises unfolding the electrode array.
40. The method of claim 38 wherein the step of expanding the electrode array comprises inflating the electrode array.
40. A method for mapping electrode sites on a diaphragm, the method comprising:
placing a mapping electrode array on a surface of the diaphragm;
sensing and recording an intrinsic breathing pattern;
selecting an electrode of the mapping electrode array;
delivering a stimulus wave to the electrode; and,
sensing and recording a response to the stimulus wave.
41. The method of claim 40 further comprising calculating intrinsic breathing parameters and establishing a target response.
42. The method of claim 41 further comprising comparing the response to the target response.
43. The method of claim 42 further comprising the step of determining whether the response sufficiently correlates with the target response.
44. The method of claim 40 wherein the stimulus is applied asynchronously.
45. The method of claim 40 wherein the stimulus is applied synchronously.
46. The method of claim 40 wherein the stimulus is applied between intrinsic breathing cycles.
47. A method for mapping electrode sites on a diaphragm, the method comprising:
placing a mapping electrode array on a surface of the diaphragm;
selecting an electrode of the mapping electrode array;
delivering a stimulus to the selected electrode; and,
sensing and recording a response to the stimulus.
48. The method of claim 47 further comprising the step of:
defining an acceptable breathing response morphology.
49. The method of claim 48 further comprising the step of comparing the recorded response to the acceptable breathing response morphology.
50. The method of claim 49 further comprising the step of determining whether the response is sufficiently close to the desired breathing response morphology.
51. A system for electrically stimulating a diaphragm comprising:
an implantable electrode configured to be positioned on the diaphragm;
a signal source configured to provide a stimulation signal to the diaphragm through the electrodes, wherein the stimulation signal comprises a series of pulses that vary in amplitude.
52. The system of claim 51 wherein the pulses vary in frequency.
53. A system for electrically stimulating a diaphragm comprising:
an implantable electrode configured to be positioned on the diaphragm;
a signal source configured to provide a stimulation signal to the diaphragm through the electrodes, wherein the stimulation signal comprises a series of pulses that vary in frequency.
US10966484 2003-10-15 2004-10-15 System and method for mapping diaphragm electrode sites Abandoned US20050085869A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US10686891 US8467876B2 (en) 2003-10-15 2003-10-15 Breathing disorder detection and therapy delivery device and method
US10966484 US20050085869A1 (en) 2003-10-15 2004-10-15 System and method for mapping diaphragm electrode sites

Applications Claiming Priority (25)

Application Number Priority Date Filing Date Title
US10966484 US20050085869A1 (en) 2003-10-15 2004-10-15 System and method for mapping diaphragm electrode sites
US11271554 US9259573B2 (en) 2003-10-15 2005-11-10 Device and method for manipulating exhalation
US11271726 US7970475B2 (en) 2003-10-15 2005-11-10 Device and method for biasing lung volume
US11271264 US7979128B2 (en) 2003-10-15 2005-11-10 Device and method for gradually controlling breathing
US11272353 US20060167523A1 (en) 2003-10-15 2005-11-10 Device and method for improving upper airway functionality
US11271315 US8244358B2 (en) 2003-10-15 2005-11-10 Device and method for treating obstructive sleep apnea
US11480074 US8160711B2 (en) 2003-10-15 2006-06-29 Multimode device and method for controlling breathing
US11981800 US8116872B2 (en) 2003-10-15 2007-10-31 Device and method for biasing and stimulating respiration
US11981342 US8140164B2 (en) 2003-10-15 2007-10-31 Therapeutic diaphragm stimulation device and method
US12004932 US20080177347A1 (en) 2003-10-15 2007-12-21 Method for treating a subject having neuromuscular impairment of the diaphragm
US12005198 US20080161878A1 (en) 2003-10-15 2007-12-26 Device and method to for independently stimulating hemidiaphragms
US12069823 US20080215106A1 (en) 2003-10-15 2008-02-13 Thoracoscopically implantable diaphragm stimulator
US12080133 US20080188903A1 (en) 2003-10-15 2008-04-01 Device and method for biasing and stimulating respiration
US12082057 US8265759B2 (en) 2003-10-15 2008-04-08 Device and method for treating disorders of the cardiovascular system or heart
US12150052 US20080288015A1 (en) 2003-10-15 2008-04-23 Diaphragm stimulation device and method for use with cardiovascular or heart patients
US12150045 US20080288010A1 (en) 2003-10-15 2008-04-23 Subcutaneous diaphragm stimulation device and method for use
US13015302 US20110288609A1 (en) 2003-10-15 2011-01-27 Therapeutic diaphragm stimulation device and method
US13118802 US20110230932A1 (en) 2003-10-15 2011-05-31 Device and method for independently stimulating hemidiaphragms
US13170076 US9370657B2 (en) 2003-10-15 2011-06-27 Device for manipulating tidal volume and breathing entrainment
US13347474 US8335567B2 (en) 2003-10-15 2012-01-10 Multimode device and method for controlling breathing
US13371153 US20120158091A1 (en) 2003-10-15 2012-02-10 Therapeutic diaphragm stimulation device and method
US13598284 US20120323293A1 (en) 2003-10-15 2012-08-29 Device and method for treating disorders of the cardiovascular system or heart
US13740041 US20130197601A1 (en) 2003-10-15 2013-01-11 Device and method for independently stimulating hemidiaphragms
US14494244 US20150034081A1 (en) 2003-10-15 2014-09-23 Therapeutic diaphragm stimulation device and method
US15181973 US20170036017A1 (en) 2003-10-15 2016-06-14 Device and method for biasing lung volume

Related Parent Applications (3)

Application Number Title Priority Date Filing Date
US10686891 Continuation-In-Part US8467876B2 (en) 2003-10-15 2003-10-15 Breathing disorder detection and therapy delivery device and method
US10966421 Continuation-In-Part US8255056B2 (en) 2003-10-15 2004-10-15 Breathing disorder and precursor predictor and therapy delivery device and method
US10966474 Continuation-In-Part US8412331B2 (en) 2003-10-15 2004-10-15 Breathing therapy device and method

Related Child Applications (5)

Application Number Title Priority Date Filing Date
US10966474 Continuation-In-Part US8412331B2 (en) 2003-10-15 2004-10-15 Breathing therapy device and method
US11271554 Continuation-In-Part US9259573B2 (en) 2003-10-15 2005-11-10 Device and method for manipulating exhalation
US11271315 Continuation-In-Part US8244358B2 (en) 2003-10-15 2005-11-10 Device and method for treating obstructive sleep apnea
US11271726 Continuation-In-Part US7970475B2 (en) 2003-10-15 2005-11-10 Device and method for biasing lung volume
US11271726 Continuation US7970475B2 (en) 2003-10-15 2005-11-10 Device and method for biasing lung volume

Publications (1)

Publication Number Publication Date
US20050085869A1 true true US20050085869A1 (en) 2005-04-21

Family

ID=34465515

Family Applications (15)

Application Number Title Priority Date Filing Date
US10686891 Active 2026-09-30 US8467876B2 (en) 2003-10-15 2003-10-15 Breathing disorder detection and therapy delivery device and method
US10966474 Active 2025-11-29 US8412331B2 (en) 2003-10-15 2004-10-15 Breathing therapy device and method
US10966484 Abandoned US20050085869A1 (en) 2003-10-15 2004-10-15 System and method for mapping diaphragm electrode sites
US10966421 Active 2026-02-19 US8255056B2 (en) 2003-10-15 2004-10-15 Breathing disorder and precursor predictor and therapy delivery device and method
US10966487 Abandoned US20050085734A1 (en) 2003-10-15 2004-10-15 Heart failure patient treatment and management device
US10966472 Active 2026-12-07 US8200336B2 (en) 2003-10-15 2004-10-15 System and method for diaphragm stimulation
US11246439 Abandoned US20060030894A1 (en) 2003-10-15 2005-10-11 Breathing disorder detection and therapy device for providing intrinsic breathing
US11249718 Active 2024-09-20 US8348941B2 (en) 2003-10-15 2005-10-13 Demand-based system for treating breathing disorders
US11526949 Expired - Fee Related US8509901B2 (en) 2003-10-15 2006-09-25 Device and method for adding to breathing
US11981800 Active 2024-12-08 US8116872B2 (en) 2003-10-15 2007-10-31 Device and method for biasing and stimulating respiration
US11981831 Abandoned US20080183240A1 (en) 2003-10-15 2007-10-31 Device and method for manipulating minute ventilation
US11981727 Abandoned US20080183239A1 (en) 2003-10-15 2007-10-31 Breathing therapy device and method
US12080133 Abandoned US20080188903A1 (en) 2003-10-15 2008-04-01 Device and method for biasing and stimulating respiration
US13851003 Abandoned US20130296973A1 (en) 2003-10-15 2013-03-26 Breathing therapy device and method
US13915316 Abandoned US20130296964A1 (en) 2003-10-15 2013-06-11 Breathing disorder detection and therapy delivery device and method

Family Applications Before (2)

Application Number Title Priority Date Filing Date
US10686891 Active 2026-09-30 US8467876B2 (en) 2003-10-15 2003-10-15 Breathing disorder detection and therapy delivery device and method
US10966474 Active 2025-11-29 US8412331B2 (en) 2003-10-15 2004-10-15 Breathing therapy device and method

Family Applications After (12)

Application Number Title Priority Date Filing Date
US10966421 Active 2026-02-19 US8255056B2 (en) 2003-10-15 2004-10-15 Breathing disorder and precursor predictor and therapy delivery device and method
US10966487 Abandoned US20050085734A1 (en) 2003-10-15 2004-10-15 Heart failure patient treatment and management device
US10966472 Active 2026-12-07 US8200336B2 (en) 2003-10-15 2004-10-15 System and method for diaphragm stimulation
US11246439 Abandoned US20060030894A1 (en) 2003-10-15 2005-10-11 Breathing disorder detection and therapy device for providing intrinsic breathing
US11249718 Active 2024-09-20 US8348941B2 (en) 2003-10-15 2005-10-13 Demand-based system for treating breathing disorders
US11526949 Expired - Fee Related US8509901B2 (en) 2003-10-15 2006-09-25 Device and method for adding to breathing
US11981800 Active 2024-12-08 US8116872B2 (en) 2003-10-15 2007-10-31 Device and method for biasing and stimulating respiration
US11981831 Abandoned US20080183240A1 (en) 2003-10-15 2007-10-31 Device and method for manipulating minute ventilation
US11981727 Abandoned US20080183239A1 (en) 2003-10-15 2007-10-31 Breathing therapy device and method
US12080133 Abandoned US20080188903A1 (en) 2003-10-15 2008-04-01 Device and method for biasing and stimulating respiration
US13851003 Abandoned US20130296973A1 (en) 2003-10-15 2013-03-26 Breathing therapy device and method
US13915316 Abandoned US20130296964A1 (en) 2003-10-15 2013-06-11 Breathing disorder detection and therapy delivery device and method

Country Status (3)

Country Link
US (15) US8467876B2 (en)
DE (3) DE112004001953T5 (en)
WO (6) WO2005037172A3 (en)

Cited By (59)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050021102A1 (en) * 2003-07-23 2005-01-27 Ignagni Anthony R. System and method for conditioning a diaphragm of a patient
US20050085867A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. System and method for diaphragm stimulation
US20060122662A1 (en) * 2003-10-15 2006-06-08 Tehrani Amir J Device and method for increasing functional residual capacity
US20060122661A1 (en) * 2004-12-03 2006-06-08 Mandell Lee J Diaphragmatic pacing with activity monitor adjustment
US20060149334A1 (en) * 2003-10-15 2006-07-06 Tehrani Amir J Device and method for controlling breathing
US20060155341A1 (en) * 2003-10-15 2006-07-13 Tehrani Amir J Device and method for biasing lung volume
US20060247729A1 (en) * 2003-10-15 2006-11-02 Tehrani Amir J Multimode device and method for controlling breathing
US20070044669A1 (en) * 2005-08-24 2007-03-01 Geise Gregory D Aluminum can compacting mechanism with improved actuation handle assembly
US20070049793A1 (en) * 2005-08-25 2007-03-01 Ignagni Anthony R Method And Apparatus For Transgastric Neurostimulation
US20070118183A1 (en) * 2005-11-18 2007-05-24 Mark Gelfand System and method to modulate phrenic nerve to prevent sleep apnea
US20070150023A1 (en) * 2005-12-02 2007-06-28 Ignagni Anthony R Transvisceral neurostimulation mapping device and method
US20070265611A1 (en) * 2004-07-23 2007-11-15 Ignagni Anthony R Ventilatory assist system and methods to improve respiratory function
US20070272242A1 (en) * 2006-04-21 2007-11-29 Sanborn Warren G Work of breathing display for a ventilation system
US20080072902A1 (en) * 2006-09-27 2008-03-27 Nellcor Puritan Bennett Incorporated Preset breath delivery therapies for a breathing assistance system
US20080103407A1 (en) * 2006-10-13 2008-05-01 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US20080109047A1 (en) * 2006-10-26 2008-05-08 Pless Benjamin D Apnea treatment device
US20080154330A1 (en) * 2006-12-22 2008-06-26 Tehrani Amir J Device and method to treat flow limitations
US20080167695A1 (en) * 2003-10-15 2008-07-10 Tehrani Amir J Therapeutic diaphragm stimulation device and method
US20080188904A1 (en) * 2003-10-15 2008-08-07 Tehrani Amir J Device and method for treating disorders of the cardiovascular system or heart
US20080188867A1 (en) * 2007-02-05 2008-08-07 Ignagni Anthony R Removable intramuscular electrode
US20080208282A1 (en) * 2007-01-22 2008-08-28 Mark Gelfand Device and method for the treatment of breathing disorders and cardiac disorders
US20080287820A1 (en) * 2007-05-17 2008-11-20 Synapse Biomedical, Inc. Devices and methods for assessing motor point electromyogram as a biomarker
US20090024176A1 (en) * 2007-07-17 2009-01-22 Joonkyoo Anthony Yun Methods and devices for producing respiratory sinus arrhythmia
US20090062882A1 (en) * 2007-08-28 2009-03-05 Cardiac Pacemakers, Inc. Method and apparatus for inspiratory muscle stimulation using implantable device
US20090099621A1 (en) * 2007-10-10 2009-04-16 Zheng Lin Respiratory stimulation for treating periodic breathing
US20090118785A1 (en) * 2007-10-30 2009-05-07 Ignagni Anthony R Method of improving sleep disordered breathing
US20090270963A1 (en) * 2006-05-23 2009-10-29 Publiekrechtelijke Rechtspersoon Academisch Ziekenhuis Leiden H.O.D.N. Leids Universitair Medi Medical probe
US7644714B2 (en) 2005-05-27 2010-01-12 Apnex Medical, Inc. Devices and methods for treating sleep disorders
US20100049037A1 (en) * 2006-09-11 2010-02-25 Koninklijke Philips Electronics N.V. System and method for positioning electrodes on a patient body
US20100106047A1 (en) * 2007-02-01 2010-04-29 Ls Biopath, Inc. Electrical methods for detection and characterization of abnormal tissue and cells
US20100179436A1 (en) * 2007-02-01 2010-07-15 Moshe Sarfaty Optical system for detection and characterization of abnormal tissue and cells
US20110060380A1 (en) * 2009-09-10 2011-03-10 Mark Gelfand Respiratory rectification
USD638852S1 (en) 2009-12-04 2011-05-31 Nellcor Puritan Bennett Llc Ventilator display screen with an alarm icon
US20110152706A1 (en) * 2008-05-15 2011-06-23 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
US8001967B2 (en) 1997-03-14 2011-08-23 Nellcor Puritan Bennett Llc Ventilator breath display and graphic user interface
US20110230932A1 (en) * 2003-10-15 2011-09-22 Rmx, Llc Device and method for independently stimulating hemidiaphragms
USD649157S1 (en) 2009-12-04 2011-11-22 Nellcor Puritan Bennett Llc Ventilator display screen with a user interface
US20120150061A1 (en) * 2010-11-02 2012-06-14 Industry-Academic Cooperation Foundation, Yonsei University Sensor for Detecting Cancerous Tissue and Method of Manufacturing the Same
US20120203293A1 (en) * 2004-06-08 2012-08-09 Greenberg Robert J Locating a Neural Prosthesis using Impedance and Electrode Height
US8244358B2 (en) 2003-10-15 2012-08-14 Rmx, Llc Device and method for treating obstructive sleep apnea
US8335992B2 (en) 2009-12-04 2012-12-18 Nellcor Puritan Bennett Llc Visual indication of settings changes on a ventilator graphical user interface
US8386046B2 (en) 2011-01-28 2013-02-26 Apnex Medical, Inc. Screening devices and methods for obstructive sleep apnea therapy
US8428726B2 (en) 2007-10-30 2013-04-23 Synapse Biomedical, Inc. Device and method of neuromodulation to effect a functionally restorative adaption of the neuromuscular system
US8433412B1 (en) 2008-02-07 2013-04-30 Respicardia, Inc. Muscle and nerve stimulation
US8443294B2 (en) 2009-12-18 2013-05-14 Covidien Lp Visual indication of alarms on a ventilator graphical user interface
US8453645B2 (en) 2006-09-26 2013-06-04 Covidien Lp Three-dimensional waveform display for a breathing assistance system
US8855771B2 (en) 2011-01-28 2014-10-07 Cyberonics, Inc. Screening devices and methods for obstructive sleep apnea therapy
US8924878B2 (en) 2009-12-04 2014-12-30 Covidien Lp Display and access to settings on a ventilator graphical user interface
US8934992B2 (en) 2011-09-01 2015-01-13 Inspire Medical Systems, Inc. Nerve cuff
US8938299B2 (en) 2008-11-19 2015-01-20 Inspire Medical Systems, Inc. System for treating sleep disordered breathing
US8983572B2 (en) 2010-10-29 2015-03-17 Inspire Medical Systems, Inc. System and method for patient selection in treating sleep disordered breathing
WO2015109401A1 (en) * 2014-01-21 2015-07-30 Simon Fraser University Systems and related methods for optimization of multi-electrode nerve pacing
US9119925B2 (en) 2009-12-04 2015-09-01 Covidien Lp Quick initiation of respiratory support via a ventilator user interface
US9186511B2 (en) 2006-10-13 2015-11-17 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US9205262B2 (en) 2011-05-12 2015-12-08 Cyberonics, Inc. Devices and methods for sleep apnea treatment
US9262588B2 (en) 2009-12-18 2016-02-16 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US9486628B2 (en) 2009-03-31 2016-11-08 Inspire Medical Systems, Inc. Percutaneous access for systems and methods of treating sleep apnea
US9498625B2 (en) 2012-12-19 2016-11-22 Viscardia, Inc. Hemodynamic performance enhancement through asymptomatic diaphragm stimulation
US9744354B2 (en) 2008-12-31 2017-08-29 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods

Families Citing this family (159)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9042952B2 (en) 1997-01-27 2015-05-26 Lawrence A. Lynn System and method for automatic detection of a plurality of SPO2 time series pattern types
US9468378B2 (en) 1997-01-27 2016-10-18 Lawrence A. Lynn Airway instability detection system and method
US20060155206A1 (en) 1997-01-27 2006-07-13 Lynn Lawrence A System and method for sound and oximetry integration
US9521971B2 (en) 1997-07-14 2016-12-20 Lawrence A. Lynn System and method for automatic detection of a plurality of SPO2 time series pattern types
US8932227B2 (en) 2000-07-28 2015-01-13 Lawrence A. Lynn System and method for CO2 and oximetry integration
US9053222B2 (en) 2002-05-17 2015-06-09 Lawrence A. Lynn Patient safety processor
US20060195041A1 (en) 2002-05-17 2006-08-31 Lynn Lawrence A Centralized hospital monitoring system for automatically detecting upper airway instability and for preventing and aborting adverse drug reactions
US7206635B2 (en) * 2001-06-07 2007-04-17 Medtronic, Inc. Method and apparatus for modifying delivery of a therapy in response to onset of sleep
US20080077192A1 (en) * 2002-05-03 2008-03-27 Afferent Corporation System and method for neuro-stimulation
DE10248590B4 (en) 2002-10-17 2016-10-27 Resmed R&D Germany Gmbh A method and apparatus for performing signal processing of an observation with the respiratory activity of a person in connection measuring signal
US20050107838A1 (en) * 2003-09-18 2005-05-19 Lovett Eric G. Subcutaneous cardiac rhythm management with disordered breathing detection and treatment
US7477932B2 (en) * 2003-05-28 2009-01-13 Cardiac Pacemakers, Inc. Cardiac waveform template creation, maintenance and use
EP2008581B1 (en) 2003-08-18 2011-08-17 Cardiac Pacemakers, Inc. Patient monitoring, diagnosis, and/or therapy systems and methods
US7396333B2 (en) 2003-08-18 2008-07-08 Cardiac Pacemakers, Inc. Prediction of disordered breathing
US8002553B2 (en) 2003-08-18 2011-08-23 Cardiac Pacemakers, Inc. Sleep quality data collection and evaluation
US7575553B2 (en) * 2003-09-18 2009-08-18 Cardiac Pacemakers, Inc. Methods and systems for assessing pulmonary disease
US7662101B2 (en) * 2003-09-18 2010-02-16 Cardiac Pacemakers, Inc. Therapy control based on cardiopulmonary status
US7510531B2 (en) * 2003-09-18 2009-03-31 Cardiac Pacemakers, Inc. System and method for discrimination of central and obstructive disordered breathing events
US7887493B2 (en) 2003-09-18 2011-02-15 Cardiac Pacemakers, Inc. Implantable device employing movement sensing for detecting sleep-related disorders
US20060167523A1 (en) * 2003-10-15 2006-07-27 Tehrani Amir J Device and method for improving upper airway functionality
US20050085874A1 (en) * 2003-10-17 2005-04-21 Ross Davis Method and system for treating sleep apnea
US7319900B2 (en) * 2003-12-11 2008-01-15 Cardiac Pacemakers, Inc. Cardiac response classification using multiple classification windows
US7774064B2 (en) 2003-12-12 2010-08-10 Cardiac Pacemakers, Inc. Cardiac response classification using retriggerable classification windows
US8521284B2 (en) 2003-12-12 2013-08-27 Cardiac Pacemakers, Inc. Cardiac response classification using multisite sensing and pacing
US7421296B1 (en) * 2004-01-26 2008-09-02 Pacesetter, Inc. Termination of respiratory oscillations characteristic of Cheyne-Stokes respiration
US7363085B1 (en) * 2004-01-26 2008-04-22 Pacesetters, Inc. Augmenting hypoventilation
US8403865B2 (en) 2004-02-05 2013-03-26 Earlysense Ltd. Prediction and monitoring of clinical episodes
EP1786315A4 (en) 2004-02-05 2010-03-03 Earlysense Ltd Techniques for prediction and monitoring of respiration-manifested clinical episodes
US8942779B2 (en) 2004-02-05 2015-01-27 Early Sense Ltd. Monitoring a condition of a subject
US8491492B2 (en) 2004-02-05 2013-07-23 Earlysense Ltd. Monitoring a condition of a subject
US20050197588A1 (en) * 2004-03-04 2005-09-08 Scott Freeberg Sleep disordered breathing alert system
US7751894B1 (en) * 2004-03-04 2010-07-06 Cardiac Pacemakers, Inc. Systems and methods for indicating aberrant behavior detected by an implanted medical device
US7371220B1 (en) * 2004-06-30 2008-05-13 Pacesetter, Inc. System and method for real-time apnea/hypopnea detection using an implantable medical system
US7269458B2 (en) 2004-08-09 2007-09-11 Cardiac Pacemakers, Inc. Cardiopulmonary functional status assessment via heart rate response detection by implantable cardiac device
US7389143B2 (en) 2004-08-12 2008-06-17 Cardiac Pacemakers, Inc. Cardiopulmonary functional status assessment via metabolic response detection by implantable cardiac device
JP2006136511A (en) * 2004-11-12 2006-06-01 Matsushita Electric Ind Co Ltd Drum type washing/drying machine
KR101133807B1 (en) * 2004-11-22 2012-04-05 미츠루 사사키 Simulator for preventing apnea
US8473058B2 (en) * 2004-11-22 2013-06-25 Mitsuru Sasaki Apnea preventing stimulation apparatus
US7966072B2 (en) * 2005-02-18 2011-06-21 Palo Alto Investors Methods and compositions for treating obesity-hypoventilation syndrome
US7680534B2 (en) 2005-02-28 2010-03-16 Cardiac Pacemakers, Inc. Implantable cardiac device with dyspnea measurement
US7704211B1 (en) * 2005-03-21 2010-04-27 Pacesetter, Inc. Method and apparatus for assessing fluid level in lungs
US7404799B1 (en) * 2005-04-05 2008-07-29 Pacesetter, Inc. System and method for detection of respiration patterns via integration of intracardiac electrogram signals
US7630763B2 (en) 2005-04-20 2009-12-08 Cardiac Pacemakers, Inc. Thoracic or intracardiac impedance detection with automatic vector selection
US7314451B2 (en) 2005-04-25 2008-01-01 Earlysense Ltd. Techniques for prediction and monitoring of clinical episodes
US7392086B2 (en) 2005-04-26 2008-06-24 Cardiac Pacemakers, Inc. Implantable cardiac device and method for reduced phrenic nerve stimulation
US7499751B2 (en) * 2005-04-28 2009-03-03 Cardiac Pacemakers, Inc. Cardiac signal template generation using waveform clustering
US20060247693A1 (en) 2005-04-28 2006-11-02 Yanting Dong Non-captured intrinsic discrimination in cardiac pacing response classification
US8900154B2 (en) * 2005-05-24 2014-12-02 Cardiac Pacemakers, Inc. Prediction of thoracic fluid accumulation
US20060271121A1 (en) 2005-05-25 2006-11-30 Cardiac Pacemakers, Inc. Closed loop impedance-based cardiac resynchronization therapy systems, devices, and methods
US8364455B2 (en) * 2005-06-09 2013-01-29 Maquet Critical Care Ab Simulator for use with a breathing-assist device
US8036750B2 (en) * 2005-06-13 2011-10-11 Cardiac Pacemakers, Inc. System for neural control of respiration
US20070021678A1 (en) * 2005-07-19 2007-01-25 Cardiac Pacemakers, Inc. Methods and apparatus for monitoring physiological responses to steady state activity
US8494618B2 (en) * 2005-08-22 2013-07-23 Cardiac Pacemakers, Inc. Intracardiac impedance and its applications
US9839781B2 (en) 2005-08-22 2017-12-12 Cardiac Pacemakers, Inc. Intracardiac impedance and its applications
US7731663B2 (en) * 2005-09-16 2010-06-08 Cardiac Pacemakers, Inc. System and method for generating a trend parameter based on respiration rate distribution
US7974691B2 (en) * 2005-09-21 2011-07-05 Cardiac Pacemakers, Inc. Method and apparatus for controlling cardiac resynchronization therapy using cardiac impedance
US20070118054A1 (en) * 2005-11-01 2007-05-24 Earlysense Ltd. Methods and systems for monitoring patients for clinical episodes
JP2009515174A (en) * 2005-11-04 2009-04-09 レスメド・リミテッドResmed Ltd Method and apparatus for supporting the diagnosis and management of sleep-disordered breathing
US20090036947A1 (en) * 2006-11-17 2009-02-05 Westlund Randy W Transvenous Phrenic Nerve Stimulation System
US7766840B2 (en) * 2005-12-01 2010-08-03 Cardiac Pacemakers, Inc. Method and system for heart failure status evaluation based on a disordered breathing index
US8281792B2 (en) * 2005-12-31 2012-10-09 John W Royalty Electromagnetic diaphragm assist device and method for assisting a diaphragm function
KR100845464B1 (en) * 2006-06-14 2008-07-10 (주)머티리얼솔루션테크놀로지 Implantable diaphragm stimulator and breathing pacemaker using the same
US8226570B2 (en) 2006-08-08 2012-07-24 Cardiac Pacemakers, Inc. Respiration monitoring for heart failure using implantable device
US20080071185A1 (en) * 2006-08-08 2008-03-20 Cardiac Pacemakers, Inc. Periodic breathing during activity
US8103341B2 (en) 2006-08-25 2012-01-24 Cardiac Pacemakers, Inc. System for abating neural stimulation side effects
US8121692B2 (en) 2006-08-30 2012-02-21 Cardiac Pacemakers, Inc. Method and apparatus for neural stimulation with respiratory feedback
US8050765B2 (en) * 2006-08-30 2011-11-01 Cardiac Pacemakers, Inc. Method and apparatus for controlling neural stimulation during disordered breathing
US8209013B2 (en) 2006-09-14 2012-06-26 Cardiac Pacemakers, Inc. Therapeutic electrical stimulation that avoids undesirable activation
US7917194B1 (en) * 2006-11-15 2011-03-29 Pacesetter, Inc. Method and apparatus for detecting pulmonary edema
US8983609B2 (en) 2007-05-30 2015-03-17 The Cleveland Clinic Foundation Apparatus and method for treating pulmonary conditions
EP2107920B1 (en) 2007-01-29 2013-07-10 Simon Fraser University Transvascular nerve stimulation apparatus
US8417351B2 (en) * 2007-02-09 2013-04-09 Mayo Foundation For Medical Education And Research Peripheral oxistimulator apparatus and methods
US20080228093A1 (en) * 2007-03-13 2008-09-18 Yanting Dong Systems and methods for enhancing cardiac signal features used in morphology discrimination
US20080234556A1 (en) * 2007-03-20 2008-09-25 Cardiac Pacemakers, Inc. Method and apparatus for sensing respiratory activities using sensor in lymphatic system
US20080243016A1 (en) * 2007-03-28 2008-10-02 Cardiac Pacemakers, Inc. Pulmonary Artery Pressure Signals And Methods of Using
US7950560B2 (en) * 2007-04-13 2011-05-31 Tyco Healthcare Group Lp Powered surgical instrument
US8585607B2 (en) 2007-05-02 2013-11-19 Earlysense Ltd. Monitoring, predicting and treating clinical episodes
WO2008147253A1 (en) * 2007-05-28 2008-12-04 St. Jude Medical Ab Implantable medical device for monitoring lung deficiency
US20090024047A1 (en) * 2007-07-20 2009-01-22 Cardiac Pacemakers, Inc. Devices and methods for respiration therapy
US8265736B2 (en) 2007-08-07 2012-09-11 Cardiac Pacemakers, Inc. Method and apparatus to perform electrode combination selection
US9037239B2 (en) 2007-08-07 2015-05-19 Cardiac Pacemakers, Inc. Method and apparatus to perform electrode combination selection
RU2506961C2 (en) * 2007-08-22 2014-02-20 Дзе Рисерч Фаундейшн Оф Стейт Юниверсити Оф Нью Йорк System and method for supply and shared use of breathing gas
EP2194864A4 (en) 2007-09-14 2014-11-12 Corventis Inc System and methods for wireless body fluid monitoring
WO2009036256A1 (en) 2007-09-14 2009-03-19 Corventis, Inc. Injectable physiological monitoring system
US8591430B2 (en) 2007-09-14 2013-11-26 Corventis, Inc. Adherent device for respiratory monitoring
US20090076345A1 (en) 2007-09-14 2009-03-19 Corventis, Inc. Adherent Device with Multiple Physiological Sensors
US9411936B2 (en) 2007-09-14 2016-08-09 Medtronic Monitoring, Inc. Dynamic pairing of patients to data collection gateways
EP2194858B1 (en) 2007-09-14 2017-11-22 Corventis, Inc. Medical device automatic start-up upon contact to patient tissue
EP2194856A4 (en) 2007-09-14 2014-07-16 Corventis Inc Adherent cardiac monitor with advanced sensing capabilities
WO2009049278A1 (en) 2007-10-12 2009-04-16 Patientslikeme, Inc. Self-improving method of using online communities to predict health-related outcomes
US20170188940A9 (en) * 2007-11-26 2017-07-06 Whispersom Corporation Device to detect and treat Apneas and Hypopnea
US8155744B2 (en) 2007-12-13 2012-04-10 The Cleveland Clinic Foundation Neuromodulatory methods for treating pulmonary disorders
WO2009091583A1 (en) * 2008-01-16 2009-07-23 Massachusetts Institute Of Technology Method and apparatus for predicting patient outcomes form a physiological segmentable patient signal
EP2254661B1 (en) 2008-02-14 2015-10-07 Cardiac Pacemakers, Inc. Apparatus for phrenic stimulation detection
WO2009114548A1 (en) 2008-03-12 2009-09-17 Corventis, Inc. Heart failure decompensation prediction based on cardiac rhythm
WO2009118737A3 (en) * 2008-03-27 2010-03-11 Widemed Ltd. Diagnosis of periodic breathing
WO2009146214A1 (en) 2008-04-18 2009-12-03 Corventis, Inc. Method and apparatus to measure bioelectric impedance of patient tissue
EP2701131A2 (en) 2008-05-12 2014-02-26 Earlysense Ltd. Monitoring, predicting and treating clinical episodes
US8882684B2 (en) 2008-05-12 2014-11-11 Earlysense Ltd. Monitoring, predicting and treating clinical episodes
US8229566B2 (en) * 2008-06-25 2012-07-24 Sheng Li Method and apparatus of breathing-controlled electrical stimulation for skeletal muscles
US8340746B2 (en) * 2008-07-17 2012-12-25 Massachusetts Institute Of Technology Motif discovery in physiological datasets: a methodology for inferring predictive elements
US8202223B2 (en) * 2008-09-19 2012-06-19 Medtronic, Inc. Method and apparatus for determining respiratory effort in a medical device
US8302602B2 (en) 2008-09-30 2012-11-06 Nellcor Puritan Bennett Llc Breathing assistance system with multiple pressure sensors
US20100087893A1 (en) * 2008-10-03 2010-04-08 Solange Pasquet Operant Conditioning-Based Device for Snoring and Obstructive Sleep Apnea and Method of Use
US8644939B2 (en) * 2008-11-18 2014-02-04 Neurostream Technologies General Partnership Method and device for the detection, identification and treatment of sleep apnea/hypopnea
US8823490B2 (en) 2008-12-15 2014-09-02 Corventis, Inc. Patient monitoring systems and methods
EP2198779A1 (en) * 2008-12-22 2010-06-23 Sendsor GmbH Device and method for early detection of exacerbations
US8870773B2 (en) * 2009-02-09 2014-10-28 The Cleveland Clinic Foundation Ultrasound-guided delivery of a therapy delivery device to a nerve target
US20100204567A1 (en) * 2009-02-09 2010-08-12 The Cleveland Clinic Foundation Ultrasound-guided delivery of a therapy delivery device to a phrenic nerve
US8378832B2 (en) * 2009-07-09 2013-02-19 Harry J. Cassidy Breathing disorder treatment system and method
EP2454697A2 (en) 2009-07-15 2012-05-23 Cardiac Pacemakers, Inc. Remote pace detection in an implantable medical device
EP2453975B1 (en) * 2009-07-15 2016-11-02 Cardiac Pacemakers, Inc. Remote sensing in an implantable medical device
EP2453977B1 (en) 2009-07-15 2017-11-08 Cardiac Pacemakers, Inc. Physiological vibration detection in an implanted medical device
US20120165623A1 (en) * 2009-08-28 2012-06-28 Lawrence Allan Lynn Relational Thermorespirometer Spot Vitals Monitor
US9072899B1 (en) * 2009-09-04 2015-07-07 Todd Nickloes Diaphragm pacemaker
US8574145B2 (en) * 2009-09-14 2013-11-05 Sleep Methods, Inc. System and method for training and promoting a conditioned reflex intervention during sleep
WO2011050283A3 (en) 2009-10-22 2011-07-14 Corventis, Inc. Remote detection and monitoring of functional chronotropic incompetence
US8409108B2 (en) * 2009-11-05 2013-04-02 Inovise Medical, Inc. Multi-axial heart sounds and murmur detection for hemodynamic-condition assessment
US9451897B2 (en) 2009-12-14 2016-09-27 Medtronic Monitoring, Inc. Body adherent patch with electronics for physiologic monitoring
JP2011213096A (en) * 2010-03-19 2011-10-27 Makita Corp Power tool
US8965498B2 (en) 2010-04-05 2015-02-24 Corventis, Inc. Method and apparatus for personalized physiologic parameters
US8585604B2 (en) 2010-10-29 2013-11-19 Medtronic, Inc. Integrated patient care
US9457186B2 (en) 2010-11-15 2016-10-04 Bluewind Medical Ltd. Bilateral feedback
US9186504B2 (en) 2010-11-15 2015-11-17 Rainbow Medical Ltd Sleep apnea treatment
US9717868B2 (en) * 2010-11-23 2017-08-01 Koninklijke Philips N.V. Obesity hypventilation syndrome treatment system and method
US20120157799A1 (en) * 2010-12-20 2012-06-21 Abhilash Patangay Using device based sensors to classify events and generate alerts
US9744349B2 (en) 2011-02-10 2017-08-29 Respicardia, Inc. Medical lead and implantation
WO2012167266A1 (en) * 2011-06-03 2012-12-06 Children's Hospital Los Angeles Electrophysiological diagnosis and treatment for asthma
US8478413B2 (en) 2011-07-27 2013-07-02 Medtronic, Inc. Bilateral phrenic nerve stimulation with reduced dyssynchrony
US8706235B2 (en) 2011-07-27 2014-04-22 Medtronic, Inc. Transvenous method to induce respiration
US8509902B2 (en) 2011-07-28 2013-08-13 Medtronic, Inc. Medical device to provide breathing therapy
US9861817B2 (en) 2011-07-28 2018-01-09 Medtronic, Inc. Medical device to provide breathing therapy
US20130053717A1 (en) * 2011-08-30 2013-02-28 Nellcor Puritan Bennett Llc Automatic ventilator challenge to induce spontaneous breathing efforts
US8855783B2 (en) 2011-09-09 2014-10-07 Enopace Biomedical Ltd. Detector-based arterial stimulation
US9364624B2 (en) 2011-12-07 2016-06-14 Covidien Lp Methods and systems for adaptive base flow
US9498589B2 (en) 2011-12-31 2016-11-22 Covidien Lp Methods and systems for adaptive base flow and leak compensation
EP2807412B1 (en) 2012-01-26 2017-08-02 MED-EL Elektromedizinische Geräte GmbH Neural monitoring systems for treating pharyngeal disorders
CA2862867A1 (en) * 2012-01-27 2013-08-01 T4 Analytics Llc Anesthesia monitoring systems and methods of monitoring anesthesia
US20130197385A1 (en) * 2012-01-31 2013-08-01 Medtronic, Inc. Respiratory function detection
US8844526B2 (en) 2012-03-30 2014-09-30 Covidien Lp Methods and systems for triggering with unknown base flow
EP2863987A4 (en) 2012-06-21 2016-07-27 Univ Fraser Simon Transvascular diaphragm pacing systems and methods of use
WO2014008171A1 (en) * 2012-07-02 2014-01-09 Medisci L.L.C. Method and device for respiratory and cardiorespiratory support
CN104661588B (en) * 2012-07-27 2017-03-08 心脏起搏器股份公司 Stratification of patients with heart failure
CN102949770B (en) * 2012-11-09 2015-04-22 张红璇 External diaphragm pacing and breathing machine synergistic air supply method and device thereof
CN103055417B (en) * 2012-12-31 2015-09-09 中国人民解放军第三军医大学第一附属医院 A non-invasive transcutaneous electrical stimulator
US20150025395A1 (en) * 2013-04-15 2015-01-22 Yonglin Biotech Corp. Breathing analysis method, system, and apparatus
US9295397B2 (en) 2013-06-14 2016-03-29 Massachusetts Institute Of Technology Method and apparatus for beat-space frequency domain prediction of cardiovascular death after acute coronary event
EP3030143A1 (en) 2013-08-05 2016-06-15 Cardiac Pacemakers, Inc. System and method for detecting worsening of heart failure based on rapid shallow breathing index
EP2839859B1 (en) * 2013-08-20 2016-04-27 Sorin CRM SAS Active medical device, in particular a CRT resynchroniser, including predictive warning means for cardiac decompensation in the presence of central sleep apnoea
US9242088B2 (en) 2013-11-22 2016-01-26 Simon Fraser University Apparatus and methods for assisted breathing by transvascular nerve stimulation
CN103800999A (en) * 2014-02-25 2014-05-21 郑州雅晨生物科技有限公司 Obstructive sleep apnea hypopnea syndrome therapeutic apparatus
US20160361012A1 (en) * 2014-02-25 2016-12-15 Somnics, Inc Methods and applications for detection of breath flow and the system thereof
US20150283382A1 (en) * 2014-04-04 2015-10-08 Med-El Elektromedizinische Geraete Gmbh Respiration Sensors For Recording Of Triggered Respiratory Signals In Neurostimulators
JPWO2016013684A1 (en) * 2014-07-22 2017-04-27 帝人ファーマ株式会社 Evaluation method and diagnostic apparatus of heart failure
US9808591B2 (en) 2014-08-15 2017-11-07 Covidien Lp Methods and systems for breath delivery synchronization
EP3064131A1 (en) * 2015-03-03 2016-09-07 BIOTRONIK SE & Co. KG Combined vagus-phrenic nerve stimulation apparatus
US9839786B2 (en) * 2015-04-17 2017-12-12 Inspire Medical Systems, Inc. System and method of monitoring for and reporting on patient-made stimulation therapy programming changes
US20170202509A1 (en) * 2016-01-20 2017-07-20 Soniphi Llc Frequency Analysis Feedback Systems and Methods
CN105879223B (en) * 2016-04-22 2017-02-08 广州雪利昂生物科技有限公司 Method and apparatus for surface EMG signal as a synchronization signal to trigger external diaphragm pacemakers

Citations (89)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US240240A (en) * 1881-04-19 Beer-faucet
US4827935A (en) * 1986-04-24 1989-05-09 Purdue Research Foundation Demand electroventilator
US4830008A (en) * 1987-04-24 1989-05-16 Meer Jeffrey A Method and system for treatment of sleep apnea
US5056519A (en) * 1990-05-14 1991-10-15 Vince Dennis J Unilateral diaphragmatic pacer
US5146918A (en) * 1991-03-19 1992-09-15 Medtronic, Inc. Demand apnea control of central and obstructive sleep apnea
US5174287A (en) * 1991-05-28 1992-12-29 Medtronic, Inc. Airway feedback measurement system responsive to detected inspiration and obstructive apnea event
US5211173A (en) * 1991-01-09 1993-05-18 Medtronic, Inc. Servo muscle control
US5215082A (en) * 1991-04-02 1993-06-01 Medtronic, Inc. Implantable apnea generator with ramp on generator
US5233983A (en) * 1991-09-03 1993-08-10 Medtronic, Inc. Method and apparatus for apnea patient screening
US5265604A (en) * 1990-05-14 1993-11-30 Vince Dennis J Demand - diaphragmatic pacing (skeletal muscle pressure modified)
US5281219A (en) * 1990-11-23 1994-01-25 Medtronic, Inc. Multiple stimulation electrodes
US5300094A (en) * 1991-01-09 1994-04-05 Medtronic, Inc. Servo muscle control
US5423372A (en) * 1993-12-27 1995-06-13 Ford Motor Company Joining sand cores for making castings
US5483969A (en) * 1994-09-21 1996-01-16 Medtronic, Inc. Method and apparatus for providing a respiratory effort waveform for the treatment of obstructive sleep apnea
US5485851A (en) * 1994-09-21 1996-01-23 Medtronic, Inc. Method and apparatus for arousal detection
US5522862A (en) * 1994-09-21 1996-06-04 Medtronic, Inc. Method and apparatus for treating obstructive sleep apnea
US5524632A (en) * 1994-01-07 1996-06-11 Medtronic, Inc. Method for implanting electromyographic sensing electrodes
US5540732A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for impedance detecting and treating obstructive airway disorders
US5540733A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for detecting and treating obstructive sleep apnea
US5540731A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for pressure detecting and treating obstructive airway disorders
US5546952A (en) * 1994-09-21 1996-08-20 Medtronic, Inc. Method and apparatus for detection of a respiratory waveform
US5549655A (en) * 1994-09-21 1996-08-27 Medtronic, Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US5678535A (en) * 1995-04-21 1997-10-21 Dimarco; Anthony Fortunato Method and apparatus for electrical stimulation of the respiratory muscles to achieve artificial ventilation in a patient
US5797923A (en) * 1997-05-12 1998-08-25 Aiyar; Harish Electrode delivery instrument
US5800470A (en) * 1994-01-07 1998-09-01 Medtronic, Inc. Respiratory muscle electromyographic rate responsive pacemaker
US5814086A (en) * 1996-10-18 1998-09-29 Pacesetter Ab Perex respiratory system stimulation upon tachycardia detection
US5895360A (en) * 1996-06-26 1999-04-20 Medtronic, Inc. Gain control for a periodic signal and method regarding same
US5944680A (en) * 1996-06-26 1999-08-31 Medtronic, Inc. Respiratory effort detection method and apparatus
US6021352A (en) * 1996-06-26 2000-02-01 Medtronic, Inc, Diagnostic testing methods and apparatus for implantable therapy devices
US6099479A (en) * 1996-06-26 2000-08-08 Medtronic, Inc. Method and apparatus for operating therapy system
US6251126B1 (en) * 1998-04-23 2001-06-26 Medtronic Inc Method and apparatus for synchronized treatment of obstructive sleep apnea
US6269269B1 (en) * 1998-04-23 2001-07-31 Medtronic Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US6345202B2 (en) * 1998-08-14 2002-02-05 Advanced Bionics Corporation Method of treating obstructive sleep apnea using implantable electrodes
US20020049482A1 (en) * 2000-06-14 2002-04-25 Willa Fabian Lifestyle management system
US6415183B1 (en) * 1999-12-09 2002-07-02 Cardiac Pacemakers, Inc. Method and apparatus for diaphragmatic pacing
US6463327B1 (en) * 1998-06-11 2002-10-08 Cprx Llc Stimulatory device and methods to electrically stimulate the phrenic nerve
US20020193697A1 (en) * 2001-04-30 2002-12-19 Cho Yong Kyun Method and apparatus to detect and treat sleep respiratory events
US20020193839A1 (en) * 2001-06-07 2002-12-19 Cho Yong Kyun Method for providing a therapy to a patient involving modifying the therapy after detecting an onset of sleep in the patient, and implantable medical device embodying same
US6512949B1 (en) * 1999-07-12 2003-01-28 Medtronic, Inc. Implantable medical device for measuring time varying physiologic conditions especially edema and for responding thereto
US6542774B2 (en) * 1996-04-30 2003-04-01 Medtronic, Inc. Method and device for electronically controlling the beating of a heart
US6574507B1 (en) * 1998-07-06 2003-06-03 Ela Medical S.A. Active implantable medical device for treating sleep apnea syndrome by electrostimulation
US6572543B1 (en) * 1996-06-26 2003-06-03 Medtronic, Inc Sensor, method of sensor implant and system for treatment of respiratory disorders
US20030127091A1 (en) * 1999-12-15 2003-07-10 Chang Yung Chi Scientific respiration for self-health-care
US20030153956A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Cardiac stimulation device including sleep apnea prevention and treatment
US20030153954A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Sleep apnea therapy device using dynamic overdrive pacing
US20030153955A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Cardiac stimulation device including sleep apnea prevention and treatment
US6633779B1 (en) * 2000-11-27 2003-10-14 Science Medicus, Inc. Treatment of asthma and respiratory disease by means of electrical neuro-receptive waveforms
US20030195571A1 (en) * 2002-04-12 2003-10-16 Burnes John E. Method and apparatus for the treatment of central sleep apnea using biventricular pacing
US20030204213A1 (en) * 2002-04-30 2003-10-30 Jensen Donald N. Method and apparatus to detect and monitor the frequency of obstructive sleep apnea
US6651652B1 (en) * 1998-06-30 2003-11-25 Siemens-Elema Ab Method for identifying respiration attempts by analyzing neuroelectrical signals, and respiration detector and respiratory aid system operating according to the method
US20040077953A1 (en) * 2002-10-18 2004-04-22 Turcott Robert G. Hemodynamic analysis
US20040088015A1 (en) * 2002-10-31 2004-05-06 Casavant David A. Respiratory nerve stimulation
US20040111040A1 (en) * 2002-12-04 2004-06-10 Quan Ni Detection of disordered breathing
US20040134496A1 (en) * 2003-01-10 2004-07-15 Cho Yong K. Method and apparatus for detecting respiratory disturbances
US20040138719A1 (en) * 2003-01-10 2004-07-15 Cho Yong K. System and method for automatically monitoring and delivering therapy for sleep-related disordered breathing
US20040176809A1 (en) * 2001-06-07 2004-09-09 Medtronic, Inc. Method and apparatus for modifying delivery of a therapy in response to onset of sleep
US20040225226A1 (en) * 2000-08-17 2004-11-11 Ilife Systems, Inc. System and method for detecting the onset of an obstructive sleep apnea event
US20040237963A1 (en) * 1998-05-22 2004-12-02 Michael Berthon-Jones Ventilatory assistance for treatment of cardiac failure and Cheyne-Stokes breathing
US20050021102A1 (en) * 2003-07-23 2005-01-27 Ignagni Anthony R. System and method for conditioning a diaphragm of a patient
US20050043644A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Prediction of disordered breathing
US20050039745A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Adaptive therapy for disordered breathing
US20050043772A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Therapy triggered by prediction of disordered breathing
US20050055060A1 (en) * 2003-09-05 2005-03-10 Steve Koh Determination of respiratory characteristics from AV conduction intervals
US20050061319A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Methods and systems for implantably monitoring external breathing therapy
US20050061320A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Coordinated use of respiratory and cardiac therapies for sleep disordered breathing
US20050061315A1 (en) * 2003-09-18 2005-03-24 Kent Lee Feedback system and method for sleep disordered breathing therapy
US20050065563A1 (en) * 2003-09-23 2005-03-24 Avram Scheiner Paced ventilation therapy by an implantable cardiac device
US20050065567A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Therapy control based on cardiopulmonary status
US20050074741A1 (en) * 2003-09-18 2005-04-07 Kent Lee System and method for discrimination of central and obstructive disordered breathing events
US20050080461A1 (en) * 2003-09-18 2005-04-14 Stahmann Jeffrey E. System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep
US6881192B1 (en) * 2002-06-12 2005-04-19 Pacesetter, Inc. Measurement of sleep apnea duration and evaluation of response therapies using duration metrics
US20050085868A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Breathing therapy device and method
US20050101833A1 (en) * 2003-09-02 2005-05-12 Biotronik Gmbh & Co. Kg Apparatus for the treatment of sleep apnea
US20050107860A1 (en) * 2003-07-23 2005-05-19 Ignagni Anthony R. Mapping probe system for neuromuscular electrical stimulation apparatus
US20050115561A1 (en) * 2003-08-18 2005-06-02 Stahmann Jeffrey E. Patient monitoring, diagnosis, and/or therapy systems and methods
US20050119711A1 (en) * 2003-01-10 2005-06-02 Cho Yong K. Apparatus and method for monitoring for disordered breathing
US20050148897A1 (en) * 2003-12-24 2005-07-07 Cho Yong K. Implantable medical device with sleep disordered breathing monitoring
US20050145246A1 (en) * 2003-09-18 2005-07-07 Hartley Jesse W. Posture detection system and method
US20050165457A1 (en) * 2004-01-26 2005-07-28 Michael Benser Tiered therapy for respiratory oscillations characteristic of Cheyne-Stokes respiration
US20050224076A1 (en) * 2004-04-07 2005-10-13 Pari Gmbh Spezialisten Fur Effektive Inhalation Aerosol generation device and inhalation device therewith
US20050261600A1 (en) * 2004-05-20 2005-11-24 Airmatrix Technologies, Inc. Method and system for diagnosing central versus obstructive apnea
US20060058852A1 (en) * 2004-09-10 2006-03-16 Steve Koh Multi-variable feedback control of stimulation for inspiratory facilitation
US20060122622A1 (en) * 2004-12-06 2006-06-08 Csaba Truckai Bone treatment systems and methods
US20060142815A1 (en) * 2003-10-15 2006-06-29 Tehrani Amir J Device and method for treating obstructive sleep apnea
US20060149334A1 (en) * 2003-10-15 2006-07-06 Tehrani Amir J Device and method for controlling breathing
US20060155341A1 (en) * 2003-10-15 2006-07-13 Tehrani Amir J Device and method for biasing lung volume
US7082331B1 (en) * 2004-04-21 2006-07-25 Pacesetter, Inc. System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device
US20060167523A1 (en) * 2003-10-15 2006-07-27 Tehrani Amir J Device and method for improving upper airway functionality
US20060247729A1 (en) * 2003-10-15 2006-11-02 Tehrani Amir J Multimode device and method for controlling breathing

Family Cites Families (110)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US345202A (en) * 1886-07-06 Treating lac
US193697A (en) * 1877-07-31 Improvement in mowers
US85869A (en) * 1869-01-12 Improvement in horse-rakes
US142815A (en) * 1873-09-16 Improvement in car-couplings
US56519A (en) * 1866-07-24 Improvement in clamps for holding saws
US176809A (en) * 1876-05-02 Improvement in machinery for cutting waved edges on leather
US77953A (en) * 1868-05-19 b i c k e
US225226A (en) * 1880-03-09 Rotary engine
US85866A (en) * 1869-01-12 Improved bed-bottom
US204213A (en) * 1878-05-28 Improvement in loom-pickers
US167523A (en) * 1875-09-07 Improvement in sole-channeling machines
US215082A (en) * 1879-05-06 Improvement in type-writing machines
US237963A (en) * 1881-02-22 Manufacture of sheet-iron
US61320A (en) * 1867-01-22 of lewiston
US65567A (en) * 1867-06-11 Improved soeew machine
US281219A (en) * 1883-07-10 Half to alonzo e
US85734A (en) * 1869-01-12 Improvement in gr
US115561A (en) * 1871-06-06 Improvement in electro-sviagnetic separators
US300094A (en) * 1884-06-10 Machine
US148897A (en) * 1874-03-24 Improvement in machines for pressing pantaloons
US540732A (en) * 1895-06-11 Martin freund
US211173A (en) * 1879-01-07 Improvement in wagon-tracks for roads
US85868A (en) * 1869-01-12 Improvement in steam water-elevators
US85865A (en) * 1869-01-12 Improvement in threshing-knives
US99479A (en) * 1870-02-01 Edwin r
US127091A (en) * 1872-05-21 Improvement in spark-arresters
US61319A (en) * 1867-01-22 Improvement in pumps
US540731A (en) * 1895-06-11 Wire-reel
US39745A (en) * 1863-09-01 Improvement in hoisting apparatus
US574507A (en) * 1897-01-05 Account-keeping book
US21795A (en) * 1858-10-12 Improvement in cotton-gins
US138719A (en) * 1873-05-06 Improvement in fly-switches
US174287A (en) * 1876-02-29 Improvement in tool-holders
US149334A (en) * 1874-04-07 Improvement in railroad-frogs
US122622A (en) * 1872-01-09 Improvement in compartment-cars for railways
US540733A (en) * 1895-06-11 Ernst gerstenberg and herman barghausen
US155341A (en) * 1874-09-22 Improvement in fertilizers
US88015A (en) * 1869-03-23 Improvement in lifting-jacks
US101833A (en) * 1870-04-12 Improved coal-box
US522862A (en) * 1894-07-10 Sawhorse
US111040A (en) * 1871-01-17 Improvement in fluid-meters
US36294A (en) * 1862-08-26 Improved portable sugar-evaporatx
US74741A (en) * 1868-02-18 George w
US59240A (en) * 1866-10-30 Maeshall t
US85867A (en) * 1869-01-12 Improvement in blind-fastener
US119711A (en) * 1871-10-10 Improvement in staple-machines
US55060A (en) * 1866-05-29 Improvement in harvester-rakes
US65563A (en) * 1867-06-11 Julius hackert
US247729A (en) * 1881-09-27 Corset-stay
US61315A (en) * 1867-01-22 Improved apparatus for decomposing animal and vegetable substances
US146918A (en) * 1874-01-27 Improvement in car-couplings
US681192A (en) * 1900-11-19 1901-08-27 Natural Food Company Marking-machine.
US678535A (en) * 1901-02-02 1901-07-16 Austen Bigg Hoe.
US911218A (en) * 1908-02-17 1909-02-02 Elias B Wrenn Trace-holder.
US1496918A (en) * 1922-08-23 1924-06-10 Frederick M Baldwin Signaling device for vehicles
US3773051A (en) 1972-03-01 1973-11-20 Research Corp Method and apparatus for stimulation of body tissue
US4146918A (en) * 1978-01-18 1979-03-27 Albert Tureck Photographic flash reflector and diffuser system
US5329931A (en) * 1989-02-21 1994-07-19 William L. Clauson Apparatus and method for automatic stimulation of mammals in response to blood gas analysis
US5190036A (en) * 1991-02-28 1993-03-02 Linder Steven H Abdominal binder for effectuating cough stimulation
US5572543A (en) 1992-04-09 1996-11-05 Deutsch Aerospace Ag Laser system with a micro-mechanically moved mirror
FR2739760B1 (en) * 1995-10-11 1997-12-12 Salomon Sa Method and device for heating a shoe inner lining
FR2739782B1 (en) * 1995-10-13 1997-12-19 Ela Medical Sa Active implantable medical device, in particular pacemaker enslaved operation and reduced consumption
US5830008A (en) 1996-12-17 1998-11-03 The Whitaker Corporation Panel mountable connector
US5876353A (en) * 1997-01-31 1999-03-02 Medtronic, Inc. Impedance monitor for discerning edema through evaluation of respiratory rate
WO1999020339A1 (en) 1997-10-17 1999-04-29 Respironics, Inc. Muscle stimulating device and method for diagnosing and treating a breathing disorder
US6021362A (en) * 1998-02-17 2000-02-01 Maggard; Karl J. Method and apparatus for dispensing samples and premiums
CN101333244B (en) 1998-05-06 2013-12-18 基因技术股份有限公司 Protein purification by ion exchange chromatography
US6312399B1 (en) 1998-06-11 2001-11-06 Cprx, Llc Stimulatory device and methods to enhance venous blood return during cardiopulmonary resuscitation
US6234985B1 (en) * 1998-06-11 2001-05-22 Cprx Llc Device and method for performing cardiopulmonary resuscitation
WO2000006249A3 (en) * 1998-07-27 2000-05-18 Dominique Durand Method and apparatus for closed-loop stimulation of the hypoglossal nerve in human patients to treat obstructive sleep apnea
US6212435B1 (en) * 1998-11-13 2001-04-03 Respironics, Inc. Intraoral electromuscular stimulation device and method
US7577475B2 (en) * 1999-04-16 2009-08-18 Cardiocom System, method, and apparatus for combining information from an implanted device with information from a patient monitoring apparatus
US6314324B1 (en) 1999-05-05 2001-11-06 Respironics, Inc. Vestibular stimulation system and method
US6600949B1 (en) * 1999-11-10 2003-07-29 Pacesetter, Inc. Method for monitoring heart failure via respiratory patterns
US6527729B1 (en) * 1999-11-10 2003-03-04 Pacesetter, Inc. Method for monitoring patient using acoustic sensor
US6480733B1 (en) 1999-11-10 2002-11-12 Pacesetter, Inc. Method for monitoring heart failure
US6336903B1 (en) 1999-11-16 2002-01-08 Cardiac Intelligence Corp. Automated collection and analysis patient care system and method for diagnosing and monitoring congestive heart failure and outcomes thereof
US6752765B1 (en) * 1999-12-01 2004-06-22 Medtronic, Inc. Method and apparatus for monitoring heart rate and abnormal respiration
US6418346B1 (en) * 1999-12-14 2002-07-09 Medtronic, Inc. Apparatus and method for remote therapy and diagnosis in medical devices via interface systems
US6710094B2 (en) * 1999-12-29 2004-03-23 Styrochem Delaware, Inc. Processes for preparing patterns for use in metal castings
US6589188B1 (en) * 2000-05-05 2003-07-08 Pacesetter, Inc. Method for monitoring heart failure via respiratory patterns
US6357438B1 (en) * 2000-10-19 2002-03-19 Mallinckrodt Inc. Implantable sensor for proportional assist ventilation
US6572949B1 (en) * 2001-08-30 2003-06-03 Carlton Paul Lewis Paint mask and method of using
FR2829917B1 (en) 2001-09-24 2004-06-11 Ela Medical Sa Active medical device comprising diagnostic means respiratory profile
US20030225339A1 (en) 2002-05-06 2003-12-04 Respironics Novametrix Methods for inducing temporary changes in ventilation for estimation of hemodynamic performance
EP1393773B1 (en) * 2002-08-28 2006-10-18 Maquet Critical Care AB Nerve stimulation device
JP4095391B2 (en) * 2002-09-24 2008-06-04 キヤノン株式会社 Position detection method
JP4309111B2 (en) * 2002-10-02 2009-08-05 株式会社スズケン Health management system, activity measuring apparatus and a data processing device
US8672852B2 (en) * 2002-12-13 2014-03-18 Intercure Ltd. Apparatus and method for beneficial modification of biorhythmic activity
US8391989B2 (en) * 2002-12-18 2013-03-05 Cardiac Pacemakers, Inc. Advanced patient management for defining, identifying and using predetermined health-related events
US20050020240A1 (en) * 2003-02-07 2005-01-27 Darin Minter Private wireless network
US20050261747A1 (en) 2003-05-16 2005-11-24 Schuler Eleanor L Method and system to control respiration by means of neuro-electrical coded signals
US6905788B2 (en) * 2003-09-12 2005-06-14 Eastman Kodak Company Stabilized OLED device
US7610094B2 (en) * 2003-09-18 2009-10-27 Cardiac Pacemakers, Inc. Synergistic use of medical devices for detecting medical disorders
US7532934B2 (en) * 2003-09-18 2009-05-12 Cardiac Pacemakers, Inc. Snoring detection system and method
US9259573B2 (en) * 2003-10-15 2016-02-16 Rmx, Llc Device and method for manipulating exhalation
US8265759B2 (en) 2003-10-15 2012-09-11 Rmx, Llc Device and method for treating disorders of the cardiovascular system or heart
US20080161878A1 (en) 2003-10-15 2008-07-03 Tehrani Amir J Device and method to for independently stimulating hemidiaphragms
US20120158091A1 (en) * 2003-10-15 2012-06-21 Rmx, Llc Therapeutic diaphragm stimulation device and method
US8140164B2 (en) * 2003-10-15 2012-03-20 Rmx, Llc Therapeutic diaphragm stimulation device and method
EP1680010A4 (en) 2003-11-04 2009-07-01 Quantum Intech Inc Systems and methods for facilitating physiological coherence using respiration training
EP1786315A4 (en) 2004-02-05 2010-03-03 Earlysense Ltd Techniques for prediction and monitoring of respiration-manifested clinical episodes
US7070568B1 (en) * 2004-03-02 2006-07-04 Pacesetter, Inc. System and method for diagnosing and tracking congestive heart failure based on the periodicity of Cheyne-Stokes Respiration using an implantable medical device
US7245971B2 (en) 2004-04-21 2007-07-17 Pacesetter, Inc. System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device
JP4396380B2 (en) 2004-04-26 2010-01-13 アイシン・エィ・ダブリュ株式会社 Transmitting apparatus and method for transmitting traffic information
US20060122661A1 (en) * 2004-12-03 2006-06-08 Mandell Lee J Diaphragmatic pacing with activity monitor adjustment
US7680538B2 (en) 2005-03-31 2010-03-16 Case Western Reserve University Method of treating obstructive sleep apnea using electrical nerve stimulation
US8036750B2 (en) 2005-06-13 2011-10-11 Cardiac Pacemakers, Inc. System for neural control of respiration
US20080021506A1 (en) * 2006-05-09 2008-01-24 Massachusetts General Hospital Method and device for the electrical treatment of sleep apnea and snoring
US8280513B2 (en) 2006-12-22 2012-10-02 Rmx, Llc Device and method to treat flow limitations

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US240240A (en) * 1881-04-19 Beer-faucet
US4827935A (en) * 1986-04-24 1989-05-09 Purdue Research Foundation Demand electroventilator
US4830008A (en) * 1987-04-24 1989-05-16 Meer Jeffrey A Method and system for treatment of sleep apnea
US5056519A (en) * 1990-05-14 1991-10-15 Vince Dennis J Unilateral diaphragmatic pacer
US5265604A (en) * 1990-05-14 1993-11-30 Vince Dennis J Demand - diaphragmatic pacing (skeletal muscle pressure modified)
US5281219A (en) * 1990-11-23 1994-01-25 Medtronic, Inc. Multiple stimulation electrodes
US5300094A (en) * 1991-01-09 1994-04-05 Medtronic, Inc. Servo muscle control
US5211173A (en) * 1991-01-09 1993-05-18 Medtronic, Inc. Servo muscle control
US5146918A (en) * 1991-03-19 1992-09-15 Medtronic, Inc. Demand apnea control of central and obstructive sleep apnea
US5215082A (en) * 1991-04-02 1993-06-01 Medtronic, Inc. Implantable apnea generator with ramp on generator
US5174287A (en) * 1991-05-28 1992-12-29 Medtronic, Inc. Airway feedback measurement system responsive to detected inspiration and obstructive apnea event
US5233983A (en) * 1991-09-03 1993-08-10 Medtronic, Inc. Method and apparatus for apnea patient screening
US5423372A (en) * 1993-12-27 1995-06-13 Ford Motor Company Joining sand cores for making castings
US5524632A (en) * 1994-01-07 1996-06-11 Medtronic, Inc. Method for implanting electromyographic sensing electrodes
US5800470A (en) * 1994-01-07 1998-09-01 Medtronic, Inc. Respiratory muscle electromyographic rate responsive pacemaker
US5483969A (en) * 1994-09-21 1996-01-16 Medtronic, Inc. Method and apparatus for providing a respiratory effort waveform for the treatment of obstructive sleep apnea
US5485851A (en) * 1994-09-21 1996-01-23 Medtronic, Inc. Method and apparatus for arousal detection
US5522862A (en) * 1994-09-21 1996-06-04 Medtronic, Inc. Method and apparatus for treating obstructive sleep apnea
US5540733A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for detecting and treating obstructive sleep apnea
US5540731A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for pressure detecting and treating obstructive airway disorders
US5546952A (en) * 1994-09-21 1996-08-20 Medtronic, Inc. Method and apparatus for detection of a respiratory waveform
US5549655A (en) * 1994-09-21 1996-08-27 Medtronic, Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US5540732A (en) * 1994-09-21 1996-07-30 Medtronic, Inc. Method and apparatus for impedance detecting and treating obstructive airway disorders
US5678535A (en) * 1995-04-21 1997-10-21 Dimarco; Anthony Fortunato Method and apparatus for electrical stimulation of the respiratory muscles to achieve artificial ventilation in a patient
US5911218A (en) * 1995-04-21 1999-06-15 Dimarco; Anthony Fortunato Method and apparatus for electrical stimulation of the respiratory muscles to achieve artificial ventilation in a patient
US6542774B2 (en) * 1996-04-30 2003-04-01 Medtronic, Inc. Method and device for electronically controlling the beating of a heart
US5895360A (en) * 1996-06-26 1999-04-20 Medtronic, Inc. Gain control for a periodic signal and method regarding same
US6572543B1 (en) * 1996-06-26 2003-06-03 Medtronic, Inc Sensor, method of sensor implant and system for treatment of respiratory disorders
US5944680A (en) * 1996-06-26 1999-08-31 Medtronic, Inc. Respiratory effort detection method and apparatus
US6021352A (en) * 1996-06-26 2000-02-01 Medtronic, Inc, Diagnostic testing methods and apparatus for implantable therapy devices
US6099479A (en) * 1996-06-26 2000-08-08 Medtronic, Inc. Method and apparatus for operating therapy system
US5814086A (en) * 1996-10-18 1998-09-29 Pacesetter Ab Perex respiratory system stimulation upon tachycardia detection
US5797923A (en) * 1997-05-12 1998-08-25 Aiyar; Harish Electrode delivery instrument
US6269269B1 (en) * 1998-04-23 2001-07-31 Medtronic Inc. Method and apparatus for synchronized treatment of obstructive sleep apnea
US6251126B1 (en) * 1998-04-23 2001-06-26 Medtronic Inc Method and apparatus for synchronized treatment of obstructive sleep apnea
US20040237963A1 (en) * 1998-05-22 2004-12-02 Michael Berthon-Jones Ventilatory assistance for treatment of cardiac failure and Cheyne-Stokes breathing
US6463327B1 (en) * 1998-06-11 2002-10-08 Cprx Llc Stimulatory device and methods to electrically stimulate the phrenic nerve
US6651652B1 (en) * 1998-06-30 2003-11-25 Siemens-Elema Ab Method for identifying respiration attempts by analyzing neuroelectrical signals, and respiration detector and respiratory aid system operating according to the method
US6574507B1 (en) * 1998-07-06 2003-06-03 Ela Medical S.A. Active implantable medical device for treating sleep apnea syndrome by electrostimulation
US6345202B2 (en) * 1998-08-14 2002-02-05 Advanced Bionics Corporation Method of treating obstructive sleep apnea using implantable electrodes
US6512949B1 (en) * 1999-07-12 2003-01-28 Medtronic, Inc. Implantable medical device for measuring time varying physiologic conditions especially edema and for responding thereto
US6415183B1 (en) * 1999-12-09 2002-07-02 Cardiac Pacemakers, Inc. Method and apparatus for diaphragmatic pacing
US20030127091A1 (en) * 1999-12-15 2003-07-10 Chang Yung Chi Scientific respiration for self-health-care
US20020049482A1 (en) * 2000-06-14 2002-04-25 Willa Fabian Lifestyle management system
US20040225226A1 (en) * 2000-08-17 2004-11-11 Ilife Systems, Inc. System and method for detecting the onset of an obstructive sleep apnea event
US6633779B1 (en) * 2000-11-27 2003-10-14 Science Medicus, Inc. Treatment of asthma and respiratory disease by means of electrical neuro-receptive waveforms
US20040059240A1 (en) * 2001-04-30 2004-03-25 Medtronic, Inc. Method and apparatus to detect and treat sleep respiratory events
US20020193697A1 (en) * 2001-04-30 2002-12-19 Cho Yong Kyun Method and apparatus to detect and treat sleep respiratory events
US20040176809A1 (en) * 2001-06-07 2004-09-09 Medtronic, Inc. Method and apparatus for modifying delivery of a therapy in response to onset of sleep
US20020193839A1 (en) * 2001-06-07 2002-12-19 Cho Yong Kyun Method for providing a therapy to a patient involving modifying the therapy after detecting an onset of sleep in the patient, and implantable medical device embodying same
US20030153955A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Cardiac stimulation device including sleep apnea prevention and treatment
US20030153954A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Sleep apnea therapy device using dynamic overdrive pacing
US20030153956A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Cardiac stimulation device including sleep apnea prevention and treatment
US20030153953A1 (en) * 2002-02-14 2003-08-14 Euljoon Park Stimulation device for sleep apnea prevention, detection and treatment
US20030195571A1 (en) * 2002-04-12 2003-10-16 Burnes John E. Method and apparatus for the treatment of central sleep apnea using biventricular pacing
US20030204213A1 (en) * 2002-04-30 2003-10-30 Jensen Donald N. Method and apparatus to detect and monitor the frequency of obstructive sleep apnea
US6881192B1 (en) * 2002-06-12 2005-04-19 Pacesetter, Inc. Measurement of sleep apnea duration and evaluation of response therapies using duration metrics
US20040077953A1 (en) * 2002-10-18 2004-04-22 Turcott Robert G. Hemodynamic analysis
US20040088015A1 (en) * 2002-10-31 2004-05-06 Casavant David A. Respiratory nerve stimulation
US20040111040A1 (en) * 2002-12-04 2004-06-10 Quan Ni Detection of disordered breathing
US20040134496A1 (en) * 2003-01-10 2004-07-15 Cho Yong K. Method and apparatus for detecting respiratory disturbances
US20040138719A1 (en) * 2003-01-10 2004-07-15 Cho Yong K. System and method for automatically monitoring and delivering therapy for sleep-related disordered breathing
US20050119711A1 (en) * 2003-01-10 2005-06-02 Cho Yong K. Apparatus and method for monitoring for disordered breathing
US20050107860A1 (en) * 2003-07-23 2005-05-19 Ignagni Anthony R. Mapping probe system for neuromuscular electrical stimulation apparatus
US20050021102A1 (en) * 2003-07-23 2005-01-27 Ignagni Anthony R. System and method for conditioning a diaphragm of a patient
US20050039745A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Adaptive therapy for disordered breathing
US20050043772A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Therapy triggered by prediction of disordered breathing
US20050115561A1 (en) * 2003-08-18 2005-06-02 Stahmann Jeffrey E. Patient monitoring, diagnosis, and/or therapy systems and methods
US20050043644A1 (en) * 2003-08-18 2005-02-24 Stahmann Jeffrey E. Prediction of disordered breathing
US20050101833A1 (en) * 2003-09-02 2005-05-12 Biotronik Gmbh & Co. Kg Apparatus for the treatment of sleep apnea
US20050055060A1 (en) * 2003-09-05 2005-03-10 Steve Koh Determination of respiratory characteristics from AV conduction intervals
US20050065567A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Therapy control based on cardiopulmonary status
US20050074741A1 (en) * 2003-09-18 2005-04-07 Kent Lee System and method for discrimination of central and obstructive disordered breathing events
US20050145246A1 (en) * 2003-09-18 2005-07-07 Hartley Jesse W. Posture detection system and method
US20050061315A1 (en) * 2003-09-18 2005-03-24 Kent Lee Feedback system and method for sleep disordered breathing therapy
US20050061320A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Coordinated use of respiratory and cardiac therapies for sleep disordered breathing
US20050061319A1 (en) * 2003-09-18 2005-03-24 Cardiac Pacemakers, Inc. Methods and systems for implantably monitoring external breathing therapy
US20050080461A1 (en) * 2003-09-18 2005-04-14 Stahmann Jeffrey E. System and method for moderating a therapy delivered during sleep using physiologic data acquired during non-sleep
US20050065563A1 (en) * 2003-09-23 2005-03-24 Avram Scheiner Paced ventilation therapy by an implantable cardiac device
US20050085866A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Breathing disorder and precursor predictor and therapy delivery device and method
US20050085865A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Breathing disorder detection and therapy delivery device and method
US20060247729A1 (en) * 2003-10-15 2006-11-02 Tehrani Amir J Multimode device and method for controlling breathing
US20050085734A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Heart failure patient treatment and management device
US20060167523A1 (en) * 2003-10-15 2006-07-27 Tehrani Amir J Device and method for improving upper airway functionality
US20060142815A1 (en) * 2003-10-15 2006-06-29 Tehrani Amir J Device and method for treating obstructive sleep apnea
US20060155341A1 (en) * 2003-10-15 2006-07-13 Tehrani Amir J Device and method for biasing lung volume
US20070021795A1 (en) * 2003-10-15 2007-01-25 Inspiration Medical, Inc. Device and method for adding to breathing
US20060149334A1 (en) * 2003-10-15 2006-07-06 Tehrani Amir J Device and method for controlling breathing
US20060030894A1 (en) * 2003-10-15 2006-02-09 Tehrani Amir J Breathing disorder detection and therapy device for providing intrinsic breathing
US20060036294A1 (en) * 2003-10-15 2006-02-16 Tehrani Amir J Patient compliance management device and method
US20050085867A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. System and method for diaphragm stimulation
US20050085868A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Breathing therapy device and method
US20050148897A1 (en) * 2003-12-24 2005-07-07 Cho Yong K. Implantable medical device with sleep disordered breathing monitoring
US20050165457A1 (en) * 2004-01-26 2005-07-28 Michael Benser Tiered therapy for respiratory oscillations characteristic of Cheyne-Stokes respiration
US20050224076A1 (en) * 2004-04-07 2005-10-13 Pari Gmbh Spezialisten Fur Effektive Inhalation Aerosol generation device and inhalation device therewith
US7082331B1 (en) * 2004-04-21 2006-07-25 Pacesetter, Inc. System and method for applying therapy during hyperpnea phase of periodic breathing using an implantable medical device
US20050261600A1 (en) * 2004-05-20 2005-11-24 Airmatrix Technologies, Inc. Method and system for diagnosing central versus obstructive apnea
US20060058852A1 (en) * 2004-09-10 2006-03-16 Steve Koh Multi-variable feedback control of stimulation for inspiratory facilitation
US20060122622A1 (en) * 2004-12-06 2006-06-08 Csaba Truckai Bone treatment systems and methods

Cited By (132)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8555882B2 (en) 1997-03-14 2013-10-15 Covidien Lp Ventilator breath display and graphic user interface
US8555881B2 (en) 1997-03-14 2013-10-15 Covidien Lp Ventilator breath display and graphic interface
US8001967B2 (en) 1997-03-14 2011-08-23 Nellcor Puritan Bennett Llc Ventilator breath display and graphic user interface
US8706236B2 (en) 2003-07-23 2014-04-22 Synapse Biomedical, Inc. System and method for conditioning a diaphragm of a patient
US7840270B2 (en) 2003-07-23 2010-11-23 Synapse Biomedical, Inc. System and method for conditioning a diaphragm of a patient
US20050021102A1 (en) * 2003-07-23 2005-01-27 Ignagni Anthony R. System and method for conditioning a diaphragm of a patient
US8406885B2 (en) 2003-07-23 2013-03-26 Synapse Biomedical, Inc. System and method for conditioning a diaphragm of a patient
US20110060381A1 (en) * 2003-07-23 2011-03-10 Ignagni Anthony R System and Method for Conditioning a Diaphragm of a Patient
US8265759B2 (en) 2003-10-15 2012-09-11 Rmx, Llc Device and method for treating disorders of the cardiovascular system or heart
US20060155341A1 (en) * 2003-10-15 2006-07-13 Tehrani Amir J Device and method for biasing lung volume
US20060247729A1 (en) * 2003-10-15 2006-11-02 Tehrani Amir J Multimode device and method for controlling breathing
US8412331B2 (en) 2003-10-15 2013-04-02 Rmx, Llc Breathing therapy device and method
US20060149334A1 (en) * 2003-10-15 2006-07-06 Tehrani Amir J Device and method for controlling breathing
US8509901B2 (en) 2003-10-15 2013-08-13 Rmx, Llc Device and method for adding to breathing
US8348941B2 (en) 2003-10-15 2013-01-08 Rmx, Llc Demand-based system for treating breathing disorders
US8335567B2 (en) 2003-10-15 2012-12-18 Rmx, Llc Multimode device and method for controlling breathing
US20060122662A1 (en) * 2003-10-15 2006-06-08 Tehrani Amir J Device and method for increasing functional residual capacity
US20060036294A1 (en) * 2003-10-15 2006-02-16 Tehrani Amir J Patient compliance management device and method
US8255056B2 (en) 2003-10-15 2012-08-28 Rmx, Llc Breathing disorder and precursor predictor and therapy delivery device and method
US8244358B2 (en) 2003-10-15 2012-08-14 Rmx, Llc Device and method for treating obstructive sleep apnea
US8200336B2 (en) 2003-10-15 2012-06-12 Rmx, Llc System and method for diaphragm stimulation
US8160711B2 (en) 2003-10-15 2012-04-17 Rmx, Llc Multimode device and method for controlling breathing
US20080167695A1 (en) * 2003-10-15 2008-07-10 Tehrani Amir J Therapeutic diaphragm stimulation device and method
US20080188904A1 (en) * 2003-10-15 2008-08-07 Tehrani Amir J Device and method for treating disorders of the cardiovascular system or heart
US8140164B2 (en) 2003-10-15 2012-03-20 Rmx, Llc Therapeutic diaphragm stimulation device and method
US20080208281A1 (en) * 2003-10-15 2008-08-28 Tehrani Amir J Device and method for biasing and stimulating respiration
US8116872B2 (en) 2003-10-15 2012-02-14 Rmx, Llc Device and method for biasing and stimulating respiration
US20110230932A1 (en) * 2003-10-15 2011-09-22 Rmx, Llc Device and method for independently stimulating hemidiaphragms
US7979128B2 (en) 2003-10-15 2011-07-12 Rmx, Llc Device and method for gradually controlling breathing
US20060030894A1 (en) * 2003-10-15 2006-02-09 Tehrani Amir J Breathing disorder detection and therapy device for providing intrinsic breathing
US9259573B2 (en) 2003-10-15 2016-02-16 Rmx, Llc Device and method for manipulating exhalation
US7970475B2 (en) 2003-10-15 2011-06-28 Rmx, Llc Device and method for biasing lung volume
US20050085734A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. Heart failure patient treatment and management device
US20050085867A1 (en) * 2003-10-15 2005-04-21 Tehrani Amir J. System and method for diaphragm stimulation
US9370657B2 (en) 2003-10-15 2016-06-21 Rmx, Llc Device for manipulating tidal volume and breathing entrainment
US8467876B2 (en) * 2003-10-15 2013-06-18 Rmx, Llc Breathing disorder detection and therapy delivery device and method
US20120203293A1 (en) * 2004-06-08 2012-08-09 Greenberg Robert J Locating a Neural Prosthesis using Impedance and Electrode Height
US9597495B2 (en) * 2004-06-08 2017-03-21 Second Sight Medical Products, Inc. Locating a neural prosthesis using impedance and electrode height
US20070265611A1 (en) * 2004-07-23 2007-11-15 Ignagni Anthony R Ventilatory assist system and methods to improve respiratory function
US7962215B2 (en) 2004-07-23 2011-06-14 Synapse Biomedical, Inc. Ventilatory assist system and methods to improve respiratory function
US20060122661A1 (en) * 2004-12-03 2006-06-08 Mandell Lee J Diaphragmatic pacing with activity monitor adjustment
WO2006062710A1 (en) * 2004-12-03 2006-06-15 The Alfred E. Mann Foundation For Scientific Research Diaphragmatic pacing with physiological need adjustment
US7644714B2 (en) 2005-05-27 2010-01-12 Apnex Medical, Inc. Devices and methods for treating sleep disorders
US20070044669A1 (en) * 2005-08-24 2007-03-01 Geise Gregory D Aluminum can compacting mechanism with improved actuation handle assembly
US20070049793A1 (en) * 2005-08-25 2007-03-01 Ignagni Anthony R Method And Apparatus For Transgastric Neurostimulation
US9050005B2 (en) 2005-08-25 2015-06-09 Synapse Biomedical, Inc. Method and apparatus for transgastric neurostimulation
US20070118183A1 (en) * 2005-11-18 2007-05-24 Mark Gelfand System and method to modulate phrenic nerve to prevent sleep apnea
US8244359B2 (en) * 2005-11-18 2012-08-14 Respicardia, Inc. System and method to modulate phrenic nerve to prevent sleep apnea
US20070150023A1 (en) * 2005-12-02 2007-06-28 Ignagni Anthony R Transvisceral neurostimulation mapping device and method
US20080125828A1 (en) * 2006-03-09 2008-05-29 Ignagni Anthony R Ventilatory assist system and methods to improve respiratory function
US8676323B2 (en) 2006-03-09 2014-03-18 Synapse Biomedical, Inc. Ventilatory assist system and methods to improve respiratory function
US8021310B2 (en) 2006-04-21 2011-09-20 Nellcor Puritan Bennett Llc Work of breathing display for a ventilation system
US20070272242A1 (en) * 2006-04-21 2007-11-29 Sanborn Warren G Work of breathing display for a ventilation system
US8597198B2 (en) 2006-04-21 2013-12-03 Covidien Lp Work of breathing display for a ventilation system
US9656067B2 (en) 2006-05-23 2017-05-23 Publiekrechtelijke Rechtspersoon Academisch Ziekenhuis Leiden H.O.D.N. Leids Universitair Medisch Centrum Medical probe for electro-stimulation and training of pelvic floor musculature
US20090270963A1 (en) * 2006-05-23 2009-10-29 Publiekrechtelijke Rechtspersoon Academisch Ziekenhuis Leiden H.O.D.N. Leids Universitair Medi Medical probe
US8983627B2 (en) * 2006-05-23 2015-03-17 Publiekrechtelijke Rechtspersoon Academisch Ziekenhuis Leiden H.O.D.N. Leids Universitair Medisch Centrum Medical probe for electro-stimulation and bio-feedback training of pelvic floor musculature
US20100049037A1 (en) * 2006-09-11 2010-02-25 Koninklijke Philips Electronics N.V. System and method for positioning electrodes on a patient body
US8577439B2 (en) * 2006-09-11 2013-11-05 Koninklijke Philips N.V. System and method for positioning electrodes on a patient body
US8453645B2 (en) 2006-09-26 2013-06-04 Covidien Lp Three-dimensional waveform display for a breathing assistance system
US20080072902A1 (en) * 2006-09-27 2008-03-27 Nellcor Puritan Bennett Incorporated Preset breath delivery therapies for a breathing assistance system
US9186511B2 (en) 2006-10-13 2015-11-17 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8498712B2 (en) 2006-10-13 2013-07-30 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8428727B2 (en) 2006-10-13 2013-04-23 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8311645B2 (en) 2006-10-13 2012-11-13 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8744589B2 (en) 2006-10-13 2014-06-03 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8417343B2 (en) 2006-10-13 2013-04-09 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8718783B2 (en) 2006-10-13 2014-05-06 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8626304B2 (en) 2006-10-13 2014-01-07 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US8639354B2 (en) 2006-10-13 2014-01-28 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US7809442B2 (en) 2006-10-13 2010-10-05 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US20080103407A1 (en) * 2006-10-13 2008-05-01 Apnex Medical, Inc. Obstructive sleep apnea treatment devices, systems and methods
US20080109047A1 (en) * 2006-10-26 2008-05-08 Pless Benjamin D Apnea treatment device
US20080154330A1 (en) * 2006-12-22 2008-06-26 Tehrani Amir J Device and method to treat flow limitations
US8280513B2 (en) * 2006-12-22 2012-10-02 Rmx, Llc Device and method to treat flow limitations
US9744351B1 (en) 2007-01-22 2017-08-29 Respicardia, Inc. Device and method for the treatment of breathing disorders and cardiac disorders
US20080208282A1 (en) * 2007-01-22 2008-08-28 Mark Gelfand Device and method for the treatment of breathing disorders and cardiac disorders
US8909341B2 (en) 2007-01-22 2014-12-09 Respicardia, Inc. Device and method for the treatment of breathing disorders and cardiac disorders
US20130230883A1 (en) * 2007-02-01 2013-09-05 Ls Biopath, Inc. Methods for detection and characterization of abnormal tissue and cells using an electrical system
US8437845B2 (en) * 2007-02-01 2013-05-07 Ls Biopath, Inc. Electrical methods for detection and characterization of abnormal tissue and cells
US20100179436A1 (en) * 2007-02-01 2010-07-15 Moshe Sarfaty Optical system for detection and characterization of abnormal tissue and cells
US8865076B2 (en) * 2007-02-01 2014-10-21 Ls Biopath, Inc. Methods for detection and characterization of abnormal tissue and cells using an electrical system
US20100121173A1 (en) * 2007-02-01 2010-05-13 Moshe Sarfaty Electrical systems for detection and characterization of abnormal tissue and cells
US9566030B2 (en) 2007-02-01 2017-02-14 Ls Biopath, Inc. Optical system for detection and characterization of abnormal tissue and cells
US8417328B2 (en) * 2007-02-01 2013-04-09 Ls Biopath, Inc. Electrical systems for detection and characterization of abnormal tissue and cells
US20100106047A1 (en) * 2007-02-01 2010-04-29 Ls Biopath, Inc. Electrical methods for detection and characterization of abnormal tissue and cells
US20080188867A1 (en) * 2007-02-05 2008-08-07 Ignagni Anthony R Removable intramuscular electrode
US9079016B2 (en) 2007-02-05 2015-07-14 Synapse Biomedical, Inc. Removable intramuscular electrode
US9820671B2 (en) 2007-05-17 2017-11-21 Synapse Biomedical, Inc. Devices and methods for assessing motor point electromyogram as a biomarker
US20080287820A1 (en) * 2007-05-17 2008-11-20 Synapse Biomedical, Inc. Devices and methods for assessing motor point electromyogram as a biomarker
US20090024176A1 (en) * 2007-07-17 2009-01-22 Joonkyoo Anthony Yun Methods and devices for producing respiratory sinus arrhythmia
US8135471B2 (en) 2007-08-28 2012-03-13 Cardiac Pacemakers, Inc. Method and apparatus for inspiratory muscle stimulation using implantable device
US20090062882A1 (en) * 2007-08-28 2009-03-05 Cardiac Pacemakers, Inc. Method and apparatus for inspiratory muscle stimulation using implantable device
US8914113B2 (en) 2007-08-28 2014-12-16 Cardiac Pacemakers, Inc. Method and apparatus for inspiratory muscle stimulation using implantable device
US20090099621A1 (en) * 2007-10-10 2009-04-16 Zheng Lin Respiratory stimulation for treating periodic breathing
US8838245B2 (en) 2007-10-10 2014-09-16 Cardiac Pacemakers, Inc. Respiratory stimulation for treating periodic breathing
US8428711B2 (en) 2007-10-10 2013-04-23 Cardiac Pacemakers, Inc. Respiratory stimulation for treating periodic breathing
US20090118785A1 (en) * 2007-10-30 2009-05-07 Ignagni Anthony R Method of improving sleep disordered breathing
US8478412B2 (en) 2007-10-30 2013-07-02 Synapse Biomedical, Inc. Method of improving sleep disordered breathing
US9138580B2 (en) 2007-10-30 2015-09-22 Synapse Biomedical, Inc. Device and method of neuromodulation to effect a functionally restorative adaption of the neuromuscular system
US8428726B2 (en) 2007-10-30 2013-04-23 Synapse Biomedical, Inc. Device and method of neuromodulation to effect a functionally restorative adaption of the neuromuscular system
US8433412B1 (en) 2008-02-07 2013-04-30 Respicardia, Inc. Muscle and nerve stimulation
US9295846B2 (en) 2008-02-07 2016-03-29 Respicardia, Inc. Muscle and nerve stimulation
US20110152706A1 (en) * 2008-05-15 2011-06-23 Inspire Medical Systems, Inc. Method and apparatus for sensing respiratory pressure in an implantable stimulation system
US8938299B2 (en) 2008-11-19 2015-01-20 Inspire Medical Systems, Inc. System for treating sleep disordered breathing
US9744354B2 (en) 2008-12-31 2017-08-29 Cyberonics, Inc. Obstructive sleep apnea treatment devices, systems and methods
US9486628B2 (en) 2009-03-31 2016-11-08 Inspire Medical Systems, Inc. Percutaneous access for systems and methods of treating sleep apnea
US8233987B2 (en) 2009-09-10 2012-07-31 Respicardia, Inc. Respiratory rectification
US20110060380A1 (en) * 2009-09-10 2011-03-10 Mark Gelfand Respiratory rectification
USD649157S1 (en) 2009-12-04 2011-11-22 Nellcor Puritan Bennett Llc Ventilator display screen with a user interface
US8335992B2 (en) 2009-12-04 2012-12-18 Nellcor Puritan Bennett Llc Visual indication of settings changes on a ventilator graphical user interface
US9119925B2 (en) 2009-12-04 2015-09-01 Covidien Lp Quick initiation of respiratory support via a ventilator user interface
USD638852S1 (en) 2009-12-04 2011-05-31 Nellcor Puritan Bennett Llc Ventilator display screen with an alarm icon
US8924878B2 (en) 2009-12-04 2014-12-30 Covidien Lp Display and access to settings on a ventilator graphical user interface
US9262588B2 (en) 2009-12-18 2016-02-16 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US8443294B2 (en) 2009-12-18 2013-05-14 Covidien Lp Visual indication of alarms on a ventilator graphical user interface
US8499252B2 (en) 2009-12-18 2013-07-30 Covidien Lp Display of respiratory data graphs on a ventilator graphical user interface
US8983572B2 (en) 2010-10-29 2015-03-17 Inspire Medical Systems, Inc. System and method for patient selection in treating sleep disordered breathing
US20120150061A1 (en) * 2010-11-02 2012-06-14 Industry-Academic Cooperation Foundation, Yonsei University Sensor for Detecting Cancerous Tissue and Method of Manufacturing the Same
US8386046B2 (en) 2011-01-28 2013-02-26 Apnex Medical, Inc. Screening devices and methods for obstructive sleep apnea therapy
US9113838B2 (en) 2011-01-28 2015-08-25 Cyberonics, Inc. Screening devices and methods for obstructive sleep apnea therapy
US9555247B2 (en) 2011-01-28 2017-01-31 Cyberonics, Inc. Screening devices and methods for obstructive sleep apnea therapy
US8855771B2 (en) 2011-01-28 2014-10-07 Cyberonics, Inc. Screening devices and methods for obstructive sleep apnea therapy
US9757564B2 (en) 2011-05-12 2017-09-12 Cyberonics, Inc. Devices and methods for sleep apnea treatment
US9205262B2 (en) 2011-05-12 2015-12-08 Cyberonics, Inc. Devices and methods for sleep apnea treatment
US8934992B2 (en) 2011-09-01 2015-01-13 Inspire Medical Systems, Inc. Nerve cuff
US9694185B2 (en) 2012-12-19 2017-07-04 Viscardia, Inc. Hemodynamic performance enhancement through asymptomatic diaphragm stimulation
US9498625B2 (en) 2012-12-19 2016-11-22 Viscardia, Inc. Hemodynamic performance enhancement through asymptomatic diaphragm stimulation
US9597509B2 (en) 2014-01-21 2017-03-21 Simon Fraser University Systems and related methods for optimization of multi-electrode nerve pacing
EP3096835A4 (en) * 2014-01-21 2017-08-09 Univ Fraser Simon Systems and related methods for optimization of multi-electrode nerve pacing
US9333363B2 (en) 2014-01-21 2016-05-10 Simon Fraser University Systems and related methods for optimization of multi-electrode nerve pacing
WO2015109401A1 (en) * 2014-01-21 2015-07-30 Simon Fraser University Systems and related methods for optimization of multi-electrode nerve pacing

Also Published As

Publication number Publication date Type
WO2005037220A2 (en) 2005-04-28 application
WO2005037172A3 (en) 2005-08-04 application
DE112004001954B4 (en) 2015-10-22 grant
US8348941B2 (en) 2013-01-08 grant
US20130296964A1 (en) 2013-11-07 application
US8467876B2 (en) 2013-06-18 grant
WO2005037172A2 (en) 2005-04-28 application
US20070021795A1 (en) 2007-01-25 application
US20050085734A1 (en) 2005-04-21 application
US20080188903A1 (en) 2008-08-07 application
WO2005037366A1 (en) 2005-04-28 application
WO2005037077A2 (en) 2005-04-28 application
US8509901B2 (en) 2013-08-13 grant
US20060036294A1 (en) 2006-02-16 application
US20050085867A1 (en) 2005-04-21 application
US20080208281A1 (en) 2008-08-28 application
WO2005037174A2 (en) 2005-04-28 application
US20080183240A1 (en) 2008-07-31 application
DE112004001957T5 (en) 2006-08-31 application
WO2005037173A2 (en) 2005-04-28 application
US20050085865A1 (en) 2005-04-21 application
US8200336B2 (en) 2012-06-12 grant
US8412331B2 (en) 2013-04-02 grant
WO2005037174A3 (en) 2005-06-09 application
US8116872B2 (en) 2012-02-14 grant
WO2005037220A3 (en) 2005-07-07 application
US8255056B2 (en) 2012-08-28 grant
DE112004001954T5 (en) 2006-10-26 application
US20050085868A1 (en) 2005-04-21 application
US20130296973A1 (en) 2013-11-07 application
US20080183239A1 (en) 2008-07-31 application
US20060030894A1 (en) 2006-02-09 application
WO2005037077A3 (en) 2005-09-09 application
US20050085866A1 (en) 2005-04-21 application
WO2005037173A3 (en) 2005-06-30 application
DE112004001953T5 (en) 2006-10-26 application

Similar Documents

Publication Publication Date Title
Danon et al. Function of the isolated paced diaphragm and the cervical accessory muscles in C1 quadriplegics
US5999855A (en) Method and apparatus for electrical activation of the expiratory muscles to restore cough
Glenn et al. Ventilatory support of the quadriplegic patient with respiratory paralysis by diaphragm pacing
US5476484A (en) Apparatus for sensing a physical condition in a living subject
Laghi et al. Comparison of magnetic and electrical phrenic nerve stimulation in assessment of diaphragmatic contractility
US7720548B2 (en) Impedance-based stimulation adjustment
US7801603B2 (en) Method and apparatus for optimizing vagal nerve stimulation using laryngeal activity
US7480532B2 (en) Baroreflex activation for pain control, sedation and sleep
De Troyer et al. Action of costal and crural parts of the diaphragm on the rib cage in dog
US4566456A (en) Apparatus and method for adjusting heart/pacer rate relative to right ventricular systolic pressure to obtain a required cardiac output
EP1938862B1 (en) Disordered breathing management system and methods
US7069083B2 (en) System and method for electrical stimulation of the intervertebral disc
US7869885B2 (en) Threshold optimization for tissue stimulation therapy
US20080039866A1 (en) Locating guide
US6415183B1 (en) Method and apparatus for diaphragmatic pacing
US20120192874A1 (en) Obstructive sleep apnea treatment devices, systems and methods
US6445953B1 (en) Wireless cardiac pacing system with vascular electrode-stents
US20030220678A1 (en) Adjustable implantable captivation fixation anchor-stop
US20050115561A1 (en) Patient monitoring, diagnosis, and/or therapy systems and methods
US20090264739A1 (en) Determining a position of a member within a sheath
US20110054560A1 (en) Pacing, sensing and other parameter maps based on localization system data
US6345202B2 (en) Method of treating obstructive sleep apnea using implantable electrodes
Saigal et al. Intraspinal microstimulation generates functional movements after spinal-cord injury
US4735205A (en) Method and apparatus including a sliding insulation lead for cardiac assistance
US6224562B1 (en) Methods and devices for performing cardiopulmonary resuscitation

Legal Events

Date Code Title Description
AS Assignment

Owner name: INSPIRATION MEDICAL, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:TEHRANI, AMIR J.;LEE, CHANG;LIGON, DAVID;AND OTHERS;REEL/FRAME:015899/0862;SIGNING DATES FROM 20050110 TO 20050201

AS Assignment

Owner name: RMX, L.L.C., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:INSPIRATION MEDICAL, INC.;REEL/FRAME:020266/0533

Effective date: 20070831