WO1997038751A1 - Transcutaneous nerve stimulator - Google Patents

Transcutaneous nerve stimulator Download PDF

Info

Publication number
WO1997038751A1
WO1997038751A1 PCT/DE1997/000721 DE9700721W WO9738751A1 WO 1997038751 A1 WO1997038751 A1 WO 1997038751A1 DE 9700721 W DE9700721 W DE 9700721W WO 9738751 A1 WO9738751 A1 WO 9738751A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
nerve stimulator
stimuli
nerve
stimulator according
electrodes
Prior art date
Application number
PCT/DE1997/000721
Other languages
German (de)
French (fr)
Inventor
Brigitte Stroetmann
Siegfried Kallert
Alessandra D'intino
Waltraud Lager
Original Assignee
Siemens Aktiengesellschaft
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

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/0404Electrodes for external use
    • A61N1/0408Use-related aspects
    • A61N1/0456Specially adapted for transcutaneous electrical nerve stimulation [TENS]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/0404Electrodes for external use
    • A61N1/0472Structure-related aspects
    • 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
    • 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
    • A61N1/36014External stimulators, e.g. with patch electrodes
    • A61N1/36021External stimulators, e.g. with patch electrodes for treatment of pain
    • 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
    • A61N1/36014External stimulators, e.g. with patch electrodes

Abstract

A transcutaneous nerve stimulator is disclosed, as well as its use in artificial respiration or in combination with a conventional respirator to avoid diaphragmatic atrophy. The nerve stimulator has electrodes and a pulse generator. Complex stimuli composed of individual stimuli are generated. The individual stimuli which make up a complex stimulus have the same form and repetition frequency.

Description

Besehreibung

transcutaneous nerve stimulator

The invention relates to a transcutaneous nerve stimulator and its use for artificial respiration or nation in Kombi¬ with a conventional ventilator for the dung Vermei¬ Inaktivi- occurring in artificial respiration tätsatrophie the diaphragm.

In general, the artificial respiration is as so. Carried out "pressure ventilation". This means that is incremented for the inhalation, the pressure pg in the breathing gas container to the pressure p L in the lung (= pressure), so that because of PB ^ PL directed into the pulmonary gas flow, namely the Einat¬ mung occurs. In this case, the lungs and thorax are stretched according to the elevated intrathoracic pressure. Due to the elasticity of these tissues exhalation can be passive when the invisible "pressure".

In the physiological form of the respiratory mechanics, a negative pressure relative to the ambient air pressure py testifies er¬ by the respiratory muscles over the expansion of the thorax expansion in the thorax, so that <PU inhalation occurs because PL. Again, it comes to passive exhalation when the thorax and lungs stretching, cease forces of the respiratory muscles.

Immediately after exhalation (this situation is defined as respiratory rest position), the pressure within the thorax in both respiratory form the same, but while in the physiological form of breathing for the inspiration phase, the pressure in the thorax decreases, it increases in the positive pressure ventilation to. This pressure and na¬ Türlich his changes are transferred to the blood vessels after Superpositions- principle. It affects sich'vor especially on the veins and atria. It comes in the physiological respiratory form, namely during inspiration by the increased pressure gradient between the thorax and abdomen to increased venous inflow into the thorax and the heart. Thus, the cardiac output is increased under otherwise completely glei economy conditions. One bezeich¬ net this as the pumping effect of respiration on the circulation. When airway pressure just a ent set against pressure gradient is established for inspiration, so it is more likely to be a counter-rotating, so fect circulation impeding Pumpef¬.

Rhythmic breathing activation of the diaphragm by entspre¬-reaching excitation of the phrenic nerve, which triggers contraction the diaphragmatic would approach the artificial respiration mechanics of physiological respiratory mechanics, thus enabling the Atem¬ pumping effect on the circulatory system. So it is a goal of producing devices that perform in accordance with the normal physiological respiratory mechanics by activation of the diaphragm for ventilation.

In patients who are mechanically ventilated, the methods some time after conventional positive pressure, occurs inactivity atrophy of the diaphragm to varying degrees. The muscle fibers of the diaphragm (skeletal muscles) weaken it and this leads to respiratory failure and requires that the patient must be laboriously weaned after the artificial respiration again by the ventilator. Regular Aktivie¬ tion of the diaphragm during artificial respiration on rhythmic respiratory stimulation of the phrenic nerve prevents die¬ se disuse atrophy.

While the electrical stimulation of the phrenic nerve is already clinically established method, but it is limited to implan¬ tierbare nerve stimulators.

Already in 1952 was used by the Siemens cleaner works with a heating current device named Phrenoton developed (DE-PS 919 961) which was used for transcutaneous nerve stimulation. With the Phrenoton a single phrenic nerve of the patient via a generated by electron tubes stimulus pulse was stimulated. Which consists of a modulation of three pulses Gl, G2 and G3 zusammen¬ (each with different shapes and frequencies) compound stimulus had a duration of 4 ms (or 2ms) and a repetition rate of 50 Hz (or 150 Hz). 4ms the lasting Im¬ pulse was obtained by chopping a daε Niederfrequenzr current of 5 kHz (or 7 kHz). this pulse was superimposed, generated by an RC element, rectangular pulses of frequency Fre¬ 10-60 / min.

The result was a one-sided, intermittently and unnecessarily violent stimulation of the nerve, which is not physiologically and led to baldi¬ gen fatigue of the nerve. an advancement

I

Winding the unit did not take place yet, because the Phreno- ton soon for medical treatment of respiratory weakness in polio obsolete was (see archive for physikali¬ specific therapy, issue of 1952, page 326/327). Meanwhile, there is again an increased need for neural stimulators that can be used also for artificial respiration or for supportive treatment-in artificial respiration.

The physiological arousal of a muscle, a stimulus to the nerve innervating it is given. Characterized action potentials are simultaneously tripped, which add up to a sum of action potential in the individual nerve fibers. Depending on the stimulus thickness none, some or all nerve fibers are excited, resulting in the occurrence or the amplitude and Dau¬ it shows the action potential of the nerve. Each motori¬ specific nerve fiber is divided more muscle fibers diver- gierend on. The excitation of a nerve fiber also triggers action potentials in all of their innervated muscle fibers. To a single muscle fiber action potential a Muskelfaserzuckung done. While on the electromechanical coupling a Einzelzuk- effect comes about tential to a single Aktionspo¬ enters the follow superposition and finally tetanus the muscle (= smooth long-lasting contraction = tetanic Muskelkon by superimposing the mechanics with several action potentials, the aufeinan¬ fast enough ¬ traction) on. A complex stimulus that causes tetanic contraction Muskel¬ is called tetanic stimulus.

The object of the present invention is to provide a device for transcutaneous nerve stimulation, which triggers a targeted tetanic stimulation.

The invention stimulator a transcutaneous nerve, which summarizes a pulse generator and stimulating electrodes um¬, wherein the pulse generator produces complex stimuli which are composed of individual stimuli whose amperage Folge¬ frequency and duration is variably adjustable and in which the individual stimuli in a complex have each stimulus same shapes and repetition rates. Further subject of the invention is the use of such Nervenstimula¬ tors to the diaphragm contraction through the stimulation of the phrenic nerve, as well as the use of such Nervenstimu¬ lators for two-sided stimulation of the nerves. phrenic, the use of the nerve stimulator for artificial respiration and finally the use of the stimulator in combination with a conventional ventilator for preventing Zwerchfellatrophie.

Preferably, the nerve stimulator is designed so that it is current-stabilized, which means that actions also when changing the resistance of the skin, for example by sweating or Hautre¬, the nerve thickness each having approximately the same Strom¬ is irritated.

The following is adjusted independently of one another via the pulse generator:

- The single stimulus duration,

- the form of single stimuli - the phase of individual stimuli,

- the amplitude (s) of the individual stimuli and

- the repetition rate of the individual stimuli. The duration of the individual stimuli can vary anywhere between 100 microseconds and 2ms. It may, however when applications demand it er¬, be longer or shorter than the specified range. The shape of the individual stimuli is also arbitrary, spielsweise sinusoidal, trapezoidal or rectangular. The amplitudes of the individual stimuli varied, for example between 0 and 50 mA. The repetition rate of the individual stimuli is also va¬ riabel and depends on the application of the nerve stimulator.

the shape of the complex stimulus arises from the individual stimuli. and the duration of the complex Rei¬ zes, the repetition frequency of the complex stimulus and the amplitude de (n) of the complex stimulus (rise, fall slope, and holding time) is set via the pulse generator.

Although complex stimuli can be included in a number of different stimulations ge formed, however, each complex stimulus consisting of only a single pulse shape. A superposition of pulse shapes according to the invention will not take place.

In a present embodiment, the Anstiegs¬ and fall time of each complex stimulus is adjustable so that, for example, a rise time of the complex stimulus can face 2s of a fall time of ls (see Figure 1). Thus, the shape of the complex stimulus may be both symmetrical and asymmetrical. It must, as I said, not to be uniformly repeating units again in the complex stimuli.

To trigger the desired tetanic contraction of the muscle a Folgefre¬ frequency of the individual stimuli of about 30 Hz is required in the case of diaphragmatic contraction.

To avoid to ver¬ in the irritated tissue electrolytic processes, biphasic pulses with load balancing are used for stimulation. In this case, a positive stimulus is alternating with a negative stimulus or it can already have the individual single stimuli have alternately positive and negative phases, for example, in the sequence of complex stimuli.

The stimulating electrodes for transcutaneous application timiert op¬ for faster placement possibility and ease of use. They are applied from the outside and can body and additionally be fixed in a holder. This mount may include one or more guide rails and Fi¬ xierungsmittel for fixing the electrodes comprise relative to each other and relative to the patient. On the patient, the holder is preferably attached to the neck or fi xed by a down around the neck strap relative to the neck. The guide rails are used for height, width and depth adjustment. Thus, a simple, quick and precise adjustment of the electrode to the desired stimulation points on the skin of the patient is possible. On the skin itself, the electrodes may be attached to patch or be integrated into a pavement.

In one embodiment, the stimulating electrode is grated inte¬ in a pillow, which is connected to an adjustable bracket, to allow for adjustment to the desired stimulus points and by an adjustment relative to the patient.

The stimulation electrodes are made of electrically conductive material and preferably have a porous surface for Herabset¬ wetting of the skin resistance. in the case of two-dimensional paving electrodes in addition, a narcotic, or a drug ande res be applied, which (for example, a narcotic to the local Be¬ täubung) outputs according to the principle of iontophoresis in the medicament to the stimulating skin layer. The porous surface of the electrodes also makes it possible that devices are provided which enable an automatic and uniform wetting of the electrodes. The stimulating electrodes are rial of an electrically conductive Mate¬ such as stainless steel, platinum, titanium, titanium nitride, carbon, electrically conductive plastics, ceramics among others prepared. This can be either rod-shaped and to scale electrodes, for better fixing this spielsweise may be on a patch which may in turn have also stored medications applied.

The invention is by no means limited to such types of electron trodes, but rather may include all types of electrode systems.

to be irritating nerve is stimulated preferably symmetrical, ie

I both the right and the left phrenic nerve is stimulated lines. An advantage of the two-sided or symmetrical Rei¬ wetting with respect to the one-sided, is that both halves diaphragmatic evenly and are stimulated equally. In the unilateral irritation only the entspre¬-reaching half of the diaphragm to contract. The other part is contracted only slightly due to the mechanics.

With symmetric diaphragmatic contraction, the nerves are. phrenic irritating ge with two counter electrodes at their respective left and right engine point in the neck region and with an electrode at the exit point in the cervical area in height C3 / C5. The electrodes may be applied so that

- either an electrode at the exit point of the nerve and two counter-electrodes are regions at both motor points in the ear,

- or the electrodes on both sides in the neck region and the Ge counter-electrode at a suitable place, possibly in the neck, placed. The invention is approximately examples using various Ausfüh¬ and wrote the accompanying five figures closer be¬.

Figures 1 and 2 illustrate the device by way of example with reference to various stimulus pulse pattern for triggering an tetA African diaphragmatic contraction and

3 to 5 indicate various configurations for stimulating electrodes or their holders.

Fig. 1, the current intensity of the complex stimulus in Abhän¬ shows dependence of time. The amount of time here covers 10s,

I shows two complex stimuli, which are composed in each case of biphasic individual stimuli. This is evident from the fact that the complex stimuli are each mirror-symmetrically in the positive, as shown in the negative ampere range. As can be seen, there is no pulse blocks within the Einhül¬ sirloin (= complex stimulus), but there is a uniform rectangular pulse sequence.

The complex stimulus composing individual stimuli have here a repetition frequency of about 30 Hz. The amplitude of the re¬ sulting complex stimuli as that of the individual stimuli be variably and here is 30 to 35 mA. Also variable is the holding time of the complex stimulus with the max. Amperage and the time interval between two complex stimuli, which may also be expressed such that the repetition frequency of the stimuli, there are suitable complexes is variable. The single stimuli shown top right of the picture, an amplitude of 0 to about 35 mA and a duration of about 100 microseconds to 2 ms, is simple rectangular pulses in this example. As a complex stimulus, the entire current path from 0 to 5000 ms is bezeich¬ net.

In Figure la, the first complex stimulus is again shown in Figure 1, wherein a rectangle R stands einge- leftmost edge. Figure lb shows an enlargement of this square-wave gon l la from the figure, in which the individual biphasic rectangular stimuli that result in the complex stimulus, the visible wer¬.

again Fig. 2 shows a trapezoidal complex stimulus, wherein the shape of the stimulus according to the invention not set to trapezoidal or rectangular shape, but is variable. getting to er¬ here is that in contrast to FIG. 1, la and lb there are no biphasic individual stimuli but two aufeinander¬ following complex stimuli once are positive and negative. Wie¬ located the single stimulus repetition rate about 30 Hz, the amplitude of the individual stimuli between 0 and 35 mA and the duration of the individual stimuli may vary between 100 microseconds and 2 milliseconds. With the illustrated sequence of complex stimuli a te¬ tanische Zerchfellkontraktion arises in stimulation of the nerves. phrenic, being able to be up to 2,8s referred to as mung Einat¬ phase in the illustrated case, the time and the time will be referred to from 2.8 to 5.0s as passive exhalation.

Figures 2a and 2b show analogous to the figures la and lb, the marking of the rectangle R in the left complex stimulus of Figure 2 (Fig. 2a) and the magnification of this rectangle (Fig. 2b), so that the individual pulses are visible.

Figure 3 shows the schematic representation of a pad 4, wherein the pad, also without that the representation is received here it may be ergonomically shaped. In the middle of the Kis¬ sens is the planar electrode 1, which is embedded with a remaining increase of a few centimeters in the pillow. Also in the middle of Me¬ is tallbügel 2 on which the counter electrodes are attached. The electrode 1 is fed into a rasterized Fuhrungs- and Fixie¬ approximately rail 3 and fixed. In the case of the Nervenstimu- Nn lation. phrenicii can the neck or Wirbelsäulen¬ running of each patient to be adjusted individually. The electrode 1 is connected through a contact 5 to the Pulsge¬ erator a nerve stimulator.

The two counter electrodes are mounted temple 2 to an insulated metal, the rail perpendicular to an extra fixation 6 stands. Due to a special screening at both En¬ to the metal bracket 2 (this can be seen again deut¬ Lich in Figure 2), this retractable by the fixing rail 6 in the pad 4 and can thus be changed in its Weiteneinstel- lung. An individual adjustment to the neck circumference of the patient is easily possible as a result.

In Figure 4, the exact embodiment of the metal strap 2, the grids at both ends and the straight run can be seen namely above. The two electrodes 14 (Gegen¬ electrodes) are attached to the round metal bar 2 in each case with the aid of a ring hook 3, the hook 3 can be moved freely on the bracket. On the Positionie¬ approximately aid 10, which may possibly be a screw, the two rod-shaped electrodes 14 can be belie¬ big displaced along the bar 2 and fixed. With this arrangement, the electrodes kön¬ NEN variably to the stimulation points on the right and left positioned in the neck area and then with the screw 10 (positioning aid) are fixed. Once the trigger point has been located, the rod electrodes 14 by means of the variable depth adjustment 7 that can alter the length of the rod to the engine point (trigger point) to be pressed of the nerve. the pressure can be variably set on the depth adjustment. 7 The electrodes 14 are again connected via a cable 5 to the pulse generator of the nerve stimulator. On both sides of the bracket 2, which is preferably an insulated metal strap, the grids are hen 9 to se¬, by whose means the depth adjustment of the strap, ie how far the clip is recessed into the cushion can be adjusted. Figure 5 shows another variant of the electrode fixation, wherein iron, this arrangement of two circular, insulated metal, namely, the electrode bracket 2 and the Gegenelektro¬ denbügel 2 'exists. The electrode bar 2 is tightly wrapped around the patient's neck and in such a manner that the electrode 12 is present at the exit point of the good / of the nerves in the neck '. The counter electrode bar 2 ', which rests against the / Motor¬ the point (s) of the / of the nerve is loosely laid forward around the neck of the patient. The two counter electrodes are in turn attached by means of an annular attachment 3 to the circular counter electrode bar 2 'and slide freely over the clip. Both brackets 2,2 'are on the pair of Fuhrungs- and fixing rails 17 by means of the fixation

I rings 8 attached. The advantage of this arrangement is that the patient can put, for example, during the period of stimulation and thus has some freedom of movement.

With the new stimulator of both inhalation and exhalation is controlled and ranges er¬ an even breathing process. The invention is not restricted to the irritation of the phrenic nerve but can be used for all sorts of nerve irritation rather, each using the repetition rate of the person concerned is required for a tetanic stimulation the muscle to be contracted. The proposed support we beziehungswei¬ a simple adaptation of the stimulation electrodes on the patient's body se the trigger points possible. Compared to the implanted stimulating electrodes stress to the patient is less and attaching the stimulating electrodes easier.

Claims

claims
1. A transcutaneous nerve stimulator comprising a pulse generator and stimulation electrodes for application to the skin of a patient, the pulse generator comprises means for generating complex stimuli, wherein said stimuli from individual stimuli zusammenge¬ sets are, the current intensity, repetition rate and duration varia¬ bel are adjustable and have the individual stimuli within ei¬ nes complex stimulus zen each have the same shapes and Folgefrequen-.
2. nerve stimulator according to claim 1, which is current-stabilized.
3. nerve stimulator according to any one of claims 1 or 2, wherein the amplitude and the shape of the complex stimuli are adjustable independently of each other by the pulse generator.
4. nerve stimulator according to any of the preceding claims, in which the rise by the pulse generator, and Abfalls-
Retention times of the complex stimuli are variably adjustable.
5. according to any one of the preceding claims, which sends complex stimuli, alternating nerve stimulator as a consequence of the complex stimuli positive and negative stimuli.
6. nerve stimulator according to any one of claims 1 to 4, positive and negative stimuli switch ab¬ wherein in the sequence of the individual stimuli.
7. nerve stimulator according to any of the preceding claims, whose stimulation electrodes are made of electrically conductive material having a porous or smooth surface.
8. nerve stimulator according to any one of claims 2 - 7, wherein zu¬ least one stimulating electrode is flat and in the surface of a stimulus electrode drugs are incorporated so at least that they wirk¬ at the base point of the electrode on the skin are sam.
9. nerve stimulator according to any of the preceding claims, wherein the three stimulation electrodes are provided which are so brin supply provided for An¬ that an electrode on the initial entry point of the nerve from the spine, and two other electrodes are to be arranged on two motor points of the nerve ,
10. nerve stimulator according to any of the preceding claims, wherein the electrodes are provided such that two electrodes are to be placed at the motor points of the nerve and a counter electrode over a large area in the neck or shoulder area.
11. nerve stimulator according to any of the preceding claims, in which a holder is provided for the stimulating electrodes, the guide rails and fixing means for adjusting the stimulation electrodes relative to each other and includes relative to a patient-.
12. Use of the nerve stimulator according to any of claims vorste¬ Henden for diaphragmatic contraction.
13. Use of the nerve stimulator according to any of claims vorste¬ Henden for symmetrical (two-sided) Stimulie¬ tion of Nn. phrenic, wherein simultaneously with two Gegenelek¬ trodes of each of the right and left motor point of the nerve in the neck area and is additionally irritated point of the nerve from the spinal column in the cervical area in height C3 / C5 with an electrode of the exit.
14. Use of the nerve stimulator according to any of claims vorste¬ Henden for artificial respiration.
15. Use of the nerve stimulator according to any one of claims l to 11 in combination with a conventional device for preventing Beatmungs¬ Zwerchfellatrophie.
PCT/DE1997/000721 1996-04-12 1997-04-09 Transcutaneous nerve stimulator WO1997038751A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
DE19614508.2 1996-04-12
DE19614508 1996-04-12
DE19621771.7 1996-05-30
DE1996121771 DE19621771A1 (en) 1996-05-30 1996-05-30 Transcutaneous nerve stimulator for artificial respiration

Publications (1)

Publication Number Publication Date
WO1997038751A1 true true WO1997038751A1 (en) 1997-10-23

Family

ID=26024684

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1997/000721 WO1997038751A1 (en) 1996-04-12 1997-04-09 Transcutaneous nerve stimulator

Country Status (1)

Country Link
WO (1) WO1997038751A1 (en)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0993841A1 (en) * 1998-10-14 2000-04-19 Siemens-Elema AB System for assisted breathing
EP1393773A1 (en) * 2002-08-28 2004-03-03 Siemens-Elema AB Nerve stimulation device
EP1940504A1 (en) * 2005-05-13 2008-07-09 Neurosignal Technologies, Inc Method and system to control respiration by means of simulated neuro-electrical coded signals
US9233553B2 (en) 2000-09-11 2016-01-12 Videojet Technologies (Nottingham) Limited Tape drive and printing apparatus

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0009920A1 (en) * 1978-09-26 1980-04-16 Stimtech, Inc. Electronic tissue stimulator with output signal controls
WO1983001742A1 (en) * 1981-11-23 1983-05-26 Van Rij, Gerhard, Leendert Apparatus and method for generating nerve or muscle stimulation signals
EP0293068A1 (en) * 1987-05-27 1988-11-30 Teijin Limited An electric therapeutic apparatus
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
WO1991005583A1 (en) * 1989-10-16 1991-05-02 Brunswick Biomedical Technologies, Inc. Method and apparatus for controlling breathing
WO1994015527A1 (en) * 1993-01-11 1994-07-21 Jens Axelgaard Medical electrode system
EP0702978A2 (en) * 1994-09-21 1996-03-27 Medtronic, Inc. Apparatus for treating obstructive sleep apnea

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0009920A1 (en) * 1978-09-26 1980-04-16 Stimtech, Inc. Electronic tissue stimulator with output signal controls
WO1983001742A1 (en) * 1981-11-23 1983-05-26 Van Rij, Gerhard, Leendert Apparatus and method for generating nerve or muscle stimulation signals
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
EP0293068A1 (en) * 1987-05-27 1988-11-30 Teijin Limited An electric therapeutic apparatus
WO1991005583A1 (en) * 1989-10-16 1991-05-02 Brunswick Biomedical Technologies, Inc. Method and apparatus for controlling breathing
WO1994015527A1 (en) * 1993-01-11 1994-07-21 Jens Axelgaard Medical electrode system
EP0702978A2 (en) * 1994-09-21 1996-03-27 Medtronic, Inc. Apparatus for treating obstructive sleep apnea

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0993841A1 (en) * 1998-10-14 2000-04-19 Siemens-Elema AB System for assisted breathing
US6360740B1 (en) 1998-10-14 2002-03-26 Siemens Elema Ab Method and apparatus for assisted breathing
US9233553B2 (en) 2000-09-11 2016-01-12 Videojet Technologies (Nottingham) Limited Tape drive and printing apparatus
EP1393773A1 (en) * 2002-08-28 2004-03-03 Siemens-Elema AB Nerve stimulation device
US7283875B2 (en) 2002-08-28 2007-10-16 Maquet Critical Care Ab Nerve stimulation device
EP1940504A1 (en) * 2005-05-13 2008-07-09 Neurosignal Technologies, Inc Method and system to control respiration by means of simulated neuro-electrical coded signals
EP1940504A4 (en) * 2005-05-13 2009-02-18 Neurosignal Technologies Inc Method and system to control respiration by means of simulated neuro-electrical coded signals

Similar Documents

Publication Publication Date Title
Gorman et al. The effect of stimulus parameters on the recruitment characteristics of direct nerve stimulation
Sarnoff et al. Electrophrenic respiration
US3911930A (en) Method and structure of preventing and treating ileus, and reducing acute pain by electrical pulse stimulation
Sweeney et al. A nerve cuff technique for selective excitation of peripheral nerve trunk regions
US7480532B2 (en) Baroreflex activation for pain control, sedation and sleep
US6192889B1 (en) Method of suppression and prevention of the gag reflex
US5897579A (en) Method of relieving airway obstruction in patients with bilateral vocal impairment
US6701185B2 (en) Method and apparatus for electromagnetic stimulation of nerve, muscle, and body tissues
Crago et al. The choice of pulse duration for chronic electrical stimulation via surface, nerve, and intramuscular electrodes
US20050033381A1 (en) Electro therapy method and apparatus
McNeal et al. Selective activation of muscles using peripheral nerve electrodes
US4408609A (en) Electrical muscle stimulation for treatment of scoliosis and other spinal deformities
US5999855A (en) Method and apparatus for electrical activation of the expiratory muscles to restore cough
US4342317A (en) Method of electrical muscle stimulation for treatment of scoliosis and other spinal deformities
US5281219A (en) Multiple stimulation electrodes
US20100016929A1 (en) Method and system for controlled nerve ablation
US20020049479A1 (en) Method and apparatus for creating afferents to prevent obstructive sleep apnea
US7561922B2 (en) Construction of electrode assembly for nerve control
US20110276112A1 (en) Devices and methods for non-invasive capacitive electrical stimulation and their use for vagus nerve stimulation on the neck of a patient
US20020087192A1 (en) Treatment of obesity by sub-diaphragmatic nerve stimulation
US5036848A (en) Method and apparatus for controlling breathing employing internal and external electrodes
US20080132983A1 (en) Electrode assembly for nerve control
US20060235484A1 (en) Stimulation of a stimulation site within the neck or head
US5265604A (en) Demand - diaphragmatic pacing (skeletal muscle pressure modified)
US5425752A (en) Method of direct electrical myostimulation using acupuncture needles

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): JP US

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
NENP Non-entry into the national phase in:

Ref country code: JP

Ref document number: 97536641

Format of ref document f/p: F

122 Ep: pct application non-entry in european phase