Device and method for treating disorders of the cardiovascular system or heart

Abstract

A device and method are provided to treat heart failure by stimulating to cause diaphragm contraction.

1 . A method of treating heart failure comprising:
 sensing an initial respiration parameter during intrinsic breathing of a subject via at least one electrode positioned internally within the patient;   synchronizing an electrical stimulation protocol with the sensed respiration parameter via a controller in communication with the at least one electrode; and,   applying the electrical stimulation protocol which comprises a burst or series of pulses to tissue associated with a phrenic nerve or diaphragm tissue to contract a diaphragm at a beginning or during an onset of each intrinsic breathing cycle and sustaining the electrical stimulation protocol such that the respiration rate is reduced where a loading on a heart of the subject is reduced.   
     
     
         2 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises electrically stimulating the tissue such that inspiration is augmented. 
     
     
         3 . The method of  claim 1  wherein the step of the electrical stimulation protocol comprises pacing each intrinsic breathing cycle such that minute ventilation is maintained or reduced. 
     
     
         4 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises further applying the electrical stimulation protocol during a beginning portion of an inspiration cycle. 
     
     
         5 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises further applying the electrical stimulation protocol during an end portion of an inspiration cycle. 
     
     
         6 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises applying the electrical stimulation protocol such that tidal volume is increased during the reduced respiration relative to intrinsic breathing. 
     
     
         7 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises applying the electrical stimulation protocol such that functional residual capacity is increased during the reduced respiration relative to intrinsic breathing. 
     
     
         8 . The method of  claim 15  wherein the step of applying the electrical stimulation protocol comprises applying the electrical stimulation protocol such that an exhalation rate is slowed relative to the intrinsic breathing. 
     
     
         9 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises applying the electrical stimulation protocol during the subject's sleep cycle. 
     
     
         10 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises providing a low energy stimulation. 
     
     
         11 . The method of  claim 1  wherein the step of applying the electrical stimulation protocol comprises applying the electrical stimulation protocol such that a resting lung volume is increased relative to the intrinsic breathing. 
     
     
         12 . The method of  claim 1  further comprising further applying the electrical stimulation protocol until the intrinsic breathing is entrained. 
     
     
         13 . A method for treating a subject with heart failure comprising:
 sensing an initial respiration parameter during intrinsic breathing of a subject via at least one electrode positioned internally within the patient;   synchronizing an electrical stimulation protocol with the sensed respiration parameter via a processor in communication with the at least one electrode; and,   applying the electrical stimulation protocol which comprises a burst or series of pulses to tissue associated with a phrenic nerve or diaphragm tissue to contract a diaphragm at a beginning or during an onset of each intrinsic breathing cycle and sustaining the electrical stimulation protocol such that the intrathoracic pressure is reduced relative to a pressure during intrinsic breathing where a loading on a heart of the subject is reduced.   
     
     
         14 . The method of  claim 12  wherein a single hemidiaphragm is stimulated by the electrical stimulation protocol. 
     
     
         15 . The method of  claim 12  further comprising further applying the electrical stimulation protocol until the intrinsic breathing is entrained.