Apparatus and methods for assisted breathing by transvascular nerve stimulation

Abstract

A catheter may include electrodes for transvascular nerve stimulation. The electrodes may be positioned within lumens of the catheter and aligned with apertures in the outer wall of the catheter. The electrodes may produce focused electrical fields for stimulation of one or more nerves. In one embodiment, the catheter may include a set of proximal electrodes and a set of distal electrodes, and the proximal electrodes may stimulate a patient's left phrenic nerve and the distal electrodes may stimulate a patient's right phrenic nerve.

1 - 20 . (canceled) 
     
     
         21 . A catheter, comprising:
 a plurality of lumens extending from a proximal end of the catheter to a distal portion of the catheter;   a plurality of proximal electrodes positioned on an exterior surface of a catheter;   a plurality of distal electrodes positioned on the exterior surface of the catheter;   a first plurality of electrical leads positioned on the exterior surface of the catheter for connecting the plurality of proximal electrodes to a signal generator, and a second plurality of electrical leads distinct from the first plurality of leads, positioned on the exterior surface of the catheter, for connecting the plurality of distal electrodes to the signal generator;   wherein at least one lead of the second plurality of leads extends past the plurality of proximal electrodes without contacting the proximal electrodes.   
     
     
         22 . The catheter of  claim 21 , wherein the plurality of proximal electrodes, the plurality of distal electrodes, the first plurality of electrical leads, the second plurality of electrical leads, or combinations thereof, comprise conductive ink adhered to the exterior surface of the catheter. 
     
     
         23 . The catheter of  claim 21 , wherein the plurality of proximal electrodes and the plurality of distal electrodes comprise a different conductive material than the first plurality of electrical leads and the second plurality of electrical leads. 
     
     
         24 . The catheter of  claim 21 , wherein a portion of at least one of the leads of the first plurality of leads, the second plurality of leads, or both, is transverse one or more lumens of the catheter. 
     
     
         25 . The catheter of  claim 21 , wherein a portion of at least one of either the first plurality of leads or the second plurality of leads is covered with a non-conductive material. 
     
     
         26 . The catheter of  claim 21 , wherein no lead of the second plurality of electrical leads contacts an electrode of the plurality of proximal electrodes. 
     
     
         27 . The catheter of  claim 21 , wherein one or more lumens of the plurality of lumens is configured to deliver fluid to a patient, remove fluid from a patient, or receive a guidewire or other steering mechanism. 
     
     
         28 . The catheter of  claim 21 , wherein one or more lumens of the plurality of lumens is configured for central venous pressure monitoring. 
     
     
         29 . A catheter, comprising:
 a plurality of lumens extending from a proximal end of the catheter to a distal portion of the catheter;   a plurality of proximal electrodes, comprised of conductive ink adhered to an exterior surface of the catheter;   a plurality of distal electrodes, comprised of conductive ink adhered to the exterior surface of the catheter;   a first plurality of electrical leads positioned on the exterior surface of the catheter for connecting the plurality of proximal electrodes to a signal generator, and a second plurality of electrical leads distinct from the first plurality of leads, positioned on the exterior surface of the catheter, for connecting the plurality of distal electrodes to the signal generator;   wherein the proximal electrodes are configured to be positioned in a venous system of a patient to stimulate a left phrenic nerve, and the distal electrodes are configured to be positioned in a venous system of a patient to stimulate a right phrenic nerve.   
     
     
         30 . The catheter of  claim 29 , wherein the first plurality of electrical leads, the second plurality of electrical leads, or both, comprise conductive ink adhered to the exterior surface of the catheter. 
     
     
         31 . The catheter of  claim 30 , wherein the plurality of proximal electrodes and the plurality of distal electrodes comprise a different conductive material than the first plurality of electrical leads and the second plurality of electrical leads. 
     
     
         32 . The catheter of  claim 29 , wherein a portion of at least one of either the first plurality of leads or the second plurality of leads is covered with a non-conductive material. 
     
     
         33 . The catheter of  claim 32 , wherein the non-conductive material comprises polyurethane or other flexible insulative film. 
     
     
         34 . The catheter of  claim 29 , wherein one or more lumens of the plurality of lumens is configured to deliver fluid to a patient, remove fluid from a patient, or receive a guidewire or other steering mechanism. 
     
     
         35 . The catheter of  claim 29 , wherein one or more lumens of the plurality of lumens is configured for central venous pressure monitoring. 
     
     
         36 . A method for nerve stimulation comprising:
 positioning a catheter in a venous system of a patient, the catheter comprising:
 a plurality of lumens extending from a proximal end of the catheter to a distal portion of the catheter; 
 a plurality of proximal electrodes, comprised of conductive ink adhered to an exterior surface of the catheter; 
 a plurality of distal electrodes, comprised of conductive ink adhered to an exterior surface of the catheter; 
 a plurality of electrical leads positioned on the exterior surface of the catheter and connecting the plurality of proximal electrodes and the plurality of distal electrodes to the signal generator, wherein the plurality of electrical leads comprise conductive ink adhered to the exterior surface of the catheter; 
   stimulating a left phrenic nerve with the plurality of proximal electrodes; and   stimulating a right phrenic nerve with the plurality of distal electrodes.   
     
     
         37 . The method of  claim 36 , further comprising monitoring central venous pressuring via at least one of the plurality of lumens. 
     
     
         38 . The method of  claim 37 , wherein a portion of at least one of the plurality of leads is coated by a non-conductive material. 
     
     
         39 . The method of  claim 36 , further comprising at least one of delivering fluid to or removing fluid from a patient through one of the plurality of lumens. 
     
     
         40 . The method of  claim 36 , further comprising:
 positioning the plurality of proximal electrodes in at least one of a left jugular vein or a left subclavian vein; or   positioning the plurality of distal electrodes in a superior vena cava.