Apparatus and methods for assisted breathing by transvascular nerve stimulation

Abstract

This disclosure describes, among other embodiments, a catheter. The catheter may include an outer layer defining a plurality of apertures therethrough, and a body defining at least one longitudinal lumen therein. The body may be within the outer layer, and the apertures may be radially outward of the lumen. The catheter may also include a plurality of electrodes positioned in or on the catheter, with each electrode being electrically exposed through an aperture of the plurality of apertures. A ribbon cable may extend through the lumen and include a plurality of leads, with the plurality of leads being electrically connected to the plurality of electrodes. The plurality of leads and electrodes may be formed by the deposition of conductive inks or paints, or by the electrodeposition of copper or other conductive metals or materials.

1 .- 30 . (canceled) 
     
     
         31 . A catheter, comprising:
 a tubular body having an outer surface and defining a plurality of lumens therein; and   an electrical assembly helically disposed on the outer surface of the tubular body, the electrical assembly including:
 a flexible circuit including a plurality of metal leads and insulative material, wherein each of the metal leads is surrounded by the insulative material and separated from other of the metal leads by the insulative material; and 
 electrodes positioned on the flexible circuit, each electrode being electrically connected to a corresponding metal lead of the plurality of metal leads, the electrodes including a distal set of electrodes and a proximal set of electrodes. 
   
     
     
         32 . The catheter of  claim 31 , wherein each electrode comprises platinum, gold, palladium, or a combination thereof. 
     
     
         33 . The catheter of  claim 31 , wherein each of the plurality of metal leads has a different material composition than the electrode corresponding to the metal lead. 
     
     
         34 . The catheter of  claim 31 , further comprising an application specific integrated circuit. 
     
     
         35 . The catheter of  claim 31 , wherein the proximal set of electrodes includes at least two longitudinal rows of electrodes. 
     
     
         36 . The catheter of  claim 31 , wherein the distal set of electrodes includes at least two longitudinal rows of electrodes. 
     
     
         37 . The catheter of  claim 31 , wherein the proximal set of electrodes includes at least two longitudinal rows of electrodes, and no row of electrodes of the proximal set of electrodes is circumferentially aligned with any row of electrodes of the distal set of electrodes. 
     
     
         38 . The catheter of  claim 31 , wherein the flexible circuit is a flexible printed circuit. 
     
     
         39 . The catheter of  claim 31 , wherein at least one electrode of the distal set of electrodes is positioned on the tubular body to stimulate a right phrenic nerve; and
 at least one electrode of the proximal set of electrodes is positioned on the tubular body to stimulate a left phrenic nerve.   
     
     
         40 . A catheter, comprising:
 a tubular body having an outer surface and defining a plurality of lumens therein; and   an electrical assembly disposed on the outer surface of the tubular body, the electrical assembly including:
 a flexible circuit including a plurality of metal leads and insulative material, wherein each of the metal leads is surrounded by the insulative material and separated from other of the metal leads by the insulative material; and 
 electrodes positioned on the flexible circuit, each electrode being electrically connected to a corresponding metal lead of the plurality of metal leads, the electrodes including a distal set of electrodes and a proximal set of electrodes; 
   wherein each of the electrodes is disposed in a corresponding groove in the insulative material.   
     
     
         41 . The catheter of  claim 40 , wherein the electrical assembly is helically disposed on the outer surface of the tubular body. 
     
     
         42 . The catheter of  claim 40 , wherein the proximal set of electrodes, the distal set of electrodes, or both, comprise two rows of electrodes. 
     
     
         43 . The catheter of  claim 40 , wherein at least one groove is disposed at a circumferential position about a longitudinal axis of the tubular body, 90° from at least one other groove. 
     
     
         44 . The catheter of  claim 40 , further comprising an application specific integrated circuit connected to each of the plurality of metal leads;
 wherein the electrical assembly includes at least three branches, the three branches extending distally from the application specific integrated circuit.   
     
     
         45 . The catheter of  claim 40 , wherein the flexible circuit is a flexible printed circuit. 
     
     
         46 . The catheter of  claim 40 , wherein the proximal set of electrodes includes a first row of electrodes and a second row of electrodes; and
 the catheter further comprises a radiopaque feature positioned circumferentially opposite to a line extending between the first row of electrodes and the second row of electrodes.   
     
     
         47 . The catheter of  claim 40 , wherein the distal set of electrodes comprises two rows of electrodes, each row of electrodes of the distal set of electrodes comprising three electrodes; and the proximal set of electrodes comprises two rows of electrodes, each row of electrodes of the proximal set of electrodes comprising four electrodes. 
     
     
         48 . The catheter of  claim 47 , wherein no row of electrodes of the proximal set of electrodes is circumferentially aligned with any row of electrodes of the distal set of electrodes. 
     
     
         49 . A catheter, comprising:
 a tubular body having an outer surface and defining a plurality of lumens therein; and   an electrical assembly helically disposed on the outer surface of the tubular body, the electrical assembly including:
 a flexible printed circuit including a plurality of metal leads and insulative material, wherein each of the metal leads is surrounded by the insulative material and separated from other of the metal leads by the insulative material; 
 electrodes positioned on the flexible printed circuit, each electrode being electrically connected to a corresponding metal lead of the plurality of metal leads, the electrodes including a distal set of electrodes and a proximal set of electrodes; 
   wherein the proximal set of electrodes are positioned on the tubular body to stimulate a left phrenic nerve, and the distal set of electrodes are positioned on the tubular body to stimulate a right phrenic nerve;   a distance along the tubular body between any two electrodes of the proximal set of electrodes is less than a distance along the tubular body between a most distal electrode of the proximal set of electrodes and a most proximal electrode of the distal set of electrodes;   at least one electrode of the proximal set of electrodes is at a different circumferential position of the tubular body, than at least one other electrode of the proximal set of electrodes; and   at least one electrode of the distal set of electrodes is at a different circumferential position of the tubular body, than at least one other electrode of the distal set of electrodes.   
     
     
         50 . The catheter of  claim 49 , wherein each electrode comprises gold, platinum, palladium, or combinations thereof; and
 each of the plurality of metal leads has a different material composition than the electrode corresponding to each metal lead.