Systems and methods for sensing and stimulation

Abstract

A system for stimulating body tissue may include a stimulation lead, sensors, and a control unit. The stimulation lead may include one or more energy sources. The control unit may include a processor and non-transitory computer readable medium, and an interface (e.g., touch screen interface) for receiving user inputs and communicating information to the user. The sensors may be configured to provide impedance measurements to the control unit. The control unit may calculate lung gas distributions and/or generate an image modeling lung gas distributions. Stimulation delivered by the stimulation may be adjusted based on the impedance measurements.

What is claimed is: 
     
         1 - 20 . (canceled) 
     
     
         21 . A method of positioning a stimulation lead, the method comprising:
 positioning a cannula within a patient, the cannula comprising an energy emitter;   delivering stimulation via the energy emitter;   detecting a respiratory response to the stimulation delivered via the energy emitter;   inserting a stimulation lead comprising a plurality of electrodes into a lumen of the cannula; and   anchoring the stimulation lead to tissue.   
     
     
         22 . The method of  claim 21 , wherein positioning the cannula includes positioning the energy emitter of the cannula in proximity to a phrenic nerve, a vagus nerve, or both; and
 wherein delivering stimulation via the energy emitter includes delivering stimulation to the phrenic nerve, the vagus nerve, or both.   
     
     
         23 . The method of  claim 21 , wherein positioning the cannula includes positioning the cannula within a subclavian vein, a superior vena cava, a jugular vein, an axillary vein, a cephalic vein, a cardiophrenic vein, a brachial vein, or a radial vein. 
     
     
         24 . The method of  claim 21 , wherein the cannula includes a plurality of apertures between a proximal end and a distal end of the cannula;
 inserting the stimulation lead includes aligning an electrode of the plurality of electrodes with an aperture of the plurality of apertures; and   anchoring the stimulation lead to tissue includes anchoring the stimulation lead to subcutaneous tissue.   
     
     
         25 . The method of  claim 21 , further comprising:
 selecting a combination of electrodes from the plurality of electrodes; and   delivering a pulse train via the combination of electrodes, wherein the pulse train causes contraction of a respiratory muscle.   
     
     
         26 . The method of  claim 25 , wherein the pulse train is a first pulse train including a first stimulation parameter, and the method further comprises:
 measuring a lung gas parameter;   comparing the lung gas parameter to a pre-determined or calculated value;   based on the comparison of the lung gas parameter to the pre-determined or calculated value, determining a second stimulation parameter; and   delivering a second pulse train including the second stimulation parameter via the combination of electrodes, wherein the second pulse train causes contraction of the respiratory muscle.   
     
     
         27 . A system for stimulating tissue comprising:
 a cannula including an energy emitter;   a stimulation lead;   a sensor; and   a control unit configured to:
 deliver an electrical signal to the energy emitter; 
 determine a stimulation parameter based on information received from the sensor; and 
 deliver a stimulation signal, including the stimulation parameter, to tissue, via the stimulation lead. 
   
     
     
         28 . The system of  claim 27 , wherein the stimulation lead is a transcutaneous lead or a subcutaneous lead. 
     
     
         29 . The system of  claim 27 , wherein the stimulation lead includes a plurality of electrodes;
 the cannula includes a plurality of apertures between a proximal end and a distal end of the cannula;   and the stimulation lead is configured to be inserted in a lumen of the cannula such that each aperture of the plurality of apertures aligns with an electrode of the plurality of electrodes.   
     
     
         30 . The system of  claim 27 , wherein the energy emitter is located at a distal end of the cannula. 
     
     
         31 . The system of  claim 27 , wherein the cannula comprises a radiopaque marker, a portion of the cannula is detectable via ultrasound, or both. 
     
     
         32 . The system of  claim 27 , wherein the cannula comprises an orientation indicator, the control unit is wearable, the stimulation lead comprises a reversible anchoring mechanism, or a combination thereof. 
     
     
         33 . The system of  claim 27 , wherein the sensor measures gas concentration, motion, airway flow, airway pressure, impedance, electromyography, or a combination thereof. 
     
     
         34 . The system of  claim 27 , wherein the stimulation parameter includes a timing of the stimulation signal. 
     
     
         35 . A system for stimulating tissue comprising:
 a cannula including a lumen and an energy emitter;   a lead having a diameter less than a diameter of the lumen of the cannula;   a sensor; and   a control unit configured to:
 determine a first lung volume based on a signal from the sensor; 
 determine a stimulation parameter based on the first lung volume; and 
 deliver a stimulation signal, including the stimulation parameter, to tissue, via the lead. 
   
     
     
         36 . The system of  claim 35 , wherein determining the stimulation parameter based on the first lung volume includes:
 determining a second lung volume;   comparing the second lung volume to the first lung volume; and   determining the stimulation parameter based on the comparison of the second lung volume to the first lung volume.   
     
     
         37 . The system of  claim 35 , wherein determining the stimulation parameter based on the first lung volume includes:
 comparing the first lung volume to a pre-determined value or a calculated value; and   determining the stimulation parameter based on the comparison of the first lung volume to the pre-determined value or the calculated value.   
     
     
         38 . The system of  claim 35 , further comprising an external respiratory support device configured to provide positive pressure ventilation, wherein the control unit is further configured to determine the timing of the positive pressure ventilation and the timing of the delivery of the stimulation signal. 
     
     
         39 . The system of  claim 35 , wherein the control unit is further configured to generate an image corresponding to the distribution of gas between lung portions. 
     
     
         40 . The system of  claim 39 , wherein the signal from the sensor is an impedance, and the lung portions include a posterior lung region, an anterior lung region, a superior lung region, an inferior lung region, a left lung, a right lung, or a combination thereof.