Phrenic Nerve Stimulation for Cheyne-Stokes Breath Stabilization
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Disordered breathing patterns, such as Cheyne-Stokes respiration, are not effectively addressed by existing technologies, leading to unstable blood gas chemistry and respiratory overshoot, which can be severe in patients with heart disease.
Innovation Solution
A device that senses respiration and synchronizes a stimulus to one lung via a phrenic nerve, using a stimulation signal to temporarily still the diaphragm, leveraging physiologic feedback mechanisms to prolong breaths and modulate tidal volume, thereby preventing carbon dioxide levels from dropping too low.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If existing respiratory monitoring and treatment technologies are used, then basic respiratory function is maintained, but disordered breathing patterns such as Cheyne-Stokes respiration are not effectively addressed, leading to unstable blood gas chemistry and respiratory overshoot
Solution Approach 1:
The device employs a closed-loop feedback system where respiratory sensors continuously monitor breathing patterns and provide real-time data to the control circuitry. The system detects disordered breathing patterns such as Cheyne-Stokes respiration and automatically adjusts phrenic nerve stimulation parameters accordingly, creating a responsive feedback mechanism that stabilizes blood gas chemistry by adapting to dynamic respiratory conditions
Solution Approach 2:
The patent implements dynamic parameter adjustment of electrical stimulation delivered to the phrenic nerve. The control circuitry modifies stimulation amplitude, pulse width, and frequency based on detected respiratory phase and pattern, allowing the system to effectively address various disordered breathing patterns while maintaining stable blood gas chemistry through adaptive parameter optimization
2Duration of action of moving object
If phrenic nerve stimulation is applied to still the diaphragm, then breath duration is prolonged and tidal volume is modulated, but the complexity of synchronizing stimulation with respiratory phase increases
Solution Approach 1:
The control circuitry is programmed with predetermined respiratory phase detection algorithms that identify optimal stimulation timing in advance. By detecting characteristic patterns of inspiration and expiration phases, the system prepares and delivers phrenic nerve stimulation at the appropriate moment in the respiratory cycle, prolonging breath duration without requiring complex real-time synchronization adjustments
Solution Approach 2:
The system utilizes the body's own respiratory signals as the timing reference for stimulation delivery. The control circuitry automatically synchronizes phrenic nerve stimulation with the natural respiratory cycle by detecting respiratory phase transitions, allowing the physiological system itself to provide the synchronization reference and reducing the need for external complex control mechanisms
3Measurement precision
If respiratory sensors continuously monitor breathing patterns, then disordered breathing can be detected, but energy consumption increases
Solution Approach 1:
The respiratory sensors operate in a periodic sampling mode rather than continuous monitoring. The control circuitry activates sensors at specific intervals and during key respiratory phases to detect disordered breathing patterns such as Cheyne-Stokes respiration, maintaining adequate measurement precision while significantly reducing overall energy consumption compared to continuous operation
Solution Approach 2:
The system employs selective monitoring where sensors focus on detecting specific critical parameters and patterns indicative of disordered breathing rather than continuously measuring all respiratory parameters at full resolution. This partial monitoring approach maintains sufficient detection capability for clinically relevant conditions while conserving energy resources
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The device extends breaths, reducing respiratory overshoot and stabilizing breathing patterns, thereby preventing apnea and improving oxygenation in patients with disordered breathing.
Implementation Method 1
The central nervous system commands the diaphragm and other muscles in the chest as well as in the neck to phasically contract and relax thus producing a breath of certain shape and tidal volume
Implementation Method 2
The stimulus is of a sufficient character to cause that lung to 'be still,' with some amount of air retained in the lung, and lung volume generally will not change during the stimulation
Implementation Method 3
a device may operate by sensing natural respiration and phasically synchronizing the delivery of a stimulus with the breath after inspiration
Implementation Method 4
it may be sufficient to stimulate and still only one lung under the theory that compensatory physiologic feedback mechanisms preserved on the unstimulated lung of the central and autonomic nervous system will interact in a virtuous and favorable way with the stimulation regime
Implementation Method 5
This reduction of tidal volume may prevent blood carbon dioxide from being driven to low levels associated with apnea
Data Source
AI summary
A system for treating disordered breathing of a human being includes an implantable transvenous stimulation lead having at least one stimulation electrode and a sensor configured to detect activity level of the human being. The system includes an energy source, a pulse generator and circuitry, the circuitry operative to receive a signal indicative of the activity level of the human being from the sensor, wherein the circuitry is configured to cause the energy source and the pulse generator to deliver spaced apart stimulation signals to the at least one stimulation electrode while the activity level of the human being is sufficiently low to be indicative of sleep. Spaced apart stimulation pulses from the electrode are configured to extend a duration of a time of at least one breath being defined as the time from an onset of inhalation to the onset of inhalation of a successive breath.