Implantable medical devices and methods for real-time or near real-time adjustment of diaphragmatic stimulation parameters to affect pressures within the intrathoracic cavity

An apparatus for affecting a pressure within an intrathoracic cavity of a patient, the apparatus comprising:

• one or more electrodes configured for placement on or near a diaphragm of the patient;
• a pressure measurement source configured to provide a signal indicative of a pressure within an intrathoracic cavity of the patient;
• and
• a controller configured to:
• detect a cyclic cardiac event within a cardiac cycle of the patient based on a signal obtained from a cardiac event source;
• deliver an electrical stimulation therapy to a diaphragm of the patient through the one or more electrodes, wherein delivery of the electrical stimulation therapy is timed to the detection of the cyclic cardiac event, and the electrical stimulation therapy is defined by a plurality of stimulation parameters;
• derive from the signal indicative of a pressure within an intrathoracic cavity of the patient, a measure of interest at or near a selected fiducial point within a cardiac cycle during which the electrical stimulation therapy was delivered:
• evaluate the measure of interest against a baseline measure of interest;
• determine to adjust one or more of the stimulation parameters based on the evaluation;
• and
• adjust one or more of the stimulation parameters based on the determining.