# US 10,765,867 B2 · Transvascular nerve stimulation apparatus and methods > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,765,867 B2 - Document ID: US10765867B2 - Status: Granted - Kind: B2 - Application number: 16/298,784 - Filed: 2019-03-11 - Published: 2019-07-04 - Granted: 2020-09-08 - Earliest claimed: 2007-01-29 - Assignees: Lungpacer Medical Inc. - Applicants: Lungpacer Medical Inc. - Inventors: Joaquin Andres Hoffer - Web page: https://patentgrep.com/patent/US10765867B2 ## CPC - A61N 1/3611: {Respiration control (stimulating respiratory organs A61N1/3601)} - A61N 1/05: for implantation or insertion into the body, e.g. heart electrode (A61N1/06 takes precedence) - A61N 1/0551: {Spinal or peripheral nerve electrodes} - A61N 1/0558: {Anchoring or fixation means therefor} - A61N 1/3601: {of respiratory organs} - A61N 1/36139: {with automatic adjustment} - A61N 1/36185: {Selection of the electrode configuration} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract Methods of stimulating a nerve may include inserting a lead structure into one or more blood vessels. The lead structure may include an insulating member, first electrodes and second electrodes supported on the insulating member, and at least one metal lead. The first electrodes and second electrodes may be positioned in one or more blood vessels. The methods of stimulating a nerve may further include the lead structures being applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves. ## Claims ### Claim 1 A method of stimulating at least one nerve, the method comprising: inserting a lead structure into one or more blood vessels, the lead structure to receive stimulation signals from a signal generator outside of a body having the blood vessel, wherein the lead structure includes an insulating member, first electrodes and second electrodes supported on the insulating member, and one or more metal leads surrounded by the insulating member; positioning the first electrodes in the one or more blood vessels and proximate a right phrenic nerve; positioning the second electrodes in the one or more blood vessels and proximate a left phrenic nerve; and during inspiration, stimulating at least one of the left phrenic nerve and the right phrenic nerve, via one or more electrodes of the first electrodes and the second electrodes in the one or more blood vessels, to assist in contracting a diaphragm; wherein positioning the first electrodes includes positioning at least two electrodes along a line generally parallel to the right phrenic nerve, and positioning the second electrodes includes positioning at least two electrodes along a line generally parallel to the left phrenic nerve. ### Claim 2 (depends on 1) The method of claim 1, wherein the stimulating step includes stimulating both of the left phrenic nerve via at least one of the second electrodes and the right phrenic nerve via at least one of the first electrodes. ### Claim 3 (depends on 2) The method of claim 2, further comprising: selecting the at least one of the second electrodes to stimulate the left phrenic nerve based on optimal stimulation of the left phrenic nerve; and selecting the at least one of the first electrodes to stimulate the right phrenic nerve based on optimal stimulation of the right phrenic nerve. ### Claim 4 (depends on 1) The method of claim 1, wherein the insulating member is tubular and defines a lumen extending longitudinally through the insulating member. ### Claim 5 (depends on 1) The method of claim 1, wherein the first electrodes and the second electrodes do not contact the left phrenic nerve, the right phrenic nerve, and the diaphragm. ### Claim 6 (depends on 1) The method of claim 1, wherein the second electrodes are positioned in one of a left subclavian vein or a left internal jugular vein, and the first electrodes are positioned in a vena cava. ### Claim 7 (depends on 1) The method of claim 1, wherein the one or more metal leads include a first metal lead extending from the first electrodes, through the insulating member positioned in a left brachiocephalic vein, to the second electrodes. ### Claim 8 (depends on 1) The method of claim 1, further comprising: sensing a condition of the body; and adjusting stimulation of the at least one of the left phrenic nerve and the right phrenic nerve based on the sensed condition. ### Claim 9 (depends on 1) The method of claim 1, wherein the stimulating step includes transmitting an electric current from only a portion of a circumference of the lead structure. ### Claim 10 (depends on 1) The method of claim 1, wherein the first electrodes and the second electrodes are positioned about a same longitudinal axis of the lead structure. ### Claim 11 (depends on 1) The method of claim 1, wherein the first electrodes and the second electrodes are exposed through apertures in the lead structure. ### Claim 12 A method of stimulating at least one nerve, the method comprising: positioning a first electrode array having two or more first electrodes in a first blood vessel; positioning a second electrode array having two or more second electrodes in a second blood vessel, said first and second electrode arrays arranged to receive stimulation signals from a signal generator outside of a body having the first and second blood vessels; selecting at least one of the first electrodes proximate a right phrenic nerve; selecting at least one of the second electrodes proximate a left phrenic nerve; and stimulating the first electrodes in the first blood vessel and the second electrodes in the second blood vessel, to assist in contracting a diaphragms wherein the first electrode array and the second electrode array are supported on an insulating member; and wherein positioning the first electrode array includes positioning at least two first electrodes along a line generally parallel to the right phrenic nerve, and positioning the second electrode array includes positioning a least two second electrodes along a line generally parallel to the left phrenic nerve. ### Claim 13 (depends on 12) The method of claim 12, wherein the selecting the at least one of the second electrodes is based on optimal stimulation of the left phrenic nerve; and selecting the at least one of the first electrodes is based on optimal stimulation of the right phrenic nerve. ### Claim 14 (depends on 12) The method of claim 12, wherein the stimulating step occurs during inspiration and does not occur during expiration. ### Claim 15 (depends on 12) The method of claim 12, wherein the first electrode array and the second electrode array do not contact the left phrenic nerve, the right phrenic nerve, and the diaphragm. ### Claim 16 (depends on 12) The method of claim 12, wherein the second electrode array is positioned in one of a left subclavian vein or a left internal jugular vein, and the first electrode array is positioned in a vena cava. ### Claim 17 (depends on 12) The method of claim 12, wherein a lead structure includes at least one metal lead extending from the first electrode array, through the insulating member positioned in a left brachiocephalic vein, to the second electrode array. ### Claim 18 (depends on 17) The method of claim 17, wherein the stimulating step includes transmitting an electric current from only a portion of a circumference of the lead structure, and wherein the first electrodes and the second electrodes are positioned about a same longitudinal axis of the lead structure. ### Claim 19 A method of stimulating at least one nerve, the method comprising: inserting a lead structure into one or more blood vessels, the lead structure to receive stimulation signals from a signal generator outside of a body having the blood vessel, wherein the lead structure includes first electrodes and second electrodes; positioning the first electrodes in the one or more blood vessels and proximate a right phrenic nerve; positioning the second electrodes in the one or more blood vessels and proximate a left phrenic nerve; and during inspiration, stimulating at least one of the left phrenic nerve and the right phrenic nerve, via one or more electrodes of the first electrodes and the second electrodes in the one or more blood vessels, to assist in contracting a diaphragm; wherein the stimulating step does not occur during expiration. ### Claim 20 (depends on 19) The method of claim 19, wherein the stimulating step includes stimulating both of the left phrenic nerve via at least one of the second electrodes and the right phrenic nerve via at least one of the first electrodes. ### Claim 21 (depends on 20) The method of claim 20, further comprising: selecting the at least one of the second electrodes to stimulate the left phrenic nerve based on optimal stimulation of the left phrenic nerve; and selecting the at least one of the first electrodes to stimulate the right phrenic nerve based on optimal stimulation of the right phrenic nerve. ### Claim 22 (depends on 19) The method of claim 19, further comprising: sensing a condition of the body; and adjusting stimulation of the at least one of the left phrenic nerve and the right phrenic nerve based on the sensed condition. ### Claim 23 (depends on 19) The method of claim 19, wherein the stimulating step includes transmitting an electric current from only a portion of a circumference of the lead structure. ### Claim 24 A method of stimulating at least one nerve, the method comprising: positioning a first electrode array having two or more first electrodes in a first blood vessel; positioning a second electrode array having two or more second electrodes in a second blood vessel, said first and second electrode arrays arranged to receive stimulation signals from a signal generator outside of a body having the first and second blood vessels; selecting at least one of the first electrodes proximate a right phrenic nerve; selecting at least one of the second electrodes proximate a left phrenic nerve; and stimulating the first electrodes in the first blood vessel and the second electrodes in the second blood vessel, to assist in contracting a diaphragm; wherein the stimulating step does not occur during expiration. ### Claim 25 (depends on 24) The method of claim 24, wherein the selecting the at least one of the second electrodes is based on optimal stimulation of the left phrenic nerve; and selecting the at least one of the first electrodes is based on optimal stimulation of the right phrenic nerve. ### Claim 26 (depends on 24) The method of claim 24, wherein the first electrode array and the second electrode array do not contact the left phrenic nerve, the right phrenic nerve, and the diaphragm. ### Claim 27 (depends on 24) The method of claim 24, wherein the second electrode array is positioned in one of a left subclavian vein or a left internal jugular vein, and the first electrode array is positioned in a vena cava. ### Claim 28 (depends on 24) The method of claim 24, wherein the stimulating step includes transmitting an electric current from only a portion of a circumference of the lead structure, and wherein the first electrodes and the second electrodes are positioned about a same longitudinal axis of the lead structure.