Implantable medical systems, devices and methods for delivering asymptomatic diaphragmatic stimulation

An implantable medical device comprising:

• a cardiac event sensor configured to be located in or on a region of a heart in proximity to a diaphragm;
• an asymptomatic diaphragmatic stimulation (ADS) therapy mechanism configured to be located in proximity with the region of the heart;
• and
• an ADS controller coupled to the cardiac event sensor and the ADS therapy mechanism, and configured to:
• detect a cardiac event based on signals sensed through the cardiac event sensor;
• and
• responsive to a detection of a cardiac event, deliver an ADS therapy to the diaphragm through the ADS therapy mechanism,
• wherein the ADS therapy is configured to capture a muscle of the diaphragm to induce a transient contraction of a portion of a hemisphere of the diaphragm that is less than the entirety of the hemisphere of the diaphragm, and is delivered during a refractory period of the heart associated with the cardiac event to avoid inducing a contraction of the heart.

A method of transcardiac diaphragmatic stimulation, the method comprising:

• detecting a cardiac event based on signals sensed through a cardiac event sensor located in or on a region of a heart in proximity to a diaphragm;
• and
• delivering an asymptomatic diaphragmatic stimulation (ADS) therapy through an ADS therapy mechanism located in proximity with the region of the heart, to induce a contraction of the diaphragm without inducing a contraction of the heart,
• wherein the cardiac event sensor and the ADS therapy mechanism are each included in a lead implanted in one of a right atrium and a right ventricle, and having a distal end structure with a portion that extends through a cardiac wall, and through the diaphragm, and into an abdominal cavity.

An implantable medical device comprising:

• a cardiac event sensor configured to be located in or on a region of a heart in proximity to a diaphragm;
• an asymptomatic diaphragmatic stimulation (ADS) therapy mechanism configured to be located in proximity with the region of the heart;
• and
• an ADS controller coupled to the cardiac event sensor and the ADS therapy mechanism, and configured to:
• detect a cardiac event based on signals sensed through the cardiac event sensor;
• and
• deliver an ADS therapy to the diaphragm through the ADS therapy mechanism,
• wherein the cardiac event sensor and the ADS therapy mechanism are each included in a lead configured to be implanted in one of a right atrium and a right ventricle, wherein the lead comprises a distal end structure with a portion configured to extend through a cardiac wall, and through the diaphragm, and into an abdominal cavity.