Method and apparatus for the treatment of central sleep apnea using biventricular pacing

#The present invention generally relates to implantable medical devices. Specifically, the invention relates to the prevention of hypopnia during sleep apnea by stimulating the phrenic nerve with implanted cardiac leads, when the onset of sleep apnea is detected. More specifically, the invention relates to a biventricular pacemaker adapted to provide an automatically adjustable output via a lead preferably located in the coronary sinus.

#Sleep apnea is generally associated with the cessation of breathing during sleep. The medical characteristics of sleep apnea have been known for some time. Sleep apnea is terminated by the subject's arousal, followed by hyperventilation. Such arousals from sleep are generally associated with increased sympathetic nervous system activity and blood pressure, which may contribute to the worsening of a patient's cardiac condition.

#Generally, there are two types of sleep apnea. The first is central sleep apnea, which relates to the failure of the body to automatically generate the neuro-muscular stimulation necessary to initiate and control the respiratory cycle at the proper time. The second sleep apnea syndrome is known as obstructive sleep apnea. This generally relates to an obstructive apnea that includes reduction of the size of the superior airways, an increase in their compliance and reduction in the activity of the dilator muscles.

#The invention may be understood by reference to the following description taken in conjunction with the accompanying drawings, in which the leftmost significant digit(s) in the reference numerals denote(s) the first figure in which the respective reference numerals appear, and in which:

#FIG. 1 is a stylized view of an embodiment of an implantable medical device according to the present invention for use in treating sleep apnea;

#FIG. 2 is a stylized view of an implantable medical device lead according to the present invention that is attached to a myocardium of a heart for use in treating sleep apnea;

#While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that the description herein of specific embodiments is not intended to limit the invention to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.

#Illustrative embodiments of the invention are described below. In the interest of clarity, not all features of an actual implementation are described in this specification. It will of course be appreciated that in the development of any such actual embodiment, numerous implementation-specific decisions must be made to achieve the developer's specific goals, such as compliance with system-related and business-related constraints, which will vary from one implementation to another. Moreover, it will be appreciated that such a development effort might be complex and time-consuming but would nevertheless be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure.

#The present invention encompasses an apparatus and method for managing sleep apnea by stimulating a patient's phrenic nerve and/or diaphragm through the use of one or more electrodes disposed in a patient's body, such as the patient's heart, vasculature, or the like. The one or more electrodes may be placed proximately within the blood-carrying structure or proximately outside the blood-carrying structure. The phrenic nerve includes branches from the C3 through C5 spinal nerves and descends therefrom, through the thorax proximate to the heart, to the diaphragm. Electrical signals are transmitted through the phrenic nerve from the brain to cause the diaphragm to move, thus producing respiration.