Implantable neurostimulator-implemented method for managing tachyarrhythmic risk during sleep through vagus nerve stimulation

An implantable neurostimulator-implemented method for managing tachyarrhythmic risk accompanying central sleep apnea through vagus nerve stimulation, comprising the steps of:

• providing an implantable neurostimulator comprising a pulse generator configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (simultaneously in both afferent and efferent directions) of action potentials within neuronal fibers comprising a patient's cervical vagus nerve;
• storing operating modes of the pulse generator in a recordable memory, comprising:
• parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses at an intensity that avoids acute physiological side affects and with an unchanging cycle not triggered by physiological markers;
• and
• parametrically defining a boost dose of the electrical therapeutic stimulation tuned to prevent initiation of or disrupt tachyarrhythmia through periodic electrical pulses delivered at higher intensity than the maintenance dose;
• therapeutically delivering the maintenance dose to the vagus nerve independent of cardiac cycle via a pulse generator comprised in the implantable neurostimulator through at least a pair of helical electrodes electrically coupled to the pulse generator via a nerve stimulation therapy lead;
• and
• monitoring the patient's physiological state via at least one sensor comprised in the implantable neurostimulator, and upon sensing a pattern indicative of Cheyne-Stokes respiration, delivering the boost dose to the vagus nerve via the pulse generator through the pair of helical electrodes.

An implantable neurostimulator-implemented apparatus for managing tachyarrhythmic risk accompanying central sleep apnea through vagus nerve stimulation, comprising the steps of:

• means for providing an implantable neurostimulator comprising a pulse generator configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (simultaneously in both afferent and efferent directions) of action potentials within neuronal fibers comprising a patient's cervical vagus nerve;
• means for storing operating modes of the pulse generator in a recordable memory, comprising:
• means for parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses at an intensity that avoids acute physiological side affects and with an unchanging cycle not triggered by physiological markers;
• and
• means for parametrically defining a boost dose of the electrical therapeutic stimulation tuned to prevent initiation of or disrupt tachyarrhythmia through periodic electrical pulses delivered at higher intensity than the maintenance dose;
• means for therapeutically delivering the maintenance dose to the vagus nerve independent of cardiac cycle via a pulse generator comprised in the implantable neurostimulator through at least a pair of helical electrodes electrically coupled to the pulse generator via a nerve stimulation therapy lead;
• and
• means for monitoring the patient's physiological state via at least one sensor comprised in the implantable neurostimulator, and upon sensing a pattern indicative of Cheyne-Stokes respiration, delivering the boost dose to the vagus nerve via the pulse generator through the pair of helical electrodes.