Abstract: Methods and systems for treating sleep apnea using electrical stimulation to a patient's upper and/or lower respiratory nerve or muscle are described. A stimulation regimen can be used to achieve upper airway patency and/or rhythmic air flow in a coordinated fashion during sleep. In some cases, diaphragm activity is monitored to determine whether sufficient upper airway patency and/or rhythmic air flow is achieved and maintained. The stimulation regimen may be adjusted based on the diaphragm activity. In some cases, the system includes modularized components so that the components can be customized to an individual's needs.

Abstract: Methods and systems for treating sleep apnea using electrical stimulation to a patient's upper and/or lower respiratory nerve or muscle are described. A stimulation regimen can be used to achieve upper airway patency and/or rhythmic air flow in a coordinated fashion during sleep. In some cases, diaphragm activity is monitored to determine whether sufficient upper airway patency and/or rhythmic air flow is achieved and maintained. The stimulation regimen may be adjusted based on the diaphragm activity. In some cases, the system includes modularized components so that the components can be customized to an individual's needs.

Abstract: Methods and systems for treating sleep apnea using electrical stimulation to a patient's upper and/or lower respiratory nerve or muscle are described. A stimulation regimen can be used to achieve upper airway patency and/or rhythmic air flow in a coordinated fashion during sleep. In some cases, diaphragm activity is monitored to determine whether sufficient upper airway patency and/or rhythmic air flow is achieved and maintained. The stimulation regimen may be adjusted based on the diaphragm activity. In some cases, the system includes modularized components so that the components can be customized to an individual's needs.

Abstract: Systems and methods for implanting an electrode under ultrasound guidance in muscle, such as the diaphragm, or near nerve tissue can include inserting under ultrasound guidance a catheter or cannula into a body cavity of the patient proximate the target muscle or near the target nerve tissue; inserting under ultrasound guidance an insertion needle, with the electrode loaded into a lumen of the insertion needle, into the body cavity and into the target muscle or near the target nerve tissue; and withdrawing the insertion needle to expulse the electrode and lead from the central lumen of the insertion needle.

Abstract: Described herein are methods of detecting the presence or progression of neuromuscular disorders (including ALS) based at least in part on diaphragm EMG signals taken at different points in time from the same implanted electrode(s). Signals may be used to diagnose or to monitor progression of a disorder or to track a treatment. Thus, diaphragm EMG signal may be used as a marker (e.g., a “biomarker”) for the detection or progression of a neurological disorder such as ALS. The characteristics or parameters of diaphragm EMG signals may be used to create an activity index, which may be output or compared and further analyzed. These signals may also be analyzed to show a difference between the left and right sides of the diaphragm.

Abstract: Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.

Abstract: An implantable medical electrode system for intramuscular use that is readily removable is provided, as well as methods for its use. The system includes an electrode, an electrical lead mechanically and electrically connected to the electrode and extending proximally, and a tether bonded to the electrode and extending proximally. A conductor with an insulated portion enwraps the electrical lead; an uninsulated portion enwraps the electrode. Some embodiments may include a tissue-piercing guide such as a needle. In some embodiments, the electrode includes a barb, although in some of these embodiments the tether does not extend through the barb. The method of using the system includes inserting the through a target tissue, pulling the electrode with the needle into the target tissue, and extending the electrical lead and tether proximally to an electrical connection. Methods are further provided for removing the electrode which take advantage of structural features of the system.

Abstract: A method of placing an electrode in a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; and using the endoscope to place the electrode in contact with tissue within the peritoneal cavity other than stomach tissue. Another aspect of the invention provides a method of electrically mapping tissue accessed from a peritoneal cavity including the following steps: inserting an endoscope through a patient's mouth into the patient's stomach; passing the endoscope through an opening in the stomach into the peritoneal cavity; passing an electrode through the endoscope; placing the electrode in contact with tissue within the peritoneal cavity other than stomach tissue; and applying a mapping stimulation signal to the electrode from a mapping stimulator.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.

Abstract: Systems and methods are provided to improve respiratory function. Systems include an external electrical stimulator coupled to electrodes that stimulates diaphragm contraction and may optionally include a positive pressure mechanical ventilator. The system further includes an electrode suitable for temporary implantation. Electrical stimulation is provided to specific portions of the diaphragm, such as one hemidiaphragm preferentially over another. By preferentially contracting one hemidiaphragm, a specific portion of a lung may be expanded, such as a posterior portion. By the provision of the negative intrathoracic pressure from diaphragm contraction, greater expansion of specific portion of lung is achieved in relationship to air pressure within the lung, thereby improving compliance. Supplementation of stimulated diaphragm contraction with positive pressure driven air flow from a PPMV directs the air flow to specific portions of the lung.

Abstract: Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.

Abstract: A diaphragm pacing stimulatory method and a system to implement the method are provided to improve respiratory function and the quality of sleep in patients whose sleep is compromised by poor respiration. The diaphragm pacing method includes adaptations that make it particularly compatible with the onset of sleep and sustaining sleep. Embodiments of the method are operated independently of breathing effort the patient may make during sleep. Patients for whom the invention is appropriate include those with a neuromuscular disease, such as amyotrophic lateral sclerosis (ALS). System elements include an external electrical stimulator coupled to one or more implanted electrodes that stimulate diaphragm contraction. The system and method provide for a pacing of the diaphragm, improved breathing, and improved sleep. Features of improved sleep include longer sleep time, an increased amount of REM sleep, and fewer episodes of wakefulness and restlessness.

Abstract: Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.

Abstract: Systems and methods are provided to improve respiratory function. Systems include an external electrical stimulator coupled to electrodes that stimulates diaphragm contraction and may optionally include a positive pressure mechanical ventilator. The system further includes an electrode suitable for temporary implantation. Electrical stimulation is provided to specific portions of the diaphragm, such as one hemidiaphragm preferentially over another. By preferentially contracting one hemidiaphragm, a specific portion of a lung may be expanded, such as a posterior portion. By the provision of the negative intrathoracic pressure from diaphragm contraction, greater expansion of specific portion of lung is achieved in relationship to air pressure within the lung, thereby improving compliance. Supplementation of stimulated diaphragm contraction with positive pressure driven air flow from a PPMV directs the air flow to specific portions of the lung.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.

Abstract: A method of conditioning a diaphragm of a patient is provided. The method can include the steps of implanting an electrode adjacent a target site in the diaphragm of the patient and operating the electrode to deliver a sufficient amount of electrical stimulation to the target site in the diaphragm of the patient to cause the diaphragm to contract.

Abstract: Described herein are methods and systems for improving or adapting a breathing pattern of a patient with disordered breathing toward a more helpful state, as well as systems and devices for adapting breathing. These methods and systems may be used for improving sleep in patients with sleep disordered breathing and a system by which to implement devices for performing these methods.

Abstract: A monopolar neuromuscular electrical stimulation (NMES) apparatus is configured for use with a cannula and a remote electrode. The apparatus includes a longitudinally rigid rod that is movable in the cannula throughout a range of operative positions in which inner and outer end portions of the rod extend longitudinally outward from the inner and outer ends of the cannula. The apparatus further includes a single electrode configured to be supported as a solitary electrode on the inner end portion of the rod for movement with the rod through the cannula. In this manner, the electrode can be moved into and out of contact with internal test sites to apply NMES at the internal test sites in an electrical circuit with the remote electrode upon movement of the rod back and forth in the cannula. Additionally, the rod is a rigid tube and the electrode is a suction-tip electrode configured to communicate pneumatically with the rigid tube.