Abstract: A trans mucosal neuromuscular electrical stimulation device (1) including a mouthpiece (3, 103), electrodes (32a, 33a, 132a, 133a) associated with the mouthpiece (3, 103). The device (1) and/or mouthpiece (3, 103) incorporates electrical circuitry operatively connecting to the electrodes (32a, 33a, 132a, 133a) to a power source and is configured to provide, in use, electrical stimulation to one or more palate and/or tongue muscles via the electrodes (32a, 33a, 132a, 133a) through the oral mucosa. The treatment regime, including the location of stimulation and the parameters used, is designed to increase resting muscle tone and/or muscle tone during sleep.

Abstract: Electrode structures for transvascular nerve stimulation combine electrodes with an electrically-insulating backing layer. The backing layer increases the electrical impedance of electrical paths through blood in a lumen of a blood vessel and consequently increases the flow of electrical current through surrounding tissues. The electrode structures may be applied to stimulate nerves such as the phrenic, vagus, trigeminal, obturator or other nerves.

Abstract: Diaphragm pacing systems and methods are disclosed for providing respiratory therapy to a patient. The diaphragm pacing systems can provide rapid insertion and deployment of pacing electrodes in critically ill patients who require intubation and invasive Positive Pressure Mechanical Ventilation (PPMV) in order to support the physiological requirements of the human ventilatory system. The systems and methods make best use of the contractile properties of the diaphragm muscle and prevent muscle disuse and muscle atrophy. This can be carried out by engaging the phrenic nerves using patterned functional electrical stimulation. The diaphragm pacing systems can be designed to seamlessly interface with any commercially available positive-pressure ventilatory assistance/support equipment such as is commonly in use in hospital intensive care units (ICU) for treating critically ill patients with breathing insufficiencies, pain, trauma, sepsis or neurological diseases or deficits.

Abstract: A controller detects a cyclic cardiac event of the patient based on a signal obtained from one or more electrodes configured for placement on or near a diaphragm, and delivers an electrical stimulation therapy to a diaphragm of the patient through the one or more electrodes. The delivery of electrical stimulation therapy is timed to the detection of the cyclic cardiac event, and the electrical stimulation therapy is defined by stimulation parameters. The controller monitors a pressure associated with the intrathoracic cavity of the patient based on a signal provided by a pressure measurement source configured to provide a signal indicative of a pressure within an intrathoracic cavity, to determine whether an adjustment of one or more of the stimulation parameters is warranted.

Abstract: The present teaching relates to surgical procedure assistance. In one example, a first volume of air inside a lung is obtained based on a first image of the lung captured prior to a surgical procedure. The lung has a first shape on the first image. A second volume of air deflated from the lung is determined based on a second image of the lung captured during the surgical procedure. A second shape of the lung is estimated based on the first shape of the lung and the first air volume inside the lung and second volume of air deflated from the lung. A surgical plan is updated based on the estimated second shape of the lung.

Abstract: A controller delivers electrical stimulation therapy to a diaphragm through the one or more electrodes, and obtains a signal indicative of a pressure within an intrathoracic cavity from a pressure measurement source. The electrical stimulation therapy is defined by stimulation parameters. The controller obtains at least one additional signal indicative of a pressure within an intrathoracic cavity by changing at least one of the stimulation parameters, and delivering an electrical stimulation therapy to the diaphragm in accordance with the changed one of the plurality of stimulation parameters. The controller repeats the process of obtaining additional signals indicative of pressure based on a changing stimulation parameter by scanning through a range of values for the changing stimulation parameter.

Abstract: Methods and systems for monitoring, preventing and/or treating upper airway disorders such as apnea, dysphagia, reflux and/or snoring are described. The methods and systems monitor the upper airway disorders by processing one or more neural signals obtained from one or more upper airway afferents. Upper airway disorders are prevented and/or treated by delivering one or more stimulations to one or more reflex-related afferents, efferents, muscles, and sensory receptors to manipulate the threshold and/or trigger an upper airway reflex including, but not limited to a swallow reflex and/or a negative-pressure reflex.

Abstract: Methods for treating a subject for a parasympathetic bias mediated condition are provided. Aspects of the methods include modulating at least a portion of the subject's autonomic nervous system to increase the sympathetic/parasympathetic activity ratio in a manner effective to treat the subject for the parasympathetic bias mediated condition. In some instances, the subject is known to have parasympathetic bias. Also provided are devices that find use in practicing various embodiments of the methods.

Abstract: A lead system and method of use for treating breathing disorders by the transvenous stimulation of the phrenic nerve. The lead is implanted in a vein near one portion of the phrenic nerve.

Abstract: Transvascular diaphragm pacing systems (TDPS) and methods are disclosed for providing respiratory therapy to a patient. The TDPS can provide rapid insertion and deployment of endovascular pacing electrodes in critically ill patients who require intubation and invasive PPMV in order to support the physiological requirements of the human ventilatory system. The systems and methods make best use of the contractile properties of the diaphragm muscle and prevent muscle disuse and muscle atrophy. This can be carried out by engaging the phrenic nerves using patterned functional electrical stimulation applied to endovascular electrodes that are temporarily and reversibly inserted in central veins of the patient, such as the left subclavian vein and the superior vena cava.

Abstract: A method for treating a heart failure patient by ablating a nerve of the splanchnic sympathetic nervous system to increase venous capacitance and reduce pulmonary blood pressure. A method including: inserting a catheter into a vein adjacent the nerve, applying stimulation energy and observing hemodynamic effects, applying ablation energy and observing hemodynamic effects, applying simulation energy after the ablation and observing hemodynamic effects.

Abstract: A lead for placement on a diaphragm includes a sensor assembly, a connector, and a lead body. The sensor assembly includes a housing having a first end surface and a second end surface opposite the first end surface. The first end surface is intended to contact the diaphragm. The sensor assembly includes at least one fixation structure also associated with the first end surface. The fixation structure is configured to preserve the hermetic integrity of the intrathoracic cavity. The fixation structure may extend through the diaphragm and transition to a state that forms a seal between itself and tissue of the diaphragm. Alternatively, the fixation structure may surround the sensor assembly and form a seal between itself and the surface of the diaphragm.

Abstract: Neuromodulation systems with nerve monitoring assemblies and associated devices, systems, and methods are disclosed herein. A neuromodulation system configured in accordance with some embodiments of the present technology can include, for example, a generator, a nerve monitoring assembly configured to detect electroneurogram (ENG) signals, and a neuromodulation catheter. The neuromodulation catheter can include an elongated shaft with a distal portion and a proximal portion. The distal portion of the shaft can include an array of electrodes configured to detect nerve activity from within a blood vessel of a human. The proximal portion of the shaft can include at least one connector that operably couples the electrodes to the generator and to the nerve monitoring assembly.

Abstract: A method for controlling a position of a patient's tongue includes attaching at least one electrode to the patient's Hypoglossal nerve and applying an electric signal through the electrode to at least one targeted motor efferent located within the Hypoglossal nerve to stimulate at least one muscle of the tongue. Methods may also include the use of more than one contact to target more than one motor efferent and stimulating more than one muscle. The stimulation load to maintain the position of the tongue may be shared by each muscle. The position of the patient's tongue may be controlled in order to prevent obstructive sleep apnea.

Abstract: An apparatus for monitoring EMG signals of a patient's laryngeal muscles includes an endotracheal tube having an exterior surface. Conductive electrodes are formed on the endotracheal tube. The conductive electrodes are configured to receive the EMG signals from the laryngeal muscles when the endotracheal tube is placed in a trachea of the patient. At least wireless sensor is formed on the endotracheal tube, and is configured to wirelessly transmit information to a processing apparatus.

Abstract: A method for positioning an intravascular catheter may include inserting the intravascular catheter into a venous system of a patient, wherein the catheter includes a plurality of electrodes, and multiple electrodes of the plurality of electrodes are configured to emit electrical signals; positioning a distal portion of the catheter in a first position; using one or more electrodes of the plurality of electrodes to acquire an ECG signal; based on the acquired ECG signal, adjusting the distal portion of the catheter to a second position different from the first position; identifying at least one first electrode of the plurality of electrodes to stimulate a first nerve; identifying at least one second electrode of the plurality of electrodes to stimulate a second nerve; and stimulating at least one of the first and second nerves to cause a contraction of a respiratory muscle.

Abstract: A method adapted to diagnose airway obstruction in a subject is disclosed. The method comprises the following steps: providing plural cross-sectional ultrasound images of a region of the respiratory tract during the subject's normal breathing, wherein each ultrasound image has plural pixels and each pixel has a color scale value; selecting a region of interest in each ultrasound image; calculating a respective first statistic value. The pixels in each of the region of interest are identified to define a respective airspace region by the color scale values larger than or equal to the respective first statistic value. A respective width of the respiratory tract is calculated and based on the distribution of the pixels in the respective airspace region. The status about an airway obstruction in the subject is classified according to the second statistic value obtained by the calculation of the widths of the respiratory tract.

Abstract: Disclosed is a method for interacting with the nervous system. The method includes detecting signals associated with a biological function at one or more sensors. It also includes processing the signals to create a representation thereof, delivering effector responses based on the representations, and controlling a physical process.

Abstract: A trans mucosal neuromuscular electrical stimulation device (1) including a mouthpiece (3, 103) and electrodes (32a, 33a, 132a, 133a) associated with the mouthpiece (3, 103). The device (1) and/or mouthpiece (3, 103) incorporates electrical circuitry operatively connecting the electrodes (32a, 33a, 132a, 133a) to a power source and is configured to provide, in use, electrical stimulation to one or more palate and/or tongue muscles via the electrodes (32a, 33a, 132a, 133a) through the oral mucosa. The treatment regime, including the location of stimulation and the parameters used, is designed to increase resting muscle tone and/or muscle tone during sleep.

Abstract: A method for positioning an intravascular catheter may include inserting the intravascular catheter into a venous system of a patient, wherein the catheter includes a plurality of electrodes, and multiple electrodes of the plurality of electrodes are configured to emit electrical signals; positioning a distal portion of the catheter in a first position; using one or more electrodes of the plurality of electrodes to acquire an ECG signal; based on the acquired ECG signal, adjusting the distal portion of the catheter to a second position different from the first position; identifying at least one first electrode of the plurality of electrodes to stimulate a first nerve; identifying at least one second electrode of the plurality of electrodes to stimulate a second nerve; and stimulating at least one of the first and second nerves to cause a contraction of a respiratory muscle.

Abstract: A means for treating breathing disorders by stimulating respiratory muscles or nerves to entrain respiratory systems while leaving respiratory drive intact. Embodiments of the invention employ frequency analysis to determine if appropriate stimulation energy is being applied.

Abstract: A device for conveying power from a location external to a subject to a location within the subject may include a flexible carrier and an adhesive on a first side of the carrier. A coil of electrically conductive material may be associated with the flexible carrier. A mechanical connector may be associated with the carrier opposite the adhesive, wherein the mechanical connector is configured to retain a housing and permit the housing to rotate relative to the flexible carrier. At least one electrical portion may be associated with the carrier in a manner permitting electrical connection to be maintained between the flexible carrier and the housing as the housing is rotated.

Abstract: The present invention provides, among other things, apparatus and methods of use for treating a subject in need of assistance with breathing. In some embodiments the subject suffers from airflow obstruction. In some embodiments, the subject suffers from chronic obstructive pulmonary disease.

Abstract: An implant unit according to some embodiments may include a flexible carrier, at least one pair of modulation electrodes on the flexible carrier, and at least one implantable circuit in electrical communication with the at least one pair of modulation electrodes. The at least one pair of modulation electrodes and the at least one circuit may be configured for implantation through derma on an underside of a subject's chin and for location proximate to terminal fibers of the medial branch of the subject's hypoglossal nerve, such that an electric field extending from the at least one pair of modulation electrodes can modulate one or more of the terminal fibers of the medial branch of the hypoglossal nerve.

Abstract: Adaptive systems and methods for automatically determining and continuously updating stimulation parameters for adjusting ventilation to accommodate a patient's specific physiology, metabolic needs, and muscle state are disclosed herein. Having a closed loop implementation, the system may comprise a controller including a neuromorphic controlled adaptive feed-forward Pattern Generator/Pattern Shaper (PG/PS) assembly, which controls respiratory muscle movement using electrical stimulation. This PG/PS assembly comprises a biomimetic design where the pattern generator includes a neural network mimicking the simplified connectivity pattern of respiratory related neurons in the brain stem to produce a rhythmic breathing pattern frequency and the pattern shaper includes a neural network mimicking the simplified connectivity pattern of neurons to produce a stimulus control signal.

Abstract: A method and system for creating shear stress and endothelial mechanotransduction through neuromuscular stimulation of the muscle pump. Chronic application a minimum of 30 days triggers the autocrine and paracrine processes which elevates production of vasoactive substances including nitric oxide, prostacyclin, superoxide dismutase, thrombomodulin, glutathion, Krupple-like factor 2 and many others. Chronic application also promotes angiogenesis and development of collateral circulation. This is a cost-effective, non-invasive, drug-free therapy to treat vascular dysfunction and ameliorate or reverse its effects on cardiovascular health.

Abstract: A trans mucosal neuromuscular electrical stimulation device (1) including a mouthpiece (3, 103), electrodes (32a, 33a, 132a, 133a) associated with the mouthpiece (3, 103). The device (1) and/or mouthpiece (3, 103) incorporates electrical circuitry operatively connecting to the electrodes (32a, 33a, 132a, 133a) to a power source and is configured to provide, in use, electrical stimulation to one or more palate and/or tongue muscles via the electrodes (32a, 33a, 132a, 133a) through the oral mucosa. The treatment regime, including the location of stimulation and the parameters used, is designed to increase resting muscle tone and/or muscle tone during sleep.

Abstract: A surgical instrument including a housing, an endoscopic portion, a shaft portion, and an end effector is disclosed. The endoscopic portion extends distally from the housing and defines a longitudinal axis. The shaft portion is selectively connectable to a distal end of the endoscopic portion. The end effector is selectively connectable to a distal end of the shaft portion.

Abstract: Provided is a respiratory abnormality improvement apparatus capable of effectively improving respiratory abnormality during sleep. The present invention is a respiratory abnormality improvement apparatus for applying a stimulus signal generated in a stimulus generating unit to a patient as an electric stimulus. Here, the apparatus includes a respiration detection unit for detecting a respiratory condition of the patient. Particularly, the stimulus generating unit is so configured that a first stimulus signal generated at a current level preset at a given time, and a second stimulus signal of a current level different from that of the first stimulus signal are generated as stimulus signals to an electrode member worn by the patient based on a detection signal from the respiration detection unit when the patient has been judged to be under a respiratory abnormality condition.

Abstract: In some examples, one or more processors determine characteristics of frequency components of a sensed bioelectrical signal. In response to determining the characteristics, the one or more processors determine therapy parameters for frequency components of a stimulation signal. The one or more processors may determine the therapy parameters based on the characteristics of the frequency components of the sensed bioelectrical signal. As another example, the one or more processors may determine the therapy parameters based on received information after the characteristics of the frequency components of the sensed bioelectrical signal are displayed to a user.

Abstract: An implantable system, and methodology, for improving a heart's hemodynamic performance featuring (a) bimodal electrodes placeable on the diaphragm, out of contact with the heart, possessing one mode for sensing cardiac electrical activity, and another for applying cardiac-cycle-synchronized, asymptomatic electrical stimulation to the diaphragm to trigger biphasic, diaphragmatic motion, (b) an accelerometer adjacent the electrodes for sensing both heart sounds, and stimulation-induced diaphragmatic motion, and (c) circuit structure, connected both to the electrodes and the accelerometer, operable, in predetermined timed relationships to the presences of valid V-events noted in one of sensed electrical and sensed mechanical, cardiac activity, to deliver diaphragmatic stimulation.

Abstract: The embodiments of the invention provide a snore stopping device. The snore stopping device comprises a sleep information acquisition module used for acquiring actual sleep information of a user; a processing module used for comparing the actual sleep information acquired by the sleep information acquisition module with a normal sleep information range, and capable of generating a trigger signal when the actual sleep information goes beyond the normal sleep information range; and an electric stimulation module used for contacting the skin of the user and generating an electric stimulation signal according to the trigger signal. The snore stopping device can effectively cause the snoring user to change his/her sleeping posture, so as to achieve the snore stopping effect.

Abstract: A method for treatment of COPD, hypertension, and left ventricular hypertrophy, and chronic hypoxia including creation of an artificial arterio-venous fistula and installation of a flow mediating device proximate the fistula. The flow mediating device is operated to limit flow as medically indicated to provide the optimum amount of bypass flow.

Abstract: A method, device and/or system for generating arbitrary waveforms of a desired shape that can be used for generating a stimulation pulse for medical purposes such as for spinal cord stimulation therapy, including the option of using such arbitrary waveforms for charge balancing purposes.

Abstract: A method of developing a respiration pacing signal includes detecting respiration and movement activity in an implanted patient and developing corresponding respiration and movement signals. A respiration pacing signal is synchronized with the detected respiration activity and delivered to respiration neural tissue of the implanted patient to promote breathing of the implanted patient. A plurality of respiration sensing modes are used that reflect activity of the movement signal over time to optimize system power consumption over time, including: i. an active respiration mode when the movement signal is either actively changing or remains unchanged for a brief period less than some reduced activity period, wherein the respiration signal is measured continuously, and ii. a plurality of reduced activity respiration modes when the movement signal has remained unchanged for the reduced activity period, wherein the respiration signal is measured only during a limited respiration sampling period.

Abstract: A method for titrating a stimulation parameter for one or more electrode contacts in a system for stimulating a hypoglossal nerve of a patient includes activating one of the one or more electrode contacts to stimulate the hypoglossal nerve of the patient, obtaining a first and/or second physiological measurement from the patient, comparing the first and/or second physiological measurement to a first and/or second predetermined target value, adjusting a stimulation parameter for the one of the one or more electrode contacts if the first and/or second physiological measurement differs from the first and/or second predetermined target value.

Abstract: At least one of a medical device, such as an implantable medical device, and a programming device determines values for one or more metrics that indicate the quality of a patient's sleep. Sleep efficiency, sleep latency, and time spent in deeper sleep states are example sleep quality metrics for which values may be determined. In some embodiments, determined sleep quality metric values are associated with a current therapy parameter set. In some embodiments, a programming device presents sleep quality information to a user based on determined sleep quality metric values. A clinician, for example, may use the sleep quality information presented by the programming device to evaluate the effectiveness of therapy delivered to the patient by the medical device, to adjust the therapy delivered by the medical device, or to prescribe a therapy not delivered by the medical device in order to improve the quality of the patient's sleep.

Abstract: The present invention provides, among other things, apparatus and methods of use for treating a subject in need of assistance with breathing. In some embodiments the subject suffers from airflow obstruction. In some embodiments, the subject suffers from chronic obstructive pulmonary disease.

Abstract: Devices and methods for treating obstructive sleep apnea by first performing an assessment of the patient that involves observing the patient's upper airway during a tongue protrusion maneuver. The assessment may, for example, be done using endoscopy to observe the upper airway while the patient is awake in the supine position. An adequate response of the upper airway during the tongue protrusion maneuver is indicative of likely therapeutic success with hypoglossal nerve stimulation, and may be used for making clinical decisions. The principles of the present invention may be applied to other therapeutic interventions for OSA involving the upper airway.

Abstract: A system for treating medical conditions by neuromodulation of one or more target sites in the nervous system. In certain embodiments, at least one of the target sites is the medial thalamic region, including the intralaminar nucleus and the adjacent white and grey matter. In certain embodiments, where there is more than one target site, the other target sites is elsewhere in the nervous system, including the globus pallidus interna, subthalamic nucleus, corpus callosum, cerebellum, cerebral cortex (including the premotor cortex, motor cortex, and sensory cortex), ventral striatum, lateral thalamus, substantia nigra, and pedunculopontine nuclei. The medical conditions include movement disorders or improvement of movement function, stroke, neuropsychiatric or neuropsychologic disorders, neurodevelopmental disorders, and pain. Methods for treating medical conditions by neuromodulation of the intralaminar nuclei either alone or in combination with another target site(s) is also provided.

Abstract: An implantable system, and methodology, for improving a heart's hemodynamic performance featuring (a) bimodal electrodes placeable on the diaphragm, out of contact with the heart, possessing one mode for sensing cardiac electrical activity, and another for applying cardiac-cycle-synchronized, asymptomatic electrical stimulation to the diaphragm to trigger biphasic, diaphragmatic motion, (b) an accelerometer adjacent the electrodes for sensing both heart sounds, and stimulation-induced diaphragmatic motion, and (c) circuit structure, connected both to the electrodes and the accelerometer, operable, in predetermined timed relationships to the presences of valid V-events noted in one of sensed electrical and sensed mechanical, cardiac activity, to deliver diaphragmatic stimulation.

Abstract: A medical system (100) is disclosed that provides a respiratory-based control of at least one medical procedure. In this regard, the medical system (100) includes one or more appropriate sensors (108) for providing respiratory data on a patient (104). This respiratory data is utilized by respiration assessment logic (116) to determine if the respiratory data has exceeded one or more respiration thresholds and which may be equated with a “sudden” respiratory event. Identification of such a sudden respiratory event by the logic (116) results in the suspension of the noted medical procedure. Patient respiration data may also be displayed, for instance in a color that depends upon its magnitude or level.

Abstract: This disclosure provides non-invasive methods to induce motor control in a mammal subject to spinal cord or other neurological injuries. In certain embodiments the method involves administering transcutaneous electrical spinal cord stimulation (tSCS) to the mammal at a frequency and intensity that induces the desired locomotor activity.

Abstract: A method for delivering energy as a function of degree coupling may utilize an external unit configured for location external to a body of a subject and at least one processor associated with the implant unit and configured for electrical communication with a power source. The method may determine a degree of coupling between the primary antenna and a secondary antenna associated with the implant unit, and regulate delivery of power to the implant unit based on the degree of coupling between the primary antenna and the secondary antenna.

Abstract: A method for delivering energy as a function of degree coupling may utilize an external unit configured for location external to a body of a subject and at least one processor associated with the implant unit and configured for electrical communication with a power source. The method may determine a degree of coupling between the primary antenna and a secondary antenna associated with the implant unit, and regulate delivery of power to the implant unit based on the degree of coupling between the primary antenna and the secondary antenna.

Abstract: A device embodiment is configured to deliver vagal stimulation therapy (VST) to a vagus nerve of a patient. The device embodiment includes a neural stimulator, an implantable pressure sensor, and a pressure analyzer. The neural stimulator is configured to deliver the VST to the vagus nerve in a cervical region of the patient. The implantable pressure sensor is configured to be implanted in the cervical region and to detect pressure changes in the cervical region caused by laryngeal vibrations. The pressure sensor is configured to generate sensed pressure values. The pressure analyzer is configured to analyze the sensed pressure values generated by the pressure sensor. The analyzer is configured to detect laryngeal vibrations or cough from the sensed pressure values.

Abstract: A device and method is provided for biasing lung volume by electrically stimulating tissue associated with the diaphragm or phrenic nerve at a low level.

Abstract: Neuromodulation systems with nerve monitoring assemblies and associated devices, systems, and methods are disclosed herein. A neuromodulation system configured in accordance with some embodiments of the present technology can include, for example, a generator, a nerve monitoring assembly configured to detect electroneurogram (ENG) signals, and a neuromodulation catheter. The neuromodulation catheter can include an elongated shaft with a distal portion and a proximal portion. The distal portion of the shaft can include an array of electrodes configured to detect nerve activity from within a blood vessel of a human. The proximal portion of the shaft can include at least one connector that operably couples the electrodes to the generator and to the nerve monitoring assembly.

Abstract: A method for controlling a position of a patient's tongue includes attaching at least one electrode to the patient's Hypoglossal nerve and applying an electric signal through the electrode to at least one targeted motor efferent located within the Hypoglossal nerve to stimulate at least one muscle of the tongue. Methods may also include the use of more than one contact to target more than one motor efferent and stimulating more than one muscle. The stimulation load to maintain the position of the tongue may be shared by each muscle. The position of the patient's tongue may be controlled in order to prevent obstructive sleep apnea.

Abstract: Strain relief loops are forced by being formed into medical leads such that a body of the lead imposes a force to regain the loop if the loop has been disturbed. Because the strain relief loop is forced, the surgeon implanting the medical lead is not required to create the strain relief loop as a step in the implantation procedure. Forcing the strain relief loop ensures that the strain relief is achieved. The forced strain relief loop also ensures that the loop is present to reduce heating at the electrodes of the medical caused by exposure to excessive radiofrequency energy. The forced strain relief loop may be created by heating the lead body while held in the loop configuration by a mold to cause the loop configuration to persist once the medical lead is removed from the mold.