Abstract: Disclosed herein are various methods, systems, an apparatuses for determining appropriate situations to treat conditions such as sleep apnea. At appropriate times, treatment can be applied such as through electrical stimulation to a person (e.g., an electrical stimulation of a person's genioglossus muscle in response to detecting that the person is undergoing an obstructive sleep apnea precursor event). In exemplary embodiments, a sensor such as a microphone and/or motion sensor can be used to provide a processor with data to facilitate a determination by the processor as to whether an electrical stimulus should be applied.

Abstract: One aspect of the present disclosure relates to a system for treating obstructive sleep apnea in a subject. The system can include a power source and a neuromuscular stimulator in electrical communications with the power source. The neuromuscular stimulator can include a controller and at least one electrode. The controller can be configured to receive certain power and stimulation parameters associated with a therapy signal from the power source. The at least one electrode can be configured to deliver the therapy signal to a target tissue associated with control of a posterior base of the tongue of the subject.

Abstract: Methods and devices for treating bronchial constriction related to asthma and anaphylaxis wherein the treatment includes providing an electrical impulse to a selected region of the vagus nerve and/or the lungs of a patient suffering from bronchial constriction.

Abstract: Devices, systems and methods for treating bronchoconstriction associated with asthma, anaphylaxis or chronic obstructive pulmonary disease. The treatment comprises transmitting impulses of energy non-invasively to selected nerve fibers that are responsible for smooth muscle dilation, such as the vagus nerve.

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: A unit configured for implantation in a subject's body may include a carrier, an implantable circuit associated with the carrier, an antenna arranged on the carrier and configured to wirelessly receive energy from a location external to the subject's body and to provide at least a portion of the energy to the implantable circuit, and at least one component associated with the carrier for receiving energy from the implantable circuit. Wherein the implantable circuit and the antenna have an internal resonant frequency mismatched from an external resonant frequency of an external circuit, to account for resonance frequency variation as a result of implantation in the subject's body.

Abstract: An embodiment of the invention includes a method for decreasing resistance to airflow within a bronchial tree of a subject. The method may include the step of moving an intraluminal device along a lumen of an airway of a bronchial tree, where the intraluminal device includes an expandable member and an energy emitter. The method also may include damaging nerves along the airway using the intraluminal device without destroying an inner surface of an airway wall disposed radially between the intraluminal device and the nerves.

Abstract: Some embodiments provide a method comprising delivering neural stimulation for a neural stimulation therapy according to a programmed schedule, detecting a swallow event, and responding to the detected swallow event by overriding the programmed schedule.

Abstract: Some embodiments provide a method comprising delivering neural stimulation for a neural stimulation therapy according to a programmed schedule, detecting a swallow event, and responding to the detected swallow event by overriding the programmed schedule.

Abstract: A system 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. The system 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: This document discusses, among other things, apparatus, systems, and methods for transvascularly stimulation of a nerve or nerve trunk. In an example, an apparatus is configured to transvascularly stimulate a nerve trunk through a blood vessel. The apparatus includes an expandable electrode that is chronically implantable in a blood vessel proximate a nerve trunk. The expandable electrode is configured to abut a predetermined surface area of the vessel wall along a predetermined length of the vessel. An electrical lead is coupled to the expandable electrode. An implantable pulse generator is coupled to the lead and configured to deliver an electrical stimulation signal to the electrode through the lead. in an example method, an electrical signal is delivered from an implanted medical device to an electrode chronically implanted in a blood vessel proximate a nerve trunk to transvascularly deliver neural stimulation from the electrode to the nerve trunk.

Abstract: Systems, delivery devices, and methods to treat, ablate, damage, or otherwise affect tissue in an airway of a patient. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue while cooling non-targeted tissue to protect the non-targeted tissue from damage. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input.

Abstract: In order to treat hypertension, an implantable receiving device is connected to implantable leads which are adapted to deliver electrical energy to the carotid body or bodies of the patient. The receiving device is arranged to receive electoral energy from an external generator. The device thus enables the delivery of electrical currents which modify the function of neural tissue, particularly where repeated treatments are needed or where positioning of a percutaneous needle is difficult.

Abstract: An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input.

Abstract: An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Abstract: A device for delivering energy as a function of degree coupling may include 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 device may further include a primary antenna associated with the at least one processor. The processor may be configured to 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 treating a pulmonary condition in a subject is provided. One step of the method includes providing an apparatus for positioning at a target site innervated by at least one nerve of the autonomic nervous system (ANS). The apparatus includes a fluid exchange catheter, an inflatable balloon coupled to the fluid exchange catheter, and an energy delivery mechanism including at least one energy delivery member for delivering electrical energy to the target site. Next, an expansion medium is delivered to the apparatus so that the inflatable balloon is sufficiently inflated to sandwich at least a portion of the at least one energy delivery member between the inflatable balloon and a luminal wall of the tracheo-bronchial tree at the target site. Electrical energy is then delivered to the at least one energy delivery member to effect a change in the ANS of the subject.

Abstract: An apparatus comprises a physiologic sensing circuit and a control circuit. The physiologic sensing circuit is configured to sense an electrical respiration signal representative of respiration of a subject. The control circuit includes a respiration monitor circuit and a therapy circuit. The respiration monitor circuit is configured to extract a respiration parameter from the respiration signal and detect that a value of the respiration parameter is outside of a target value range for the respiration parameter. The therapy circuit is configured to deliver neural stimulation to the carotid sinus of the subject to stimulate respiration and to adjust respiration to maintain the value of the respiration parameter within the target value range.

Abstract: An apparatus for positioning at a target site and for treating a pulmonary condition in a subject includes a fluid exchange catheter for insertion into a tracheo-bronchial tree and an inflatable balloon coupled to the fluid exchange catheter. At least a portion of the inflatable balloon is for engaging a luminal wall of the tracheo-bronchial tree at the target site. The apparatus further includes an energy delivery mechanism operably coupled to the inflatable balloon. The energy delivery mechanism includes at least one energy delivery member for delivering electrical energy to the target site.

Abstract: A hybrid method is provided for modulating upper airway function in a subject. The method includes applying first and second therapy signals to the subject to modulate at least one extrinsic laryngeal muscle and at least one intrinsic laryngeal muscle to synergistically control laryngeal motion and vocal fold movement, respectively.

Abstract: Devices for monitoring patient breaching comprise a collar having a microprocessor and memory which is connectable to a plurality of sensors. Therapeutic devices comprise similar diagnostic capabilities and further provide energy delivery elements for stimulating a patient's upper respiratory muscles in order to terminate and an apneic or snoring event.

Abstract: Devices and systems are disclosed for the non-invasive treatment of medical conditions through delivery of energy to target tissue, comprising a source of electrical power, a magnetically permeable toroidal core, and a coil that is wound around the core. The coil and core are embedded in a continuous electrically conducting medium, which is adapted to have a shape that conforms to the contour of an arbitrarily oriented target body surface of a patient. The conducting medium is applied to that surface by any of several disclosed methods, and the source of power supplies a pulse of electric charge to the coil, such that the coil induces an electric current and/or an electric field within the patient, thereby stimulating tissue and/or one or more nerve fibers within the patient. The invention shapes an elongated electric field of effect that can be oriented parallel to a long nerve. In one embodiment, the device comprises two toroidal cores that lie adjacent to one another.

Abstract: This document provides methods and materials for modulating afferent nerve signals to treat medical conditions such as CHF, CHF respiration, dyspnea, peripheral vascular disease (e.g., peripheral arterial disease or venous insufficiency), hypertension (e.g., age-associated hypertension, resistant hypertension, or chronic refractory hypertension), COPD, sleep apnea, and chronic forms of lung disease where muscle dysfunction is a part of the disease pathophysiology. For example, methods and materials involved in using electrical and/or chemical techniques to block or reduce afferent nerve signals (e.g., nerve signals of group III and/or IV afferents coming from skeletal muscle and/or the kidneys) are provided.

Abstract: Described herein are implantable composites, kits comprising the composites, implant devices comprising the composites, and methods of making and using same, including point of use methods.

Abstract: A stimulation protocol determination system includes an input module and a selector module. The input module is provided to receive an indication of an upper airway flow limitation via sensed respiratory effort information. The selection module is provided to automatically select, based on the indicated upper airway flow limitation, a stimulation protocol.

Abstract: Apparatus comprising (1) a breathing sensor, configured to detect a breathing-related factor of a subject; (2) at least a first electrode configured to be placed in a vicinity of a respective first hypoglossal nerve, and to be driven, in response to the detected breathing-related factor, to apply a first electrical current to the first hypoglossal nerve; (3) at least a second electrode configured to be placed in a vicinity of a respective second hypoglossal nerve, and to be driven, in response to the detected breathing-related factor, to apply a second electrical current to the second hypoglossal nerve; and (4) circuitry configured to, in response to a detected symmetry-related factor indicative of a degree of symmetry of the subject, configure at least one current selected from the group consisting of: the first current and the second current. Other embodiments are also described.

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: Devices, systems and methods are disclosed for treating a variety of diseases and disorders that are primarily or at least partially driven by an imbalance in neurotransmitters in the brain, such as asthma, COPD, depression, anxiety, epilepsy, fibromyalgia, and the like. The technology involves the use of an energy source comprising magnetic and/or electrical energy that is transmitted non-invasively to, or in close proximity to, a selected nerve to temporarily stimulate, block and/or modulate the signals in the selected nerve such that neural pathways are activated to release inhibitory neurotransmitters in the patient's brain.

Abstract: Some embodiments of the present disclosure may include a device for conveying power from a location external to a subject to a location within the subject The device may include a flexible carrier, an adhesive on a first side of the carrier, a coil of electrically conductive material associated with the flexible carrier, and a mechanical connector extending from a second side of the carrier opposite the adhesive. The mechanical connector may be configured to be received by and retained by a receiver associated with a housing configured for mounting on the carrier.

Abstract: A system and method for use during the administration of CPR chest compressions and defibrillating shock on a cardiac arrest victim. The system analyzes compression waveforms from a compression depth monitor to determine the source of chest compressions, and enables the delivery of defibrillating shock during a compression cycle if the compression waveforms are characteristic of an automated CPR chest compression device.

Abstract: A system is disclosed for applying a treatment therapy for sleep disordered breathing. The system includes a sensing module configured to sense physiologic conditions and an implantable pulse generator in communication with the sensing module and including an automatic therapy manager. The automatic therapy manager operates in a first state to detect sleep indicative behavior, a second state to detect sleep disordered breathing behavior, and a third state to apply a nerve stimulation signal.

Abstract: Electric stimulation method and system for treating Obstructive Sleep Apnea (OSA) Syndrome using an external actuator on the pharyngeal-laryngeal muscles. Using this actuator, the muscles involved receive an electric stimulus, with the aim of widening the muscular opening and attaining sufficient air flow to prevent the lack of air. Said stimulus only acts in the event of an apnea episode being detected, by means of analyzing sound patterns of the upper airways. Both detection and treatment arc self-regulatory, in order to adapt to the patient's morphology and the evolution of the condition or problem.

Abstract: Methods and devices for treating anaphylaxis, anaphylactic shock, bronchial constriction, and/or asthma include providing an electrical impulse to a selected region of the vagus nerve of a patient suffering from anaphylaxis to block and/or modulate nerve signals that would regulate the function of, for example, myocardial tissue, vasodilation/constriction and/or pulmonary tissue.

Abstract: A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

Abstract: Systems and methods to treat a pulmonary disorder are provided. A particular method includes positioning an electrode in a patient's body at a location proximate a branch of a vagus nerve. The branch of the vagus nerve includes at least one of a bronchial branch of the vagus nerve and a pulmonary plexus. The method also includes activating the electrode such that energy is delivered from the electrode to the branch of the vagus nerve so as to block intrinsic neural activity in the branch of the vagus nerve to treat the pulmonary disorder.

Abstract: An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation.

Abstract: A neuro-stimulation system employs a includes a stimulator which may include electrode devices and/or vibration elements. A controller may be employed to drive the stimulating elements with an electrical signal. In response to the electrical signal, the stimulating elements deliver electrical and/or mechanical stimulation to the body part. The stimulation may be an aperiodic stimulation and/or may be a subthreshold stimulation. In one embodiment, the stimulator is disposable and the processor determines usage of the stimulator and ensures that the stimulator is limited to a certain amount of use. Neuro-stimulation systems may be applied to sensory cells of body parts during movement of the body parts to induce neuroplastic changes. Such movement may involve a variety of therapeutic applications, e.g. in stroke patient therapy.

Abstract: The present invention is related to an implantable medical device for treating breathing disorders and cardiac disorders by delivering stimulation energy to the phrenic nerve, hypoglossal nerves and cardiac muscle tissues.

Abstract: A device for the treatment of snoring is provided. The device may include a flexible substrate configured for removable attachment to a subject's skin, a primary antenna disposed on the flexible substrate, an interface configured to receive a feedback signal that varies based upon a breathing pattern of the subject; and at least one processing device. The processing device may be configured to analyze the feedback signal and determine whether the subject is snoring based on the analysis of the feedback signal, and if snoring is detected, cause a hypoglossal nerve modulation control signal to be applied to the primary antenna in order to wirelessly transmit the hypoglossal nerve modulation control signal to a secondary antenna associated with an implant unit configured for location in a body of the subject.

Abstract: A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device.

Abstract: An implant unit delivery tool is disclosed having an implant tool and an implant activator. The implant tool may be configured to retain an implant unit during an implantation procedure in which the implant unit is fixated to tissue. The implant activator may be associated with the implant tool. Additionally, the implant activator may be configured to selectively transfer power to the implant unit during the implantation procedure to cause modulation of at least one nerve in the body of a subject prior to final fixation of the implant unit to the tissue.

Abstract: A system and method for controlling respiration depth or respiration rate is provided. A bipolar pair of a plurality of electrodes is selected in a location for stimulating a phrenic nerve. Electrical stimulation is delivered through a medical electrical lead electrode proximate phrenic nerve tissue. Modulating respiration is elicited in response to electrical stimulation of the phrenic nerve.

Abstract: Disclosed herein are various methods, systems, an apparatuses for determining appropriate situations to treat conditions such as sleep apnea. At appropriate times, treatment can be applied such as through electrical stimulation to a person (e.g., an electrical stimulation of a person's genioglossus muscle in response to detecting that the person is undergoing an obstructive sleep apnea precursor event). In exemplary embodiments, a sensor such as a microphone and/or motion sensor can be used to provide a processor with data to facilitate a determination by the processor as to whether an electrical stimulus should be applied.

Abstract: Devices, systems and methods are disclosed for treating bronchial constriction related to asthma, anaphylaxis or chronic obstructive pulmonary disease. The treatment comprises transmitting impulses of energy non-invasively to selected nerve fibers that are responsible for smooth muscle dilation. The transmitted energy impulses, comprising magnetic and/or electrical, mechanical and/or acoustic, and optical and/or thermal energy, stimulate the selected nerve fibers.

Abstract: A system 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. The system 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: Control systems and methods for delivery of energy that may include control algorithms that prevent energy delivery if a fault is detected and may provide energy delivery to produce a substantially constant temperature at a delivery site. In some embodiments, the control systems and methods may be used to control the delivery of energy, such as radiofrequency energy, to body tissue, such as lung tissue.

Abstract: Systems and devices for selectively applying electrical energy to a target region beneath a skin surface of a patient involve applying an electrical impulse to one or more electrodes on a skin surface of the patient to modulate one or more nerves at the target region, where the impulse is substantially blocked at nerves located between the target region and the skin surface such that only the nerves at the target region are modulated by the electrical impulse.

Abstract: A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.

Abstract: The present invention describes an apparatus, a systems and a method for the treatment of obstructive sleep apnea. the treatment involves monitoring the position of the tongue and/or the force exerted by the tongue an electrical stimulation of the hypoglossal nerve to move the tongue into an anterior position or to maintain the tongue in an anterior position.