Systems and related methods for optimization of multi-electrode nerve pacing

摘要

This disclosure describes, among other embodiments, systems and related methods for selecting electrode combinations to be used during nerve pacing procedures. A first set of electrode combinations of a nerve pacing system, such as a phrenic nerve pacing system for diaphragm activation, may be mapped (or tested) to determine the location of the electrode combinations relative to a target nerve. Once the general location of the target nerve is known, a more localized second set of electrode combinations may be tested to determine the most suitable electrode combinations for nerve stimulation. At various stages of the mapping process, electrode combinations that are non-optimal may be discarded as candidates for use in a nerve pacing procedure. The systems and methods described herein may allow for the selection of electrode combinations that are most suitable for stimulation of the left and right phrenic nerves during diaphragm pacing.

主权项

1. A method of electrical stimulation, comprising:
delivering a series of first electrical stimulations to a phrenic nerve via each of a first plurality of electrode combinations, with each of the first plurality of electrode combinations being utilized one at a time; monitoring a first patient response to each of the first electrical stimulations of the phrenic nerve; selecting a first subset of the first plurality of electrode combinations based on the first patient responses indicating that the first subset is in proximity to the phrenic nerve; determining a second plurality of electrode combinations from the electrodes within the first subset of the first plurality of electrode combinations; delivering a series of second electrical stimulations to the phrenic nerve via each of the second plurality of electrode combinations, with each of the second plurality of electrode combinations being utilized one at a time; monitoring a second patient response to each of the second electrical stimulations of the phrenic nerve; and based on the second patient responses, selecting a second subset of the second plurality of electrode combinations, wherein the second subset includes at least one electrode combination having a greater second patient response than other of the second plurality of electrode combinations.