Methods and apparatus for intravascularly-induced neuromodulation
First Claim
1. A method for treating a hypertensive human patient, the method comprising:
- positioning a catheter within a renal artery of the patient and proximate to renal nerves innervating a kidney of the patient;
transforming an impedance-altering element at a distal portion of the catheter from a low-profile delivery configuration to an expanded treatment configuration within the renal artery; and
inhibiting neural signaling along the renal nerves via thermal energy from a pair of bipolar electrodes carried by the catheter,wherein the pair of bipolar electrodes are positioned on a shaft of the catheter on opposite ends of and external to the impedance-altering element,wherein the impedance-altering element is configured to locally increase impedance between the pair of bipolar electrodes during intravascular delivery of the thermal energy, andwherein inhibiting neural signaling along the renal nerves results in a therapeutically beneficial reduction in blood pressure of the patient.
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Abstract
Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient'"'"'s vessel, e.g., with the impedance-altering element deployed into contact with the vessel wall at a treatment site within the patient'"'"'s vasculature, a magnitude of applied voltage delivered across the bipolar electrodes necessary to achieve desired neuromodulation is reduced relative to an intravascular PEF system having similarly spaced electrodes but no (or an undeployed) impedance-altering element. In a preferred embodiment, the impedance-altering element comprises an inflatable balloon configured to locally increase impedance within a patient'"'"'s vasculature. The methods and apparatus of the present invention may be used to modulate a neural fiber that contributes to renal function.
1311 Citations
20 Claims
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1. A method for treating a hypertensive human patient, the method comprising:
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positioning a catheter within a renal artery of the patient and proximate to renal nerves innervating a kidney of the patient; transforming an impedance-altering element at a distal portion of the catheter from a low-profile delivery configuration to an expanded treatment configuration within the renal artery; and inhibiting neural signaling along the renal nerves via thermal energy from a pair of bipolar electrodes carried by the catheter, wherein the pair of bipolar electrodes are positioned on a shaft of the catheter on opposite ends of and external to the impedance-altering element, wherein the impedance-altering element is configured to locally increase impedance between the pair of bipolar electrodes during intravascular delivery of the thermal energy, and wherein inhibiting neural signaling along the renal nerves results in a therapeutically beneficial reduction in blood pressure of the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification