Method and apparatus to minimize effects of a cardiac insult

• US 20020143369A1
• Filed: 10/26/2001
• Published: 10/03/2002
• Est. Priority Date: 10/26/2000
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Zhou, Xiaohong, Mullen, Thomas J., King, Gary W., Hill, Michael R.S.
• Granted Patent: US 7,010,345 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method and apparatus are provided for protecting cardiac tissue from insult. The method comprises identifying the occurrence of an insult, such as a heart attack, and delivering electrical stimulation to one or more predetermined nerves in a patient'"'"'s body in response to identifying the occurrence of the insult. The stimulation may be provided at the spinal canal or on the chest wall of the patient through cutaneous electrodes.

Claims

1. A method for protecting cardiac tissue from insult, comprising:

identifying the occurrence of the insult; and

delivering electrical stimulation to one or more predetermined nerves in a patient'"'"'s body using one or more electrodes positioned adjacent an external surface of the body.

2. The method of claim 1, wherein identifying the occurrence of the insult further comprises identifying one or more symptoms of a heart attack.

3. The method of claim 1, further comprising identifying the severity of the insult.

4. The method of claim 3, wherein delivering electrical stimulation further comprises delivering electrical stimulation having an intensity based on the identified severity of the insult.

5. The method of claim 1, wherein the delivering electrical stimulation further comprises:

storing data descriptive of the electrical stimulation;

analyzing the effectiveness of the electrical stimulation; and

adjusting the delivery of electrical stimulation in a subsequent delivery of electrical stimulation.

6. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation for a period of time extending beyond a cessation of the insult.

7. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation for a preselected duration of time.

8. The method of claim 1, wherein the one or more electrodes are positioned substantially adjacent one or more of T1-T12 vertebrae or dermotones of T1-T12 nerves of the patient.

9. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a preselected region of skin.

10. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of muscle tissue.

11. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region adjacent a spinal canal of the patient.

12. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of a chest wall of the patient.

13. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of a patient'"'"'s body adjacent one or more of C1-C8 vertebrae or C1-C8 nerves.

14. The method of claim 1, wherein identifying the occurrence of the insult further comprises determining that a defibrillation shock has been administered.

15. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting myocardial ischemia.

16. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting an arrhythmic event.

17. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting non-sustained ventricular tachycardia.

18. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting precursors to a ventricular arrhythmia.

19. The method of claim 1, and further comprising sensing a physiologic parameter;

and

adjusting delivery of electrical stimulation based on the sensed physiologic parameter.

20. The method of claim 19, wherein multiple physiologic parameters are sensed;

and wherein delivery of electrical stimulation is adjusted based on the multiple physiologic parameters.

21. The method of claim 20, and further comprising obtaining an indication based on a weighting of the multiple physiologic parameters;

and

adjusting delivery of the electrical stimulation based on the indication.

22. The method of claim 21, and further comprising providing a patient notification indicative of the cardiac insult.

25. The apparatus of claim 24, and further, wherein the at least one electrode includes a surface to provide stimulation to at least one of a region of skin, muscle tissue, and spinal neurons of the patient'"'"'s body.

27. The apparatus of claim 24, further comprising memory adapted to store data descriptive of the electrical stimulation, and wherein the controller is adapted to analyze the stored data and adjust electrical stimulation in response thereto.

28. The apparatus of claim 24, further comprising a sensor configured to detect a physiologic condition representative of an operating characteristic of the patient'"'"'s heart, and wherein the controller is adapted to deliver electrical stimulation to the at least one electrode based on an indication of the physiologic condition.

29. The apparatus of claim 28, wherein the controller includes a circuit to control delivery of electrical stimulation to the electrodes for a preselected duration of time.

23. A method for protecting cardiac tissue from insult, comprising:

anticipating the occurrence of the insult; and

delivering electrical stimulation to one or more predetermined nerves in a patient'"'"'s body using one or more electrodes positioned adjacent an external surface of the body.

24. An apparatus for protecting cardiac tissue from insult, comprising:

at least one electrode positionable adjacent an external surface of a body proximate to nerve tissue; and

a controller adapted to deliver electrical stimulation to the at least one electrode.

30. An apparatus for protecting cardiac tissue from insult, comprising:

at least one electrode positionable at a region adjacent a surface of a body, wherein the electrode is capable of stimulating at least a portion of a nervous system of the body;

trigger means; and

means for delivering electrical stimulation to the at least one electrode in response to activation of the trigger means.

31. The apparatus of claim 30, wherein the trigger means includes means for being activated by a person.

32. The apparatus of claim 30, and further including a sensor to measure a physiological signal, and wherein the trigger means includes means for being activated based on a predetermined condition indicated by the physiological signal.

33. The apparatus of claim 32, wherein the means for delivering electrical stimulation including means for delivering the electrical stimulation for a predetermined period of time.

34. The apparatus of claim 30, wherein the trigger means includes means for being activated in anticipation of the insult.