Renal nerve stimulation method and apparatus for treatment of patients

• US 20030216792A1
• Filed: 04/08/2003
• Published: 11/20/2003
• Est. Priority Date: 04/08/2002
• Status: Active Grant

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Ardian, Inc. (Medtronic Plc)
• Inventors: Levin, Howard R., Gelfand, Mark
• Granted Patent: US 7,162,303 B2
• Time in Patent Office: Days
• US Class Current: 607/48
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61M 1/3627 Degassing devices; Buffer reservoirs; Drip chambers; Blood filters
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00

Abstract

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Claims

1. A method for treating a human patient comprising:

a. positioning a nerve stimulation device adjacent to a renal nerve of at least one kidney of the patient, and

b. at least partially blocking the renal nerve of the kidney.

2. A method as in claim 1 wherein the nerve stimulation device is an electrode, and the electrode is positioned surgically in the patient.

3. A method as in claim 1 wherein the nerve stimulation device is a drug delivery device, and the device is positioned surgically in the patient.

4. A method as in claim 1 where the nerve stimulation device is placed in a renal vein of the kidney.

5. A method as in claim 1 where the nerve stimulation device is placed in a renal artery of the kidney.

6. The method of claim 1 wherein the nerve stimulation device is a cuff placed around a renal artery of the kidney.

7. The method of claim 1 wherein the nerve stimulation device is implanted in the patient.

8. The method as in claim 1 wherein afferent fibers of the renal nerve are blocked and efferent fibers are not blocked.

9. The method as in claim 1 wherein efferent fibers of the renal nerve are blocked and afferent fibers are not blocked.

10. A method as in claim 1 wherein the step of blocking the renal nerve is accomplished by a block selected from a group consisting of an anodal block, a cathodal block and a collision block.

11. A method as in claim 1 wherein the step of blocking the renal nerve is accomplished by overpacing the nerve.

12. A method as in claim 1 wherein the step of blocking is accomplished by continuous infusion of an anesthetic drug to the nerve.

13. A method as in claim 1 further comprising monitoring blood pressure of the patient, and adjusting a level of blocking in response to said blood pressure.

14. A method as in claim 1 wherein the nerve stimulation device is a catheter.

15. A method as in claim 1 wherein the nerve stimulation device is a lead with multiple electrode.

16. A method as in claim 1 wherein the step of blocking is accomplished by the injection of a neurotoxin.

17. A method as in claim 1 wherein the step of blocking is accomplished by ablation of the renal nerve.

18. A method as in claim 1 wherein the step of blocking is accomplished by cooling of the renal nerve.

19. A method-as in claim 1 applied to a patient suffering from at least one of heart failure, chronic renal failure and hypertension.

20. A method to stimulate a renal nerve in a mammalian patient comprising:

a. positioning a nerve stimulation device proximate a renal nerve of a kidney of the patient;

b. applying a stimulation signal with the device to the renal nerve, and

c. at least partially blocking the renal nerve by application of the stimulation signal.

21. A method as in claim 20 wherein the nerve stimulation device is an electrode, and the stimulation signal is an electrical current applied by the electrode to the renal nerve.

22. A method as in claim 20 wherein the nerve stimulation device is a drug delivery device and the stimulation signal is a nerve blocking drug applied to the renal nerve.

23. A method as in claim 20 wherein the nerve stimulation device is coupled to a renal blood vessel proximate the renal nerve.

24. A method as in claims 20 wherein the nerve stimulation device is a cuff applied to a renal blood vessel proximate the renal nerve, and the cuff applies a stimulation signal to the renal nerve.

25. A method for reducing abnormally elevated sympathetic renal nerve signals comprising:

a. positioning at least one electrode proximate to a renal nerve of a mammalian patient;

b. applying an electrical current to the electrode with an electric controller to stimulate the renal nerve to at least reduce signal traffic in sympathetic efferent renal nerve fibers, and

c. said controller regulating the current applied to the electrode based on at least one condition of the patient being monitored by a sensor.

26. A method as in claim 25 wherein the controller monitors blood pressure in the patient and the sensor is a blood pressure sensor.

27. A method as in claim 25 wherein the controller monitors blood oxygen in the patient and the sensor is a blood oxygen sensor.

28. An apparatus for reducing abnormally elevated sympathetic comprising:

a nerve stimulation device to be placed proximate to a renal nerve of the patient and said device adapted to stimulate the renal nerve, and

a nerve stimulator activating the stimulation device to stimulate the renal nerve.

29. An apparatus as in claim 28 wherein the stimulation device is an electrode and said stimulator is a controller that applies an electrical current to the electrode.

30. An apparatus as in claim 28 wherein the stimulation device is a drug delivery catheter insertable into a renal blood vessel, and said stimulator is a drug dispenser coupled to said catheter.

31. An apparatus as in claim 28 further comprising a patient sensor connectable to said stimulator, wherein said stimulator receives a signal from the sensor indicative of a condition of the patient and controls the activation of the stimulation device based on said signal.

32. An apparatus as in claim 31 wherein said sensor is a blood pressure sensor and said condition is a blood pressure level of the patient.

33. An apparatus as in claim 31 wherein said sensor is a blood oxygen sensor and said condition is a blood oxygen level of the patient.

34. An apparatus as in claim 28 wherein the said stimulator dispenses drug an anesthetic drug periodically into the said catheter.

35. An apparatus for reducing abnormally elevated sympathetic comprising:

a nerve stimulation device positionable proximate to a renal blood vessel of the patient and said device adapted to stimulate a renal nerve adjacent the vessel, and

a nerve stimulator activating the stimulation device to stimulate the renal nerve.

36. A nerve stimulation device implantable in a mammalian patient comprising:

an implantable stimulator,

an implantable lead connected to said stimulator,

an implanted nerve stimulation cuff connectable to said lead and adapted to receive signals generated by the stimulator, wherein said cuff at least partially envelopes an artery.

37. A nerve stimulation device as in claim 36 wherein said cuff is at least partially attached to an external surface of an artery

38. A nerve stimulation device comprising:

a stimulator implantable into a mammalian patient,

a nerve stimulation cuff in communication with said stimulator to receive a nerve stimulation signal for the stimulator, and said cuff adapted to be implanted into the patient and positioned proximate to an outer surface of an artery of the patient, wherein said cuff stimulates a nerve adjacent the artery when activated by the nerve stimulation signal.

39. A nerve stimulation device as in claim 38 wherein said cuff is adapted to at least partially envelopes the said artery.

40. A nerve stimulation device as in claim 38 wherein said cuff dispenses a drug to the artery and the stimulator is a drug dispensing device.

41. A nerve stimulation device as in claim 38 wherein said stimulator is an electrostimulator.

42. A nerve stimulation device as in claim 38 wherein said cuff includes electrodes.

43. A nerve stimulation device as in claim 38 further comprising a catheter lead extending from the stimulator to the cuff.