Heart failure therapy device and method
First Claim
1. A device for reducing the normal sinus heart rate of a patient, comprising:
- (a) a lead with electrodes configured for implantation in the patient such that the electrodes are in electrical communication with tissue proximate to a right vagus nerve of the patient;
(b) detection circuitry with electrodes configured to detect a complex in the patient'"'"'s normal sinus rhythm;
(c) stimulation circuitry in electrical communication with the lead for delivering electrical energy to the lead electrodes to stimulate the right vagus nerve of the patient; and
(d) control circuitry in communication with the stimulation circuitry for controlling the delivery of the electrical energy to the lead electrodes.
1 Assignment
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Accused Products
Abstract
The heart rate of a patient with conditions such as chronic heart failure, ischemia, or acute myocardial infarction is reduced by electrically stimulating the right vagus nerve of the patient. A lead is implanted with electrodes in electrical communication with tissue proximate to the vagus nerve. A stimulator in electrical communication with the electrodes delivers electrical energy that stimulates the release of acetylcholine from the vagus nerve. The amount of energy may be determined in accordance with a difference between the patient'"'"'s actual heart rate and a maximum target heart rate for the patient. Delivery of energy to the lead electrodes is preferably synchronized with the detection of a P-wave. Automatic adjustment of the target heart rate may be based on current day and/or time of day information, and patient physical activity. The voltage, pulse width, or number of pulses in the stimulation may be controlled.
239 Citations
131 Claims
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1. A device for reducing the normal sinus heart rate of a patient, comprising:
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(a) a lead with electrodes configured for implantation in the patient such that the electrodes are in electrical communication with tissue proximate to a right vagus nerve of the patient;
(b) detection circuitry with electrodes configured to detect a complex in the patient'"'"'s normal sinus rhythm;
(c) stimulation circuitry in electrical communication with the lead for delivering electrical energy to the lead electrodes to stimulate the right vagus nerve of the patient; and
(d) control circuitry in communication with the stimulation circuitry for controlling the delivery of the electrical energy to the lead electrodes. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 114)
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34. A device for treating heart failure or ischemia in a patient, comprising:
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(a) a power source for providing electrical energy;
(b) a stimulator connected to the power source for delivering electrical energy in one or more pulses shaped for stimulation of the right vagus nerve of the patient; and
(c) a processor in communication with the stimulator, the processor being configured to control the delivery of the one or more pulses from the stimulator, wherein the stimulation of the right vagus nerve by the one or more pulses produces a reduction of the normal sinus heart rate of the patient. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58)
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59. A vagal nerve stimulator, comprising:
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(a) electrodes configured for implanting in a patient such that the electrodes are proximate to tissue next to or surrounding the patient'"'"'s right vagus nerve in the area of the sinoatrial node of the patient'"'"'s heart;
(b) a detector for receiving a physiological signal from the patient and producing a detection signal signifying detection of a contraction in the patient'"'"'s heart;
(c) a stimulator configured to receive the detection signal and deliver electrical energy to the electrodes during a refractory period following the contraction of the patient'"'"'s heart. - View Dependent Claims (60, 61, 62, 63, 64, 65)
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66. A method for reducing the normal sinus heart rate of a patient, comprising:
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(a) implanting a lead with electrodes in the patient such that the electrodes are in electrical communication with tissue proximate to a right vagus nerve of the patient;
(b) detecting a complex in the patient'"'"'s normal sinus rhythm;
(c) stimulating the right vagus nerve of the patient by delivering electrical energy to the lead electrodes synchronized with the detection of a complex in the patient'"'"'s normal sinus rhythm. - View Dependent Claims (67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92)
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93. A method for treating heart failure or ischemia, comprising:
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(a) providing a power source;
(b) delivering electrical energy from the power source in one or more pulses shaped for stimulation of the right vagus nerve of a patient; and
(c) controlling the delivery of the one or more pulses such that the stimulation of the right vagus nerve by the one or more pulses produces a reduction of the normal sinus heart rate of the patient. - View Dependent Claims (94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113)
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115. A device for treating cardiovascular disease in a patient, comprising:
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(a) a lead with electrodes configured for implantation in the patient near the sinoatrial node of the patient'"'"'s heart; and
(b) a pulse generator in electrical communication with the lead electrodes for delivering one or more electrical pulses to the electrodes that stimulate cholinergic fibers to release acetylcholine which is taken up by the patient'"'"'s sinoatrial node. - View Dependent Claims (116, 117, 118, 119, 120, 121)
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122. A method of treating cardiovascular disease in a patient, comprising:
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(a) implanting a lead with electrodes in the patient near the sinoatrial node of the patient'"'"'s heart; and
(b) delivering to the lead electrodes one or more electrical pulses that stimulate cholinergic fibers to release acetylcholine which is taken up by the patient'"'"'s sinoatrial node. - View Dependent Claims (123, 124, 125, 126, 127)
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128. An electrical lead configured for implantation in a patient'"'"'s heart, comprising:
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(a) a length of electrically conductive material in an insulating substrate; and
(b) a plurality of electrodes attached to the insulating substrate and electrically connected to the conductive material, in which a first electrode is disposed along the length of the insulating substrate and a second electrode is disposed near a distal end of the lead, the first and second electrodes having sufficient distance between them to allow the first electrode to be located in the superior vena cava while the second electrode is located in the atrium near the sinoatrial node when implanted in the heart of the patient. - View Dependent Claims (129, 130, 131)
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Specification