Devices and methods for cardiovascular reflex control via coupled electrodes

• US 20040019364A1
• Filed: 03/27/2003
• Published: 01/29/2004
• Est. Priority Date: 09/27/2000
• Status: Active Grant

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Keith, Peter T., Serdar, David J., Persson, Bruce J., Rossing, Martin A., Kieval, Robert S.
• Granted Patent: US 7,616,997 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/37229 Shape or location of the implanted or external antenna

Abstract

Devices, systems and methods are disclosed by which the blood pressure, nervous system activity, and neurohormonal activity may be selectively and controllably reduced by activating baroreceptors. A baroreceptor activation device is positioned near a baroreceptor, preferably a baroreceptor located in the carotid sinus. A control system may be used to modulate the baroreceptor activation device. The control system may utilize an algorithm defining a stimulus regimen which promotes long term efficacy and reduces power requirements/consumption. The baroreceptor activation device may utilize RF-coupled or other electrodes to activate the baroreceptors. The electrodes may be adapted for connection to the carotid arteries at or near the carotid sinus, and may be designed to minimize extraneous tissue stimulation.

Claims

1. A system for inducing a baroreceptor signal to effect a change in the baroreflex system in a patient, the system comprising:

a baroreceptor activation device positionable proximate a baroreceptor such that activation of the baroreceptor activation device induces a baroreceptor signal; and

a control system coupled to the baroreceptor activation device, the control system including a processor and a memory, wherein the memory includes software defining an activation, the control system generating a control signal as a function of the stimulus regimen, wherein the coupling between the baroreceptor activation device and the control system includes at least one wireless link between the device and the control system.

2. A system as in claim 1, wherein the activation devices comprises an electrode structure implantable in a vascular lumen adjacent to the baroreceptor.

3. A system as in claim 2, wherein the control system comprises a transmitting antenna implantable in a vein adjacent to the baroreceptor site in the blood vessel, wherein the antenna transmits a signal which wirelessly couples to the electrode structure to produce a current flow therein.

4. A system for activating vascular receptors, said system comprising:

an extravascular transmitter; and

an electrode structure implantable in an vascular lumen, said electrode structure adapted to receive a signal transmitted from the extravascular transmitter and to produce electrical current which activates the vascular receptor.

5. A system as in claim 4, wherein the extravascular transmitter comprises an inductive coil.

6. A system as in claim 4, wherein the extravascular transmitter comprises a electromagnetic transmitter.

7. A system as in claim 4, wherein the extravascular transmitter comprises a microwave transmitter.

8. A system as in claim 4, wherein the extravascular transmitter is adapted to be implanted in a patient'"'"'s body.

9. A system as in claim 8, wherein the transmitter is adapted to be implanted in a vascular lumen adjacent to a target receptor in a blood vessel.

10. A system as in claim 9, wherein the transmitter comprises an antenna and a cable, wherein the cable is adapted to be disposed in a lumen of the vein.

11. A system as in claim 4, further comprising a control system having a driver which generates a control signal which is coupled to the extravascular transmitter.

12. A system as in claim 11, wherein the control system is implantable.

13. A system as in claim 12, further comprising a cable connecting the control system to the extravascular transmitter.

14. A system as in claim 12, wherein the transmitter is incorporated into the implantable control system.

15. A system as in claim 14, wherein the extravascular transmitter is adapted to be implanted in a vein adjacent to an arterial site where the electrode structure is implanted, wherein the cable is adapted to be placed in a venous lumen between the control system and the transmitter.

16. A system as in claim 4, wherein the electrode structure comprises a stent like structure which may be intravascularly delivered in a collapsed state and expanded to be implanted in a blood vessel near a target receptor.

17. A system as in claim 4, wherein the electrode structure comprises a conductive metal which can be energized by EM transmission from the transmitter.

18. A system as in claim 17, wherein the conductive metal is insulated.

19. A system as in claim 4, wherein the electrode structure comprises a receiving coil.

20. A system as in claim 19, wherein the electrode structure comprises electrode pads connected to the receiving coil.

21. A system for activating a baroreceptor in a carotid artery, said system comprising:

an electrode structure implantable in the carotid artery proximate a baroreceptor; and

a transmitter implantable in a jugular vein proximate the carotid artery.

22. A system as in claim 21, wherein the electrode structure comprises a receiving coil and the transmitter comprises a transmitting coil.

23. A system as in claim 22, further comprising a control system which produces a EM control signal and leads, wherein the control system is implantable and the leads are adapted to connect the transmitter to the control system through the vein via a remote entry site.

24. A method for activating a blood vessel receptor, said method comprising:

transmitting a control signal from an extravascular location;

wherein the control signal is received by an electrode structure implanted in or on a blood vessel to the blood vessel receptor, whereby the control signal induces electrical current in the electrode structure which activates the receptor.

25. A method as in claim 24, wherein the control signal is transmitted from a vein adjacent to the blood vessel receptor.

26. A method as in claim 25, wherein the control signal is generated by a control system implanted remotely from an arterial receptor, wherein the control system is wired through a venous lumen to a transmitter in the vein adjacent to the arterial receptor.

27. A method for implanting an electrode structure in an artery, said method comprising:

intravascularly positioning the electrode structure at a target location in the artery;

advancing at least one electrical lead through a lumen of a vein to a location adjacent the electrode structure in the artery; and

connecting the at least one electrical lead to the electrode structure through the arterial and venous walls.