Baroreflex modulation based on monitored cardiovascular parameter

• US 20050143779A1
• Filed: 09/13/2004
• Published: 06/30/2005
• Est. Priority Date: 12/24/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad
• Granted Patent: US 7,647,114 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• 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 1/36139 with automatic adjustment
• 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 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

An aspect of the present subject matter relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate. Other aspects are provided herein.

Claims

1. A system for providing baroreflex stimulation, comprising:

a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate; and

a baroreflex stimulator, including;

a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy; and

a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.

2. The system of claim 1, wherein the desired heart rate includes a programmable value.

3. The system of claim 1, wherein the desired heart rate includes a percent change based on a heart rate during a time without baroreflex stimulation and a heart rate during a time with baroreflex stimulation.

4. The system of claim 1, wherein the desired heart rate includes a change in a number of heart beats for a heart rate during a time without baroreflex stimulation and a heart rate during a time with baroreflex stimulation.

5. The system of claim 1, wherein the modulator is adapted to adjust an amplitude of the stimulation signal.

6. The system of claim 1, wherein the modulator is adapted to adjust a frequency of the stimulation signal.

7. The system of claim 1, wherein the modulator is adapted to adjust a burst frequency of the stimulation signal.

8. The system of claim 1, wherein the modulator is adapted to adjust a pulse width of the stimulation signal.

9. The system of claim 1, wherein the modulator is adapted to adjust a duty cycle of the stimulation signal.

10. The system of claim 1, wherein the modulator is adapted to adjust any combination of at least two stimulation signal attributes from a group of stimulation signal attributes consisting of:

an amplitude, a frequency, a burst frequency, a pulse width, and a duty cycle.

11. The system of claim 1, wherein the baroreflex therapy includes at least one of preventing remodeling of cardiac tissue and reverse remodeling of cardiac tissue.

12. The system of claim 1, further comprising an implantable neural stimulator (NS) device and an implantable cardiac stimulator, wherein the implantable NS device includes the baroreflex stimulator and the implantable cardiac stimulator includes the heart rate monitor.

13. The system of claim 1, further comprising an implantable neural stimulator (NS) device, wherein implantable NS device includes the baroreflex stimulator and the heart rate monitor.

14. A system for providing baroreflex stimulation, comprising:

a baroreflex stimulator, including;

a pulse generator to generate a stimulation signal to provide intermittent baroreflex stimulation for a baroreflex therapy; and

a modulator to adjust the stimulation signal;

a cardiovascular parameter monitor to monitor at least one cardiovascular parameter and provide a first signal indicative of the cardiovascular parameter during the baroreflex stimulation and a second signal indicative of the cardiovascular parameter without the baroreflex stimulation; and

a comparator to provide a detected change for the cardiovascular parameter based on the first and second signals, and to provide a therapy control signal based on a desired change for the cardiovascular parameter and the detected change.

15. The system of claim 14, wherein the modulator is adapted to adjust at least one stimulation signal attribute from a group of stimulation signal attributes consisting of:

an amplitude, a frequency, a burst frequency, a pulse width, and a duty cycle.

16. The system of claim 14, wherein the cardiovascular parameter monitor is adapted to monitor a heart rate.

17. The system of claim 14, wherein the cardiovascular parameter monitor is adapted to monitor a blood pressure.

18. The system of claim 14, wherein the cardiovascular parameter monitor is adapted to monitor a respiration rate.

19. The system of claim 14, wherein the at least one cardiovascular parameter includes a surrogate parameter for heart rate that increases and decreases with the heart rate.

20. The system of claim 14, wherein the desired change for the cardiovascular parameter includes a percent change for the cardiovascular parameter when influenced by the baroreflex stimulation.

21. The system of claim 14, wherein the desired change for the cardiovascular parameter includes a quantitative change associated with the cardiovascular parameter when influenced by the baroreflex stimulation.

22. A baroreflex stimulator, comprising:

means for intermittently providing baroreflex stimulation for a baroreflex therapy over a period of time;

means for comparing values for at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied to provide a detected feedback change;

means for comparing the detected feedback change to a desired feedback change to provide a comparison result; and

means for adjusting the baroreflex stimulation based on the comparison result to control the baroreflex therapy over the period of time.

23. The baroreflex stimulator of claim 22, wherein the baroreflex therapy includes at least one of preventing remodeling of cardiac tissue and reverse remodeling of cardiac tissue.

24. The baroreflex stimulator of claim 22, wherein the means for comparing values for at least one cardiovascular feedback parameter includes means for comparing heart rate when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.

25. The baroreflex stimulator of claim 22, further comprising means for programming the desired feedback change.

26. A method, comprising:

intermittently providing baroreflex stimulation for a baroreflex therapy over a period of time;

comparing values for at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied to provide a detected feedback change;

comparing the detected feedback change to a desired feedback change to provide a comparison result; and

adjusting the baroreflex stimulation based on the comparison result to control the baroreflex therapy over the period of time.

27. The method of claim 26, further comprising programming the desired feedback change for use in comparing the detected feedback change to the desired feedback change.

28. The method of claim 27, wherein programming the desired feedback change includes programming a percent change for the at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.

29. The method of claim 27, wherein programming the desired feedback change includes programming a quantitative value change for the at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.

30. The method of claim 26, wherein the baroreflex therapy includes at least one of preventing remodeling of cardiac tissue and reverse remodeling of cardiac tissue.

31. The method of claim 26, wherein the at least one cardiovascular feedback parameter includes heart rate.

32. The method of claim 26, wherein the at least one cardiovascular feedback parameter includes blood pressure.

33. The method of claim 26, wherein the at least one cardiovascular feedback parameter includes respiration.

34. The method of claim 26, wherein adjusting the baroreflex stimulation includes adjusting an amplitude of a baroreflex signal used to provide the baroreflex stimulation.

35. The method of claim 26, wherein adjusting the baroreflex stimulation includes adjusting a frequency of a baroreflex signal used to provide the baroreflex stimulation.

36. The method of claim 26, wherein adjusting the baroreflex stimulation includes adjusting burst frequency of a baroreflex signal used to provide the baroreflex stimulation.

37. The method of claim 26, wherein adjusting the baroreflex stimulation includes adjusting pulse width of a baroreflex signal used to provide the baroreflex stimulation.

38. The method of claim 26, wherein adjusting the baroreflex stimulation includes adjusting a duty cycle of a baroreflex signal used to provide the baroreflex stimulation.