Baroreflex stimulation to treat acute myocardial infarction

• US 20050149126A1
• Filed: 12/24/2003
• Published: 07/07/2005
• 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 7,460,906 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36117 for treating hypertension
• 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 1/36564 controlled by blood pressure

Abstract

An aspect of the present subject relates to an implantable medical system. An embodiment of the system includes a baroreflex stimulator, a myocardial infarction detector, and a controller. The baroreflex stimulator applies a baroreflex stimulation signal through an electrode. The myocardial infarction detector detects an event indicative of myocardial infarction. The controller is connected to the baroreflex stimulator and to the myocardial infarction detector, and is adapted to apply a baroreflex therapy in response to a detected event indicative of myocardial infarction. Other aspects are provided herein.

Claims

1. An implantable medical system, including:

a baroreflex stimulator to apply a baroreflex stimulation signal through an electrode; and

a myocardial infarction detector to detect an event indicative of myocardial infarction; and

a controller connected to the baroreflex stimulator and to the myocardial infarction detector, the controller adapted to apply a baroreflex therapy in response to a detected event indicative of myocardial infarction.

2. The device of claim 1, wherein the event indicative of myocardial infarction includes a detected myocardial infarction.

3. The device of claim 1, wherein the event indicative of myocardial infarction includes a detected precursor to myocardial infarction.

4. The device of claim 1, wherein the controller includes a controller adapted to initiate a baroreflex therapy in response to a detected event indicative of myocardial infarction.

5. The device of claim 1, wherein the controller includes a controller adapted to increase an existing baroreflex therapy in response to a detected event indicative of myocardial infarction.

6. An implantable medical system, comprising:

means for detecting a myocardial infarction; and

means for applying baroreflex therapy to a pressoreceptive region to decrease coronary vascular resistance and increase blood flow in response to detecting the myocardial infarction.

7. The system of claim 6, wherein the means for applying baroreflex therapy includes means for increasing baroreflex stimulation in response to the myocardial infarction.

8. The system of claim 6, wherein the means for applying baroreflex therapy includes means for applying baroreflex stimulation signals to a baroreceptor site in a pulmonary artery.

9. The system of claim 6, wherein the means for applying baroreflex therapy includes means for applying baroreflex stimulation signals to a baroreflex neural target in a cardiac fat pad.

10. The system of claim 6, wherein the means for applying baroreflex therapy includes means for applying baroreflex stimulation signals to an afferent nerve.

11. The system of claim 10, wherein the means for applying baroreflex stimulation signals to an afferent nerve includes means to intravascularly position an electrode in a blood vessel proximate to the afferent nerve to transvascularly stimulate the afferent nerve.

12. The system of claim 6, further comprising means for monitoring systemic blood pressure, and means for modulating the baroreflex therapy based on the systemic blood pressure.

13. The system of claim 6, further comprising means for sensing the blood pressure.

14. The system of claim 6, further comprising means for sensing respiration as a surrogate parameter for blood pressure.

32. The system of claim 10, wherein the means for applying baroreflex stimulation signals to an afferent nerve includes means for applying baroreflex stimulation signals to the afferent nerve using a cuff electrode.

15. A method, comprising:

inserting a lead through a right ventricle and a pulmonary valve into a pulmonary artery to position an electrode proximate to a baroreceptor site; and

applying a baroreflex therapy through the electrode to the baroreceptor site.

16. The method of claim 15, further comprising monitoring systemic blood pressure and modulating the baroreflex therapy based on the blood pressure.

17. The method of claim 15, wherein monitoring systemic blood pressure includes monitoring blood pressure in the pulmonary artery.

18. The method of claim 15, further comprising monitoring a surrogate parameter of systemic blood pressure and modulating the baroreflex therapy based on the surrogate parameter.

19. The method of claim 18, wherein the surrogate parameter includes a respiration parameter.

20. A method, comprising:

detecting an event corresponding to a myocardial infarction; and

in response to a detected event corresponding to a myocardial infarction, applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target.

21. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target includes applying a baroreflex therapy using an electrode positioned in a pulmonary artery.

22. The method of claim 21, wherein monitoring systemic blood pressure includes monitoring blood pressure in the pulmonary artery.

23. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target includes applying a baroreflex therapy to a baroreflex neural target in a cardiac fat pad.

24. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target includes transvascularly applying a baroreflex therapy using an electrode positioned in a blood vessel proximate to a carotid sinus nerve.

25. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target includes transvascularly applying a baroreflex therapy using an electrode positioned in a blood vessel proximate to a vagus nerve.

26. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target includes transvascularly applying a baroreflex therapy using an electrode positioned in a blood vessel proximate to an aortic nerve.

27. The method of claim 20, further comprising monitoring systemic blood pressure and modulating the baroreflex therapy based on the blood pressure.

28. The method of claim 20, further comprising monitoring a surrogate parameter of systemic blood pressure and modulating the baroreflex therapy based on the surrogate parameter.

29. The method of claim 28, wherein the surrogate parameter includes a respiration parameter.

30. The method of claim 20, wherein the event corresponding to a myocardial infarction includes a detected myocardial infarction.

31. The method of claim 20, wherein the event corresponding to a myocardial infarction includes a detected precursor to a myocardial infarction.

33. The method of claim 20, wherein applying a baroreflex therapy using an electrode positioned proximate to a baroreflex neural target to induce a baroreflex includes using a cuff electrode to stimulate the afferent nerve.