Baroreflex stimulation synchronized to circadian rhythm

• US 20050149130A1
• 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 7,706,884 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3601 of respiratory organs
• 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 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. Other aspects are provided herein.

Claims

1. A baroreflex stimulator, including:

a pulse generator to provide a baroreflex stimulation signal through an electrode; and

a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template.

2. The stimulator of claim 1, wherein the baroreflex signal has an amplitude, and the modulator includes a modulator to modulate the amplitude based on the circadian rhythm.

3. The stimulator of claim 1, wherein the baroreflex signal has a frequency, and the modulator includes a modulator to modulate the frequency based on the circadian rhythm.

4. The stimulator of claim 1, wherein the baroreflex signal has a burst frequency, and the modulator includes a modulator to modulate the burst frequency based on the circadian rhythm.

5. The stimulator of claim 1, further comprising a waveform generator to produce baroreceptor signals of a desired morphology, wherein the modulator includes a modulator to change the morphology of the baroreflex stimulation signal based on the circadian rhythm.

6. The stimulator of claim 1, wherein the circadian rhythm includes a pre-programmed circadian rhythm.

7. The stimulator of claim 1, wherein the circadian rhythm includes a patient-specific circadian rhythm.

8. The stimulator of claim 1, wherein the circadian rhythm includes a mean arterial pressure template.

9. The stimulator of claim 1, wherein the circadian rhythm includes a heart rate template.

10. The stimulator of claim 1, wherein the circadian rhythm includes a stroke volume template.

11. The stimulator of claim 1, wherein the circadian rhythm includes a cardiac output template.

12. The stimulator of claim 1, wherein the circadian rhythm includes a total peripheral resistance template.

13. The stimulator of claim 1, wherein the stimulator is implantable, the stimulator further comprising a lead adapted to be electrically connected to the pulse generator and to be fed through a right ventricle and into a pulmonary artery, the lead including the electrode to be positioned in the pulmonary artery and to deliver the baroreflex stimulation signal to a baroreceptor site in the pulmonary artery.

42. The stimulator of claim 1, wherein the electrode includes a intravascularly-fed electrode adapted to transvascularly stimulate an afferent nerve.

43. The stimulator of claim 1, wherein the electrode includes a nerve cuff electrode adapted to stimulate an afferent nerve.

44. The stimulator of claim 1, wherein the electrode includes an electrode adapted to stimulate baroreceptors in a vessel wall.

14. A baroreflex stimulator, comprising:

a pulse generator to provide a baroreflex stimulation signal through an electrode; and

means for modulating the baroreflex stimulation signal based on a circadian rhythm.

15. The stimulator of claim 14, wherein the circadian rhythm includes a pre-programmed circadian rhythm.

16. The stimulator of claim 14, wherein the circadian rhythm includes a patient-specific circadian rhythm.

17. The stimulator of claim 14, wherein the circadian rhythm includes a mean arterial pressure template.

18. The stimulator of claim 14, wherein the circadian rhythm includes a heart rate template.

19. The stimulator of claim 14, wherein the circadian rhythm includes a stroke volume template.

20. The stimulator of claim 14, wherein the circadian rhythm includes a cardiac output template.

21. The stimulator of claim 14, wherein the circadian rhythm includes a total peripheral resistance template.

22. The stimulator of claim 14, wherein the baroreflex signal has an amplitude, and the means for modulating the baroreflex stimulation signal based on a circadian rhythm includes means for modulating the amplitude of the baroreflex stimulation signal based on a circadian rhythm.

23. The stimulator of claim 14, wherein the baroreflex signal has a frequency, and the means for modulating the baroreflex stimulation signal based on a circadian rhythm includes means for modulating the frequency of the baroreflex stimulation signal based on a circadian rhythm.

24. The stimulator of claim 14, wherein the baroreflex signal has a burst frequency, and the means for modulating the baroreflex stimulation signal based on a circadian rhythm includes means for modulating the burst frequency of the baroreflex stimulation signal based on a circadian rhythm.

25. The stimulator of claim 14, wherein the baroreflex signal has a waveform, and the means for modulating the baroreflex stimulation signal based on a circadian rhythm includes means for changing a waveform of the baroreflex stimulation signal based on a circadian rhythm.

26. A method for operating an implantable medical device, comprising:

applying a baroreflex stimulation therapy using a baroreflex stimulator in the implantable medical device; and

modulating the baroreflex stimulation therapy based on a circadian rhythm template.

27. The method of claim 26, wherein modulating the baroreflex stimulation therapy includes modulating an amplitude of the baroreflex stimulation signal based on the circadian rhythm template

28. The method of claim 26, wherein modulating the baroreflex stimulation therapy includes modulating a frequency of the baroreflex stimulation signal based on the circadian rhythm template.

29. The method of claim 26, wherein modulating the baroreflex stimulation therapy includes modulating a burst frequency of the baroreflex stimulation signal based on the circadian rhythm template.

30. The method of claim 26, wherein modulating the baroreflex stimulation therapy includes changing a waveform of the baroreflex stimulation signal based on the circadian rhythm template.

31. The method of claim 26, wherein the circadian rhythm template is a pre-programmed circadian rhythm template.

32. The method of claim 26, further comprising:

sensing and recording parameters related to hypertension; and

generating a patient-specific circadian rhythm template based on the recorded parameters, wherein the baroreflex stimulation therapy is modulated based on the patient-specific circadian rhythm template.

33. The method of claim 26, wherein the circadian rhythm template includes a mean arterial pressure template.

34. The method of claim 26, wherein the circadian rhythm template includes a heart rate template.

35. The method of claim 26, wherein the circadian rhythm template includes a stroke volume template.

36. The method of claim 26, wherein the circadian rhythm template includes a cardiac output template.

37. The method of claim 26, wherein the circadian rhythm includes a total peripheral resistance template.

38. The method of claim 26, further comprising delivering baroreflex stimulation through a lead adapted to be fed through a right ventricle and pulmonary valve into a pulmonary artery.

45. The method of claim 26, wherein applying baroreflex therapy includes transvascularly stimulating an afferent nerve.

46. The method of claim 26, wherein applying baroreflex therapy includes stimulating an afferent nerve using a nerve cuff.

47. The method of claim 26, wherein applying baroreflex therapy includes stimulating a baroreceptor in a vessel wall.

39. A method for treating hypertension, comprising:

accessing a circadian rhythm template;

setting a baroreflex stimulation level based on the circadian rhythm template; and

applying baroreflex stimulation at the baroreflex stimulation level to a baroreceptor site in a pulmonary artery.

40. The method of claim 39, wherein accessing a circadian rhythm template includes accessing a pre-programmed circadian rhythm template.

41. The method of claim 39, wherein:

accessing a circadian rhythm template includes;

sensing and recording parameters related to hypertension; and

generating a patient-specific circadian rhythm template based on the recorded parameters; and

setting a baroreflex stimulation level based on the circadian rhythm template includes setting a baroreflex stimulation level based on the patient-specific circadian rhythm template.