Cardiac neuromodulation and methods of using same

• US 20060111746A1
• Filed: 11/23/2005
• Published: 05/25/2006
• Est. Priority Date: 04/20/2001
• Status: Active Grant

• Current Assignee: Bengt G.S. Linderoth, Jeffrey L. Ardell, John A. Armour, Michael J.L. Dejongste, Robert D. Foreman
• Original Assignee: Bengt G.S. Linderoth, Jeffrey L. Ardell, John A. Armour, Michael J.L. Dejongste, Robert D. Foreman
• Inventors: Ardell, Jeffrey L., Armour, John A., Foreman, Robert D., Linderoth, Bengt G.S., DeJongste, Michael J. L.
• Granted Patent: US 7,860,563 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• 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

Abstract

The present invention relates in general to methodologies for the treatment quenching preconditioning and communication between the intrinsic cardiac nervous system and an electrical stimulus. In particular, the present invention utilizes spinal cord stimulation to alter and/or affect the intrinsic cardiac nervous system and thereby protect the myocytes, stabilize myocardial electrical instability and/or alleviate or diminish cardiac pathologies.

Claims

1. A method for protecting cardiac tissue from a myocardial insult resulting in necrosis of myocardial tissue, comprising:

identifying an occurrence of a myocardial insult resulting in necrosis of myocardial tissue; and

automatically delivering electrical stimulation to one or more predetermined nerves in a patient'"'"'s body using one or more electrodes positioned adjacent an internal neural structure in order to avoid necrosis of myocardial tissue due to the insult, wherein said one or more electrodes are spaced from myocardial tissue of the patient.

2. The method of claim 1, wherein identifying the occurrence of the insult further comprises identifying one or more symptoms of a heart attack.

3. The method of claim 1, further comprising identifying the severity of the insult.

4. The method of claim 3, wherein delivering electrical stimulation further comprises delivering electrical stimulation having an intensity based on the identified severity of the insult.

5. The method of claim 1, wherein the delivering electrical stimulation further comprises:

storing data descriptive of the electrical stimulation;

analyzing the effectiveness of the electrical stimulation; and

adjusting the delivery of electrical stimulation in a subsequent delivery of electrical stimulation.

6. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation for a period of time extending beyond a cessation of the insult.

7. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation for a preselected duration of time.

8. The method of claim 1, wherein the one or more electrodes are positioned substantially adjacent one or more of T1-T12 vertebrae or dermotones of T1-T12 nerves of the patient.

9. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of muscle tissue.

10. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region adjacent a spinal canal of the patient.

11. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of a chest wall of the patient.

12. The method of claim 1, wherein delivering electrical stimulation further comprises delivering electrical stimulation to a region of a patient'"'"'s body adjacent one or more of C1-C8 vertebrae of C1-C8 nerves.

13. The method of claim 1, wherein identifying the occurrence of the insult further comprises determining that a defibrillation shock has been administered.

14. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting myocardial ischemia.

15. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting an arrhythmic event.

16. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting non-sustained ventricular tachycardia.

17. The method of claim 1, wherein identifying the occurrence of the insult further comprises detecting precursors to a ventricular arrhythmia.

18. The method of claim 1, further comprising the steps of:

sensing a physiologic parameter; and

adjusting delivery of electrical stimulation based on the sensed physiologic parameter.

19. The method of claim 18, wherein multiple physiologic parameters are sensed, and wherein delivery of electrical stimulation is adjusted based on the multiple physiologic parameters.

20. The method of claim 19, further comprising the steps of:

obtaining an indication based on a weighting of the multiple physiologic parameters; and

adjusting delivery of the electrical stimulation based on the indication.

21. The method of claim 20, and further comprising providing a patient notification indicative of the cardiac insult.

22. An apparatus for protecting cardiac tissue from a myocardial insult resulting in necrosis of myocardial tissue, comprising:

at least one electrode positionable adjacent an internal neural structure proximate to nerve tissue and spaced from myocardial tissue; and

a controller adapted to automatically deliver electrical stimulation to the at least one electrode in order to avoid necrosis of myocardial tissue due to the insult.

23. The apparatus of claim 22, and further, wherein the at least one electrode includes a surface to provide stimulation to at least one of a region of skin, muscle tissue, and spinal neurons of the patient'"'"'s body.

24. The apparatus of claim 22, further comprising memory adapted to store data descriptive of the electrical stimulation, and wherein the controller is adapted to analyze the stored data and adjust electrical stimulation in response thereto.

25. The apparatus of claim 22, further comprising a sensor configured to detect a physiologic condition representative of an operating characteristic of the patient'"'"'s heart, and wherein the controller is adapted to deliver electrical stimulation to the at least one electrode based on an indication of the physiologic condition.

26. The apparatus of claim 25, wherein the controller includes a circuit to control delivery of electrical stimulation to the electrodes for a preselected duration of time.

27. A computer readable medium for storing instructions for performing a computer-implemented method to protect cardiac tissue from a myocardial insult resulting in necrosis of myocardial tissue, comprising:

software encoded instructions for identifying an occurrence of a myocardial insult; and

software encoded instructions automatically delivering electrical stimulation to one or more predetermined nerves in a patient'"'"'s body using one or more electrodes positioned adjacent an internal neural structure in order to avoid necrosis of myocardial tissue due to the insult.

28. A medium according to claim 27, wherein the software encoded instructions for identifying the occurrence of the insult further comprises software-encoded instructions for identifying one or more symptoms of a heart attack.

29. A medium according to claim 27, further comprising identifying the severity of the insult, which produces said necrosis of myocardial tissue.

30. A medium according to claim 29, wherein the software encoded instructions for delivering electrical stimulation further comprises software encoded instructions for delivering electrical stimulation having an intensity based on the identified severity of the insult.

31. A medium according to claim 27, wherein the software encoded instructions for delivering electrical stimulation further comprises:

software encoded instructions for storing data descriptive of the electrical stimulation;

software encoded instructions for analyzing the effectiveness of the electrical stimulation; and

software encoded instructions for adjusting the delivery of electrical stimulation in a subsequent delivery of electrical stimulation.