System to provide myocardial and neural stimulation

• US 20060217772A1
• Filed: 03/23/2005
• Published: 09/28/2006
• Est. Priority Date: 03/23/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhu, Qingsheng, Kramer, Andrew P., Libbus, Imad, James, Kristofer J., Vanderlinde, Scott, Garg, Ankur
• Granted Patent: US 7,660,628 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36057 adapted for stimulating afferent nerves
• 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 1/36128 Control systems
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Various aspects provide an implantable device. In various embodiments, the device comprises at least one port, where each port is adapted to connect a lead with an electrode to the device. The device further includes a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode. The stimulation circuit is adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy. The sensing and stimulation circuits are adapted to perform CRM functions. The device further includes a controller connected to the sensing circuit and the stimulation circuit to control the neural stimulation therapy and the CRM therapy. Other aspects and embodiments are provided herein.

Claims

1. An implantable device, comprising:

at least one port, each port being adapted to connect a lead with an electrode to the device;

a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode, the stimulation circuit being adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy, the sensing circuit and the stimulation circuit being adapted to perform CRM functions; and

a controller connected to the sensing circuit and the stimulation circuit, the controller being adapted to control the neural stimulation therapy and the CRM therapy.

2. The device of claim 1, wherein the controller is adapted to deliver a neural stimulation signal over the stimulation channel to the electrode during a first time and to deliver a CRM signal over the stimulation channel to the electrode during a second time that is separate from the first time.

3. The device of claim 2, wherein the controller is adapted to alternate between delivering the neural stimulation signal and the CRM signal.

4. The device of claim 1, wherein the stimulation channel to the electrode is a first stimulation channel to a first electrode, the device further comprising a second stimulation channel to a second electrode, the stimulation circuit being adapted to deliver stimulation signals through the first stimulation channel for both neural stimulation therapy and CRM therapy and through the second stimulation channel for both neural stimulation therapy and CRM therapy, wherein the controller is adapted to control the stimulation circuit to provide a neural stimulation signal for neural stimulation therapy through the first stimulation channel to the first electrode and to provide a CRM stimulation signal for CRM therapy through the second stimulation channel to the second electrode.

5. The device of claim 1, wherein the stimulation circuit is adapted to deliver a stimulation signal through the stimulation channel to the electrode to simultaneously provide neural stimulation therapy and CRM therapy.

6. The device of claim 1, wherein:

the controller is adapted to control a stimulation mode for the stimulation channel;

the controller controls the stimulation circuit to deliver neural stimulation signals over the stimulation channel to the electrode for a neural stimulation mode; and

the controller controls the stimulation circuit to deliver CRM stimulation signals over the stimulation channel to the electrode for a CRM stimulation mode.

7. The device of claim 6, wherein, for a combined neural stimulation and CRM stimulation mode, the controller is further adapted to control the stimulation circuit to deliver stimulation signals over the stimulation channel to the electrode where the stimulation signals are effective for simultaneously providing neural stimulation therapy and CRM therapy.

8. The device of claim 6, wherein the stimulation circuit is adapted to adjust at least one an amplitude and a frequency of the stimulation signal when changing between the neural stimulation and CRM therapies.

9. An implantable medical device, comprising:

a pace module;

a stimulation channel to conduct an electrical signal from the pace module to an electrode;

means for determining a desired therapy to be delivered through the stimulation channel to the electrode;

means for delivering a cardiac rhythm management (CRM) stimulation signal through the stimulation channel to the electrode to capture a heart muscle when a CRM therapy is desired; and

means for delivering a neural stimulation signal through the stimulation channel to the electrode to elicit a neural response when a neural stimulation therapy is desired.

10. The device of claim 9, further comprising means for delivering a stimulation signal through the stimulation channel to simultaneously provide the neural stimulation therapy and the CRM stimulation therapy.

11. The device of claim 9, further comprising means for delivering the CRM stimulation signal to the electrode during a first time and delivering the neural stimulation signal to the electrode during a second time that is separate from the first time.

12. The device of claim 9, wherein the stimulation channel includes a first stimulation channel and the electrode includes a first electrode, the device further comprising:

a second stimulation channel to conduct an electrical signal from the pace module to a second electrode;

means for selecting from an available CRM stimulation mode or neural stimulation mode for the first stimulation channel, and delivering a CRM stimulation signal through the first stimulation channel to the first electrode; and

means for selecting from an available CRM stimulation mode or neural stimulation mode for the second stimulation channel, and delivering a neural stimulation signal through the second stimulation channel to the second electrode.

13. The device of claim 12, wherein the means for selecting from an available CRM stimulation mode or neural stimulation mode includes means for adjusting at least one of an amplitude and a frequency of a stimulation signal generated by the pace module.

14. A method for operating an implantable device to deliver a desired stimulation signal through a stimulation channel to an electrode, comprising:

determining a desired therapy to be delivered through the stimulation channel to the electrode;

upon determining that a cardiac rhythm management (CRM) therapy is desired, delivering a CRM stimulation signal through the stimulation channel to the electrode to capture a heart muscle; and

upon determining that a neural stimulation therapy is desired, delivering a neural stimulation signal through the stimulation channel to the electrode to elicit a neural response.

15. The method of claim 14, further comprising delivering a stimulation signal through the stimulation channel to simultaneously provide the neural stimulation therapy and the CRM stimulation therapy.

16. The method of claim 14, further comprising delivering the CRM stimulation signal to the electrode during a first time and delivering the neural stimulation signal to the electrode during a second time that is separate from the first time.

17. The method of claim 14, wherein the stimulation channel includes a first stimulation channel and the electrode includes a first electrode, and the device includes a second stimulation channel to conduct an electrical signal from the pace module to a second electrode, the method further comprising:

means for selecting from an available CRM stimulation mode or neural stimulation mode for the first stimulation channel, and delivering a CRM stimulation signal through the first stimulation channel to the first electrode; and

means for selecting from an available CRM stimulation mode or neural stimulation mode for the second stimulation channel, and delivering a neural stimulation signal through the second stimulation channel to the second electrode.

18. The device of claim 17, wherein selecting from an available CRM stimulation mode or neural stimulation mode includes adjusting at least one of an amplitude and a frequency of a stimulation signal generated by the pace module.

19. A method for making an implantable medical device, comprising:

connecting a controller to a memory;

connecting the controller to a sensing module adapted to sense intrinsic cardiac signals over a sensing channel from an electrode;

connecting the controller to a stimulation module adapted to generate stimulation signals on a stimulation channel to the electrode; and

storing computer instructions in the memory to be performed by the controller, the computer instructions including instructions to perform a neural stimulation therapy using the stimulation module and to perform a cardiac rhythm management (CRM) therapy using the sensing module and the stimulation module, the computer instructions further including instructions to receive a therapy selection input, to generate a neural stimulation signal on the stimulation channel to the electrode if the neural stimulation therapy is selected, and to generate a CRM stimulation signal on the stimulation channel to the electrode if the neural CRM therapy is selected.

20. The method of claim 19, wherein:

the stimulation channel is a first stimulation channel and the electrode is a first electrode;

the stimulation module is adapted to generate stimulation signals on a second stimulation channel to a second electrode;

the computer instructions stored in the memory further include instructions to select a therapy mode for each of the first and second stimulation channels, and to generate a corresponding stimulation signal on the first and second stimulation channels according to the selected therapy mode.

21. The method of claim 20, wherein the therapy mode is selected from a group comprising a neural stimulation therapy mode, and a CRM stimulation therapy mode.

22. The method of claim 20, wherein the therapy mode is selected from a group comprising a neural stimulation therapy mode, a CRM stimulation therapy mode, and a combined neural stimulation and CRM stimulation therapy mode.

23. The method of claim 19, wherein the computer instructions include instructions to generate the neural stimulation signal on the stimulation channel to the electrode during a first time, and to generate a CRM stimulation signal on the stimulation channel to the electrode during a second time separate from the first time.

24. The method of claim 23, wherein the instructions include instructions to generate the neural stimulation signal and the CRM stimulation signal using a time division multiplexing scheme.

25. The method of claim 19, wherein the instructions include instructions to generate a stimulation signal on the stimulation channel to simultaneously perform the neural stimulation therapy and the CRM therapy.