Baroreflex stimulation system to reduce hypertension

• US 20070038262A1
• Filed: 07/07/2006
• Published: 02/15/2007
• Est. Priority Date: 09/27/2000
• Status: Abandoned Application

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Kieval, Robert, Keith, Peter, Serdar, David, Burns, Matthew
• Application Number:
  US11/482,662
• Publication Number:
  US 20070038262A1
• Time in Patent Office: Days
• US Class Current: 607/44
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

The present invention is an implantable medical device comprising, a pulse generator to generate a baroreceptor stimulation signal as part of a baroreflex therapy, a lead to be electrically connected to the pulse generator and to be intravascularly fed into a heart, the lead including an electrode to be positioned in or proximate to the heart to deliver the baroreceptor signal to a baroreceptor region in or proximate to the heart, a sensor to sense a physiological parameter regarding the need to modify the baroreflex system and to provide a signal indicative of the need to modify the baroreflex system and a controller connected to the pulse generator to control the baroreceptor stimulation signal and to the sensor to receive the signal indicative of the need to modify the baroreflex system.

Claims

1. An implantable medical device, comprising:

a pulse generator to generate a baroreflex stimulation signal as part of a baroreflex therapy;

a lead to be electrically connected to the pulse generator and to be intravascularly fed into a heart, the lead including an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart;

a sensor to sense a physiological parameter regarding an efficacy of the baroreflex therapy and to provide a signal indicative of the efficacy of the baroreflex therapy; and

a controller connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy.

2. The device of claim 1, further comprising a telemetry circuit to communicate with the controller and to wirelessly communicate with an external programmer, wherein the implantable medical device is adapted to communicate therapy data to the programmer for processing and display by the programmer, and is adapted to receive programming commands from the programmer.

3. The device of claim 1, wherein the lead is adapted to position the electrode near an endocardial baroreceptor site within the heart.

4. The device of claim 3, wherein the electrode is positioned in a chamber selected from the set of:

an atrial chamber and a ventricle chamber.

5. The device of claim 1, wherein the pulse generator is further adapted to generate a cardiac pacing signal, the lead further including a second electrode to be positioned to deliver the cardiac pacing signal to capture the heart.

6. An implantable baroreflex stimulator, comprising:

means for delivering baroreflex therapy through a lead intravascularly fed through at least a portion of the heart to a baroreceptor region proximate to a heart to inhibit sympathetic activity; and

means for providing feedback regarding an efficacy of the baroreflex therapy for use to control delivery of the baroreflex therapy.

7. The stimulator of claim 6, wherein the means for delivering baroreflex therapy includes means for delivering the baroreflex therapy to endocardial baroreceptor tissues.

8. The stimulator of claim 6, further comprising means for determining an appropriate time to deliver the stimulation signal.

9. The stimulator of claim 6, further comprising means for communicating with a programmer for data display and patient management.

10. The stimulator of claim 6, wherein the means for providing feedback includes means for sensing systemic blood pressure.

11. The stimulator of claim 6, wherein the means for providing feedback includes means for sensing respiration.

12. The stimulator of claim 6, further comprising means for pacing the heart.

13. A method, comprising:

applying baroreflex therapy, including electrically stimulating a baroreceptor region in or near a heart using a lead intravascularly fed into at least a portion of the heart;

sensing a physiologic parameter indicative of an efficacy of the baroreflex therapy; and

modifying the baroreflex therapy based on the physiological parameter.

14. The method of claim 13, wherein sensing a physiologic parameter includes sensing blood pressure.

15. The method of claim 13, wherein sensing a physiologic parameter includes sensing respiration.

16. The method of claim 13, wherein electrically stimulating a baroreceptor region in or near a heart includes electrically stimulating a baroreceptor region in chamber selected from the set of:

an atrial chamber and a ventricle chamber.

17. The method of claim 13, wherein the lead emerges from an implantable device, the method further comprising pacing the heart using the lead.

18. The method of claim 13, wherein modifying the baroreflex therapy includes modulating a characteristic of the stimulation signal selected from the set of:

an amplitude, a frequency, a burst frequency and a morphology of a stimulation signal.

19. An implantable medical device, comprising:

a pulse generator to generate a baroreflex stimulation signal as part of a baroreflex therapy;

a lead to be electrically connected to the pulse generator, the lead including an electrode to deliver the baroreflex signal to a baroreflex target;

a sensor to sense a physiological parameter regarding an efficacy of the baroreflex therapy and to provide a signal indicative of the efficacy of the baroreflex therapy; and

a controller connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy.

20. A method, comprising:

applying baroreflex therapy, including electrically stimulating a baroreceptor region using a lead with an electrode;

sensing a physiologic parameter indicative of an efficacy of the baroreflex therapy; and

modifying the baroreflex therapy based on the physiological parameter.

21. An implantable medical device, comprising:

a pulse generator to generate a baroreceptor stimulation signal as part of a baroreflex therapy;

a lead to be electrically connected to the pulse generator and to be intravascularly fed into a heart, the lead including an electrode to be positioned in or proximate to the heart to deliver the baroreceptor signal to a baroreceptor region in or proximate to the heart;

a sensor to sense a physiological parameter regarding the need to modify the baroreflex system and to provide a signal indicative of the need to modify the baroreflex system; and

a controller connected to the pulse generator to control the baroreceptor stimulation signal and to the sensor to receive the signal indicative of the need to modify the baroreflex system.

22. An implantable baroreflex stimulator, comprising:

means for delivering baroreflex therapy through a lead intravascularly fed through at least a portion of the heart to a baroreceptor region proximate to a heart to inhibit sympathetic activity; and

means for providing feedback regarding an efficacy of the baroreflex therapy for use to control delivery of the baroreflex therapy.

23. A method, comprising:

applying baroreflex therapy, including electrically stimulating a baroreceptor region in or near a heart using a lead intravascularly fed into at least a portion of the heart;

sensing a physiologic parameter indicative of the need to modify the baroreflex system; and

modifying the baroreflex therapy based on the physiological parameter.

24. An implantable medical device, comprising:

a pulse generator to generate a baroreceptor stimulation signal as part of a baroreflex therapy;

a lead adapted to be electrically connected to the pulse generator, the lead including an electrode to deliver the baroreceptor signal to a baroreceptor neural target;

a sensor to sense a physiological parameter and to provide a signal indicative of the need to modify the baroreflex system; and

a controller connected to the pulse generator to control the baroreceptor stimulation signal and to the sensor to receive the signal indicative of the need to modify the baroreflex system.