SYNCHRONIZATION OF VAGUS NERVE STIMULATION WITH THE CARDIAC CYCLE OF A PATIENT

• US 20070233194A1
• Filed: 03/29/2007
• Published: 10/04/2007
• Est. Priority Date: 03/29/2006
• Status: Active Grant

• Current Assignee: Catholic Healthcare West (CommonSpirit Health (Illinois))
• Original Assignee: Catholic Healthcare West (CommonSpirit Health (Illinois))
• Inventors: Craig, Arthur D.
• Granted Patent: US 8,219,188 B2
• Time in Patent Office: Days
• US Class Current: 607/2
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/353 Detecting P-waves
• CPC Class Codes: A61B 5/355 Detecting T-waves
• CPC Class Codes: A61B 5/369 Electroencephalography [EEG] devices for psychotechnics A61B5/16
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/3605 Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36064 Epilepsy
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• 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 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36178 Burst or pulse train parameters

Abstract

Disclosed herein are methods, systems, and apparatus for treating a medical condition of a patient, involving detecting a physiological cycle or cycles of the patient and applying an electrical signal to a portion of the patient'"'"'s vagus nerve through an electrode at a selected point in the physiological cycle(s). The physiological cycle can be the cardiac and/or respiratory cycle. The selected point can be a point in the cardiac cycle correlated with increased afferent conduction on the vagus nerve, such as a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG, optionally during inspiration by the patient. The selected point can be a point in the cardiac cycle when said applying increases heart rate variability, such as a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG, optionally during expiration by the patient.

Claims

1. A method of treating a medical condition of a patient using a medical device, comprising:

detecting at least a portion of a physiological cycle of said patient selected from the cardiac cycle of the patient and the respiratory cycle of the patient, and

applying a first electrical signal to a portion of a vagus nerve of said patient through an electrode at a selected point in the physiological cycle, to treat the medical condition.

2. The method of claim 1, further comprising providing a programmable electrical signal generator coupled to an electrode, and wherein the applying the electrical signal to the vagus nerve comprises generating an electrical signal with the electrical signal generator and applying the electrical signal to the electrode.

3. The method of claim 2, further comprising programming the electrical signal generator to define the electrical signal by at least one parameter selected from the group consisting of a burst duration, a number of pulses per burst, an interpulse interval, an interburst period, a current magnitude, a pulse frequency, a signal width, an on-time, and an off-time, wherein the parameter is selected to treat the medical condition.

4. The method of claim 1, wherein the applying the electrical signal to the vagus nerve is performed at a point in the physiological cycle correlated with increased afferent conduction on the vagus nerve.

5. The method of claim 4, wherein the applying the electrical signal to the vagus nerve is performed beginning at a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG.

6. The method of claim 5, wherein the applying the electrical signal to the vagus nerve is performed during inspiration by the patient.

7. The method of claim 5, wherein the applying the electrical signal to the vagus nerve is performed during expiration by the patient.

8. The method of claim 1, wherein the applying the electrical signal to the vagus nerve is performed at a point in the physiological cycle when said applying increases heart rate variability

9. The method of claim 1, further comprising applying a second electrical signal to a portion of said vagus nerve of said patient through said electrode without reference to the patient'"'"'s physiological cycle.

10. The method of claim 9, wherein said second electrical signal is different from said first electrical signal in at least one parameter selected from the group consisting of a burst duration, a number of pulses per burst, an interpulse interval, an interburst period, a current magnitude, a pulse frequency, a signal width, an on-time, and an off-time.

11. A method of treating a medical condition of a patient, comprising:

coupling at least one electrode to at least one vagus nerve of the patient,

providing a programmable electrical signal generator coupled to the electrode,

detecting at least a portion of a physiological cycle of said patient selected from the cardiac cycle of the patient and the respiratory cycle of the patient,

generating an electrical signal with the electrical signal generator, and

applying the electrical signal to the electrode to treat the medical condition,

wherein the applying the electrical signal is performed at a selected point in the physiological cycle, to treat the medical condition.

12. A computer readable program storage device encoded with instructions that, when executed by a computer, perform a method, comprising:

generating an electrical signal,

detecting at least a portion of a physiological cycle of said patient selected from the cardiac cycle of the patient and the respiratory cycle of the patient, and

applying the electrical signal to an electrode coupled to at least one vagus nerve of a patient,

wherein the applying the electrical signal is performed at a selected point in the physiological cycle.

13. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 12, wherein the electrical signal is a controlled current electrical signal.

14. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 12, wherein the method further comprises programming an electrical signal generator to define the electrical signal by at least one parameter selected from the group consisting of a burst duration, a number of pulses per burst, an interpulse interval, an interburst period, a current magnitude, a pulse frequency, a signal width, an on-time, and an off-time, wherein the parameter is selected to treat a medical condition.

15. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 12, wherein the applying the electrical signal to the vagus nerve is performed at a point in the physiological cycle correlated with increased afferent conduction on the vagus nerve.

16. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 15, wherein the applying the electrical signal to the vagus nerve is performed beginning at a point from about 10 msec to about 800 msec after an R-wave of the patient'"'"'s ECG.

17. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 16, wherein the applying the electrical signal to the vagus nerve is performed during inspiration by the patient.

18. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 16, wherein the applying the electrical signal to the vagus nerve is performed during expiration by the patient.

19. The computer readable program storage device encoded with instructions that, when executed by a computer, perform the method of claim 12, wherein the applying the electrical signal to the vagus nerve is performed at a point in the physiological cycle when said applying increases heart rate variability.

20. A medical condition treatment system, comprising:

at least one electrode coupled to at least one vagus nerve of a patient,

an implantable device operatively coupled to the electrode and comprising an electrical signal generator capable of applying an electrical signal to the vagus nerve at a selected point in a physiological cycle of the patient selected from the cardiac cycle of the patient and the respiratory cycle of the patient using the electrode to treat the medical condition, and

a device operatively coupled to the electrode and capable of detecting said selected point is the patient'"'"'s physiological cycle.

21. The medical condition treatment system of claim 20, wherein the electrode is coupled to at least one vagus nerve selected from the group consisting of the left vagus nerve and the right vagus nerve.

22. The medical condition treatment system of claim 20, wherein the electrical signal generator is a programmable electrical signal generator.

23. The medical condition treatment system of claim 22, wherein the electrical signal generator is capable of defining the electrical signal by at least one parameter selected from the group consisting of an interburst period, a number of pulses per burst, an interpulse interval, a burst duration, a current magnitude, a pulse frequency, a signal width, an on-time, and an off-time, wherein the parameter is selected to treat the medical condition.