NEUROSTIMULATION SYSTEMS AND METHODS FOR CARDIAC CONDITIONS

• US 20080015659A1
• Filed: 09/25/2007
• Published: 01/17/2008
• Est. Priority Date: 12/24/2003
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: McCabe, Aaron, Zhang, Yi, Libbus, Imad, Brockway, Marina, Caparso, Anthony, Meyer, Scott
• Application Number:
  US11/860,936
• Publication Number:
  US 20080015659A1
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Various embodiments provide an implantable medical device comprising a detector, a neural stimulator, and a controller. The detector is configured to detect a pathological condition indicated for an acute neural stimulation therapy. The neural stimulator is capable of delivering a chronic neural stimulation therapy and the acute neural stimulation therapy. The controller is configured to control the neural stimulator to provide the chronic neural stimulation therapy, receive an indicator from the detector that the pathological condition is detected, and control the neural stimulator to integrate the acute neural stimulation therapy with the chronic neural stimulation therapy in response to the indicator.

Claims

1. An implantable medical device, comprising:

a detector configured to detect a pathological condition indicated for an acute neural stimulation therapy;

a neural stimulator capable of delivering a chronic neural stimulation therapy and the acute neural stimulation therapy; and

a controller configured to control the neural stimulator to provide the chronic neural stimulation therapy, receive an indicator from the detector that the pathological condition is detected, and control the neural stimulator to integrate the acute neural stimulation therapy with the chronic neural stimulation therapy in response to the indicator.

2. The device of claim 1, wherein the detector is configured to detect:

ischemia;

an acute myocardial infarction;

an arrhythmia;

a cardiogenic shock;

or

an onset of heart failure decompensation.

3. The device of claim 1, wherein the chronic neural stimulation therapy includes a heart failure remodeling therapy.

4. The device of claim 1, wherein the chronic neural stimulation therapy includes a post-myocardial infarction therapy.

5. The device of claim 1, wherein the chronic neural stimulation therapy includes an anti-hypertension therapy.

6. An implantable medical device, comprising:

means for performing a first neural stimulation therapy to treat a first pathological condition;

means for detecting a second pathological condition, wherein the second pathological condition is a cardiac condition indicated for a second neural stimulation therapy; and

means for integrating the first neural stimulation therapy and the second neural stimulation therapy into an integrated neural stimulation therapy for the first and second pathological conditions in response to detecting the second pathological condition.

7. The device of claim 6, wherein the second pathological condition includes an arrhythmia, an acute ischemic event, or an acute myocardial infarction.

8. The device of claim 7, wherein the first pathological condition includes hypertension or ventricular remodeling.

9. The device of claim 6, further comprising means for delivering a cardiac rhythm management therapy.

10. A method, comprising:

performing a first neural stimulation therapy to treat a first pathological condition;

detecting a second pathological condition, wherein the second pathological condition is a cardiac condition indicated for a second neural stimulation therapy; and

in response to detecting the second pathological condition, integrating the first neural stimulation therapy and the second neural stimulation therapy into an integrated neural stimulation therapy for the first and second pathological conditions.

11. The method of claim 10, wherein performing the first neural stimulation therapy includes chronically performing the first neural stimulation therapy.

12. The method of claim 11, wherein:

the first pathological condition is hypertension; and

the first neural stimulation therapy includes an anti-hypertension neural stimulation therapy.

13. The method of claim 11, wherein:

the first pathological condition is ventricular remodeling; and

the first neural stimulation therapy includes an anti-remodeling therapy to abate progression of ventricular remodeling.

14. The method of claim 10, wherein detecting the second pathological condition includes detecting an arrhythmia, detecting an acute ischemic event, or detecting an acute myocardial infarction.

15. The method of claim 10, wherein:

the first neural stimulation therapy is an intermittent neural stimulation therapy having neural stimulation times separated by times without neural stimulation; and

integrating the first neural stimulation therapy and the second neural stimulation therapy into an integrated neural stimulation therapy for the first and second pathological conditions includes timing neural stimulation delivered as part of the second neural stimulation therapy to occur between the neural stimulation times of the intermittent neural stimulation therapy.

16. The method of claim 10, wherein integrating the first neural stimulation therapy and the second neural stimulation therapy into an integrated neural stimulation therapy for the first and second pathological conditions includes withdrawing the first neural stimulation therapy until therapy of the second pathological condition is completed.

17. The method of claim 10, wherein integrating the first neural stimulation therapy and the second neural stimulation therapy into an integrated neural stimulation therapy for the first and second pathological conditions includes increasing or decreasing an intensity of the first neural stimulation therapy until therapy of the second pathological condition is completed.

18. The method of claim 10, wherein detecting a second pathological condition including detecting a severity of the second pathological condition, and integrating includes integrating the first neural stimulation therapy and the second neural stimulation therapy based on the severity of the second pathological condition.

19. A method, comprising:

performing a vagal stimulation therapy to treat a chronic pathological condition;

detecting ischemia; and

adjusting the vagal stimulation therapy for the chronic pathological condition in response to detecting the ischemia.

20. The method of claim 19, wherein the vagal stimulation therapy to treat the chronic pathological condition includes a therapy to treat hypertension or a post-myocardial infarction therapy.

21. The method of claim 19, wherein ischemia is a pathological cardiac condition, the method further comprising detecting at least a second pathological condition, wherein adjusting the vagal stimulation therapy includes adjusting the vagal stimulation therapy for the second pathological cardiac condition.

22. The method of claim 21, wherein detecting at least a second pathological condition includes detecting the second pathological condition and a third pathological conduction, wherein adjusting the vagal stimulation therapy includes adjusting the vagal stimulation therapy for the combination of the ischemia, the second pathological condition, and the third pathological condition.

23. The method of claim 19, further comprising detecting an arrhythmia, wherein adjusting the vagal stimulation therapy includes withdrawing the vagal stimulation therapy in response to detecting the arrhythmia.

24. The method of claim 19, further comprising detecting an acute myocardial infarction, wherein adjusting the vagal stimulation therapy includes responding to the detected myocardial infarction with stimulation of the vagus nerve.