NEUROSTIMULATION AND CORONARY ARTERY DISEASE TREATMENT

• US 20080021503A1
• Filed: 07/18/2007
• Published: 01/24/2008
• Est. Priority Date: 08/03/2001
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: McClure, Kelly, McGivern, James, Whitehurst, Todd, Thacker, James
• Granted Patent: US 8,934,968 B2
• Time in Patent Office: Days
• US Class Current: 607/3
• CPC Class Codes: A61M 2205/054 with electrotherapy
• CPC Class Codes: A61M 2205/3523 using telemetric means
• CPC Class Codes: A61M 2205/8206 battery-operated
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A method for treating a patient may include treating coronary artery disease in combination with angina pectoris and/or the control of angina pain by delivering chemical and/or electrical stimulation pulses to the cardiac and/or nervous tissue of the patient in a coordinated manner. A system for treating a patient suffering from coronary artery disease and angina may include a stimulator that generates at least one pulse in accordance with prescribed parameters, a catheter, a lead, and/or a sensor.

Claims

1. A method for treating coronary artery disease, comprising:

providing a stimulator that generates a pulse in accordance with prescribed parameters;

providing a catheter connected to the stimulator, which catheter includes a discharge portion;

implanting the catheter discharge portion near at least one cardiac tissue to be stimulated;

delivering via the stimulator and catheter infusion pulses of at least one drug as at least one treatment for coronary artery disease to the at least one cardiac tissue;

providing a lead connected to the stimulator, which lead includes an electrode;

implanting the electrode near at least one nervous tissue to be stimulated; and

delivering via the stlilulator and lead electrical stimulation pulses as at least one treatment for angina to the at least one nervous tissue.

2. The method of claim 1 wherein delivering via the stimulator and lead electrical stimulation pulses as at least one treatment for angina to the at least one nervous tissue occurs immediately prior to and after delivering via the stimulator and catheter infusion pulses of at least one drug as at least one treatment for coronary artery disease to the at least one cardiac tissue.

3. The method of claim 1 wherein delivering via the stimulator and lead electrical stimulation pulses as at least one treatment for angina to the at least one nervous tissue occurs simultaneous with delivering via the stimulator and catheter infusion pulses of at least one drug as at least one treatment for coronary artery disease to the at least one cardiac tissue.

4. The method of claim 1 wherein delivering via the stimulator and lead electrical stimulation pulses as at least one treatment for angina to the at least one nervous tissue occurs on demand and at least once every eight hours.

7. The method of claim 1 further comprising sensing an increase in blood circulation of the cardiac tissue, wherein delivering via the stimulator and catheter infusion pulses of at least one drug as at least one treatment for coronary artery disease to the at least one cardiac tissue occurs in response to the sensed increase in blood circulation.

8. The method of claim 1 further comprising sensing an increase in electrocardiograph, wherein delivering via the stimulator and lead electrical stimulation pulses as at least one treatment for angina to the at least one nervous tissue occurs in response to the sensed increase in electrocardiograph.

9. The method of claim 1 wherein the at least one cardiac tissue comprises at least one of a coronary artery, a branch of a coronary artery, a coronary vein, a branch of a coronary vein, the aorta, a pulmonary vein, the coronary sinus, the inferior vena cava, the sino-atrial (SA) node, and the atrio-ventricular (AV) node.

10. The method of claim 1 wherein the at least one nervous tissue comprises at least one of an afferent nerve fiber;

a sympathetic nerve fiber;

tissue at the spinal levels of T1, T2, T3, or T4;

the white ramus communicans;

the first, second, third, or fourth thoracic sympathetic ganglia;

the thoracic sympathetic trunk;

the cervical sympathetic trunk;

a thoracic sympathetic cardiac nerve;

a parasympathetic nerve fiber;

the vagus nerve;

the superior cervical (vagal) cardiac nerve;

the inferior cervical (vagal) cardiac nerve;

the cervical spinal cord; and

the thoracic cardiac branch of the vagus nerve.

11. The method of claim 1 wherein the drug comprises at least one of nitroglycerin, magnesium sulfate, adenosine, Atrial Natriuretic Peptide (ANP), Brain Natriuretic Peptide (BNP), isosorbide dinitrate, isosorbide mononitrate, amyl nitrite, nitric oxide, a nitric oxide donor, a calcium-channel blocker, a beta-blocker, a cholesterol-lowering agent, an anti-thrombotic agent, a kinin, prostacyclin, hypothalamic inhibitory factor (HIF), a medication used to promote angiogenesis, a gene that encodes a protein or other gene product that leads to angiogenesis, an AGE Crosslink Breaker, a gene that encodes a protein or other gene product that leads to removal of AGE Crosslinks, VEGF, phVEGF, FGF, and ALT-711.

5. The method of claim I further comprising delivering via the stimulator and lead electrical stimulation pulses to increase the blood circulation of the cardiac tissue.

6. The method of claim 5 wherein delivering via the stimulator and catheter infusion pulses of at least one drug as at least one treatment for coronary artery disease to the at least one cardiac tissue occurs during the increase of blood circulation of the cardiac tissue.

12. A method for simultaneously treating coronary artery disease and angina, comprising:

implanting a fully implantable stimulator system for generating stimulating pulses;

administering via the stimulator system stimulating pulses of at least one drug; and

administering via the stimulator system electrical stimulating pulses in concert with administering via the stimulator system stimulating pulses of at least one drug.

13. The method of claim 12 wherein administering via the stimulator system electrical stimulating pulses includes stimulating tissue to increase effectiveness of administration of the at least one drug.

14. The method of claim 12 wherein administering via the stimulator system electrical stimulating pulses occurs simultaneous with administering via the stimulator system stimulating pulses of at least one drug.

15. A system for treating coronary artery disease, comprising:

a stimulator that generates at least one pulse in accordance with prescribed parameters;

a power source housed within the stimulator for providing operating power to the stimulator;

a catheter connected to the stimulator, which catheter includes a discharge portion;

a lead connected to the stimulator, which lead includes an electrode; and

a sensor in communication with the stimulator, wherein the sensor is configured to measure a change in blood circulation.

16. The system of claim 15 wherein the sensor includes an oxygen sensor.

17. The system of claim 15 wherein the sensor includes an electrocardiograph sensor.

18. The system of claim 17 wherein the sensor is further configured to measure a physiological condition associated with angina.

19. The system of claim 15 wherein the pulse includes an infusion pulse and an electrical stimulation pulse, and wherein the stimulator is configured to coordinate delivery of the infusion pulse with delivery of the electrical stimulation pulse.

20. The system of claim 19 wherein the prescribed parameters are adjusted based on the change in blood circulation.