Vagus nerve stimulation via unidirectional propagation of action potentials

• US 20080065183A1
• Filed: 11/06/2007
• Published: 03/13/2008
• Est. Priority Date: 06/20/2002
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Advanced Bionics Corporation (Sonova Holding AG)
• Inventors: He, Tom, Haller, Matthew, McGivern, James, Carbunaru, Rafael, Bradley, Kerry, Whitehurst, Todd
• Granted Patent: US 7,783,362 B2
• Time in Patent Office: Days
• US Class Current: 607/116
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: Y10S 128/903 Radio telemetry

Abstract

Methods of using unidirectionally propagating action potentials (UPAPs) for vagus nerve stimulation and for certain disorders are provided. Stimulators capable of creating such UPAPs include, but are not limited to, miniature implantable stimulators (i.e., microstimulators), possibly with programmably configurable electrodes.

Claims

1-31. -31. (canceled)

32. A method of treating tachycardia by stimulating a vagus nerve, the method comprising:

implanting an implantable stimulator comprising at least two electrodes, wherein the electrodes are disposed and configured for application of stimulation that generates unidirectionally propagating action potentials along a vagus nerve; and

applying the stimulation to generate unidirectionally propagating action potentials in efferent fibers of the vagus nerve, thereby treating tachycardia while limiting side effects of bidirectional stimulation.

33. The method of claim 32 wherein implanting the implantable stimulator comprises implanting an implantable microstimulator through a cannula of a surgical insertion tool.

34. The method of claim 32 further comprising applying the stimulation at less than about 50-100 Hz.

35. The method of claim 32 further comprising applying the stimulation with a stimulation pulse with at least one of a plateau pulsewidth of about 10 μ

sec to about 5 msec and a decaying trailing phase with a fall time of about 50 μ

sec to about 5 msec and a charge recovery pulse with at least one of a plateau pulsewidth of about 50 μ

sec to about 10 msec and a decaying trailing phase with a fall time of about 50 μ

sec to about 5 msec.

36. The method of claim 32 wherein at least one of the electrodes comprises a virtual electrode.

37. The method of claim 32 wherein the stimulator comprises at least three electrodes.

38. The method of claim 32 further comprising:

sensing a physical condition of a patient; and

changing a parameter of the stimulation based on the sensed physical condition.

39. The method of claim 38 wherein the sensed physical condition comprises at least one of an electrical activity of the heart, a rate of the heart, a blood pressure, a blood flow, a cardiac output, an acceleration, a breathing, and an action potential propagating along the vagus nerve.

40. The method of claim 38 wherein changing the parameter comprises changing a strength of the stimulation based on the sensed physical condition.

41. The method of claim 32, wherein implanting the implantable stimulator comprises implanting the implantable stimulator comprising a leaded electrode, wherein the lead is less than 150 mm in length.

42. The method of claim 32, wherein:

implanting the implantable stimulator comprises implanting the implantable stimulator comprising a leadless electrode; and

applying the stimulation comprises applying the stimulation using the leadless electrode to generate the unidirectionally propagating action potentials.

43. The method of claim 32, wherein the implantable stimulator comprises a nerve cuff comprising a collection of electrodes distributed within the cuff to circumscribe a nerve received in the cuff, wherein the electrodes are individually programmable to position an electric field in the cuff.

44. The method of claim 32, further comprising:

sensing that a response to the applied stimulation has changed; and

changing stimulation parameters to redirect the applied stimulation.

45. The method of claim 44, wherein redirecting the applied stimulation comprises changing a current applied by one of a collection of partitioned electrodes.

46. A method of treating tachycardia by stimulating a vagus nerve, the method comprising:

sensing that a response to electrical stimulation applied by an implanted stimulator to generate unidirectionally propagating action potentials in efferent fibers of the vagus nerve has changed;

changing stimulation parameters to redirect the electrical stimulation while the implanted stimulator remains implanted; and

sensing that unidirectionally propagating action potentials are appropriately generated in the efferent fibers of the vagus nerve.

47. The method of claim 46, further comprising implanting the implantable stimulator through a cannula of a surgical insertion tool.

48. The method of claim 46, wherein changing the stimulation parameters comprises individually programming a current provided by a first electrode of a collection of electrodes distributed within a nerve cuff to circumscribe a nerve received in the cuff and thereby direct an electric field in the cuff.

49. The method of claim 46, wherein changing the stimulation parameters comprises individually programming a current provided by a first electrode of a collection of electrodes distributed around a short axis of an elongate casing, wherein the casing houses circuitry for changing the stimulation parameters.

50. The method of claim 46, wherein sensing that the response has changed comprises sensing that an electrical activity of the heart has changed.

51. The method of claim 46, further comprising inhibiting a propagation of an action potential by applying a high frequency stimulation to the vagus nerve.