NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS

• US 20080147140A1
• Filed: 12/13/2006
• Published: 06/19/2008
• Est. Priority Date: 12/13/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E., Kramer, Andrew P., Libbus, Imad, Ternes, David
• Granted Patent: US 8,706,212 B2
• Time in Patent Office: Days
• US Class Current: 607/48
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36078 Inducing or controlling sleep or relaxation non-implantable stimulator A61M21/00
• 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 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: A61N 1/39624 Pain reduction therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Various system embodiments comprise circuitry to determine when an arrhythmia has terminated, and a neural stimulator adapted to temporarily deliver a neural stimulation therapy to assist with recovering from the arrhythmia in response to termination of the arrhythmia.

Claims

1. A system, comprising:

circuitry to determine when an arrhythmia has terminated; and

a neural stimulator adapted to temporarily deliver a neural stimulation therapy to assist with recovering from the arrhythmia in response to termination of the arrhythmia.

2. The system of claim 1, further comprising:

circuitry to detect an arrhythmia; and

a pulse generator to deliver an arrhythmia therapy to terminate the arrhythmia.

3. The system of claim 2, wherein the pulse generator is adapted to deliver an anti-arrhythmia shock or anti-arrhythmia pacing.

4. The system of claim 1, wherein the neural stimulator is adapted to chronically deliver a neural stimulation signal as part of a chronic therapy and temporarily deliver the neural stimulation therapy to assist with recovering from the arrhythmia.

5. The system of claim 4, wherein temporarily delivering the neural stimulation therapy to assist with recovering from the arrhythmia includes withdrawing the neural stimulation signal delivered as part of the chronic therapy.

6. The system of claim 1, further comprising an arrhythmia detector adapted to provide a signal indicative that an arrhythmia is detected, the neural stimulator being adapted to deliver a pretherapy neural stimulation signal in preparation for an arrhythmia therapy in response to the signal indicative that the arrhythmia is detected.

7. The system of claim 6, wherein the arrhythmia therapy includes an anti-arrhythmia shock therapy, and the pretherapy neural stimulation signal includes a neural stimulation therapy to reduce pain associated with the antiarrhythmia shock therapy.

8. The system of claim 6, wherein the arrhythmia therapy includes an anti-arrhythmia shock therapy, and the pre-therapy neural stimulation signal includes a neural stimulation therapy to lower a defibrillation threshold.

9. The system of claim 6, wherein the arrhythmia therapy includes an antitachycardia pacing, and the pretherapy neural stimulation signal includes a neural stimulation therapy to modify the arrhythmia in preparation for antitachycardia pacing.

10. The system of claim 1, wherein circuitry to determine when the arrhythmia has terminated includes circuitry to sense a delivered anti-arrhythmia shock.

11. The system of claim 1, wherein circuitry to determine when the arrhythmia has terminated includes communication circuitry adapted to receive a communication signal indicating that the arrhythmia has been terminated.

12. The system of claim 1, wherein circuitry to determine when the arrhythmia has terminated includes circuitry to sense arrhythmic episodes.

13. A method, comprising:

determining that an arrhythmia has terminated; and

upon termination of the arrhythmia, temporarily delivering a neural stimulation therapy to assist with recovering from the arrhythmia.

14. The method of claim 13, further comprising chronically performing a prophylactic neural stimulation therapy before the neural stimulation therapy to assist with recovering from the arrhythmia, or after the neural stimulation therapy to assist with recovering from the arrhythmia, or before and after the neural stimulation therapy to assist with recovering from the arrhythmia.

15. The method of claim 13, wherein temporarily delivering a neural stimulation therapy to assist with recovering from the arrhythmia includes delivering at least a two stage neural stimulation therapy upon termination of the arrhythmia.

16. The method of claim 15, wherein delivering at least the two stage neural stimulation therapy includes withdrawing neural stimulation after arrhythmia termination, and then delivering the neural stimulation therapy to assist with recovering from the arrhythmia.

17. The method of claim 13, further comprising delivering pretherapy neural stimulation in preparation for the arrhythmia.

18. The method of claim 13, further comprising:

chronically performing a prophylactic neural stimulation therapy;

detecting an arrhythmia;

upon detecting the arrhythmia, delivering pretherapy neural stimulation in preparation for an arrhythmia therapy;

delivering the arrhythmia therapy;

upon arrhythmia termination, temporarily delivering the neural stimulation therapy to assist with recovering from the arrhythmia; and

chronically performing the prophylactic neural stimulation therapy after temporarily delivering the neural stimulation therapy to assist with recovering from the arrhythmia.

19. The method of claim 18, wherein delivering pretherapy neural stimulation includes delivering neural stimulation in anticipation of pain associated with the arrhythmia therapy or to lower a defibrillation threshold when the arrhythmia therapy includes an antitachycardia shock, or includes delivering neural stimulation to make an arrhythmia more amenable to an antitachycardia pacing (ATP) therapy.

20. A method, comprising:

chronically performing a prophylactic neural stimulation therapy;

in response to a therapy trigger, temporarily delivering neural stimulation as part of an arrhythmia therapy, an apnea therapy, or a pain therapy; and

upon completion of the arrhythmia therapy, the apnea therapy or the pain therapy, chronically performing the prophylactic neural stimulation therapy.

21. The method of claim 20, wherein the prophylactic neural stimulation therapy includes neural stimulation to discourage cardiac remodeling or ventricular tachyarrhythmias.

22. The method of claim 20, further comprising delivering pre-therapy neural stimulation, wherein the pre-therapy neural stimulation is distinct from the prophylactic neural stimulation therapy.

23. The method of claim 20, further comprising delivering post-therapy neural stimulation, wherein the post-therapy neural stimulation is distinct from the prophylactic neural stimulation therapy.

24. A method, comprising:

in response to a therapy trigger, delivering a pretherapy neural stimulation in preparation for delivering a therapy;

delivering the therapy; and

upon completion of delivering of the therapy, delivering a post-therapy neural stimulation to assist with recovering from the therapy.

25. The method of claim 24, wherein delivering a post-therapy neural stimulation to assist with recovering from the therapy includes delivering the post-therapy neural stimulation using a first stage of stimulation and then using a second stage of stimulation distinct from the first stage.

26. The method of claim 24, further comprising chronically performing a prophylactic neural stimulation therapy before the therapy trigger and comprising chronically performing a prophylactic neural stimulation therapy after delivering the post-therapy neural stimulation.