RENAL NERVE STIMULATION METHODS FOR TREATMENT OF PATIENTS

• US 20090036948A1
• Filed: 08/06/2008
• Published: 02/05/2009
• Est. Priority Date: 04/08/2002
• Status: Abandoned Application

• Current Assignee: Ardian, Inc. (Medtronic Plc)
• Original Assignee: Ardian, Inc. (Medtronic Plc)
• Inventors: Levin, Howard R., Gelfand, Mark
• Application Number:
  US12/186,975
• Publication Number:
  US 20090036948A1
• Time in Patent Office: Days
• US Class Current: 607/44
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61M 1/3627 Degassing devices; Buffer reservoirs; Drip chambers; Blood filters
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00

Abstract

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Claims

1-43. -43. (canceled)

44. A method of treating a patient, the method comprising:

providing instructions to a practitioner for treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, wherein the instructions include informing a practitioner to—

position an energy delivery element proximate to a renal nerve of the patient; and

deliver an energy field via the energy delivery element to modulate neural function of the renal nerve.

45. A method of treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, the method comprising:

providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber that innervates a kidney of the patient; and

providing instructions to the treatment provider to deliver energy to the neural fiber via the modulation instrument in order to modulate a function of the neural fiber and reduce sympathetic neural activity in the patient.

46. The method of claim 45 wherein providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber further comprises providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber.

47. The method of claim 46 wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to introduce the modulation instrument into the patient via the patient'"'"'s femoral artery.

48. The method of claim 46 wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to introduce a catheter into the patient.

49. The method of claim 46 wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument within a renal blood vessel of the patient.

50. The method of claim 49 wherein providing instructions to the treatment provider to position the modulation instrument within a renal blood vessel of the patient further comprises providing instructions to the treatment provider to position the modulation instrument within a renal artery of the patient.

51. The method of claim 50 wherein providing instructions to the treatment provider to position the modulation instrument within a renal artery of the patient further comprises providing instructions to the treatment provider to position the modulation instrument in contact with a wall of the renal artery.

52. The method of claim 51 wherein providing instructions to the treatment provider to position the modulation instrument in contact with a wall of the renal artery further comprises providing instructions to the treatment provider to position an electrode in contact with a wall of the renal artery.

53. The method of claim 45 wherein providing instructions to the treatment provider to deliver energy further comprises providing instructions to the treatment provider to deliver energy to the neural fiber via the modulation instrument to ablate the neural fiber and reduce sympathetic neural activity in the patient.

54. The method of claim 45 wherein providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument proximate the post-ganglionic neural fiber at an extravascular site.

55. The method of claim 45 wherein:

providing instructions to a treatment provider to position a modulation instrument further comprises providing instructions to a treatment provider to position the modulation instrument proximate to a first post-ganglionic neural fiber that innervates a first kidney of the patient and proximate to a second post-ganglionic neural fiber that innervates a second kidney of the patient; and

providing instructions to the treatment provider to deliver energy further comprises providing instructions to the treatment provider to deliver energy to the first neural fiber and the second neural fiber via the modulation instrument to modulate the functions of the first neural fiber and second neural fiber, respectively, and reduce sympathetic neural activity in the patient.

56. A method of treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, the method comprising:

providing instructions to a treatment provider to position a modulation instrument proximate to a post-ganglionic neural fiber that innervates a kidney of the patient; and

providing instructions to the treatment provider to modulate a function of the neural fiber via the modulation instrument and reduce sympathetic neural activity in the patient.

57. The method of claim 56 wherein providing instructions to a treatment provider to position a modulation instrument further comprises providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber.

58. The method of claim 57 wherein providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to implant an electrode proximate to the post-ganglionic neural fiber.

59. The method of claim 57 wherein providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to implant a drug delivery device proximate the post-ganglionic neural fiber.

60. The method of claim 56 wherein providing instructions to a treatment provider to position a modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument proximate the post-ganglionic neural fiber at an extravascular site.

61. A method of treating a patient, the method comprising:

providing instructions to a medical care provider for positioning an electrode proximate to post-ganglionic neural fibers that innervate a kidney of a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure; and

providing instructions to the medical care provider for generating an electric field via the electrode such that at least a portion of the neural fibers are in the electric field, wherein the electric field alters neural function of the neural fibers.