DEVICES AND METHODS FOR TREATMENT OF HEART FAILURE AND ASSOCIATED CONDITIONS

• US 20100004714A1
• Filed: 06/16/2009
• Published: 01/07/2010
• Est. Priority Date: 06/16/2008
• Status: Active Grant

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Cates, Adam, Georgakopoulos, Dimitrios, Lovett, Eric Grant
• Granted Patent: US 8,326,430 B2
• Time in Patent Office: Days
• US Class Current: 607/44
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61N 1/36117 for treating hypertension

Abstract

Devices and methods of use identification, treatment, and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes, determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, generating at least one signal representative of a pressure waveform based on the impedance, activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

Claims

1. A method of treating heart failure, comprising:

providing a baroreflex therapy system;

providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes; and

providing a control system coupled to the baroreflex therapy system and the implantable measurement device, the control system programmed to automatically;

determine an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle;

generate at least one signal representative of a pressure waveform based on the impedance;

activate, deactivate or otherwise modulate the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

2. The method of claim 1, wherein the control system is further programmed to automatically:

determine an augmentation index from the at least one signal representative of a pressure waveform;

activate, deactivate or otherwise modulate the baroreflex therapy system based on the augmentation index.

3. The method of claim 1, wherein the control system is further programmed to automatically:

determine arterial compliance from the at least one signal representative of a pressure waveform;

activate, deactivate or otherwise modulate the baroreflex therapy system based on the arterial compliance.

4. The method of claim 1, wherein the control system is further programmed to automatically:

determine a myocardial oxygen consumption from the at least one signal representative of a pressure waveform;

activate, deactivate or otherwise modulate the baroreflex therapy system based on the myocardial oxygen consumption.

5. The method of claim 1, wherein the control system is further programmed to automatically:

determine an augmentation index from the at least one signal representative of a pressure waveform;

activate, deactivate or otherwise modulate the baroreflex therapy system based on the augmentation index.

6. The method of claim 1, wherein the control system is further programmed to automatically:

determine a parameter indicative of left ventricle mass from the at least one signal representative of a pressure waveform;

activate, deactivate or otherwise modulate the baroreflex therapy system based on the parameter indicative of left ventricle mass.

7. A method, comprising:

providing a baroreflex therapy system;

providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes;

providing a control system coupled to the baroreflex therapy system and the implantable measurement device; and

providing instructions recorded on a tangible medium for operating the control system to deliver a therapy to treat heart failure, the instructions comprising;

determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle;

generating at least one signal representative of a pressure waveform based on the impedance;

activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

8. A method, comprising:

implanting a plurality of electrodes proximate an aorta of a patient;

automatically determining an impedance of the aorta with the electrodes over a time period of at least one cardiac cycle;

automatically generating at least one signal representative of a pressure waveform based on the impedance;

automatically generating a pressure-volume loop based at least in part on the at least one signal representative of the pressure waveform.

9. The method of claim 8, further comprising:

providing a baroreflex therapy system;

delivering a therapy with the baroreflex therapy system based at least in part on the pressure-volume loop.

10. The method of claim 9, further comprising:

activating, deactivating or otherwise modulating the baroreflex therapy system based at least in part on the at least one signal representative of the pressure waveform.

11. The method of claim 8, further comprising:

implanting a sensor proximate the aorta configured to measure blood flow;

generating a pressure-volume loop based at least in part on information received from the sensor.

12. A method, comprising:

providing a plurality of electrodes;

providing a baroreflex therapy system; and

providing instructions recorded on a tangible medium, the instructions comprising;

implanting the plurality of electrodes proximate an aorta of a patient;

determining an impedance of the aorta with the electrodes over a time period of at least one cardiac cycle;

generating at least one signal representative of a pressure waveform based on the impedance;

generating a pressure-volume loop based at least in part on the at least one signal representative of the pressure waveform; and

delivering a therapy with the baroreflex therapy system based at least in part on the pressure-volume loop.

13. A method, comprising:

implanting one or more sensors in a patient;

implanting a baroreflex therapy system;

automatically detecting with the one or more sensors an undesirable level of fluid in a pulmonary circulation of the patient; and

automatically delivering therapy with the baroreflex therapy system in response to the detecting an undesirable level of fluid in the pulmonary circulation to reduce the level of fluid in the pulmonary circulation.

14. The method of claim 13, further comprising:

upon detecting with the one or more sensors an acceptable level of fluid in the pulmonary circulation, automatically delivering a second therapy with the baroreflex therapy system to maintain the acceptable level of fluid in the pulmonary circulation.

15. The method of claim 13, wherein automatically delivering the second therapy comprises cessation of therapy.

16. A method, comprising:

providing a baroreflex activation device;

providing one or more sensors; and

providing instructions recorded on a tangible medium, the instructions comprising;

implanting the baroreflex activation device within a patient;

implanting the one or more sensors within the patient;

detecting with the one or more sensors an undesirable level of fluid in a pulmonary circulation of the patient; and

delivering therapy with the baroreflex therapy system in response to the detecting an undesirable level of fluid in the pulmonary circulation to reduce the level of fluid in the pulmonary circulation.

17. A system, comprising:

an implantable baroreflex activation device;

an implantable measurement device configured to be implanted proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes; and

a control system coupled to the baroreflex activation device and the implantable measurement device, the control system programmed to automatically;

determine an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle;

generate at least one signal representative of a pressure waveform based on the impedance;

activate, deactivate or otherwise modulate the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

18. The system of claim 17, wherein the implantable measurement device is integrated with the implantable baroreflex activation device.