Electrode devices for nerve stimulation and cardiac sensing

• US 20100042186A1
• Filed: 08/13/2008
• Published: 02/18/2010
• Est. Priority Date: 08/13/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: BioControl Medical (B.C.M) Ltd.
• Inventors: Schain, Nir, Cohen, Ehud, Ben-David, Tamir, Gross, Yossi, Ayal, Shai
• Granted Patent: US 8,615,294 B2
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

Apparatus is provided for application to a nerve of a subject, the apparatus comprising an electrode device, which comprises a housing, which is configured to be placed at least partially around the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve. The electrode device further comprises one or more first electrode contact surfaces, fixed to the inner surface of the housing, and one or more second electrode contact surfaces, fixed to the outer surface of the housing. Other embodiments are also described.

Claims

1. Apparatus for application to a nerve of a subject, the apparatus comprising an electrode device, which comprises:

a housing, which is configured to be placed at least partially around the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve;

one or more first electrode contact surfaces, fixed to the inner surface of the housing; and

one or more second electrode contact surfaces, fixed to the outer surface of the housing.

2. The apparatus according to claim 1, further comprising a control unit, which comprises:

a driving unit, which is configured to drive the first electrode contact surfaces to apply electrical stimulation to the nerve;

a sensing unit, which is configured to sense an electrical signal, using at least one of the second electrode contact surfaces; and

an analysis unit, which is configured to analyze the signal to identify a parameter of a cardiac cycle of the subject.

3. The apparatus according to claim 2, wherein the nerve is the vagus nerve, and wherein the electrode device is configured to be implanted such that the second electrode contact surfaces are in a vicinity of a blood vessel selected from the group consisting of:

a carotid artery and a jugular vein.

4. Apparatus comprising:

an electrode device, which comprises one or more device first electrode contact surfaces, and which is configured to be placed in a vicinity of a nerve of a subject at a first location neither within nor in contact with a heart of the subject;

at least one second electrode contact surface, which is not directly mechanically coupled to the electrode device, and which is configured to be positioned in a body of the subject at a second location neither within nor in contact with the heart; and

a control unit, which comprises;

a sensing unit, which is configured to sense, using at least one of the device first electrode contact surfaces and the at least one second electrode contact surface, an electrical signal; and

an analysis unit, which is configured to analyze the signal to identify a parameter of a cardiac cycle of the subject.

5. The apparatus according to claim 4, wherein the at least one second electrode contact surface is directly mechanically coupled to the control unit.

6. The apparatus according to claim 4, wherein the control unit comprises a metal can having an outer conductive surface, at least a portion of which serves as the at least one second electrode contact surface.

7. The apparatus according to claim 4, wherein the electrode device comprises a housing, which is configured to be placed at least partially around the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve, and wherein the one or more device first electrode contact surfaces are fixed to the inner surface of the housing.

8. The apparatus according to claim 4, wherein the electrode device comprises a housing, which is configured to be placed at least partially around the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve, and wherein the one or more device first electrode contact surfaces are fixed to the outer surface of the housing.

9. The apparatus according to claim 4, wherein the nerve is the vagus nerve, and wherein the electrode device is configured to be placed in the vicinity of the vagus nerve.

10. The apparatus according to claim 4, wherein the electrode device is configured to be placed at least partially around the nerve.

11. The apparatus according to claim 4, wherein the control unit comprises a driving unit, which is configured to drive at least some of the device first electrode contact surfaces to apply electrical stimulation to the nerve, and configure the stimulation responsively to the parameter of the cardiac cycle.

12. The apparatus according to claim 11,

wherein the device first electrode contact surfaces comprise one or more stimulating device first electrode contact surfaces and one or more sensing stimulating device first electrode contact surfaces,

wherein the driving unit is configured to drive the stimulating device first electrode contact surfaces, and not the sensing stimulating device first electrode contact surfaces, to apply the stimulation, and

wherein the sensing unit is configured to sense the electrical signal using the sensing device first electrode contact surfaces, and not using the stimulating device first electrode contact surfaces.

13. The apparatus according to claim 11, wherein the parameter of the cardiac cycle is indicative of ventricular contraction, and wherein the driving unit is configured to drive the at least some of the device first electrode contact surfaces to apply the stimulation during at least one heart beat after a delay from the ventricular contraction, the delay having a duration of at least 20 ms.

14. The apparatus according to claim 4, further comprising at least one lead coupled to the control unit, wherein the at least one second electrode contact surface is directly mechanically coupled to the lead.

15. The apparatus according to claim 14, wherein the at least one lead couples the electrode device to the control unit, and wherein the at least one second electrode contact surface is directly mechanically coupled to the lead at a position between the electrode device and the control unit.

16. Apparatus comprising:

an electrode device, which is configured to be placed in a vicinity of a nerve of a subject at a location neither within nor in contact with a heart of the subject;

a control unit;

at least one lead that couples the electrode device to the control unit;

at least one first electrode contact surface that is directly mechanically coupled to the lead at a location between the electrode device and the control unit; and

at least one second electrode contact surface that is directly mechanically coupled to the control unit,

wherein the control unit comprises;

a sensing unit, which is configured to sense, using the at least one first electrode contact surface and the at least one second electrode contact surface, an electrical signal; and

an analysis unit, which is configured to analyze the signal to identify a parameter of a cardiac cycle of the subject.

17. The apparatus according to claim 16, wherein the control unit comprises a metal can having an outer conductive surface, at least a portion of which serves as the at least one second electrode contact surface.

18. The apparatus according to claim 16, wherein the electrode device is configured to be placed at least partially around the nerve.

19. A method comprising:

placing an electrode device in a vicinity of a nerve and in a vicinity of a blood vessel of a subject, at a location neither within nor in contact with a heart of the subject;

applying electrical stimulation to the nerve using the electrode device; and

sensing, using the electrode device, a signal from the blood vessel indicative of a parameter of a cardiac cycle of the subject.

20. The method according to claim 19, wherein the nerve is cervical vagus nerve, wherein the blood vessel is selected from the group consisting of:

a carotid artery and a jugular vein, and wherein placing comprises placing the electrode device in the vicinity of the cervical vagus nerve and in the vicinity of the selected blood vessel.

21. The method according to claim 19,

wherein the electrode device includes a housing, which, when the electrode device is placed at least partially around the nerve, defines an outer surface of the electrode device in the vicinity of the blood vessel, and an inner surface that faces the nerve,

wherein applying the stimulation comprises driving one or more first electrode contact surfaces, which are fixed to the inner surface of the housing, to apply the stimulation, and

wherein sensing comprises sensing using at least one second electrode contact surface that is fixed to the outer surface of the housing.

22. A method comprising:

placing an electrode device in a vicinity of a nerve of a subject at a first location neither within nor in contact with a heart of the subject; and

sensing, between the electrode device and a second location within a body of the subject neither within nor in contact with the heart, a signal indicative of a parameter of a cardiac cycle of the subject.

23. The method according to claim 22, wherein sensing comprises sensing using an implanted control unit, and wherein the second location is at the control unit.

24. The method according to claim 22, wherein the nerve is a vagus nerve, and wherein placing comprises placing the electrode device in the vicinity of the vagus nerve.

25. The method according to claim 22, wherein placing the electrode device in the vicinity of the nerve comprises placing the electrode device at least partially around the nerve.

26. The method according to claim 22, wherein the electrode device includes a housing, wherein placing the electrode device comprises placing the housing in the vicinity of the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve, and wherein sensing comprises sensing using at least one electrode contact surface that is fixed to the inner surface of the housing.

27. The method according to claim 22, wherein the electrode device includes a housing, wherein placing the electrode device comprises placing the housing in the vicinity of the nerve, so as to define an outer surface of the electrode device and an inner surface that faces the nerve, and wherein sensing comprises sensing using at least one electrode contact surface that is fixed to the outer surface of the housing.

28. A method comprising:

placing an electrode device in a vicinity of a nerve of a subject at location neither within nor in contact with a heart of the subject; and

using an implanted control unit coupled to the electrode device by at least one lead, sensing, between the control unit and a location along the lead, a signal indicative of a parameter of a cardiac cycle of the subject.

29. The method according to claim 28, further comprising applying electrical stimulation to the nerve using the electrode device, and configuring the stimulation responsively to the parameter of the cardiac cycle.