SYSTEM TO PROVIDE MYOCARDIAL AND NEURAL STIMULATION

• US 20100114226A1
• Filed: 01/13/2010
• Published: 05/06/2010
• Est. Priority Date: 03/23/2005
• Status: Active Grant

• Current Assignee: Andrew P. Kramer, Ankur Garg, Imad Libbus, Kristofer J. James, Qingsheng Zhu, Scott Vanderlinde
• Original Assignee: Andrew P. Kramer, Ankur Garg, Imad Libbus, Kristofer J. James, Qingsheng Zhu, Scott Vanderlinde
• Inventors: Zhu, Qingsheng, Kramer, Andrew P., Libbus, Imad, James, Kristofer J., Vanderlinde, Scott, Garg, Ankur
• Granted Patent: US 8,478,397 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36057 adapted for stimulating afferent nerves
• 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 1/36128 Control systems
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Various aspects provide an implantable device. In various embodiments, the device comprises at least one port, where each port is adapted to connect a lead with an electrode to the device. The device further includes a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode. The stimulation circuit is adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy. The sensing and stimulation circuits are adapted to perform CRM functions. The device further includes a controller connected to the sensing circuit and the stimulation circuit to control the neural stimulation therapy and the CRM therapy. Other aspects and embodiments are provided herein.

Claims

1. A system, comprising:

an electrode;

a stimulation channel configured for use in delivering an electrical signal to the electrode;

stimulation circuitry having one stimulation output, the stimulation circuitry including;

a stimulation module configured to generate one programmed sequence of electrical pulses at a time and configured to deliver the sequence of electrical pulses from the stimulation output into the stimulation channel for a stimulation therapy; and

a memory including a neural stimulation parameter set and a myocardial stimulation parameter set, wherein the neural stimulation parameter set includes appropriate stimulation parameters for the sequence of electrical pulses to effectively depolarize a neural target for a neural stimulation therapy, and the myocardial stimulation parameter set includes appropriate stimulation parameters for the sequence of electrical pulses to effectively capture myocardial tissue for a cardiac rhythm management (CRM) therapy; and

a controller configured to control whether the stimulation circuitry generates the programmed sequence of electrical pulses using the neural stimulation parameter set for the neural stimulation therapy or the myocardial stimulation parameter set for the CRM therapy.

2. The system of claim 1, wherein the controller is adapted to control the stimulation circuitry to deliver the neural stimulation therapy over the stimulation channel during a first time and to deliver the CRM therapy over the stimulation channel during a second time, wherein the first time is different from the second time.

3. The system of claim 2, wherein the controller is configured to control the stimulation circuitry to alternate between delivering the neural stimulation therapy and the CRM therapy.

4. The system of claim 1, further comprising a switch having an input connected to the stimulation output of the stimulation circuitry, wherein the switch includes a first switch output and a second switch output, wherein the electrode is a first electrode and the stimulation channel is a first stimulation channel connected to the first switch output and configured to deliver the sequence of electrical pulses from the first switch output to the first electrode, the system further comprising a second stimulation channel connected to the second switch output and configured to deliver the sequence of electrical pulses from the second switch output to a second electrode, wherein the stimulation circuit is configured to deliver stimulation signals through the first stimulation channel for both neural stimulation therapy and CRM therapy and through the second stimulation channel for both neural stimulation therapy and CRM therapy, wherein the controller is adapted to control the stimulation circuit and the switch to control whether the neural stimulation therapy or the CRM therapy is delivered through the first stimulation channel to the first electrode and control whether the neural stimulation therapy or the CRM therapy is delivered through the second stimulation channel to the second electrode.

5. The system, of claim 1, wherein:

the memory includes a combination parameter set, wherein the combination parameter set includes appropriate stimulation parameters for the sequence of electrical pulses to effectively depolarize the neural target for the neural stimulation therapy and to effectively capture myocardial tissue for the cardiac rhythm management (CRM) therapy; and

the controller is configured to control whether the stimulation module generates the programmed sequence of electrical pulses using the neural stimulation parameter set for the neural stimulation therapy, the myocardial stimulation parameter set for the CRM therapy, or the combination parameter set for both the neural stimulation therapy and the CRM therapy.

6. The system of claim 1, wherein the stimulation module is configured to adjust an amplitude of the stimulation pulses to change between neural stimulation and CRM therapies.

7. The system of claim 1, wherein the stimulation module is configured to adjust a frequency of the stimulation pulses to change between neural stimulation and CRM therapies.

8. The system of claim 1, wherein the stimulation module includes a capacitor configured for use in generating the sequence of electrical pulses, and the capacitor is used to generate the sequence of electrical pacing pulses for the neural stimulation therapy and is used to generate the sequence of electrical pacing pulses for the CRM therapy.

9. A method for operating a system that includes stimulation circuitry with one stimulation output, wherein the stimulation circuitry includes a stimulation module configured to generate one programmed sequence of electrical pulses at a time and deliver the sequence of electrical pulses from the stimulation output into the stimulation channel for both neural stimulation and cardiac rhythm management (CRM) therapies, the method comprising:

selecting a therapy to be delivered by the system;

upon selecting the CRM therapy, using the stimulation module to deliver a CRM stimulation signal through the stimulation output into the stimulation channel, wherein the CRM stimulation signal has parameters to effectively capture myocardia for the CRM therapy; and

upon selecting the neural stimulation therapy, using the stimulation module to deliver a neural stimulation sign through the stimulation output into the stimulation channel, wherein the neural stimulation signal has parameters to effectively depolarize a neural target and elicit a desired neural response.

10. The method of claim 9, further comprising delivering a stimulation signal from the stimulation output through the stimulation channel to simultaneously depolarize the neural target for the neural stimulation therapy and capture myocardial tissue for the CRM stimulation therapy.

11. The method of claim 10, further comprising delivering the CRM stimulation signal to the electrode during a first time and delivering the neural stimulation signal to the electrode during a second time that is separate from the first time.

12. The method of claim 9, wherein the system includes a switch with a switch input connected to the stimulation output of the stimulation platform and with a first switch output and a second switch output, the stimulation channel includes a first stimulation channel connected to the first switch output, the system further including a second stimulation channel connected to the second switch output, the method further comprising:

selecting from an available CRM stimulation mode to capture the myocardial tissue or neural stimulation mode to depolarize the neural target for the first stimulation channel; and

selecting from an available CRM stimulation mode to capture the myocardial tissue or neural stimulation mode to depolarize the neural target for the second stimulation channel.

13. The method of claim 9, wherein selecting from an available CRM stimulation mode or neural stimulation mode includes adjusting an amplitude of the electrical pulses.

14. The method of claim 9, wherein selecting from an available CRM stimulation mode or neural stimulation mode includes adjusting a frequency of the electrical pulses.

15. A method for making an implantable medical device, comprising:

connecting a controller to a memory;

connecting the controller to stimulation circuitry having one stimulation output, wherein the platform includes a memory and a stimulation module configured to generate one programmed sequence of electrical pulses at a time and configured to deliver the sequence of electrical pulses from the stimulation output into the stimulation channel for a stimulation therapy delivered using the electrode; and

storing computer instructions in the memory to be performed by the controller, the computer instructions including instructions to perform a neural stimulation therapy and a cardiac rhythm management (CRM) therapy, wherein the computer instructions further include instructions to receive a therapy selection input, to generate a neural stimulation signal on the stimulation channel to the electrode if the neural stimulation therapy is selected, and to generate a CRM stimulation signal on the stimulation channel to the electrode if the CRM therapy is selected.

16. The method of claim 15, wherein:

the stimulation channel is a first stimulation channel and the electrode is a first electrode;

the stimulation circuitry is adapted to generate stimulation signals on a second stimulation channel to a second electrode; and

the computer instructions stored in the memory further include instructions to select a therapy mode for each of the first and second stimulation channels, and to generate a corresponding stimulation signal on the first and second stimulation channels according to the selected therapy mode.

17. The method of claim 15, wherein the computer instructions further include instructions to generate a combination stimulation signal on the stimulation channel if a combination of neural stimulation and CRM therapies is selected, wherein the combination stimulation signal includes a programmed sequence of electrical pulses that is effective in capturing myocardia and effective in depolarizing a neural target.

18. The method of claim 15, wherein the computer instructions include instructions to generate the neural stimulation signal on the stimulation channel to the electrode during a first time, and to generate a CRM stimulation signal on the stimulation channel to the electrode during a second time separate from the first time.

19. The method of claim 15, wherein the instructions include instructions to generate the neural stimulation signal and the CRM stimulation signal using a time division multiplexing scheme.

20. The method of claim 15, wherein the instructions include instructions to generate a combination stimulation signal on the stimulation channel to simultaneously perform the neural stimulation therapy and the CRM therapy.