SUBCLAVIAN ANSAE STIMULATION

• US 20100114254A1
• Filed: 10/31/2008
• Published: 05/06/2010
• Est. Priority Date: 10/31/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Kornet, Lilian
• Granted Patent: US 8,386,053 B2
• Time in Patent Office: Days
• US Class Current: 607/62
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

Techniques for improving cardiac performance by applying stimulation to the subclavian ansae nerve of a patient are disclosed. In one example, a method comprises identifying a human patient as having a cardiac condition, and delivering stimulation therapy to a subclavian ansae nerve of a human patient with a stimulation electrode.

Claims

1. A method comprising:

identifying a human patient as having a cardiac condition; and

delivering stimulation therapy to a subclavian ansae nerve of a human patient with a stimulation electrode.

2. The method of claim 1, further comprising implanting the stimulation electrode within the patient.

3. The method of claim 2, further comprising implanting a portion of a medical lead including the stimulation electrode within one of a group consisting of:

a subclavian artery of the patient; and

a subclavian vein of the patient.

4. The method of claim 2, wherein the stimulation electrode includes a transvascular electrode, the method further comprising implanting the transvascular electrode within a subclavian artery of the patient adjacent to the subclavian ansae nerve.

5. The method of claim 2, further comprising:

implanting a portion of a medical lead including the stimulation electrode within a subclavian vein of the patient; and

advancing the stimulation electrode through a transvascular lumen in the subclavian vein to an extravascular location adjacent the subclavian ansae nerve.

6. The method of claim 2, wherein implanting the stimulation electrode includes implanting a medical lead including the stimulation electrode while viewing the medical lead using fluoroscopic imaging.

7. The method of claim 1, wherein delivering the stimulation therapy includes delivering the stimulation therapy with an implantable stimulator via the stimulation electrode, the method further comprising implanting the stimulator within the patient.

8. The method of claim 1, wherein the stimulation electrode includes a transcutaneous electrode, and wherein delivering stimulation therapy to the subclavian ansae nerve comprises applying stimulation therapy with a transcutaneous electrical nerve stimulation system.

9. The method of claim 1, wherein delivering the stimulation therapy includes delivering the stimulation therapy with a stimulation electrode, wherein the stimulation electrode includes one of a group consisting of:

a nerve cuff electrode;

a transcutaneous electrode; and

a transvacular electrode.

10. The method of claim 1, wherein the stimulation therapy blocks axonal conduction in the subclavian ansae nerve.

11. The method of claim 1, wherein the stimulation therapy reduces sympathetic outflow to the heart of the patient.

12. The method of claim 1, wherein the stimulation therapy includes high-frequency biphasic currents to blocks axonal conduction in the subclavian ansae nerve.

13. The method of claim 1, further comprising:

monitoring a first set of one or more physiological parameters of the patient correlating to a sympathetic tone of a sympathetic nervous system of the patient;

monitoring a second set of one or more physiological parameters of the patient correlating to a parasympathetic tone of a parasympathetic nervous system of the patient; and

delivering the stimulation therapy to the subclavian ansae nerve based on the first and second sets of monitored physiological parameters.

14. The method of claim 13, wherein monitoring the first set of physiological parameters includes monitoring a neurological ganglion of the patient.

15. The method of claim 13, wherein monitoring the second set of physiological parameters includes monitoring a vagus nerve of the patient.

16. The method of claim 1, further comprising:

monitoring one or more physiological parameters of the patient;

positioning a stimulation field of the stimulation therapy to interact with the subclavian ansae nerve based on the monitored physiological parameters.

17. The method of claim 16, wherein the monitored physiological parameters include at least one of a group consisting of:

sympathetic tone;

parasympathetic tone;

an electrocardiogram (ECG);

heart rate;

QRS width;

atrioventricular (AV) dissociation;

respiration rate;

respiratory volume;

core temperature;

diaphragmatic stimulation;

skeletal muscle activity;

blood oxygen level;

cardiac output;

blood pressure;

intercardiac pressure;

time derivative of intercardiac pressure (dP/dt);

electromyogram (EMG) parameters; and

an electroencephalogram (EEG) parameters.

18. The method of claim 1, wherein the cardiac condition includes a naturally-occurring affliction selected from a group consisting of:

ventricular arrhythmias;

ventricular tachycardia (VT);

ventricular fibrillation (VF); and

coronary vasospasm.

19. A method comprising:

determining a human patient is experiencing angina pectoris; and

stimulating a subclavian ansae nerve in the patient in response to the determination.

20. The method of claim 19, further comprising treating the patient for occlusion of a coronary artery while stimulating the subclavian ansae nerve.

21. The method of claim 20, wherein treating the patient for occlusion of a coronary artery includes one or more of a group consisting of:

generating an electrocardiogram (ECG);

administering thrombolytic medication;

administering beta blockers;

administering Angiotensin-Converting Enzyme (ACE) inhibitors;

administering an anticoagulant medication;

administering an antiplatelet medication; and

administering a vasodilator.

22. The method of claim 19, further comprising determining that the patient is experiencing naturally-occurring coronary vasospasm.

23. The method of claim 19, further comprising determining that the patient is experiencing naturally-occurring myocardial infarction.

24. A medical system comprising:

a set of one or more electrodes;

a stimulation generator coupled to the electrodes; and

a processor configured to control the stimulation generator to generate a stimulation therapy signal configured to at least partially block neural activity in a subclavian ansae nerve in a patient, and deliver the stimulation therapy signal via the set of electrodes.

25. The medical system of claim 24, wherein the stimulation therapy at least partially blocks axonal conduction in the subclavian ansae nerve.

26. The medical system of claim 24, wherein the stimulation therapy includes high-frequency biphasic currents to block axonal conduction in the subclavian ansae nerve.

27. The medical system of claim 24, wherein the set one or more electrodes includes at least one of a group consisting of:

a nerve cuff electrode;

a transcutaneous electrode; and

a transvacular electrode.

28. The medical system of claim 24, wherein the set of electrodes is a first set of electrodes, wherein the stimulation therapy is a first stimulation therapy, the system further comprising a second set of one or more electrodes, wherein the processor is configured to deliver a second stimulation therapy to the patient via the second set of electrodes, wherein the second stimulation therapy includes one of a group consisting of:

cardiac pacing therapy;

cardioversion therapy; and

defibrillation therapy.

29. The medical system of claim 24, wherein the patient is a human.

30. A medical device comprising:

means for generating a stimulation therapy signal configured to at least partially block neural activity in a subclavian ansae nerve; and

means for delivering the stimulation therapy signal to the subclavian ansae nerve in a patient.