Systems And Methods For Selectively Applying Electrical Energy To Tissue

• US 20100298905A1
• Filed: 05/20/2009
• Published: 11/25/2010
• Est. Priority Date: 05/20/2009
• Status: Active Grant

• Current Assignee: electroCore, Inc., Electrocore, Llc
• Original Assignee: Elecrocore Incorporated
• Inventors: Simon, Bruce
• Granted Patent: US 8,483,832 B2
• Time in Patent Office: Days
• US Class Current: 607/40
• CPC Class Codes: A61N 1/0456 Specially adapted for transcutaneous electrical nerve stimulation [TENS]
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• 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

Abstract

Systems and devices for selectively applying electrical energy to a target region beneath a skin surface of a patient involve applying an electrical impulse to one or more electrodes on a skin surface of the patient to modulate one or more nerves at the target region, where the impulse is substantially blocked at nerves located between the target region and the skin surface such that only the nerves at the target region are modulated by the electrical impulse.

Claims

1. An apparatus for selectively applying energy to a patient comprising:

an activating device configured for applying an electrical impulse to a first target region in the patient; and

a deactivating device positioned in close proximity to the activating device and configured to inhibit the electrical impulse in a second target region of the patient.

2. The apparatus of claim 1 wherein the activating device comprises a source of electrical energy and at least one electrode coupled to the source of electrical energy.

3. The apparatus of claim 1 wherein the deactivating device comprises a source of electrical energy and at least one electrode coupled to the source of electrical energy.

4. The apparatus of claim 1 wherein the activating device comprises:

a source of electrical energy; and

first and second electrodes coupled to the source of electrical energy and configured for contacting an outer skin surface of the patient.

5. The apparatus of claim 4 wherein the deactivating device comprises first and second electrodes coupled to the source of electrical energy and configured for contacting an outer skin surface of the patient.

6. The apparatus of claim 4 wherein the source of electrical energy is configured to apply a first electrical impulse to the activating device sufficient to modulate a nerve at the first target region.

7. The apparatus of claim 4 wherein the source of electrical energy is configured to apply a second electrical impulse to the deactivating device sufficient to a nerve at the second target region to inhibit the first electrical impulse from stimulating the nerve.

8. The apparatus of claim 4 wherein the deactivating device comprises first and second pairs of electrodes configured for placement on a surface of a patient'"'"'s skin on opposite sides of the first and second electrodes, respectively.

9. The apparatus of claim 8 wherein the first and second pairs of electrodes are configured for placement about 2 cm apart from each other on either side of the first and second electrodes, respectively.

10. An apparatus for selectively applying energy to a patient comprising:

one or more electrodes configured for contacting an outer skin surface of a patient; and

a source of electrical energy coupled to the electrodes and configured to apply a first electrical impulse through the electrodes to tissue at a first target region under the outer skin surface and a second electrical impulse through the electrodes to tissue at a second target region under the outer skin surface,

wherein the second electric impulse is configured to inhibit the first electric impulse at the second target region.

11. The apparatus of claim 10 wherein the one or more electrodes comprise first and second electrodes having opposite polarities.

12. The apparatus of claim 10 wherein the one or more electrodes comprise at least one activating electrode for receiving the first electrical impulse and at least one deactivating electrode for receiving the second electric impulse.

13. The apparatus of claim 10 wherein the first target region includes a nerve.

14. The apparatus of claim 10 wherein the second target region includes a nerve located closer to the outer skin surface than the first target region.

15. The apparatus of claim 10 wherein the one or more electrodes comprise first and second activating electrodes for receiving the first electrical impulse and first and second pairs of deactivating electrodes for receiving the second electrical impulse.

16. The apparatus of claim 15 wherein the first pair of deactivating electrodes are positioned on either side of the first activating electrode and the second pair of deactivating electrodes are positioned on either side of the second activating electrode.

17. The apparatus of claim 10 wherein the first electric impulse has an amplitude and waveform configured to modulate a nerve located beneath the outer skin surface of the patient.

18. The apparatus of claim 17 wherein the nerve is located at least 2 cm below the outer skin surface.

19. The apparatus of claim 17 where the nerve is located at least 5 cm below the outer skin surface.

20. The apparatus of claim 10 wherein the second electric impulse has an amplitude and waveform configured to substantially deactivate a second nerve located at a depth of less than 4 cm below the outer skin surface such that the first electric impulse is substantially blocked from activating said second nerve.

21. The apparatus of claim 20 wherein the depth is less than 1 cm below the outer skin surface.

22. The apparatus of claim 10 wherein the first electrical impulse has an amplitude of about 20 to about 200 volts.

23. The apparatus of claim 10 wherein the first electrical impulse has a frequency of about 15 Hz to about 50 Hz.

24. The apparatus of claim 10 wherein the second electrical impulse has an amplitude of about 5 to about 50 volts.

25. The apparatus of claim 10 wherein the second electrical impulse has a frequency of about 4000 Hz to about 5000 Hz.

26. A method for selectively applying energy to a patient comprising:

applying an electric impulse to a first target region in a patient located beneath an outer skin surface of a patient; and

substantially blocking the electric impulse from modulating tissue in a second target region of the patient located beneath the outer skin surface.

27. The method of claim 26 wherein the applying step is carried out by contacting at least one activating electrode to the outer skin surface of the patient and delivering an electrical impulse to the activating electrode to modulate one or more nerves in the first target region.

28. The method of claim 26 wherein the substantially blocking step is carried out by contacting at least one deactivating electrode to the outer skin surface of the patient and delivering an electrical signal to the electrode to deactivate one or more nerves in the second target region.

29. The method of claim 28 wherein the activating and deactivating electrodes are the same electrode.

30. The method of claim 28 wherein the wherein the contacting step is carried out by contacting first and second activating electrodes to the outer skin surface and spacing the first and second activating electrodes from each other by a distance sufficient to apply the electric impulse to the first target region.

31. The method of claim 26 wherein the first target region is at least 2 cm below the outer skin surface.

32. The method of claim 26 wherein the first target region is at least 5 cm below the outer skin surface.

33. The method of claim 30 wherein the substantially blocking step is carried out by contacting first and second pairs of deactivating electrodes to the outer skin surface such that the first pair of deactivating electrodes are positioned on either side of the first activating electrode and the second pair of deactivating electrodes are positioned on either side of the second activating electrode.

34. The method of claim 33 wherein each pair of deactivating electrodes are spaced about 2 cm from each other.

35. A method of treating hypotension comprising:

contacting an activating device to an outer skin surface of a patient; and

applying an electrical impulse to the activating device such that the electrical impulse modulates at least one nerve in a selected region of a carotid sheath of a patient in need of relief from hypotension, such that increased blood pressure is achieved.

36. The method set forth in claim 35 wherein increased blood pressure is achieved by at least one of improving myocardium performance and controlling vasoconstriction.

37. The method of claim 35 further comprising substantially blocking the electrical impulse from modulating nerves in a second region between the outer skin surface and the selected region of the carotid sheath.

38. The method of claim 35 wherein the substantially blocking step is carried out be deactivating one or more nerves located between the outer skin surface and the selected region of the carotid sheath.

39. A method of treating bronchial constriction comprising:

contacting an activating device to an outer skin surface of a patient; and

applying at least one electrical impulse to the activating device such that the electrical impulse stimulates a selected region of a carotid sheath of a patient in need of relief of bronchial smooth muscle constriction whereby the magnitude of constriction of the smooth muscle is reduced.

40. The method of claim 39 further comprising substantially blocking the electrical impulse from modulating nerves in a region between the outer skin surface and the selected region of the carotid sheath.

41. The method of claim 39 wherein the substantially blocking step is carried out by deactivating one or more nerves located between the outer skin surface and the selected region of the carotid sheath.

42. A method of treating a temporary arrest of intestinal peristalsis, comprising:

contacting an activating device to an outer skin surface of a patient; and

applying an electrical impulse to the activating device to induce an electrical impulse in a selected region of a patient to modulate at least one nerve such that an intestinal peristalsis function of the patient is at least partially improved.

43. The method of claim 42 further comprising substantially blocking the electrical impulse from modulating nerves in a region between the outer skin surface and the selected region.

44. The method of claim 43 wherein the substantially blocking step is carried out by deactivating one or more nerves located between the outer skin surface and the selected region.