CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY
First Claim
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1. An implantable device for delivering neurostimulation, comprising:
- a pulse generator for outputting neural stimulation pulses to one or more stimulation electrodes connected to the pulse generator for delivering electrical stimulation to a selected neural site;
a controller connected to the pulse generator for controlling the output of neural stimulation pulses in accordance with a defined schedule and in accordance with specified stimulation parameters;
a telemetry unit interfaced to the controller for enabling user input of a defined schedule for delivering neurostimulation and specified stimulation parameters;
one or more sensing modalities for sensing a physiological variable reflective of a patient'"'"'s autonomic balance; and
,wherein the controller is programmed adjust the amount of neurostimulation delivered in accordance with a determination of the patient'"'"'s autonomic balance and further programmed to receive medication dosage information via telemetry and modify the schedule for delivering neurostimulation accordingly.
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Abstract
Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient'"'"'s autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient'"'"'s autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion.
32 Citations
20 Claims
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1. An implantable device for delivering neurostimulation, comprising:
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a pulse generator for outputting neural stimulation pulses to one or more stimulation electrodes connected to the pulse generator for delivering electrical stimulation to a selected neural site; a controller connected to the pulse generator for controlling the output of neural stimulation pulses in accordance with a defined schedule and in accordance with specified stimulation parameters; a telemetry unit interfaced to the controller for enabling user input of a defined schedule for delivering neurostimulation and specified stimulation parameters; one or more sensing modalities for sensing a physiological variable reflective of a patient'"'"'s autonomic balance; and
,wherein the controller is programmed adjust the amount of neurostimulation delivered in accordance with a determination of the patient'"'"'s autonomic balance and further programmed to receive medication dosage information via telemetry and modify the schedule for delivering neurostimulation accordingly. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. An implantable device for delivering neurostimulation, comprising:
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a pulse generator for outputting neural stimulation pulses to one or more stimulation electrodes connected to the pulse generator for delivering electrical stimulation to a selected neural site; a controller connected to the pulse generator for controlling the output of neural stimulation pulses in accordance with a defined schedule and specified stimulation parameters; a telemetry unit interfaced to the controller for enabling user input of a defined schedule and stimulation parameters for delivering neurostimulation; circuitry for measuring and collecting time intervals between successive intrinsic beats, referred to as a BB interval, and storing the collected intervals as a discrete BB interval signal, filtering the BB interval signal into defined high and low frequency bands, and determining the signal power of the BB interval signal in each of the low and high frequency bands, referred to LF and HF, respectively; circuitry for computing an LF/HF ratio and assessing autonomic balance by comparing the LF/HF ratio to a specified threshold value; wherein the controller is programmed to adjust the amount of neurostimulation delivered in accordance with the assessment of the patient'"'"'s autonomic balance. - View Dependent Claims (15, 16, 17, 18, 19, 20)
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Specification