NERVE STIMULATION TECHNIQUES

• US 20110224749A1
• Filed: 02/07/2011
• Published: 09/15/2011
• Est. Priority Date: 08/31/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: BioControl Medical (B.C.M) Ltd.
• Inventors: AYAL, Shai, GROSS, Yossi, BEN-DAVID, Tamir, COHEN, Ehud
• Granted Patent: US 8,571,653 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36075 Headache or migraine
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A method is provided for treating heart failure in a subject in need of such treatment, including applying a stimulating current to parasympathetic nervous tissue of the subject, selected from the group consisting of: a vagus nerve and an epicardial fat pad. The stimulating current is configured to inhibit release of at least one proinflammatory cytokine sufficiently to the treat heart failure of the subject. A level of the at least one proinflammatory cytokine is measured. Optionally, the stimulating current is configured to change a level of Connexin 43 of the subject, and the level of Connexin 43 is also measured. Other embodiments are also described.

Claims

1. A method for treating heart failure in a subject in need of such treatment, comprising:

applying a stimulating current to parasympathetic nervous tissue of the subject, selected from the group consisting of;

a vagus nerve and an epicardial fat pad;

configuring the stimulating current to inhibit release of at least one proinflammatory cytokine sufficiently to the treat heart failure of the subject; and

measuring a level of the at least one proinflammatory cytokine.

2. The method according to claim 1, wherein the configuring comprises configuring the stimulating current to change a level of Connexin 43 of the subject, and wherein measuring further comprises measuring the level of Connexin 43.

3. The method according to claim 1, wherein the heart failure is selected from the group consisting of:

heart failure, congestive heart failure, and diastolic heart failure.

4. The method according to claim 1, wherein applying the stimulating current comprises applying the stimulating current during a period having a duration of at least one week.

5. The method according to claim 1, wherein measuring the level of the at least one proinflammatory cytokine comprises measuring a level of mRNA expression of the at least one proinflammatory cytokine.

6. The method according to claim 1, wherein configuring the stimulating current comprises configuring the stimulating current to inhibit the release of TNF-alpha, IL-6, Activin-A, and TGF-beta, and wherein measuring the level of the at least one proinflammatory cytokine comprises measuring the level of TNF-alpha, IL-6, Activin-A, and TGF-beta.

7. Apparatus for treating a condition of a subject, comprising:

an electrode device, adapted to be coupled to longitudinal nervous tissue of the subject; and

a control unit, adapted to drive the electrode device to;

drive into the longitudinal nervous tissue a stimulating current at a first longitudinal location, which is capable of inducing action potentials that propagate in the nervous tissue in a direction, which action potentials include slower and faster action potentials; and

suppress the slower action potentials from propagating in the nervous tissue in the direction, by applying a blocking current at a second longitudinal location after a delay following driving the stimulating current, and timing the delay to allow passage of the faster action potentials, while suppressing the slower action potentials.

8. The apparatus according to claim 7, wherein the longitudinal nervous tissue includes at least one nerve selected from the group consisting of:

a sympathetic nerve of the subject, and a parasympathetic nerve of the subject, and wherein the electrode device is adapted to be coupled to the selected longitudinal nervous tissue.

9. The apparatus according to claim 7, wherein the control unit is adapted to suppress the slower action potentials by configuring the blocking current to eliminate, by collision blocking, the slower action potentials propagating in the direction.

10. The apparatus according to claim 7, wherein the delay has a duration of 200 microseconds.

11. The apparatus according to claim 7, wherein the control unit is configured to detect, using the electrode device, compound action potentials (CAPs) propagating in the nervous tissue in the direction, and to adjust the delay so as to maximize suppression of the slower action potentials.

12. A method for treating a condition of a subject, comprising:

identifying that the subject suffers from the condition; and

treating the condition by;

sequentially driving currents into respective longitudinal sites of a vagus nerve of the subject having a first set of fibers and a second set of fibers, through which first body-generated action potential propagate at a first velocity, and second body-generated action potentials propagate at a second velocity, respectively, the first set of fibers having diameters generally different from diameters of the second set of fibers, with delays between driving each of the currents that are timed to the first velocity so as to minimize undesired blocking of the first body-generated action potentials propagating through the first set of fibers, and

configuring the currents to induce respective first electrode-generated action potentials that propagate in the vagus nerve in a first direction, so as to treat the condition, and to suppress respective second electrode-generated action potentials from propagating in the vagus nerve in a second direction opposite to the first direction.

13. A method according to claim 12, wherein suppressing the second action potentials comprises suppressing the second action potentials repeatedly, during a series of temporally non-contiguous action potential suppression periods, and wherein the method comprises substantially withholding the suppressing of the second action potentials between the action potential suppression periods.