AUTOMATIC BAROREFLEX MODULATION RESPONSIVE TO ADVERSE EVENT

• US 20120232613A1
• Filed: 05/24/2012
• Published: 09/13/2012
• Est. Priority Date: 09/27/2000
• Status: Active Grant

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Kieval, Robert S., Burns, Matthew M., Serdar, David J.
• Granted Patent: US 8,712,531 B2
• Time in Patent Office: Days
• US Class Current: 607/44
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A system for providing baroreflex stimulation comprises a sensor to detect a parameter and provide a signal indicative of the parameter and a baroreflex stimulator. The baroreflex stimulator includes a driver to provide a control signal adapted to deliver a baroreflex therapy and a controller to receive the signal indicative of the parameter and modulate the control signal based on the signal indicative of the parameter to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

Claims

1. A method for operating an implantable medical device, comprising:

receiving a signal regarding a detected predetermined adverse event at a baroreceptor stimulator;

controlling blood pressure, including;

performing a first therapy using the baroreceptor stimulator when the predetermined adverse event is not detected, wherein performing a first therapy includes delivering a first baroreflex stimulation signal through an electrode proximate a vessel wall to stimulate a baroreflex neural target, the first baroreflex stimulation signal being adapted to provide the first therapy to control blood pressure through a baroreflex response; and

adjusting blood pressure for the predetermined adverse event when the predetermined adverse event is detected, including automatically performing a second therapy using the baroreceptor stimulator when the adverse event is detected, wherein automatically performing a second therapy includes delivering a second baroreflex stimulation signal through the electrode proximate a vessel wall to stimulate a baroreflex neural target, the second baroreflex stimulation signal being adapted to provide the second therapy to control blood pressure through a baroreflex response.

2. The method of claim 1, wherein performing the first therapy includes withholding therapy and performing the second therapy includes providing-baroreflex stimulation.

3. The method of claim 1, wherein performing the first therapy includes providing baroreflex stimulation and performing the second therapy includes withholding therapy.

4. The method of claim 1, wherein performing the second therapy includes identifying the adverse event, and applying a baroreflex therapy for the adverse event.

5. The method of claim 1, further comprising:

detecting the adverse event using an adverse event detector in the implantable medical device; and

sending the signal regarding the adverse event to a baroreflex stimulator in the implantable medical device.

6. The method of claim 1, further comprising delivering the first baroreflex stimulation signal and the second baroreflex stimulation signal through an electrode positioned within a blood vessel.

7. The method of claim 1, further comprising delivering the first baroreflex stimulation signal and the second baroreflex stimulation signal through an electrode positioned at least partially surrounding a blood vessel.

8. A method for operating an implantable medical device, comprising:

receiving a signal indicative of a detected predetermined parameter indicative of a need for therapy to treat hypertension and/or heart failure at a baroreceptor stimulator;

controlling blood pressure, including;

performing a first therapy using the baroreceptor stimulator when the predetermined parameter is not detected, wherein performing a first therapy includes delivering a first baroreflex stimulation signal through an electrode proximate a vessel wall to stimulate a baroreflex neural target, the first baroreflex stimulation signal being adapted to provide the first therapy to control blood pressure through a baroreflex response; and

adjusting blood pressure for the predetermined parameter when the predetermined parameter is detected, including automatically performing a second therapy using the baroreceptor stimulator when the predetermined parameter is detected, wherein automatically performing a second therapy includes delivering a second baroreflex stimulation signal through the electrode proximate a vessel wall to stimulate a baroreflex neural target, the second baroreflex stimulation signal being adapted to provide the second therapy to control blood pressure through a baroreflex response.

9. The method of claim 8, wherein the predetermined parameter is selected from the set consisting of:

a blood pressure below a lower predetermined threshold, a blood pressure above a higher predetermined threshold, and a specific physiologic event indicative of a need for therapy to treat hypertension and/or heart failure.