System and method for preventing Sudden Cardiac Death by nerve sprouting from right stellate ganglion

• US 6,487,450 B1
• Filed: 02/24/2000
• Issued: 11/26/2002
• Est. Priority Date: 02/24/2000
• Status: Expired due to Term

• Current Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Original Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Inventors: Chen, Peng-Sheng
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US09/513,059
• Time in Patent Office: 1,006 Days
• Field of Search: 604/9, 604/10, 604/501, 604/119, 128/898
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362

Abstract

A system and method are described for reducing the likelihood of the occurrence of ventricular arrhythmia in the heart of a patient having a myocardial infarction and an atrioventricular block, particularly a ventricular arrhythmia of the type potentially leading to Sudden Cardiac Death. The likelihood of the occurrence of the ventricular arrhythmia is reduced by stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient. Myocardial hyperinnervation in the sinus node and right ventricle is stimulated by applying electrical stimulation to the right stellate ganglion of the patient or by applying Nerve Growth Factor or other neurotrophic substance to the right stellate ganglion. The system and method may also be advantageously exploited for use with patients having myocardial infarction but no atrioventricular block and for patients have other heart conditions such as Brugada syndrome.

Claims

1. A method for reducing the likelihood of the occurrence of an arrhythmia in the heart of a patient, said method comprising the steps of:

implanting a neuro-stimulator in the patient positioned for applying stimulation to the right stellate ganglion of the patient; and

applying neuro-stimulation to the right stellate ganglion using the neuro-stimulator so result in nerve sprouting within portions of the myocardium supplied by nerves from the right stellate ganglion.

2. A method for use with a patient, said method comprising the steps of:

applying neuro-stimulation to the right stellate ganglion of the patient using a neuro-stimulator result in nerve sprouting within portions of the myocardium supplied by nerves from the right stellate ganglion such that the risk of an arrhythmia occurring within the heart of the patient is reduced; and

monitoring heart signals of the patient to detect any arrhythmia that may nevertheless occur within the heart of the patient and, if an arrhythmia is detected, applying responsive therapy.

3. A method for reducing the risk of a ventricular arrhythmia in the heart of a patient, said method comprising the steps of:

selecting a portion of the myocardium wherein hyperinnervation is effective for reducing the likelihood of ventricular arrhythmias in patients; and

stimulating nerve growth along a myocardial nerve pathway supplying nerves to the selected portion of the myocardium, so that nerve sprouting results, whereby the risk of the ventricular arrhythmia is reduced.

4. The method of claim 3 wherein the patient has a myocardial infarction (MI) and the ventricular arrhythmia is a phase-2 ventricular tachycardia.

5. The method of claim 4 wherein the patient has atrioventricular (AV) block.

6. The method of claim 3 wherein the patient has Brugada syndrome.

7. The method of claim 3 wherein the step of selecting a portion of the myocardium wherein hyperinnervation is effective for reducing the occurrence of the arrhythmia includes the step of selecting one or more of the sinus node or the right ventricle.

8. The method of claim 7 wherein the step of stimulating nerve growth along a myocardial nerve pathway supplying nerves to the selected portion of the myocardium includes the step of applying electrical stimulation signals to the myocardial nerve pathway.

9. The method of claim 8 wherein the electrical stimulation is applied below a threshold level above which the electrical stimulation causes an increase in heart rate or blood pressure.

10. The method of claim 9 further including the step of:

determining nominal levels for the heart rate and blood pressure of the patient; and

determining the threshold level by increasing an amount of electrical stimulation applied to the myocardial nerve pathway until the heart rate or blood pressure of the patient increases above the nominal levels by a predetermined amount, then decreasing the amount of electrical stimulation until the heart rate and blood pressure returns to the nominal levels, with the resulting amount of electrical stimulation being identified as the threshold level.

11. The method of claim 10 wherein the electrical stimulation is applied at a sub-threshold level set based on the threshold level.

12. The method of claim 11 wherein the sub-threshold level is 50% of the threshold level.

13. The method of claim 8 wherein the electrical stimulation is applied using an implanted neuro-stimulator.

14. The method of claim 7 wherein the step of stimulating nerve growth along a myocardial nerve pathway supplying nerves to the selected portion of the myocardium includes the step of applying a neurotrophic vector to a portion of the myocardial nerve pathway.

15. The method of claim 14 wherein the neurotrophic vector is selected from a group including Nerve Growth Factor, neurotrophic chemicals, and neurotrophic hormones.

16. The method of claim 3 wherein the step of stimulating nerve growth along the myocardial nerve pathway supplying nerves to the selected portion of the myocardium includes the step of stimulating nerve growth via the right stellate ganglion of the patient.

17. The method of claim 3 wherein the ventricular arrhythmia is a phase-2 ventricular tachycardia.