Implantable lead and method for stimulating the vagus nerve
First Claim
1. A method for controlling a patient'"'"'s heart rate, comprising:
- transvenously positioning a vagal electrode proximate to the patient'"'"'s right vagus nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range.
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Accused Products
Abstract
Methods and apparatus for stimulating the right vagal nerve within a living body via positioning an electrode portion of a lead proximate to the portion of the vagus nerve where the right cardiac branch is located (e.g., near or within an azygos vein, or the superior vena cava near the opening of the azygos vein) and delivering an electrical signal to an electrode portion adapted to be implanted therein. Stimulation of the right vagus nerve and/or the cardiac branch thereof act to slow the atrial heart rate. Exemplary embodiments include deploying an expandable or self-oriented electrode (e.g., a basket, an electrode umbrella, and/or an electrode spiral electrode, electrode pairs, etc). Various dedicated and single-pass leads are disclosed, as well as, various electrodes, and stabilization means. The methods include preserving sinus rhythm, avoiding asystole, preserving A-V synchrony, automatically determining parameter combinations that achieve these features, and further (in one embodiment) automatically determining parameter combinations achieve these features and reduce current drain.
377 Citations
15 Claims
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1. A method for controlling a patient'"'"'s heart rate, comprising:
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transvenously positioning a vagal electrode proximate to the patient'"'"'s right vagus nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method for controlling a patient'"'"'s heart rate, comprising:
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positioning a vagal electrode proximate to the patient'"'"'s right vagus nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range;
wherein the delivering step comprises adjusting the level of stimulation pulses so that the atrial rate decreases to a predetermined lower atrial rate;
wherein adjusting the level of stimulation pulses comprises adjusting at least one of amplitude, pulse width and frequency; and
wherein adjusting of the level of stimulation pulses further comprises;
testing a plurality of amplitude, pulse width and frequency combinations;
recording current drain for the plurality of amplitude, pulse width and frequency combinations;
determining at least one combination of amplitude, pulse width and frequency that reduces current drain; and
delivering the stimulation pulses to the vagal electrode at a level that reduces the atrial rate to the predetermined lower rate while reducing current drain.
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11. A method for controlling a patient'"'"'s heart rate, comprising:
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positioning a vagal electrode proximate to the patient'"'"'s right vagus nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range;
wherein the delivering step comprises adjusting the level of stimulation pulses so that the atrial rate decreases to a predetermined lower atrial rate;
wherein adjusting the level of stimulation pulses comprises adjusting at least one of amplitude, pulse width and frequency; and
wherein adjusting of the level of stimulation pulses further comprises;
varying a plurality of amplitude, pulse width and frequency combinations to determine whether varying degrees of lower atrial rates can be achieved;
recording corresponding atrial rates for the plurality of amplitude, pulse width and frequency combinations; and
selecting a particular amplitude, pulse width and frequency combination that corresponds to the predetermined lower atrial rate.
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12. A method for controlling a patient'"'"'s heart rate, comprising:
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positioning a vagal electrode proximate to the patient'"'"'s right vagus nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range;
wherein the positioning comprises positioning the vagal electrode in the right azygos vein. - View Dependent Claims (13)
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14. A method for controlling a patient'"'"'s heart rate, comprising:
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positioning a vagal electrode proximate to the patient'"'"'s right vague nerve near the patient'"'"'s cardiac branch;
positioning an atrial electrode in the patient'"'"'s atrium;
detecting the patient'"'"'s atrial rate; and
delivering stimulation pulses to the vagal electrode when a fast atrial rate is detected, the stimulation pulses being delivered at a level that reduces the atrial rate to a normal operating range;
wherein the positioning comprises positioning the vagal electrode in the Superior Vena Cava (SVC) near the right cardiac branch. - View Dependent Claims (15)
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Specification