Closed-loop neuromodulation for prevention and treatment of cardiac conditions
First Claim
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1. A system to perform closed loop controlled delivery of electrical stimulation to excitable neural tissue of a portion of the spine of a body, comprising:
- a sensing circuit to sense at least one physiologic parameter and provide an output signal related thereto, wherein said sensing circuit operatively couples to a sensor adapted to sense a change in paraspinal muscle tone;
a stimulation circuit to provide the electrical stimulation to excitable neural tissue of a portion of the spine in response to the output signal;
a drug dispensing apparatus coupled to a catheter and adapted to deliver biologically-active agents via the catheter to the body; and
a closed loop control circuit coupled to the sensing circuit, to the stimulation circuit, and to the drug dispensing apparatus configured to control the stimulation circuit and the drug dispensing apparatus based on anticipation of an occurrence of a cardiac insult as indicated by the at least one physiologic parameter, wherein at least one input to said closed loop control circuit includes the output signal from said sensing circuit.
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Abstract
A method and apparatus to provide therapy to a patient for protecting cardiac tissue from insult is disclosed. The method comprises delivering closed loop electrical stimulation to one or more predetermined portions of a portion of excitable tissue of the spinal cord of a patient; and monitoring one or more physiologic indices of the body. That is, a closed-loop feedback controller is used to apply electrical stimulation to preselected regions of the spinal cord of a patient'"'"'s body based upon one or more aspects of the physiologic indices.
326 Citations
17 Claims
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1. A system to perform closed loop controlled delivery of electrical stimulation to excitable neural tissue of a portion of the spine of a body, comprising:
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a sensing circuit to sense at least one physiologic parameter and provide an output signal related thereto, wherein said sensing circuit operatively couples to a sensor adapted to sense a change in paraspinal muscle tone; a stimulation circuit to provide the electrical stimulation to excitable neural tissue of a portion of the spine in response to the output signal; a drug dispensing apparatus coupled to a catheter and adapted to deliver biologically-active agents via the catheter to the body; and a closed loop control circuit coupled to the sensing circuit, to the stimulation circuit, and to the drug dispensing apparatus configured to control the stimulation circuit and the drug dispensing apparatus based on anticipation of an occurrence of a cardiac insult as indicated by the at least one physiologic parameter, wherein at least one input to said closed loop control circuit includes the output signal from said sensing circuit. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A device to provide electrical stimulation to at least one predetermined portion of excitable neural tissue of a portion of the spine of a patient, comprising:
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means for sensing at least one physiologic indication in the patient'"'"'s body which relates to a probable future cardiac insult event, wherein said means for sensing comprises a sensor adapted to sense a change in paraspinal muscle tone; means for providing stimulation to the at least one predetermined portion of excitable neural tissue of a portion of the spine of a patient; means for dispensing a biologically-active substance to the patient; and means for performing closed loop control of the stimulation means and the means for dispensing to provide the stimulation and administer the biologically-active substance based on an indication of the probable future cardiac insult event as determined by the physiologic indication.
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13. An apparatus for protecting cardiac tissue from insult, comprising:
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at least one electrode positionable at a region adjacent a portion of excitable neural tissue of a portion of the spine of a patient; a sensing circuit to detect at least one physiologic parameter and provide an output signal related thereto, wherein said sensing circuit comprises a sensor adapted to sense a change in paraspinal muscle tone; a drug dispenser including a catheter adapted to dispense a biologically-active substance to the patient; and a controller adapted to deliver closed loop-controlled of at least one of an electrical stimulation therapy to the at least one electrode for a period of time prior to onset of a cardiac insult and delivery of the biologically-active substance, wherein at least one parameter of the electrical stimulation therapy and the delivery of the biologically-active substance is controlled as a function of the output signal related to the sensed physiologic parameter. - View Dependent Claims (14, 15, 16, 17)
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Specification