Vagal stimulation for improving cardiac function in heart failure or CHF patients

• US 7,277,761 B2
• Filed: 06/11/2003
• Issued: 10/02/2007
• Est. Priority Date: 06/12/2002
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Shelchuk, Anne M.
• Primary Examiner(s): Layno; Carl
• Assistant Examiner(s): LEE, YUN H
• Application Number:
  US10/460,013
• Publication Number:
  US 20040199210A1
• Time in Patent Office: 1,574 Days
• Field of Search: 607/17, 607/18, 607/24, 607/118
• US Class Current: 607/62
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Exemplary methods for decreasing workload, maintaining or increasing cardiac output and/or achieving a desirable autonomic balance by stimulating one or more parasympathetic nerves. Various exemplary methods include delivering one or more stimulation pulses postinspiration and/or based at least in part on detection of one or more cardiac event. Other methods and/or devices are also disclosed.

Claims

1. A method comprising:

detecting a physiological parameter indicative of a need for increased cardiac output; and

responsive to detecting the physiological parameter indicative of a need for increased cardiac output, stimulating a parasympathetic nerve to increase vagal tone and increase end diastolic volume, wherein the stimulation of the parasympathetic nerve is initiated during a ventricular refractory period to increase passive ventricular contractility.

2. The method of claim 1, wherein the detecting comprises sensing a pressure.

3. The method of claim 1, wherein the stimulating occurs postinspiration only.

4. The method of claim 1, further comprising synchronizing the stimulating to one or more events in a cardiac cycle.

5. The method of claim 1, further comprising halting the stimulation after a set period of time.

6. The method of claim 1, further comprising halting the stimulating and implementing a diagnostic algorithm after the halting.

7. The method of claim 6, further comprising comparing results of the diagnostic algorithm after the halting of stimulation to results acquired prior to the halting of stimulation.

8. An apparatus comprising:

means for detecting a physiological parameter indicative of a need for increased cardiac output;

means for detecting contractions of one or more chambers of a patient'"'"'s heart; and

means for stimulating a parasympathetic nerve, responsive to the detecting, to increase vagal tone and to increase end diastolic volume, wherein the stimulation is initiated during a ventricular refractory period to increase passive ventricular contractility.

9. The apparatus of claim 8, wherein the means for detecting comprises one or more sensors.

10. The apparatus of claim 8, wherein the means for stimulating a parasympathetic nerve comprises an electrode positionable proximate to the parasympathetic nerve.