Neuromuscular stimulation to avoid pulmonary embolisms

• US 7,542,804 B2
• Filed: 12/03/2004
• Issued: 06/02/2009
• Est. Priority Date: 12/03/2004
• Status: Active Grant

• Current Assignee: Alfred E. Mann Foundation For Scientific Research
• Original Assignee: Alfred E. Mann Foundation For Scientific Research
• Inventors: Mandell, Lee J.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US11/004,369
• Publication Number:
  US 20060122663A1
• Time in Patent Office: 1,642 Days
• Field of Search: 607 2- 3, 607/46, 607 48- 49, 607/61, 600/546, 600/595
• US Class Current: 607/48
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/3606 adapted for a particular treatment
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

A system and method that provide a prophylactic treatment to a person, e.g., a patient, to avoid the occurrence of pulmonary embolisms by the system providing neuromuscular stimulation to a person'"'"'s lower extremities, e.g., the person'"'"'s legs, when the system senses that a person has been immobile for an extended period of time. An implantable neuromuscular pacer, such as that described in U.S. Pat. Nos. 5,193,539; 5,193,540; 6,164,284; 6,185,452; 6,208,894; 6,315,721; 6,564,807; and their progeny, may be used to provide to selectively provide such stimulation. Preferably, such a device may be battery powered so that it can operate independent of an external apparatus. In particular, systems and devices of the present invention preferably additionally include an activity monitor, e.g., an accelerometer or the like, that disables or limits stimulation to pronged time periods in which there is limited activity.

Claims

1. A method for prophylactically treating a person to avoid pulmonary embolisms by using an implantable electronic device, said electronic device utilizing wireless communications and configured to selectively stimulate one or more of a person'"'"'s neuromuscular pathways to facilitate blood flow, said method comprising the steps of:

automatically and sequentially measuring, at predetermined incremented times a parameter corresponding to the person'"'"'s movements;

comprising;

incrementing a timer in the absence of the persons movements; and

determining if the timer has reached a predetermined period of time; and

periodically stimulating one or more of the person'"'"'s neurological pathways utilizing at least one implanted electronic device to facilitate blood flow for avoiding pulmonary embolisms when it is determined according to said measured parameter that the person has gone through the predetermined period of time with limited movements.

2. The method of claim 1 wherein said step of periodically measuring a parameter corresponding to the person'"'"'s movements comprises measuring the person'"'"'s movements using one or more accelerometers.

3. The method of claim 1 wherein said step of periodically measuring a parameter corresponding to the person'"'"'s movements comprises measuring the person'"'"'s movements using two or more accelerometers oriented at approximately right angles to each other and said step of periodically stimulating one or more of the person'"'"'s neurological pathways to facilitate blood flow comprises periodically stimulating one or more of the person'"'"'s neurological pathways to facilitate blood flow according to weighted measurements from said two or more accelerometers.

4. The method of claim 1 wherein said step of periodically measuring a parameter corresponding to the person'"'"'s movements comprises periodically measuring EMG signals from one or more muscles associated with facilitating blood flow.

5. A system for prophylactically treating a person to avoid pulmonary embolisms by selectively stimulating one or more of the person'"'"'s neuromuscular pathways to facilitate blood flow, said system comprising:

one or more implantable pulse generators, said one or more implantable pulse generators utilizing wireless communications and configured for delivering stimulation pulses and coupling to a plurality of electrodes suitable for placement proximate to one or more neurological pathways that respond to said stimulation pulses to facilitate blood flow;

a sensor for measuring a parameter corresponding to the person'"'"'s movements;

an inactivity timer configured to be incremented in the absence of the person'"'"'s movements, said inactivity timer including means to determine whether the inactivity timer has reached a predetermined period of time; and

wherein said one or more pulse generators periodically deliver stimulation pulses for facilitating blood flow when it is determined according to said parameter measured by said sensor that the person has gone through the predetermined period of time with limited movement.

6. The system of claim 5 wherein said movement sensor comprises one or more accelerometers.

7. The system of claim 5 wherein said movement sensor comprises an EMG sensor.

8. The system of claim 5 wherein said movement sensor comprises two or more accelerometers oriented at approximately right angles to each other;

and wherein

delivery of said stimulation pulses is periodically determined according to weighted measurements from said two or more accelerometers.

9. The system of claim 5 wherein said one or more pulse generators are contained within a sealed elongate housing having an axial dimension of less than 60 mm and a lateral dimension of less than 6 mm that is suitable for implantation within the person'"'"'s body.

10. The system of claim 5 wherein said sensor and at least one of said pulse generators are contained within a sealed elongate housing having an axial dimension of less than 60 mm and a lateral dimension of less than 6 mm that is suitable for implantation within the person'"'"'s body.

11. The system of claim 10 additionally comprising:

a master controller in periodic wireless communication with said one or more pulse generators and said movement sensor; and

wherein said master controller periodically determines the need to facilitate blood flow in response to said measured parameter from said movement sensor and communicates said determination to said one or more pulse generators.

12. The system of claim 11 wherein said master controller is suitable for implantation within the person'"'"'s body.

13. The system of claim 11 wherein said master controller is configured for use external to the person'"'"'s body.

14. The system of claim 11 wherein said master controller additionally comprises said sensor for measuring a parameter corresponding to the person'"'"'s movement.

15. The system of claim 5 comprising at least two implantable devices each contained within a sealed elongate housing having an axial dimension of less than 60 mm and a lateral dimension of less than 6 mm wherein each of said implantable devices has at least one pulse generator contained within and at least one of said implantable devices contains said sensor for measuring a parameter corresponding to the person'"'"'s movements and wherein said implantable devices communicate with each other and thereby coordinate operations.

16. The system of claim 5 additionally comprising:

a master controller in periodic wireless communication with said one or more pulse generators and said movement sensor; and

wherein said master controller periodically determines the need to facilitate blood flow in response to said measured parameter from said movement sensor and communicates said determination to said one or more pulse generators.

17. The system of claim 5 additionally comprising:

a master controller;

a plurality of implantable devices suitable for stimulation of neurological pathways, wherein each of said implantable devices is contained within a sealed elongate housing having an axial dimension of less than 60 mm and a lateral dimension of less than 6 mm and is under control of wireless signals from said master controller; and

wherein said one or more pulse generators are implantable and under control of said master controller.

18. The system of claim 17 wherein said master controller is implantable.

19. The system of claim 5 additionally comprises a power source for supplying power to said one or more pulse generators and said sensor.

20. The system of claim 19 wherein said power source comprises a rechargeable battery configured for receiving recharging power from an externally-provided alternating magnetic field.

21. The system of claim 19 wherein said power source comprises a capacitor for receiving power from an externally-provided alternating magnetic field.

22. The system of claim 21 wherein said externally-provided alternating magnetic field is provided from a user support structure.

23. The system of claim 22 wherein said user support structure is selected from the group of a chair, a bed, and a wheelchair.

24. The system of claim 22 wherein said user support structure is configured for placement within a vehicle.

25. The system of claim 24 wherein said vehicle is selected from the group of a airplane, a military type vehicle, and a spacecraft.

26. The system of claim 21 wherein said externally-provided alternating magnetic field is provided from a pad configured for placement on a user support structure.