Technique for adjusting the locus of excitation of electrically excitable tissue with paired pulses

• US 7,689,289 B2
• Filed: 03/22/2006
• Issued: 03/30/2010
• Est. Priority Date: 03/22/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: King, Gary W.
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): So; Elizabeth K
• Application Number:
  US11/277,207
• Publication Number:
  US 20070225765A1
• Time in Patent Office: 1,469 Days
• Field of Search: 607/2, 607/46, 607/66, 607/67, 607/70, 607/115, 607/116, 607/117, 607/148
• US Class Current: 607/66
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36164 Sub-threshold or non-excitatory signals non-excitatory signals to the heart A61N1/3628

Abstract

The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. Substantially non-simultaneous first and second pulses are applied to first and second electrodes, respectively, to generate both first and second action potentials and first and second subthreshold potential areas, within the tissue. The locus within the tissue where additional action potentials are induced may be determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. Superposition of the first and second subthreshold areas provides deep tissue suprathreshold potential areas of adjustable locus wherein additional action potentials are induced.

Claims

1. An apparatus including at least two electrodes for inducing action potentials at an adjustable locus of electrically excitable tissue of an organism, comprising in combination:

a first electrode selected from the at least two electrodes, the first electrode capable of being driven with a first pulse, the first pulse having a pulse parameter to generate a first action potential area and a first subthreshold potential area;

a second electrode selected from the at least two electrodes, the second electrode capable of being driven with a second pulse, the second pulse having a pulse parameter to generate a second action potential area and a second subthreshold potential area; and

a generator configured to provide the first and second pulses to the first and second electrodes to create a steerable electric field,

the generator providing substantially non-simultaneous pulses to the first and second electrodes and wherein the superposition of the first subthreshold potential area with the second subthreshold potential area results in a deep tissue suprathreshold potential area of the adjustable locus wherein a third action potential is induced.

2. The apparatus of claim 1, further comprising at least one return electrode capable of being disposed within the organism.

3. The apparatus of claim 1, wherein the apparatus further comprises in combination a metallic case, the metal case holding the generator and serving as the return electrode.

4. The apparatus of claim 1, wherein the first pulse and the second pulse are paired pulses.

5. The apparatus of claim 1, wherein the first pulse and second pulse are current pulses.

6. The apparatus of claim 1, wherein the first pulse and second pulse are voltage pulses.

7. The apparatus of claim 1, wherein the corresponding pulse parameter is selected from the group consisting of pulse width, pulse amplitude, pulse frequency, pulse rise time, pulse fall time, and pulse shape.

8. The method of claim 1, wherein the first pulse has a first begin time and a first end time and the second pulse has a second begin time and a second end time, and wherein the generator is configured to adjust a time delay between the first end time of the first pulse and the second begin time of the second pulse, wherein the time delay determines a size and location of the deep suprathreshold potential area.

9. A method of inducing action potentials at an adjustable locus of electrically excitable tissue within an organism with a generator, the method comprising the steps of:

delivering a first pulse of electrical stimulation to the tissue using a first set of at least one cathode within an array of electrodes implanted near the tissue to generate a first action potential area and a first subthreshold potential area in the tissue with respect to a return electrode disposed within the organism;

delivering a second pulse of electrical stimulation to the tissue using a second set of at least one cathode within the array to generate a second action potential area and a second subthreshold potential area in the tissue with respect to the return electrode;

the second pulse substantially non-simultaneous with the first pulse;

adjusting a first pulse parameter of the first pulse to cause a corresponding adjustment of the first subthreshold potential area; and

adjusting a second pulse parameter of a second pulse to cause a corresponding adjustment of the second subthreshold potential area; and

wherein a deep tissue suprathreshold potential area results from a superposition of the first substhreshold potential area and second subthreshold potential area.

10. The method of claim 9, wherein the step of adjusting the first pulse parameter includes the step of increasing a pulse width to cause an increase of the corresponding first subthreshold potential area.

11. The method of claim 9, wherein the step of adjusting the second pulse parameter includes the step of increasing a pulse width to cause an increase of the corresponding second subthreshold potential area.

12. The method of claim 9, wherein the step of adjusting the first pulse parameter includes the step of decreasing a pulse width to cause a decrease of the corresponding first subthreshold potential area.

13. The method of claim 9, wherein the step of adjusting the second pulse parameter includes the step of decreasing a pulse width to cause a decrease of the corresponding second subthreshold potential area.

14. The method of claim 9, wherein the first pulse has a first begin time and a first end time and the second pulse has a second begin time and a second end time, and wherein the generator is configured to adjust a time delay between the first end time of the first pulse and the second begin time of the second pulse, wherein the time delay determines a size and location of the deep suprathreshold potential area.

15. The method of claim 9, wherein the first pulse has a first weighted average time and the second pulse has a second weighted average time, wherein the generator is configured to adjust a time delay between the first and second weighted average times, wherein the time delay determines a size and location of the deep suprathreshold potential area.

16. The method of claim 9, wherein the first pulse has a first peak time and the second pulse has a second peak time, wherein the generator is configured to adjust a time delay between the first and second peak times, wherein the time delay determines a size and location of a suprathreshold potential area.

17. A method of inducing an action potential at an adjustable locus of electrically excitable tissue within an organism using a two-dimensional array of electrodes comprising the steps of:

implanting the two-dimensional array of electrodes near the tissue;

selecting at least two electrodes from the two-dimensional array of electrodes;

for each of the at least two selected electrodes, delivering a substantially non-simultaneous corresponding pulse of electrical stimulation to the tissue to generate an action potential area and a subthreshold potential area in the tissue with respect to a return electrode disposed within the organism, the corresponding pulse having a corresponding pulse parameter;

adjusting the corresponding pulse parameter for at least one of the selected electrodes to cause an adjustment of the corresponding subthreshold potential area, and

wherein a deep tissue suprathreshold potential area is induced from a superposition of the two subthreshold potential areas.

18. The method of claim 17, wherein the step of adjusting the corresponding pulse parameter includes the step of increasing a pulse width to cause an increase of the corresponding subthreshold potential areas.

19. The method of claim 17, wherein the step of adjusting the corresponding pulse parameter includes the step of decreasing a pulse width to cause a decrease of the corresponding subthreshold potential areas.

20. The method of claim 17, wherein the step of adjusting the corresponding pulse parameter includes the step of adjusting a pulse parameter selected from the group consisting of pulse amplitude, pulse width, pulse rise time, pulse fall time, and pulse shape.

21. A method of inducing action potentials at an adjustable locus of electrically excitable tissue within an organism with a generator, the method comprising the steps of:

delivering a first pulse of electrical stimulation to the tissue using a first set of at least one cathode within an array of electrodes implanted near the tissue to generate a first action potential area and a first subthreshold potential area in the tissue with respect to a return electrode disposed within the organism;

delivering a second pulse of electrical stimulation to the tissue using a second set of at least one cathode within the array to generate a second subthreshold potential area in the tissue with respect to the return electrode;

the second pulse substantially non-simultaneous with the first pulse;

adjusting a first pulse parameter of the first pulse to cause a corresponding adjustment of the first subthreshold potential area; and

adjusting a second pulse parameter of a second pulse to cause a corresponding adjustment of the second subthreshold potential area; and

wherein a deep tissue suprathreshold potential area results from a superposition of the first substhreshold potential area and second subthreshold potential area.

22. The method of claim 21, wherein the first pulse has a first begin time and a first end time and the second pulse has a second begin time and a second end time, and wherein the generator is configured to adjust a time delay between the first end time of the first pulse and the second begin time of the second pulse, wherein the time delay determines a size and location of the deep suprathreshold potential area.

23. The method of claim 21, wherein the first pulse has a first weighted average time and the second pulse has a second weighted average time, wherein the generator is configured to adjust a time delay between the first and second weighted average times, wherein the time delay determines a size and location of the deep suprathreshold potential area.

24. The method of claim 21, wherein the first pulse has a first peak time and the second pulse has a second peak time, wherein the generator is configured to adjust a time delay between the first and second peak times, wherein the time delay determines a size and location of a suprathreshold potential area.