Methods and apparatus for intravascularly-induced neuromodulation
First Claim
1. An apparatus for intravascularly-induced neuromodulation, the apparatus comprising:
- an electric field generator; and
an intravascular catheter comprising a shaft, an impedance-altering element, and a pair of bipolar electrodes positioned on the shaft on opposite sides of the impedance-altering element, wherein the impedance-altering element comprises an expandable, vessel occluding member;
a first lead connected between one of the electrodes and a first terminal on the electric field generator;
a second lead connected between the other one of the electrodes and a second terminal of opposite polarity on the electric field generator;
at least one monitoring electrode carried by the impedance-altering element; and
a current supply connected to said monitoring electrode for supplying current for monitoring a tissue property,wherein (a) the apparatus is configured for intravascular delivery of an electric field across the bipolar electrodes, and (b) the impedance-altering element is configured to locally increase impedance within a patient'"'"'s vasculature between the bipolar electrodes during intravascular delivery of the electric field.
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Accused Products
Abstract
Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient'"'"'s vessel, e.g., with the impedance-altering element deployed into contact with the vessel wall at a treatment site within the patient'"'"'s vasculature, a magnitude of applied voltage delivered across the bipolar electrodes necessary to achieve desired neuromodulation is reduced relative to an intravascular PEF system having similarly spaced electrodes but no (or an undeployed) impedance-altering element. In a preferred embodiment, the impedance-altering element comprises an inflatable balloon configured to locally increase impedance within a patient'"'"'s vasculature. The methods and apparatus of the present invention may be used to modulate a neural fiber that contributes to renal function.
584 Citations
19 Claims
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1. An apparatus for intravascularly-induced neuromodulation, the apparatus comprising:
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an electric field generator; and an intravascular catheter comprising a shaft, an impedance-altering element, and a pair of bipolar electrodes positioned on the shaft on opposite sides of the impedance-altering element, wherein the impedance-altering element comprises an expandable, vessel occluding member; a first lead connected between one of the electrodes and a first terminal on the electric field generator; a second lead connected between the other one of the electrodes and a second terminal of opposite polarity on the electric field generator; at least one monitoring electrode carried by the impedance-altering element; and a current supply connected to said monitoring electrode for supplying current for monitoring a tissue property, wherein (a) the apparatus is configured for intravascular delivery of an electric field across the bipolar electrodes, and (b) the impedance-altering element is configured to locally increase impedance within a patient'"'"'s vasculature between the bipolar electrodes during intravascular delivery of the electric field. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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Specification