System and method for closed-loop neural stimulation
First Claim
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1. A neural stimulation system to modulate autonomic balance between parasympathetic tone and sympathetic tone in an autonomic nervous system (ANS), the system comprising:
- a neural stimulator adapted to generate a stimulation signal adapted to stimulate an autonomic neural target to modulate the autonomic balance in the ANS;
a premature ventricular contraction (PVC) event detector;
a heart rate detector;
an analyzer adapted to, in response to a PVC event signal from the PVC event detector, measure heart rate turbulence (HRT) using pre-PVC heart rate data and post-PVC heart rate data to generate an autonomic balance indicator (ABI); and
a controller adapted to implement a neural stimulation therapy using the neural stimulator and the analyzer to modulate the autonomic balance in the ANS,wherein the analyzer is configured to generate a plurality of ABIs at discrete times during the neural stimulation therapy,wherein the controller includes a memory, andwherein for each discrete time for which the analyzer generates one of the ABIs, the controller is adapted to;
perform the neural stimulation therapy in a closed loop to achieve a desired autonomic balance for the ANS, wherein, in performing the neural stimulation therapy in a closed loop, the controller is configured to;
receive the ABI from the analyzer,compare the received ABI to a target ABI stored in the memory to determine an error between the received ABI and the target ABI,use the error to provide stimulation control feedback, anduse the stimulation control feedback to control the neural stimulator to achieve the desired autonomic balance for the ANS,wherein the target ABI is representative of the desired autonomic balance for the ANS.
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Abstract
Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein.
62 Citations
52 Claims
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1. A neural stimulation system to modulate autonomic balance between parasympathetic tone and sympathetic tone in an autonomic nervous system (ANS), the system comprising:
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a neural stimulator adapted to generate a stimulation signal adapted to stimulate an autonomic neural target to modulate the autonomic balance in the ANS; a premature ventricular contraction (PVC) event detector; a heart rate detector; an analyzer adapted to, in response to a PVC event signal from the PVC event detector, measure heart rate turbulence (HRT) using pre-PVC heart rate data and post-PVC heart rate data to generate an autonomic balance indicator (ABI); and a controller adapted to implement a neural stimulation therapy using the neural stimulator and the analyzer to modulate the autonomic balance in the ANS, wherein the analyzer is configured to generate a plurality of ABIs at discrete times during the neural stimulation therapy, wherein the controller includes a memory, and wherein for each discrete time for which the analyzer generates one of the ABIs, the controller is adapted to; perform the neural stimulation therapy in a closed loop to achieve a desired autonomic balance for the ANS, wherein, in performing the neural stimulation therapy in a closed loop, the controller is configured to; receive the ABI from the analyzer, compare the received ABI to a target ABI stored in the memory to determine an error between the received ABI and the target ABI, use the error to provide stimulation control feedback, and use the stimulation control feedback to control the neural stimulator to achieve the desired autonomic balance for the ANS, wherein the target ABI is representative of the desired autonomic balance for the ANS. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A neural stimulation system to modulate autonomic balance between parasympathetic tone and sympathetic tone in an autonomic nervous system (ANS), the system comprising:
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neural stimulation means for stimulating an autonomic neural target to modulate the autonomic balance in the ANS; means for identifying a premature ventricular contraction (PVC) event; means for detecting pre-PVC heart rate data and post-PVC heart rate data; and means for measuring heart rate turbulence (HRT) in response to the PVC event using the pre-PVC heart rate data and the post-PVC heart rate data to generate an autonomic balance indicator (ABI); the system further comprising means for controlling the neural stimulation means using the ABI to titrate the stimulation of the autonomic neural target to achieve a desired autonomic balance for the ANS, wherein the means for controlling the neural stimulation means includes means for receiving the ABI, comparing the received ABI to a target ABI stored in the memory to determine an error between the received ABI and the target ABI, using the error to provide stimulation control feedback, and using the stimulation control feedback to control the neural stimulator to achieve the desired autonomic balance for the ANS, wherein the target ABI is representative of the desired autonomic balance for the ANS. - View Dependent Claims (27, 28, 29, 30, 31)
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32. A method for modulating autonomic balance between parasympathetic tone and sympathetic tone in an autonomic nervous system (ANS), the method comprising:
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stimulating an autonomic neural target to modulate the autonomic balance in the ANS; identifying a premature ventricular contraction (PVC) event; detecting pre-PVC heart rate data and post-PVC heart rate data; and measuring heart rate turbulence (HRT) in response to the PVC event using the pre-PVC heart rate data and the post-PVC heart rate data to generate an autonomic balance indicator (ABI); the method further comprising titrating the stimulation of the autonomic neural target using the ABI to achieve a desired autonomic balance for the ANS, wherein titrating the stimulation includes; receiving the ABI; comparing the received ABI to a target ABI to determine an error between the received ABI and the target ABI; using the error to provide stimulation control feedback; and using the stimulation control feedback to control the neural stimulator to achieve the desired autonomic balance for the ANS, wherein the target ABI is representative of the desired autonomic balance for the ANS. - View Dependent Claims (33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52)
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Specification