Method and apparatus for tissue protection against ischemia using remote conditioning
First Claim
1. A system for stimulating at least one stimulation site in a body having a heart, the at least one stimulation site remote from the heart, the system comprising:
- an implantable stimulation output device configured for delivering non-cardiac stimulation to the at least one stimulation site; and
an implantable medical device including;
a cardioprotective stimulation module coupled to the implantable stimulation output device, the cardioprotective stimulation module adapted to deliver one or more non-cardiac stimuli to the at least one stimulation site through the implantable output device, the one or more non-cardiac stimuli creating a physiologic stress at the at least one stimulation site without causing myocardial contraction in the heart, the physiologic stress capable of eliciting a cardioprotective effect that protects the heart from tissue damage caused by cardiac ischemia; and
a cardioprotective stimulation controller coupled to the cardioprotective stimulation module, the cardioprotective stimulation controller including;
a stimulation initiator including an ischemia detector adapted to detect an end of a cardiac ischemic event, the stimulation initiator adapted to produce cardioprotective stimulation signals in response to a detection of the end of the cardiac ischemic event, the cardioprotective stimulation signals each initiating a cardioprotective stimulation sequence; and
a stimulation timer adapted to time the cardioprotective stimulation sequence in response to each of the cardioprotective stimulation signals, the cardioprotective stimulation sequence including alternating stimulation and non-stimulation periods, the stimulation periods each having a stimulation duration during which the one or more non-cardiac stimuli are delivered, the non-stimulation periods each having a non-stimulation duration during which none of the one or more non-cardiac stimuli is delivered.
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Accused Products
Abstract
A stimulation system delivers stimulation to protect an ischemic region of a body from tissue damage caused by ischemia. The stimulation is delivered to one or more stimulation sites remote from the ischemic region to elicit a physiological effect that protects the ischemic region from the tissue damage caused by ischemia. In one embodiment, the stimulation system delivers cardioprotective stimulation to one or more stimulation sites remote from the heart to protect the heart from injuries associated with cardiac ischemic events. In another embodiment, the stimulation system delivers remote conditioning stimulation to one or more stimulation sites in or on the heart to protect a non-cardiac region from injuries associated with non-cardiac ischemic events.
136 Citations
32 Claims
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1. A system for stimulating at least one stimulation site in a body having a heart, the at least one stimulation site remote from the heart, the system comprising:
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an implantable stimulation output device configured for delivering non-cardiac stimulation to the at least one stimulation site; and an implantable medical device including; a cardioprotective stimulation module coupled to the implantable stimulation output device, the cardioprotective stimulation module adapted to deliver one or more non-cardiac stimuli to the at least one stimulation site through the implantable output device, the one or more non-cardiac stimuli creating a physiologic stress at the at least one stimulation site without causing myocardial contraction in the heart, the physiologic stress capable of eliciting a cardioprotective effect that protects the heart from tissue damage caused by cardiac ischemia; and a cardioprotective stimulation controller coupled to the cardioprotective stimulation module, the cardioprotective stimulation controller including; a stimulation initiator including an ischemia detector adapted to detect an end of a cardiac ischemic event, the stimulation initiator adapted to produce cardioprotective stimulation signals in response to a detection of the end of the cardiac ischemic event, the cardioprotective stimulation signals each initiating a cardioprotective stimulation sequence; and a stimulation timer adapted to time the cardioprotective stimulation sequence in response to each of the cardioprotective stimulation signals, the cardioprotective stimulation sequence including alternating stimulation and non-stimulation periods, the stimulation periods each having a stimulation duration during which the one or more non-cardiac stimuli are delivered, the non-stimulation periods each having a non-stimulation duration during which none of the one or more non-cardiac stimuli is delivered. - 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, 26, 27, 28, 29, 30)
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31. A system for stimulating at least one stimulation site in a body having a heart, the at least one stimulation site remote from the heart, the system comprising:
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an implantable stimulation output device configured for delivering non-cardiac stimulation to the at least one stimulation site; and an implantable medical device including; a cardioprotective stimulation module coupled to the implantable stimulation output device, the cardioprotective stimulation module adapted to deliver one or more non-cardiac stimuli to the at least one stimulation site through the implantable output device, the one or more non-cardiac stimuli creating a physiologic stress at the at least one stimulation site without causing myocardial contraction in the heart, the physiologic stress capable of eliciting a cardioprotective effect against cardiac ischemia; and a cardioprotective stimulation controller coupled to the cardioprotective stimulation module, the cardioprotective stimulation controller including; a stimulation initiator including an ischemia detector adapted to detect an end of a cardiac ischemic event, the stimulation initiator adapted to produce cardioprotective stimulation signals after the end of the cardiac ischemic event is detected, the cardioprotective stimulation signals each initiating a cardioprotective stimulation sequence; and a stimulation timer adapted to time the cardioprotective stimulation sequence in response to each of the cardioprotective stimulation signals, the cardioprotective stimulation sequence including alternating stimulation and non-stimulation periods, the stimulation periods each having a stimulation duration during which the one or more non-cardiac stimuli are delivered, the non-stimulation periods each having a non-stimulation duration during which none of the one or more non-cardiac stimuli is delivered, wherein the stimulation initiator is adapted to produce a postconditioning signal when a post-ischemia time interval expires, the post-ischemia time interval starting when the end of the cardiac ischemic event is detected, the postconditioning signal being one of the cardioprotective stimulation signals.
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32. A system for stimulating at least one stimulation site in a body having a heart, the at least one stimulation site remote from the heart, the system comprising:
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an implantable stimulation output device configured for delivering non-cardiac stimulation to the at least one stimulation site; and an implantable medical device including; a cardioprotective stimulation module coupled to the implantable stimulation output device, the cardioprotective stimulation module adapted to deliver one or more non-cardiac stimuli to the at least one stimulation site through the implantable output device, the one or more non-cardiac stimuli creating a physiologic stress at the at least one stimulation site without causing myocardial contraction in the heart, the physiologic stress capable of eliciting a cardioprotective effect against cardiac ischemia; and a cardioprotective stimulation controller coupled to the cardioprotective stimulation module, the cardioprotective stimulation controller including; a stimulation initiator including an ischemia detector adapted to detect an end of a cardiac ischemic event, the stimulation initiator adapted to produce cardioprotective stimulation signals after the end of the cardiac ischemic event is detected, the cardioprotective stimulation signals each initiating a cardioprotective stimulation sequence; and a stimulation timer adapted to time the cardioprotective stimulation sequence in response to each of the cardioprotective stimulation signals, the cardioprotective stimulation sequence including alternating stimulation and non-stimulation periods, the stimulation periods each having a stimulation duration during which the one or more non-cardiac stimuli are delivered, the non-stimulation periods each having a non-stimulation duration during which none of the one or more non-cardiac stimuli is delivered, wherein the stimulation initiator is adapted to produce a postconditioning signal within approximately 10 minutes after the end of the cardiac ischemic event is detected, the postconditioning signal being one of the cardioprotective stimulation signals.
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Specification