System and method for testing neural stimulation threshold
First Claim
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1. A method for setting a stimulation level for stimulating an autonomic nervous system (ANS), the method comprising:
- automatically performing an auto-threshold test, includingstimulating an autonomic neural target in the ANS, wherein stimulating the autonomic neural target includes stepping through a plurality of stimulation levels;
performing a threshold test for each of the stimulation levels, wherein performing the threshold test includes;
inducing a premature ventricular contraction (PVC) event or detecting an intrinsic PVC event;
detecting pre-PVC heart rate data and post-PVC heart rate data;
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; and
determining, using the measured HRT, whether the stimulation level provides threshold stimulation; and
setting the stimulation level for stimulating the ANS based on the threshold test for each of the stimulation levels.
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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.
29 Citations
29 Claims
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1. A method for setting a stimulation level for stimulating an autonomic nervous system (ANS), the method comprising:
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automatically performing an auto-threshold test, including stimulating an autonomic neural target in the ANS, wherein stimulating the autonomic neural target includes stepping through a plurality of stimulation levels; performing a threshold test for each of the stimulation levels, wherein performing the threshold test includes; inducing a premature ventricular contraction (PVC) event or detecting an intrinsic PVC event; detecting pre-PVC heart rate data and post-PVC heart rate data; 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; and determining, using the measured HRT, whether the stimulation level provides threshold stimulation; and setting the stimulation level for stimulating the ANS based on the threshold test for each of the stimulation levels. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A neural stimulation system for setting stimulation level for stimulating an autonomic nervous system (ANS), the system comprising:
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a neural stimulator configured to stimulate an autonomic neural target in the ANS; a premature ventricular contraction (PVC) stimulator configured to induce a PVC using a ventricular pacing pulse; a heart rate detector configured to detect heart rate both before and after the induced PVC; an analyzer connected to the heart rate detector and configured to measure heart rate turbulence (HRT) using pre-PVC heart rate data and post-PVC heart rate data; and a controller configured to automatically perform an auto-threshold test, wherein in performing the auto-threshold test the controller is configured to; control the neural stimulator to generate a neural stimulation signal to stimulate the autonomic neural target, and to step through a plurality of stimulation levels; perform a threshold test for each of the stimulation levels; control the PVC stimulator to induce the PVC; and receive measured HRT values from the analyzer for the induced PVC, wherein the measured HRT values indicate whether the stimulation level provides threshold stimulation. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21)
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22. A method for implanting a neural stimulator, comprising:
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implanting a neural stimulation lead; delivering neural stimulation through the neural stimulation lead; inducing a premature ventricular contraction (PVC) event, wherein inducing the PVC event includes delivering a myocardial pace to induce the premature ventricular contraction; detecting pre-PVC heart rate data and post-PVC heart rate data; 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; and determining, using the measured HRT, whether the delivered neural stimulation through the neural stimulation lead provides threshold stimulation. - View Dependent Claims (23, 24, 25, 26, 27, 28, 29)
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Specification