System and method to deliver therapy in presence of another therapy

• US 8,131,359 B2
• Filed: 04/23/2008
• Issued: 03/06/2012
• Est. Priority Date: 05/10/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad, Kramer, Andrew P., Linder, William J., Stahmann, Jeffrey E.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US12/148,843
• Publication Number:
  US 20080200959A1
• Time in Patent Office: 1,413 Days
• Field of Search: 607/2, 607/4, 607/9, 607/14
• US Class Current: 607/4
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein.

Claims

1. A system, comprising:

stimulator circuitry configured to deliver electrical pulses to at least one electrode as part of a first electrical therapy type;

sensor circuitry configured to sense a therapy of a second electrical therapy type; and

a controller connected to the stimulator circuitry to control delivery of the electrical pulses using a plurality of parameters for at least one programmed electrical therapy of the first electrical therapy type, wherein the controller is connected to the sensor circuitry and is configured to determine an intensity for the therapy of the second electrical therapy type and deliver the therapy of the first therapy type using a parameter set selected based on the intensity of the therapy of the second therapy type.

2. The system of claim 1, wherein the controller is further configured to:

determine whether the therapy of the second type is present,

deliver therapy of the first type using a parameter set selected for use when the therapy of the second type is not present; and

deliver the therapy of the first therapy type using the parameter set selected based on the intensity of the therapy of the second therapy type when the therapy of the second type is present.

3. The system of claim 1, wherein the controller is further configured to:

control delivery of the therapy based on a plurality of parameters organized into a first set and a second set in at least one programmed therapy for the therapy type;

deliver the therapy of the first therapy type using the first set of parameters when the intensity of the therapy of the second therapy type has not reached a threshold value; and

deliver the therapy of the first therapy type using the second set of parameters when the intensity of the therapy of the second therapy type reached the threshold value.

4. The system of claim 1, wherein the controller is configured to receive a signal indicative of the intensity of the therapy of the second therapy type and use the received signal to determine the intensity for the therapy of the second electrical therapy type.

5. The system of claim 1, wherein the first electrical therapy type is a cardiac rhythm management therapy and the second electrical therapy type is a neural stimulation therapy.

6. The system of claim 5, wherein a first pacing mode uses the first set of parameters and a second pacing mode uses the second set of parameters.

7. The system of claim 5, wherein:

the at least one programmed electrical therapy for the first electrical therapy type includes a demand pacing therapy; and

the demand pacing therapy includes a parameter for an anti-tachycardia pacing (ATP) rate, the first set of parameters including a first value for the ATP rate, the second set of parameters including a second value for the ATP rate.

8. The system of claim 5, wherein:

the at least one programmed electrical therapy for the first electrical therapy type includes a demand pacing therapy; and

the demand pacing therapy includes a parameter for an AV interval, the first set of parameters including a first value for the AV interval, the second set of parameters including a second value for the AV interval.

9. The system of claim 5, wherein:

the at least one programmed electrical therapy for the first electrical therapy type includes a demand pacing therapy; and

the demand pacing therapy includes a parameter for a VV interval, the first set of parameters including a first value for the VV interval, the second set of parameters including a second value for the VV interval.

10. The system of claim 5, wherein:

the at least one programmed electrical therapy for the first electrical therapy type includes a demand pacing therapy; and

the demand pacing therapy includes a first pacing mode with the first set of parameters and a second pacing mode with the second set of parameters.

11. The system of claim 5, wherein the at least one programmed electrical therapy for the first electrical therapy type includes a defibrillation therapy.

12. The system of claim 11, wherein the defibrillation therapy includes a parameter for defibrillation threshold, the first set of parameters including a first value for the defibrillation threshold, the second set of parameters including a second value for the defibrillation threshold.

13. The system of claim 1, wherein the first electrical therapy type is a neural stimulation therapy and the second electrical therapy type is a cardiac rhythm management therapy.

14. The system of claim 13, wherein:

the first set of parameters includes a first value for an amplitude of a neural stimulation signal, and the second set of parameters includes a second value for the amplitude;

or

the first set of parameters includes a first value for a frequency of a neural stimulation signal, and the second set of parameters includes a second value for the frequency;

or

the first set of parameters includes a first value associated with burst timing for a neural stimulation signal, and the second set of parameters includes a second value associated with the burst timing;

or

the first set of parameters includes a first value for a morphology of a neural stimulation signal, and the second set of parameters includes a second value for the morphology.

15. The system of claim 1, wherein the first set of parameters and the second set of parameters are independently programmable.

16. The system of claim 1, wherein one set of the first and second sets of parameters is a programmable set, and the other set of the first and second sets of parameters is automatically determined as a function of the programmable set.

17. The system of claim 1, wherein all of the first set of parameters is exclusive of all of the second set of parameters.

18. The system of claim 1, wherein the first set of parameters and the second set of parameters include some mutual parameters.

19. The system of claim 1, wherein the first set of parameters includes a first parameter value for a programmable parameter, and the second set of parameters includes a second parameter value for the programmable parameter that is different from the first parameter value.

20. The system of claim 1, wherein:

the system comprises a first device configured to deliver the therapy of the first electrical therapy type;

the first device includes the stimulator circuitry and the controller; and

the system further comprises a second device adapted to deliver the therapy of the second therapy type.

21. The system of claim 20, wherein at least one of the first device or the second device is implantable.

22. The system of claim 1, wherein:

the system comprises an implantable device;

the implantable device includes the stimulator circuitry and the controller for delivering the therapy of the first therapy type; and

the implantable device is configured to deliver the therapy of the second therapy type.