Baroreflex stimulation synchronized to circadian rhythm

• US 8,131,373 B2
• Filed: 03/30/2010
• Issued: 03/06/2012
• Est. Priority Date: 12/24/2003
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad
• Primary Examiner(s): Layno, Carl H.
• Assistant Examiner(s): Heller, Tammie K
• Application Number:
  US12/749,939
• Publication Number:
  US 20100185255A1
• Time in Patent Office: 707 Days
• Field of Search: 607/23, 607/44
• US Class Current: 607/44
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/3614 based on impedance measurement
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

An embodiment of a baroreflex stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. According to an embodiment of a method for operating an implantable medical device, comprising a baroreflex stimulation therapy is applied at a stimulation intensity using a baroreflex stimulator in the implantable medical device, and the baroreflex stimulation therapy is modulated based on a circadian rhythm template stored within the implantable medical device. Modulating the baroreflex stimulation therapy includes using the circadian rhythm template to change the stimulation intensity to mimic natural blood pressure fluctuations during the day.

Claims

1. A method for operating an implantable medical device, comprising:

sensing and recording parameters related to hypertension;

generating a patient-specific circadian rhythm template based on the recorded parameters;

applying a baroreflex stimulation therapy at a stimulation intensity using a baroreflex stimulator in the implantable medical device; and

modulating the baroreflex stimulation therapy based on the patient-specific circadian rhythm template stored within the implantable medical device, wherein modulating the baroreflex stimulation therapy includes using the patient specific circadian rhythm template to change the stimulation intensity to mimic natural blood pressure fluctuations during the day.

2. The method of claim 1, wherein modulating the baroreflex stimulation therapy includes modulating an amplitude of the baroreflex stimulation signal based on the patient-specific circadian rhythm template.

3. The method of claim 1, wherein modulating the baroreflex stimulation therapy includes modulating a frequency of the baroreflex stimulation signal based on the patient-specific circadian rhythm template.

4. The method of claim 1, wherein modulating the baroreflex stimulation therapy includes modulating a burst frequency of the baroreflex stimulation signal based on the patient-specific circadian rhythm template.

5. The method of claim 1, wherein modulating the baroreflex stimulation therapy includes changing a waveform of the baroreflex stimulation signal based on the patient-specific circadian rhythm template.

6. The method of claim 1, wherein the patient specific circadian rhythm template includes a mean arterial pressure template.

7. The method of claim 1, wherein the patient specific circadian rhythm template includes a heart rate template.

8. The method of claim 1, wherein the patient specific circadian rhythm template includes a stroke volume template.

9. The method of claim 1, wherein the patient specific circadian rhythm template includes a cardiac output template.

10. The method of claim 1, wherein the patient specific circadian rhythm template includes a total peripheral resistance template.

11. The method of claim 1, further comprising delivering baroreflex stimulation through a lead adapted to be fed through a right ventricle and pulmonary valve into a pulmonary artery.

12. The method of claim 1, wherein applying baroreflex therapy includes transvascularly stimulating an afferent nerve.

13. The method of claim 1, wherein applying baroreflex therapy includes stimulating an afferent nerve using a nerve cuff.

14. The method of claim 1, wherein applying baroreflex therapy includes stimulating a baroreceptor in a vessel wall.

15. A baroreflex stimulator, comprising:

a pulse generator adapted to deliver a baroreflex stimulation therapy using a baroreflex stimulation signal; and

means for modulating the baroreflex stimulation signal based on a circadian rhythm template to mimic natural blood pressure fluctuations during the day, wherein the circadian rhythm template includes a cardiac output template.

16. A method for operating an implantable medical device, comprising:

applying a baroreflex stimulation therapy at a stimulation intensity using a baroreflex stimulator in the implantable medical device; and

modulating the baroreflex stimulation therapy based on a circadian rhythm template stored within the implantable medical device, wherein modulating the baroreflex stimulation therapy includes using the circadian rhythm template to change the stimulation intensity to mimic natural blood pressure fluctuations during the day,

wherein the circadian rhythm template includes a cardiac output template.

17. The method of claim 16, wherein modulating the baroreflex stimulation therapy includes modulating an amplitude of the baroreflex stimulation signal based on the circadian rhythm template.

18. The method of claim 16, wherein modulating the baroreflex stimulation therapy includes modulating a frequency of the baroreflex stimulation signal based on the circadian rhythm template.

19. The method of claim 16, wherein modulating the baroreflex stimulation therapy includes modulating a burst frequency of the baroreflex stimulation signal based on the circadian rhythm template.

20. The method of claim 16, wherein modulating the baroreflex stimulation therapy includes changing a waveform of the baroreflex stimulation signal based on the circadian rhythm template.

21. The method of claim 16, wherein the circadian rhythm template is a pre-programmed circadian rhythm template.

22. The method of claim 16, further comprising:

sensing and recording parameters; and

generating the cardiac output template as a patient-specific circadian rhythm template based on the recorded parameters.

23. The method of claim 16, further comprising delivering baroreflex stimulation through a lead adapted to be fed through a right ventricle and pulmonary valve into a pulmonary artery.

24. The method of claim 16, wherein applying baroreflex therapy includes transvascularly stimulating an afferent nerve.

25. The method of claim 16, wherein applying baroreflex therapy includes stimulating an afferent nerve using a nerve cuff.

26. The method of claim 16, wherein applying baroreflex therapy includes stimulating a baroreceptor in a vessel wall.

27. A baroreflex stimulator, comprising:

means for sensing and recording parameters related to hypertension;

means for generating a patient-specific circadian rhythm template based on the recorded parameters;

a pulse generator adapted to deliver a baroreflex stimulation therapy using a baroreflex stimulation signal; and

means for modulating the baroreflex stimulation signal based on the patient-specific circadian rhythm template to mimic natural blood pressure fluctuations during the day.