Electrical stimulation treatment of hypotension

• US 8,233,988 B2
• Filed: 09/14/2011
• Issued: 07/31/2012
• Est. Priority Date: 02/10/2006
• Status: Active Grant

• Current Assignee: electroCore, Inc.
• Original Assignee: Electrocore, Llc
• Inventors: Errico, Joseph P., Simon, Bruce J., Mendez, Steven
• Primary Examiner(s): Manuel, George
• Assistant Examiner(s): Wieland, Robert N
• Application Number:
  US13/232,258
• Publication Number:
  US 20120065698A1
• Time in Patent Office: 321 Days
• Field of Search: 607/44
• US Class Current: 607/44
• CPC Class Codes: A61N 1/0456 Specially adapted for transcutaneous electrical nerve stimulation [TENS]
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0517 Esophageal electrodes
• CPC Class Codes: A61N 1/0519 Endotracheal electrodes
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• 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 1/3616 Voltage density or current density
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/36175 Pulse width or duty cycle

Abstract

The present invention includes methods and devices for treating hypotension, such as in cases of shock, including septic shock, anaphylactic shock and hypovolemia. The method includes the step of applying at least one electrical impulse to at least one selected region of a parasympathetic nervous system of the patient. The electrical impulse is sufficient to modulate one or more nerves of the parasympathetic nervous system to increase the ratio of blood pressure to heart rate and relieve the condition and/or extend the patient'"'"'s life.

Claims

1. A method of treating bronchoconstriction in a patient comprising applying at least one electrical impulse to at least one selected region of a parasympathetic nervous system of the patient, the electrical impulse being sufficient to modulate one or more afferent nerves in a selected region of the parasympathetic nervous system such to relax bronchial smooth muscle in the patient.

2. The method set forth in claim 1 wherein the electrical impulse is sufficient to stimulate the afferent nerves in the selected region of the parasympathetic nervous system.

3. The method set forth in claim 1 wherein the electrical impulse is insufficient to substantially modulate the efferent nerves in the selected region of the parasympathetic nervous system.

4. The method set forth in claim 2 wherein the electrical impulse is sufficient to cause the afferent nerves in the selected region to modulate one or more nerves in a sympathetic nervous system.

5. The method set forth in claim 4 wherein the afferent nerves in the selected region cause an increase in activity of the one or more nerves of the sympathetic nervous system.

6. The method set forth in claim 1 further comprising the step of positioning an electrode adjacent to or near the selected region of the parasympathetic nervous system and applying an electrical signal having an amplitude to the electrode;

wherein a distance between the electrode and the selected region and the amplitude are selected such that the electrical signal modulates the afferent nerves at the selected region of the parasympathetic nervous system without substantially modulating the efferent nerves at the selected region of the parasympathetic nervous system.

7. The method of claim 6 wherein the amplitude is less than 12 volts.

8. The method of claim 1 wherein the electrical impulse is sufficient to relax bronchial smooth muscle and maintain a substantially stable heart rate.

9. The method of claim 1 wherein the electrical impulse has a frequency of about 10 Hz to 100 Hz.

10. The method of claim 1 wherein the electrical impulse has a frequency of about 15-35 Hz, a pulsed on-time of about 100-400 microseconds, and an amplitude of about 0.1 to 2 volts.

11. A method of treating bronchoconstriction in a patient comprising applying at least one electrical impulse to at least one selected region of a vagus nerve of the patient, the electrical impulse being sufficient to modulate one or more afferent nerves in a selected region of the vagus nerve.

12. The method of claim 11 wherein the applying step is carried out by positioning an electrode near or adjacent to a cricoid cartilage of the patient and applying the electrical impulse to the electrode.

13. The method of claim 11 wherein the applying step is carried out by positioning an electrode adjacent to or on a neck of the patient and applying the electrical impulse to the electrode.

14. The method of claim 11 wherein the electrical impulse is sufficient to stimulate the afferent nerves in the selected region of the vagus nerve.

15. The method of claim 11 wherein the electrical impulse is insufficient to substantially modulate the efferent nerves of the selected region of the vagus nerve.

16. The method of claim 11 wherein the electrical impulse is sufficient to cause the afferent nerves to cause an increase in activity of one or more nerves in a sympathetic nervous system of the patient responsible to effect a dilation of bronchial smooth muscle.

17. The method of claim 13 wherein the electrical impulse to applied transcutaneously through an outer skin surface of the patient'"'"'s neck to the vagus nerve.