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Delivery of a sympatholytic cardiovascular agent to the central nervous system

  • US 8,348,884 B2
  • Filed: 05/28/2008
  • Issued: 01/08/2013
  • Est. Priority Date: 02/06/2004
  • Status: Active Grant
First Claim
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1. A system for delivering a drug dosage from a drug dispenser to receptors of the central nervous system of a patient'"'"'s body to therapeutically treat symptoms of cardiac insult or impaired cardiac performance;

  • wherein the central nervous system site comprises one of;

    the sub-arachnoid space;

    the sub-arachnoid space of the spinal cord;

    the sub-arachnoid space of the thoracic spinal cord;

    the sub-arachnoid space between the first and fifth thoracic vertebrae;

    the sympathetic preganglionic cell bodies located in the intermediolateral cell column of the spinal cord;

    the preganglionic sympathetic neurons that provide innervation to the heart; and

    the preganglionic sympathetic neurons that provide innervation to the kidneys;

    wherein the system comprises;

    a drug infusion catheter adapted to be implanted in the patient'"'"'s body so that a distal drug delivery portion is disposed at a predetermined central nervous system site;

    a drug delivery pump coupled to a proximal end of the drug infusion catheter having a drug reservoir holding a volume of a sympatholytic cardiovascular agent;

    means for operating the drug delivery pump to discharge a predetermined dosage of the sympatholytic cardiovascular agent to a central nervous system site effective to alleviate such symptoms of cardiac insult or impaired cardiac performance;

    a physiologic sensor adapted to be surgically implanted in the patient'"'"'s body;

    means for operating the physiologic sensor to derive a physiologic parameter associated with cardiac insult or impaired cardiac performance, including at least one of the group;

    a myocardial ischemia condition, a cardiac arrthymia condition, an episode of angina, a hypertension condition, a chronically elevated stress level, a chronically elevated anxiety level, and a relatively elevated sympathetic drive condition; and

    means for adjusting the dosage as a function of the monitored physiologic parameter associated with cardiac insult or impaired cardiac performance;

    wherein the sympatholytic agent comprises clonidine delivered from into the central nervous system by continuous intrathecal infusion at a dosage of 0.01 to 1.0 mg/day; and

    wherein the physiologic sensor comprises an EGM sensor, and the operating means further comprises determining one or more of heart rate, heart rate variability, and aberrations in the PQRST segment include changes in morphology, ST segment elevation, electrical alternans, and interval changes associated with cardiac insult or impaired cardiac performance.

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