Therapy using perturbation and effect of physiological systems
First Claim
1. A device for use in treatment of a patient comprising:
- perturbation apparatus configured to perturb at least one physiological system of a patient, wherein the perturbation apparatus comprises at least one electrode to stimulate the patient'"'"'s vagus nerve;
monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor the electrical activity of the patient'"'"'s vagus nerve;
a sensing module coupled to the monitoring apparatus and configured to receive the monitored physiological parameters;
a therapy delivery module configured to deliver therapy to the patient; and
a control module coupled to the perturbation apparatus, to the sensing module, and to the therapy delivery module, and configured to;
perturb at least one physiological system of the patient using the perturbation apparatus by at least delivering electrical stimulation to the patient'"'"'s vagus nerve,monitor electrical activity from the vagus nerve, wherein the electrical activity includes at least one direct component and an indirect component of a compound action potential (CAP), wherein the indirect component is not in direct response to the delivered electrical stimulation as indicated by a latency between the electrical stimulation delivered to the patient'"'"'s vagus nerve and the indirect component;
provide a response index comprising data representative of an effect on the indirect component of the monitored electrical activity of the vagus nerve in response to one or more perturbations to the at least one physiological system,assess a status of the patient'"'"'s heart by comparing the response index with the indirect component monitored after perturbing the at least one physiological system of the patient, anddetermine whether to deliver therapy to the patient using the therapy delivery module based on the assessed status of the patient'"'"'s heart.
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Accused Products
Abstract
Methods for treating a patient and further to devices for performing such treatment, e.g., methods and devices to perturb at least one physiological system and deliver therapy to the patient based on the effects of such perturbation. For example, a method for using an implantable medical device is disclosed that involves delivering electrical stimuli to an efferent nerve associated with the selected organ. Afferent electrical activity is monitored during delivery of electrical stimuli to the efferent nerve, the monitored afferent electrical activity includes an indirect component of a compound action potential (CAP). A status of the selected organ is assessed based upon the indirect component. A determination is made as to whether to deliver therapy to the selected organ in response to assessing the status of the selected organ.
341 Citations
21 Claims
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1. A device for use in treatment of a patient comprising:
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perturbation apparatus configured to perturb at least one physiological system of a patient, wherein the perturbation apparatus comprises at least one electrode to stimulate the patient'"'"'s vagus nerve; monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor the electrical activity of the patient'"'"'s vagus nerve; a sensing module coupled to the monitoring apparatus and configured to receive the monitored physiological parameters; a therapy delivery module configured to deliver therapy to the patient; and a control module coupled to the perturbation apparatus, to the sensing module, and to the therapy delivery module, and configured to; perturb at least one physiological system of the patient using the perturbation apparatus by at least delivering electrical stimulation to the patient'"'"'s vagus nerve, monitor electrical activity from the vagus nerve, wherein the electrical activity includes at least one direct component and an indirect component of a compound action potential (CAP), wherein the indirect component is not in direct response to the delivered electrical stimulation as indicated by a latency between the electrical stimulation delivered to the patient'"'"'s vagus nerve and the indirect component; provide a response index comprising data representative of an effect on the indirect component of the monitored electrical activity of the vagus nerve in response to one or more perturbations to the at least one physiological system, assess a status of the patient'"'"'s heart by comparing the response index with the indirect component monitored after perturbing the at least one physiological system of the patient, and determine whether to deliver therapy to the patient using the therapy delivery module based on the assessed status of the patient'"'"'s heart. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method for use in treatment of a patient, the method comprising:
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perturbing at least one physiological system of the patient; monitoring physiological parameters of the patient, wherein monitoring physiological parameters of the patient comprises monitoring electrical activity of at least one nerve associated with a selected organ of the patient, wherein the electrical activity includes at least one direct component and an indirect component of a compound action potential (CAP), wherein the indirect component is not in direct response to the perturbance as indicated by a latency between the perturbance to the at least one physiological system and the indirect component; providing a response index comprising data representative of an effect on the indirect component of the monitored electrical activity of the at least one nerve associated with the selected organ in response to one or more perturbations to the at least one physiological system; assessing a status of the selected organ by comparing the response index with the indirect component monitored after perturbing at least one physiological system of the patient; and determining whether to deliver therapy to the patient based on the assessed status of the selected organ. - View Dependent Claims (9, 10, 11, 12, 13, 14)
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15. A method for use in treatment of a patient, the method comprising:
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perturbing at least one physiological system of the patient, wherein perturbing at least one physiological system of the patient comprises delivering electrical stimulation to the patient'"'"'s vagus nerve; monitoring physiological parameters of the patient, wherein monitoring physiological parameters of the patient comprises monitoring electrical activity of the patient'"'"'s vagus nerve comprising at least one direct component and an indirect component, wherein the indirect component is not in direct response to the delivered electrical stimulation as indicated by a latency between the delivery of the electrical stimulation to the patient'"'"'s vagus nerve and the indirect component; providing a response index comprising data representative of an effect on the indirect component of the monitored electrical activity of the vagus nerve in response to one or more perturbations to the vagus nerve; assessing a status of the patient'"'"'s heart by comparing the response index with the indirect component monitored after perturbing at least one physiological system of the patient; and delivering therapy to the patient based on the assessed status of the patient'"'"'s heart. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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Specification