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 an efferent fiber of a vagus nerve;
monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor an afferent fiber of the vagus nerve during delivery of electrical stimulation to the efferent fiber;
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 efferent fiber,monitor electrical activity from the afferent nerve, wherein the electrical activity includes an indirect component of a compound action potential (CAP), wherein the afferent electrical activity is associated with a burst pattern during a predetermined phase of a cardiac cycle,assess a status of the patient'"'"'s heart based on the indirect component, 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.
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Citations
49 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 an efferent fiber of a vagus nerve; monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor an afferent fiber of the vagus nerve during delivery of electrical stimulation to the efferent fiber; 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 efferent fiber, monitor electrical activity from the afferent nerve, wherein the electrical activity includes an indirect component of a compound action potential (CAP), wherein the afferent electrical activity is associated with a burst pattern during a predetermined phase of a cardiac cycle, assess a status of the patient'"'"'s heart based on the indirect component, 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, 8, 9, 10, 11, 12)
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13. A method for using an implantable medical device, the method comprising:
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delivering electrical stimuli to an efferent nerve associated with a selected organ, wherein delivery of electrical stimuli is adjusted by adjusting a pacing parameter; monitoring afferent electrical activity during delivery of electrical stimuli to the efferent nerve, the monitored afferent electrical activity includes an indirect component of a compound action potential (CAP); assessing a status of the selected organ based upon the indirect component; and determining whether to deliver therapy to the selected organ in response to assessing the status of the selected organ. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A method for using an implantable medical device, the method comprising:
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introducing a perturbation, wherein the perturbation includes electrical stimulation, and wherein the electrical stimulation is adjusted to change one of AV timing and VV timing; monitoring afferent electrical activity; assessing a status of the selected organ; and determining whether to deliver therapy to the selected organ in response to assessing the status of the selected organ. - View Dependent Claims (27, 28, 29, 30, 31, 32)
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33. 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 an efferent fiber of a vagus nerve; monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor an afferent fiber of the vagus nerve during delivery of electrical stimulation to the efferent fiber; 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 efferent fiber, wherein the electrical stimulation is about 3 milliamperes, monitor electrical activity from the afferent nerve, wherein the electrical activity includes an indirect component of a compound action potential (CAP), assess a status of the patient'"'"'s heart based on the indirect component, 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 (34, 35, 36)
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37. 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 an efferent fiber of a vagus nerve; monitoring apparatus configured to monitor physiological parameters of the patient, wherein the monitoring apparatus comprises at least one electrode to monitor an afferent fiber of the vagus nerve during delivery of electrical stimulation to the efferent fiber; 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 efferent fiber, wherein the delivery of electrical stimulation is adjusted by adjusting a pacing parameter, monitor electrical activity from the afferent nerve, wherein the electrical activity includes an indirect component of a compound action potential (CAP), assess a status of the patient'"'"'s heart based on the indirect component, 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 (38, 39, 40, 41)
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42. A method for using an implantable medical device, the method comprising:
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delivering electrical stimuli to an efferent nerve associated with a selected organ, wherein the selected organ comprises one of a kidney, a stomach, and a gastrointestinal tract; monitoring afferent electrical activity during delivery of electrical stimuli to the efferent nerve, the monitored afferent electrical activity includes an indirect component of a compound action potential (CAP); assessing a status of the selected organ based upon the indirect component; and determining whether to deliver therapy to the selected organ in response to assessing the status of the selected organ. - View Dependent Claims (43, 44, 45)
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46. A method for using an implantable medical device, the method comprising:
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delivering electrical stimuli to an efferent nerve associated with a selected organ; monitoring afferent electrical activity during delivery of electrical stimuli to the efferent nerve, the monitored afferent electrical activity includes an indirect component of a compound action potential (CAP), wherein the afferent electrical activity is in response to a burst pattern of electrical stimuli during a predetermined phase of a cardiac cycle; assessing a status of the selected organ based upon the indirect component; and determining whether to deliver therapy to the selected organ in response to assessing the status of the selected organ. - View Dependent Claims (47, 48, 49)
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Specification