System and method to deliver therapy in presence of another therapy

• US 8,504,149 B2
• Filed: 02/15/2012
• Issued: 08/06/2013
• Est. Priority Date: 05/10/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad, Kramer, Andrew P., Linder, William J., Stahmann, Jeffrey E.
• Primary Examiner(s): Gedeon, Brian T
• Application Number:
  US13/397,115
• Publication Number:
  US 20120150250A1
• Time in Patent Office: 538 Days
• Field of Search: 607/2, 607/4, 607/9, 607/14
• US Class Current: 607/4
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein.

Claims

1. A method, comprising:

delivering a therapy of a first therapy type;

determining an intensity for a therapy of a second therapy type; and

controlling delivery of the therapy of the first therapy type based on the intensity of the therapy of the second therapy type, including delivering the therapy of the first therapy type using a parameter set selected based on the intensity of the therapy of the second therapy type.

2. The method of claim 1, further comprising:

determining whether the therapy of the second type is present,

delivering therapy of the first type using a parameter set selected for use when the therapy of the second type is not present; and

delivering the therapy of the first therapy type using the parameter set selected based on the intensity of the therapy of the second therapy type when the therapy of the second type is present.

3. The method of claim 1, wherein the first therapy type is a cardiac rhythm management therapy and the second therapy type is a neural stimulation therapy.

4. The method of claim 1, wherein the first therapy type is a neural stimulation therapy and the second therapy type is a cardiac rhythm management therapy.

5. The method of claim 1, wherein controlling delivery includes:

controlling delivery of the therapy based on a plurality of parameters organized into a first set and a second set in at least one programmed therapy for the therapy type;

delivering the therapy of the first therapy type using the first set of parameters when the intensity of the therapy of the second therapy type has not reached a threshold value; and

delivering the therapy of the first therapy type using the second set of parameters when the intensity of the therapy of the second therapy type reached the threshold value.

6. The method of claim 1, wherein controlling delivery of the therapy of the first therapy type based on the presence of the intensity of the therapy of the second therapy type includes receiving a signal indicative of the intensity of the therapy of the second therapy type.

7. The method of claim 1, wherein:

delivering the therapy of the first therapy type includes using a first implantable device to deliver the therapy of the first therapy type; and

delivering the therapy of the second therapy type includes using a second implantable device to deliver the therapy of the second therapy type.

8. The method of claim 1, wherein delivering the therapy of the first therapy type and delivering the therapy of the second therapy type includes using an implantable device to deliver both the therapy of the first therapy type and the therapy of the second therapy type.

9. A method, comprising:

delivering a cardiac rhythm management therapy, wherein delivering the cardiac rhythm management therapy includes delivering myocardial stimulation;

determining an intensity for a neural stimulation therapy; and

controlling delivery of the cardiac rhythm management therapy based on the intensity of the neural stimulation therapy, wherein controlling delivery includes delivering the cardiac rhythm management therapy using a parameter set selected based on the intensity of the neural stimulation therapy.

10. The method of claim 9, wherein the neural stimulation therapy includes vagal nerve stimulation.

11. The method of claim 9, wherein the neural stimulation therapy includes stimulation of a baroreceptor site.

12. The method of claim 9, wherein the neural stimulation therapy includes stimulation of a carotid sinus nerve.

13. The method of claim 9, wherein the neural stimulation includes stimulation of a cardiac fat pad.

14. The method of claim 9, wherein the cardiac rhythm management therapy is configured to operate using more than one pacing mode, and delivering the cardiac rhythm management therapy using a parameter set selected based on the intensity of the neural stimulation therapy includes changing pacing modes for the cardiac rhythm management therapy based on the intensity of the neural stimulation therapy.

15. The method of claim 9, wherein the cardiac rhythm management therapy is configured to operate at an anti-tachycardia pacing (ATP) rate, and delivering the cardiac rhythm management therapy using a parameter set selected based on the intensity of the neural stimulation therapy includes changing values for the ATP rate for the cardiac rhythm management therapy based on the intensity of the neural stimulation therapy.

16. The method of claim 9, wherein the cardiac rhythm management therapy is configured to operate using an AV interval or a VV interval, and delivering the cardiac rhythm management therapy using a parameter set selected based on the intensity of the neural stimulation therapy includes changing values for the AV interval or the VV interval based on the intensity of the neural stimulation therapy.

17. The method of claim 9, wherein delivering the cardiac rhythm management therapy includes delivering a defibrillation therapy, and delivering the cardiac rhythm management therapy using a parameter set selected based on the intensity of the neural stimulation therapy includes changing values for a defibrillation threshold for the defibrillation therapy based on the intensity of the neural stimulation therapy.

18. A method, comprising:

delivering a neural stimulation therapy;

determining an intensity for a cardiac rhythm management therapy, wherein the cardiac rhythm management therapy includes myocardial stimulation and determining the intensity includes determining an operation mode for the cardiac rhythm management therapy; and

controlling delivery of the neural stimulation therapy based on the cardiac rhythm management therapy, wherein controlling delivery includes delivering the neural stimulation therapy using a parameter set selected based on the intensity of the cardiac rhythm management therapy.

19. The method of claim 18, wherein delivering the neural stimulation therapy using a parameter set selected based on the intensity of the cardiac rhythm management therapy includes delivering the neural stimulation therapy using a neural stimulation amplitude based on the intensity of the cardiac rhythm management therapy.

20. The method of claim 18, wherein delivering the neural stimulation therapy using a parameter set selected based on the intensity of the cardiac rhythm management therapy includes delivering the neural stimulation therapy using a neural stimulation frequency based on the intensity of the cardiac rhythm management therapy.

21. The method of claim 18, wherein delivering the neural stimulation therapy using a parameter set selected based on the intensity of the cardiac rhythm management therapy includes delivering the neural stimulation therapy using neural stimulation burst timing based on the intensity of the cardiac rhythm management therapy.

22. The method of claim 18, wherein delivering the neural stimulation therapy includes delivering vagal nerve stimulation.

23. The method of claim 18, wherein delivering the neural stimulation therapy includes stimulating a baroreceptor site.

24. The method of claim 18, wherein delivering the neural stimulation therapy includes stimulating a carotid sinus nerve.

25. The method of claim 18, wherein delivering the neural stimulation therapy includes stimulating a cardiac fat pad.