System for stimulating autonomic targets from pulmonary artery

• US 8,527,064 B2
• Filed: 12/03/2008
• Issued: 09/03/2013
• Est. Priority Date: 12/12/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yunlong, Sachanandani, Haresh G., Li, Dan, Mi, Bin
• Primary Examiner(s): Manuel, George
• Assistant Examiner(s): ALTER MORSCHAUSER, ALYSSA MARGO
• Application Number:
  US12/327,601
• Publication Number:
  US 20090228078A1
• Time in Patent Office: 1,735 Days
• Field of Search: 607/62, 607/116, 607/40, 607/36
• US Class Current: 607/116
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/6862 Stents
• CPC Class Codes: A61B 5/6876 Blood vessel
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• 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 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient

Abstract

Various implantable medical device embodiments stimulate an autonomic neural target from within a pulmonary artery, and comprise at least one electrode, a power supply, a neural stimulator connected to the power supply, and an anchor structure. The neural stimulator is configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode. The anchor structure is configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery. The anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery. In various embodiments, the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve.

Claims

1. An implantable medical device for stimulating an autonomic neural target from within a pulmonary artery, comprising:

at least one electrode;

a power supply;

a neural stimulator connected to the power supply, and configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode; and

an anchor structure configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery,

wherein the neural stimulator is configured to implement the neural stimulation protocol to;

sense at least two physiological parameters indicative of autonomic health which can be used as a control input for delivering neural stimulation, wherein the at least two parameters have different time responses to a change in the autonomic health such that a first physiological parameter provides an indication of autonomic health that is more acute than a second physiological parameter;

generate a composite index using the at least two physiological parameters, including weighting each of the at least two physiological parameters based at least in part on each parameter'"'"'s time response; and

use the composite index to control delivery of the neural stimulation.

2. The device of claim 1, wherein the anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery, and the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve.

3. The device of claim 1, wherein the neural stimulator includes a control system configured to implement the neural stimulation protocol.

4. The device of claim 1, wherein the neural stimulator includes a communication module adapted to wirelessly receive instructions from a controller outside of the pulmonary artery to implement the neural stimulation protocol.

5. The device of claim 1, further comprising:

a pressure sensor configured to sense a pulmonary artery pressure or a heart rate sensor configured to sense heart rate; and

the neural stimulator is connected to the pressure sensor or heart rate sensor, and configured to control the neural stimulation protocol based on a sensed pulmonary artery pressure or a sensed heart rate.

6. The device of claim 5, wherein the neural stimulator is configured to derive heart rate from sensed pulmonary artery pressure.

7. The device of claim 1, wherein the neural stimulator is configured to generate the composite index using at least two parameters selected from the group of parameters consisting of:

a heart rate parameter, an impedance parameter, and a pulmonary artery pressure parameter.

8. The device of claim 1, wherein the anchor structure, the neural stimulator and the at least one electrode are configured to deliver neural stimulation targeted to stimulate baroreceptors in the pulmonary artery.

9. The device of claim 1, wherein the power supply includes a rechargeable battery, and means for wirelessly recharging the rechargeable battery.

10. The device of claim 1, wherein the at least one electrode is integrally formed with the anchor structure.

11. A system for stimulating baroreceptors in a pulmonary artery, comprising:

means for sensing at least one physiological parameter; and

at least one pulmonary artery device configured to be delivered through a pulmonary valve in the pulmonary artery, including;

a power supply for providing power to the at least one pulmonary artery device;

means for stimulating the autonomic neural target from within the pulmonary artery; and

means for chronically and securely implanting the at least one pulmonary artery device within the pulmonary artery;

means for sensing at least two physiological parameters indicative of autonomic health which can be used as a control input for delivering neural stimulation, wherein the at least two parameters have different time responses to a change in the autonomic health such that a first physiological parameter provides an indication of autonomic health that is more acute than a second physiological parameter;

means for generating a composite index using the at least two physiological parameters, including weighting each of the at least two physiological parameters based at least in part on each parameter'"'"'s time response; and

means for implementing a neural stimulation therapy, including means for using the composite index to control delivery of the neural stimulation.

12. The system of claim 11, further comprising means for performing a pacing therapy.

13. The system of claim 11, wherein the means for sensing includes a pulmonary artery pressure sensor configured to be chronically implanted into the pulmonary artery.

14. The system of claim 11, wherein the means for sensing includes means for sensing heart rate, impedance, heart sounds, respiration, blood flow, posture or activity.

15. The system of claim 11, wherein the means for sensing includes means for sensing using an implantable sensor outside of the pulmonary artery, and the at least one pulmonary artery device includes means for wirelessly communicating from within the pulmonary artery to the implantable sensor outside of the pulmonary artery.

16. The system of claim 11, wherein the at least one pulmonary artery device includes a first device configured to be implanted in a right pulmonary artery and a second device configured to be implanted in a left pulmonary artery, wherein the first and second device include means for communicating between each other.

17. The system of claim 11, wherein the neural stimulation therapy includes heart failure therapy, and the means for implementing a neural stimulation therapy includes means for stimulating baroreceptors within the pulmonary artery to treat heart failure.

18. The system of claim 11, wherein the means for implementing a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary artery includes means for controlling the neural stimulation from within the pulmonary artery or means for controlling the neural stimulation from outside of the pulmonary artery.

19. The system of claim 11, wherein the neural stimulation therapy includes ischemia therapy, and the means for implementing a neural stimulation therapy includes means for stimulating baroreceptors within the pulmonary artery to treat ischemia.

20. The system of claim 11, wherein the neural stimulation therapy includes an arrhythmia therapy, and the means for implementing a neural stimulation therapy includes means for stimulating baroreceptors within the pulmonary artery to treat arrhythmia.

21. The system of claim 11, wherein the neural stimulation therapy includes hypertension therapy, and the means for implementing a neural stimulation therapy includes means for stimulating baroreceptors within the pulmonary artery to treat hypertension.

22. The system of claim 11, further comprising means for performing an antitachycardia therapy.

23. The system of claim 11, further comprising means for performing a cardiac resynchronization therapy.