Implantable medical device having multiple electrode/sensor capability and stimulation based on sensed intrinsic activity

• US 8,600,521 B2
• Filed: 01/27/2005
• Issued: 12/03/2013
• Est. Priority Date: 01/27/2005
• Status: Active Grant

• Current Assignee: LivaNova USA, Inc. (LivaNova Plc)
• Original Assignee: Cyberonics, Inc
• Inventors: Armstrong, Randolph K., Armstrong, Scott A.
• Primary Examiner(s): STOKLOSA, JOSEPH A
• Application Number:
  US11/045,602
• Publication Number:
  US 20060167497A1
• Time in Patent Office: 3,232 Days
• Field of Search: 607/45, 607117-118
• US Class Current: 607/117
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36139 with automatic adjustment

Abstract

In one embodiment, an implantable neurostimulator comprises a pulse generator that generates an electrical pulse signal to stimulate a neural structure in a patient, a stimulation lead assembly coupled to the pulse generator for delivering the electrical pulse signal to the neural structure, a plurality of sensors coupled to the pulse generator, and sensor select logic. Each sensor is individually selectable and the sensor select logic selects any two or more of the plurality of sensors for sensing a voltage difference between the selected sensors. In other embodiments, two or more physiologic parameters are sensed. In yet another embodiment, a method comprises sensing intrinsic electrical activity on a person'"'"'s nerve and stimulating the nerve based on the sensed intrinsic electrical activity of the nerve.

Claims

1. An implantable medical device, comprising:

a pulse generator that provides an electrical pulse signal to stimulate a cranial nerve in a patient, wherein said electrical pulse signal comprises multiple stimulation parameters;

a stimulation lead assembly coupled to said pulse generator for delivering said electrical pulse signal to said cranial nerve, said lead assembly having a proximal end coupled to said pulse generator and a distal end comprising a stimulation electrode assembly adapted to be coupled to said cranial nerve;

a first sensor coupled to said pulse generator, wherein said first sensor is adapted to sense an evoked response in a target tissue;

a second sensor coupled to said pulse generator, wherein said second sensor is adapted to sense an evoked response in a non-target tissue; and

wherein said pulse generator adjusts at least one stimulation parameter to evoke a response in said target tissue and to not evoke a response in said non-target tissue.

2. The implantable medical device of claim 1 wherein said cranial nerve comprises a vagus nerve.

3. The implantable medical device of claim 1 wherein said plurality of stimulation parameters comprise:

current magnitude;

pulse frequency;

pulse width;

an on-time; and

an off-time.

4. The implantable medical device of claim 1 wherein said target tissue comprises said patient'"'"'s cranial nerve.

5. The implantable medical device of claim 1 wherein the target tissue comprises a specific nerve fiber type of said cranial nerve.

6. The implantable medical device of claim 5 wherein the specific nerve fiber type is selected from the group comprising:

A fibers;

B fibers; and

C fibers.

7. The implantable medical device of claim 1 wherein the non-target tissue comprises said patient'"'"'s vocal cords.

8. The implantable medical device of claim 1 wherein the non-target tissue comprises said patient'"'"'s heart.

9. The implantable medical device of claim 1 wherein the non-target tissue comprises a specific nerve fiber type of said cranial nerve.

10. The implantable medical device of claim 9 wherein the specific nerve fiber type is selected from the group comprising:

A fibers;

B fibers; and

C fibers.

11. The implantable medical device of claim 8 utilized to treat heart failure.

19. The implantable medical device of claim 1 wherein said non-target tissue comprises a specific nerve fiber type of said cranial nerve.

12. An implantable medical device to treat heart failure, comprising:

a pulse generator that provides an electrical pulse signal to stimulate a cranial nerve in a patient, wherein said electrical pulse signal comprises multiple stimulation parameters;

a stimulation lead assembly operatively coupled to said pulse generator;

a first sensor communicatively coupled to said pulse generator, wherein said first sensor is adapted to sense an evoked response in a target tissue;

a second sensor communicatively coupled to said pulse generator, wherein said second sensor is adapted to sense an evoked response in a non-target tissue; and

wherein said pulse generator adjusts at least one stimulation parameter to evoke a response in said target tissue and to not evoke a response in said non-target tissue.

13. The implantable medical device of claim 12 wherein said cranial nerve comprises a vagus nerve.

14. The implantable medical device of claim 12 wherein said target tissue comprises said patient'"'"'s cranial nerve.

15. The implantable medical device of claim 12 wherein said target tissue comprises a specific nerve fiber type of said cranial nerve.

16. The implantable medical device of claim 15 wherein the specific nerve fiber type is selected from the group comprising:

A fibers;

B fibers; and

C fibers.

17. The implantable medical device of claim 12 wherein the non-target tissue comprises said patient'"'"'s vocal cords.

18. The implantable medical device of claim 12 wherein the non-target tissue comprises said patient'"'"'s heart.

20. An implantable medical device to treat heart failure, comprising:

a pulse generator that provides an electrical pulse signal to stimulate a branch of a vagus nerve in a patient, wherein said electrical pulse signal comprises multiple stimulation parameters;

a stimulation lead assembly coupled to said pulse generator for delivering said electrical pulse signal to said vagus nerve, said lead assembly having a proximal end coupled to said pulse generator and a distal end comprising a stimulation electrode assembly adapted to be coupled to said vagus nerve;

a first sensor coupled to said pulse generator, wherein said first sensor is adapted to sense an evoked response in said vagus nerve;

a second sensor communicatively coupled to said pulse generator, wherein said second sensor is adapted to sense an evoked response in said patient'"'"'s vocal cords; and

wherein said pulse generator adjusts at least one stimulation parameter to evoke a response in said vagus nerve and to not evoke a response in said patient'"'"'s vocal cords.