Thoracic aorta and vagus nerve stimulation

• US 8,626,299 B2
• Filed: 12/01/2010
• Issued: 01/07/2014
• Est. Priority Date: 01/31/2008
• Status: Active Grant

• Current Assignee: Enopace Biomedical Ltd.
• Original Assignee: Enopace Biomedical Ltd.
• Inventors: Dagan, Amir, Reisner, Yotam, Glasberg, Offer, Hanani, Nitai, Ariav, Gal, Gross, Yossi
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US12/957,799
• Publication Number:
  US 20110137370A1
• Time in Patent Office: 1,133 Days
• Field of Search: 607/44, 607/116, 607/9
• US Class Current: 607/44
• CPC Class Codes: A61M 2205/33 Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 60/135 inside a blood vessel, e.g. using grafting
• CPC Class Codes: A61M 60/139 inside the aorta, e.g. intra-aortic balloon pumps
• CPC Class Codes: A61M 60/161 mechanically acting upon the outside of the patient's blood vessel structure, e.g. compressive structures placed around a vessel
• CPC Class Codes: A61M 60/279 Peristaltic pumps, e.g. roller pumps
• CPC Class Codes: A61M 60/289 Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
• CPC Class Codes: A61M 60/295 Balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/30 Medical purposes thereof other than the enhancement of the cardiac output
• CPC Class Codes: A61M 60/473 generated by an electromotor
• CPC Class Codes: A61M 60/486 generated by electro-active actuators, e.g. using electro-active polymers or piezoelectric elements
• CPC Class Codes: A61M 60/497 for balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/515 Regulation using real-time patient data
• CPC Class Codes: A61M 60/538 Regulation using real-time blood pump operational parameter data, e.g. motor current
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0556 Cuff electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• 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 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/3962 : in combination with another heart therapy

Abstract

Apparatus and methods are provided, including an electrode that is placed in contact with an artery of a subject. A control unit drives the electrode to perform a function with respect to the artery, the function selected from the group consisting of: driving a current into the artery, and sensing an electrical parameter of the artery. A transmitter is placed in a vein of the subject that is in a vicinity of the artery, the transmitter being wiredly connected to the control unit. The control unit is configured to drive the electrode by wirelessly transmitting a signal via the transmitter. Other embodiments are also described.

Claims

1. Apparatus, comprising:

an electrode configured to be placed in contact with an aortic site of a subject that is downstream of a bifurcation of the aorta with a left subclavian artery, and between first and fifth intercostal arteries of the subject;

a control unit configured to drive the electrode to perform a function with respect to the site, the function selected from the group consisting of;

driving a current into the site, and sensing an electrical parameter of the site; and

a transmitter configured to be placed in a vein of the subject that is in a vicinity of the site, the transmitter being wiredly connected to the control unit, and the control unit being configured to drive the electrode by wirelessly transmitting a signal via the transmitter.

2. The apparatus according to claim 1, wherein the control unit is configured to be subcutaneously implanted inside the subject.

3. The apparatus according to claim 1, wherein the transmitter comprises a coil that defines a plane, and wherein the coil is configured to be placed inside the subject'"'"'s vein such that the plane defined by the coil is at an angle of more than 10 degrees from a plane that is perpendicular to a local longitudinal axis of the vein.

4. The apparatus according to claim 3, further comprising a coil support structure, the coil being coupled to the support structure such that the support structure is configured to place the coil inside the subject'"'"'s vein such that the plane defined by the coil is at the angle of more than 10 degrees from the plane that is perpendicular to the local longitudinal axis of the vein.

5. The apparatus according to claim 1, wherein the transmitter is configured to be placed in a subclavian vein of the subject.

6. The apparatus according to claim 1, wherein the transmitter is configured to be placed in the vein such that the transmitter is at a distance of less than 20 mm from the electrode.

7. The apparatus according to claim 6, wherein the transmitter is configured to be placed in the vein such that the transmitter is at a distance of less than 5 mm from the electrode.

25. The apparatus according to claim 1, wherein the transmitter is configured to be placed in a vena cava of the subject.

8. A method, comprising:

placing an electrode in contact with an aortic site of a subject that is downstream of a bifurcation of the aorta with a left subclavian artery, and between first and fifth intercostal arteries of the subject;

placing in a vein of the subject that is in a vicinity of the site, a transmitter that is wiredly connected to a control unit; and

using the control unit, driving the electrode to perform a function with respect to the site, the function selected from the group consisting of;

driving a current into the site, and sensing an electrical parameter of the site,

the driving being performed by the control unit wirelessly transmitting a signal via the transmitter.

9. The method according to claim 8, wherein the transmitter includes a coil that defines a plane, and wherein placing the transmitter inside the subject'"'"'s vein comprises placing the coil inside the subject'"'"'s vein such that the plane defined by the coil is at an angle of more than 10 degrees from a plane that is perpendicular to a local longitudinal axis of the vein.

10. The method according to claim 8, wherein placing the transmitter inside the vein comprises placing the transmitter inside the vein such that the transmitter is at a distance of less than 20 mm from the electrode.

11. The method according to claim 10, wherein placing the transmitter inside the vein comprises placing the transmitter inside the vein such that the transmitter is at a distance of less than 5 mm from the electrode.

12. The method according to claim 8, wherein placing the transmitter inside the vein comprises placing the transmitter inside a subclavian vein of the subject.

13. The method according to claim 8, wherein placing the electrode in contact with the aortic site comprises placing the electrode in contact with a portion of the aorta that is adjacent to a portion of a vagus nerve of the subject that is between (a) a vagal bifurcation with a thoracic cardiac branch of the subject, and (b) thoracic vagal branching into the esophageal plexus of the subject.

14. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing ventricular pressure of the subject by driving a current into the aortic site via the electrode.

15. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing aortic pressure of the subject by driving a current into the aortic site via the electrode.

16. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing sympathetic tone of the subject by driving a current into the aortic site via the electrode.

17. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises increasing parasympathetic tone of the subject by driving a current into the aortic site via the electrode.

18. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing sympathetic tone and increasing parasympathetic tone of the subject by driving a current into the aortic site via the electrode.

19. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises increasing aortic compliance of the subject by driving a current into the aortic site via the electrode.

20. The method according to claim 8, wherein placing the electrode in contact with the aortic site comprises assessing a response of the subject to placement of the electrode at a plurality of sites, and implanting the electrode at the aortic site in response to the assessing.

21. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing a ratio of a low frequency component to a high frequency component of heart rate variability of the subject by driving a current into the aortic site via the electrode.

22. The method according to claim 21, wherein the low frequency component is less than 0.05 Hz, and wherein the high frequency component is between 0.15 and 0.35 Hz.

23. The method according to claim 8, wherein driving the electrode to perform the function with respect to the site comprises reducing a ratio of a low frequency component to a high frequency component of blood pressure variability of the subject by driving a current into the aortic site via the electrode.

24. The method according to claim 23, wherein the low frequency component is less than 0.05 Hz, and wherein the high frequency component is between 0.15 and 0.35 Hz.

26. The method according to claim 8, wherein placing the transmitter inside the vein comprises placing the transmitter inside a vena cava of the subject.