Automatic baroreflex modulation based on cardiac activity

• US 8,626,301 B2
• Filed: 06/03/2013
• Issued: 01/07/2014
• Est. Priority Date: 12/24/2003
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US13/908,185
• Publication Number:
  US 20130268027A1
• Time in Patent Office: 218 Days
• Field of Search: 607/2, 607/44, 607/9, 607 17- 20
• US Class Current: 607/44
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/36139 with automatic adjustment

Abstract

An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a cardiac activity monitor to sense cardiac activity and provide a signal indicative of the cardiac activity, and a baroreflex stimulator. The stimulator includes a pulse generator and a modulator. The pulse generator provides a baroreflex stimulation signal adapted to provide a baroreflex therapy. The modulator receives the signal indicative of the cardiac activity and modulates the baroreflex stimulation signal based on the signal indicative of the cardiac activity to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

Claims

1. An implantable system, comprising:

communication circuitry configured to communicate with an implantable cardiac stimulator configured to sense activity and to receive signal indicative of the sensed activity;

a baroreflex stimulator configured to deliver a baroreflex stimulation therapy;

a controller operably connected to the communication circuitry and the baroreflex stimulator, the controller configured to;

automatically classify the sensed activity as an activity level selected from at least two preprogrammed activities levels; and

automatically select a baroreflex stimulation level for the baroreflex stimulation therapy based on the activity level of the detected activity, wherein the baroreflex stimulation level is selected from at least two preprogrammed stimulation levels.

2. The system of claim 1, wherein the controller is configured to automatically classify the detected activity as rest or exercise, and automatically select the baroreflex stimulation level to apply baroreflex stimulation during rest and withdraw baroreflex stimulation during exercise.

3. The system of claim 1, wherein the at least two preprogrammed activity levels includes a first activity level and a second activity level where the first activity level is higher than the second activity level, and the controller is configured to automatically classify the detected activity as the first activity level or the second activity level, and automatically select a first baroreflex stimulation level when the activity level is determined to be the second activity level and automatically select a second baroreflex stimulation level when the activity level is determined to be the first activity level, wherein the first baroreflex stimulation level is higher than the second baroreflex stimulation level.

4. The system of claim 1, wherein the preprogrammed baroreflex stimulation levels have an inverse relationship with the preprogrammed activity levels such that an incremental increase in the activity level corresponds with an incremental decrease in the baroreflex stimulation level.

5. The system of claim 1, wherein the sensed activity includes sensed heart rate.

6. The system of claim 1, wherein the implantable cardiac stimulator is configured to sense cardiac activity and acquire heart rate data, and wherein the communication circuitry is configured to receive the heart rate data from the implantable cardiac stimulator.

7. The system of claim 1, wherein the implantable cardiac stimulator is configured to sense respiration, and wherein the communication circuitry is configured to receive respiration data from the implantable cardiac stimulator.

8. The system of claim 7, wherein the respiration data includes tidal volume data.

9. The system of claim 7, wherein the respiration data includes minute ventilation data.

10. The system of claim 1, further comprising an accelerometer, wherein the controller is further configured to use the accelerometer to sense activity.

11. The system of claim 1, wherein the implantable cardiac stimulator is configured to sense acceleration and acquire acceleration data, and wherein the communication circuitry is configured to receive the acceleration data from the implantable cardiac stimulator.

12. The system of claim 1, wherein the sensed activity includes a combination of at least two of heart rate, minute ventilation or acceleration.

13. The system of claim 1, further comprising a lead adapted to be fed through a right ventricle and pulmonary valve into a pulmonary artery, wherein the baroreflex stimulator is configured to deliver the baroreflex stimulation using the lead.

14. An implantable system, comprising:

communication circuitry configured to communicate with an implantable cardiac stimulator configured to sense activity and to receive signal indicative of the sensed activity, wherein the sensed activity includes a signal indicative of sensed heart rate, sensed respiration or sensed acceleration;

a baroreflex stimulator configured to deliver a baroreflex stimulation therapy;

a controller operably connected to the communication circuitry and the baroreflex stimulator, the controller configured to;

automatically classify the sensed activity as an activity level selected from at least two preprogrammed activities levels, wherein automatically classifying the detected activity includes automatically classifying the detected activity as rest or exercise; and

automatically select a baroreflex stimulation level for the baroreflex stimulation therapy to apply baroreflex stimulation during rest and withdraw baroreflex stimulation during exercise.

15. The system of claim 14, wherein the sensed activity includes sensed respiration, and the sensed respiration includes tidal volume or minute ventilation.

16. The system of claim 14, further comprising an accelerometer, wherein the controller is further configured to use the accelerometer to sense activity.

17. An implantable system, comprising:

an implantable cardiac stimulator configured to stimulate myocardia and to sense activity, the implantable cardiac stimulator including communication circuitry, and

a neural stimulator, including;

communication circuitry configured to communicate with the communication circuitry of the implantable cardiac stimulator and to receive signal indicative of the sensed activity;

a baroreflex stimulator configured to deliver a baroreflex stimulation therapy; and

a controller operably connected to the communication circuitry and the baroreflex stimulator, the controller configured to;

automatically classify the sensed activity as an activity level selected from at least two preprogrammed activities levels, wherein the at least two preprogrammed activity levels includes a first activity level and a second activity level where the first activity level is higher than the second activity level; and

automatically select a baroreflex stimulation level for the baroreflex stimulation therapy based on the activity level of the detected activity, including automatically select a first baroreflex stimulation level when the activity level is determined to be the second activity level and automatically select a second baroreflex stimulation level when the activity level is determined to be the first activity level, wherein the first baroreflex stimulation level is higher than the second baroreflex stimulation level.

18. The system of claim 17, wherein the preprogrammed baroreflex stimulation levels have an inverse relationship with the preprogrammed activity levels such that an incremental increase in the activity level corresponds with an incremental decrease in the baroreflex stimulation level.

19. The system of claim 18, wherein the signal indicative of sensed activity includes a signal indicative of heart rate, respiration or acceleration.

20. The system of claim 17, wherein the sensed activity includes sensed respiration, and the sensed respiration includes tidal volume or minute ventilation.