Neural stimulation with respiratory rhythm management
First Claim
1. An implantable neural stimulator for delivering chronic neural stimulation therapy that includes stimulation of a vagus nerve of a patient, the stimulator comprising:
- at least one respiration sensor configured to be used in monitoring respiration of the patient;
a neural stimulation therapy delivery module configured to generate a neural stimulation signal for use in stimulating the vagus nerve of the patient for the chronic neural stimulation therapy; and
a controller operably connected to the at least one respiration sensor and to the neural stimulation therapy delivery module to provide closed-loop therapy control using a marker for efficacy of the chronic neural stimulation therapy in treating a cardiovascular disorder, wherein the controller is configured to;
control the neural stimulation therapy delivery module, using programmable parameters and a programmed therapy schedule, to deliver the chronic neural stimulation therapy, wherein the chronic neural stimulation therapy is configured to treat the cardiovascular disorder of the patient and is delivered over a period of time that includes a plurality of low activity periods and a plurality of non-low activity periods, wherein the cardiovascular disorder is selected from the group of cardiovascular disorders consisting of heart failure, post myocardial infarction, and hypertension;
determine the marker for one or more of the plurality of low activity periods during the period of time when the chronic neural stimulation therapy is delivered, wherein in determining the marker the controller is configured to;
receive a respiration signal from the at least one respiration sensor indicative of the patient'"'"'s respiration;
monitor the respiration signal during one of the plurality of low activity periods within the period of time; and
determine a respiration variability measurement over a plurality of respiration cycles for the one of the plurality of low activity periods using the monitored respiration signal, wherein the respiratory variability measurement for the one of the plurality of low activity periods provides the marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder, wherein the respiration variability measurement includes either a respiration rate variability measurement or a tidal volume variability measurement; and
adjust an intensity of the chronic neural stimulation therapy using the determined respiratory variability measurement.
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Accused Products
Abstract
A system embodiment comprises at least one respiration sensor, a neural stimulation therapy delivery module, and a controller. The respiration sensor is adapted for use in monitoring respiration of the patient. The neural stimulation therapy delivery module is adapted to generate a neural stimulation signal for use in stimulating the autonomic neural target of the patient for the chronic neural stimulation therapy. The controller is adapted to receive a respiration signal from the at least one respiration sensor indicative of the patient'"'"'s respiration, and adapted to control the neural stimulation therapy delivery module using a respiratory variability measurement derived using the respiration signal.
25 Citations
26 Claims
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1. An implantable neural stimulator for delivering chronic neural stimulation therapy that includes stimulation of a vagus nerve of a patient, the stimulator comprising:
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at least one respiration sensor configured to be used in monitoring respiration of the patient; a neural stimulation therapy delivery module configured to generate a neural stimulation signal for use in stimulating the vagus nerve of the patient for the chronic neural stimulation therapy; and a controller operably connected to the at least one respiration sensor and to the neural stimulation therapy delivery module to provide closed-loop therapy control using a marker for efficacy of the chronic neural stimulation therapy in treating a cardiovascular disorder, wherein the controller is configured to; control the neural stimulation therapy delivery module, using programmable parameters and a programmed therapy schedule, to deliver the chronic neural stimulation therapy, wherein the chronic neural stimulation therapy is configured to treat the cardiovascular disorder of the patient and is delivered over a period of time that includes a plurality of low activity periods and a plurality of non-low activity periods, wherein the cardiovascular disorder is selected from the group of cardiovascular disorders consisting of heart failure, post myocardial infarction, and hypertension; determine the marker for one or more of the plurality of low activity periods during the period of time when the chronic neural stimulation therapy is delivered, wherein in determining the marker the controller is configured to; receive a respiration signal from the at least one respiration sensor indicative of the patient'"'"'s respiration; monitor the respiration signal during one of the plurality of low activity periods within the period of time; and determine a respiration variability measurement over a plurality of respiration cycles for the one of the plurality of low activity periods using the monitored respiration signal, wherein the respiratory variability measurement for the one of the plurality of low activity periods provides the marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder, wherein the respiration variability measurement includes either a respiration rate variability measurement or a tidal volume variability measurement; and adjust an intensity of the chronic neural stimulation therapy using the determined respiratory variability measurement. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A system, comprising:
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means for delivering a chronic neural stimulation therapy over a period of time that includes a plurality of low activity periods and a plurality of non-low activity periods to treat a cardiovascular disorder, wherein the cardiovascular disorder is selected from the group of cardiovascular disorders consisting of heart failure, post myocardial infarction, and hypertension, and wherein the means for delivering the chronic neural stimulation therapy is configured to stimulate a vagus nerve; means for determining a marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder during one or more of the plurality of low activity periods during the period of time when the chronic neural stimulation therapy is delivered, wherein the means for determining the marker includes; means for monitoring respiration during one of the plurality of low activity periods within the period of time; and means for determining a respiration variability over a plurality of respiration cycles for the one of the plurality of low activity periods using the monitored respiration, wherein the respiratory variability measurement for the one of the plurality of low activity periods provides a marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder, wherein the respiration variability measurement includes either a respiration rate variability measurement or a tidal volume variability measurement; and means for adjusting an intensity of the stimulation to the vagus nerve if the respiration variability measurement crosses a predetermined threshold to provide closed-loop therapy control. - View Dependent Claims (10, 11, 12)
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13. A method, comprising:
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delivering a chronic neural stimulation therapy over a period of time that includes a plurality of low activity periods and a plurality of non-low activity periods to treat a cardiovascular disorder selected from the group of cardiovascular disorders consisting of heart failure, post myocardial infarction, and hypertension, wherein delivering the chronic neural stimulation therapy includes delivering stimulation to a vagus nerve; determining a marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder for one or more of the plurality of low activity periods during the period of time when the chronic neural stimulation therapy is delivered, wherein determining the marker includes; monitoring respiration during one of the plurality of low activity periods within the period of time; and determining a respiration variability measurement over a plurality of respiration cycles for the one of the plurality of low activity periods using the monitored respiration, wherein the respiratory variability measurement for the one of the plurality of low activity periods provides a marker for efficacy of the chronic neural stimulation therapy in treating the cardiovascular disorder, wherein the respiration variability measurement includes either a respiration rate variability measurement or a tidal volume variability measurement; and adjusting an intensity of the stimulation to the vagus nerve using a comparison of the respiration variability measurement to at least one predetermined threshold to provide closed-loop therapy control. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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Specification