Device and implantation system for electrical stimulation of biological systems
First Claim
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1. A system for increasing pressure of a patient'"'"'s lower esophageal sphincter (LES), comprising:
- at least one electrode configured to contact the LES;
a waveform generator coupled to the electrodes; and
a controller configured to electrically stimulate the LES to increase the pressure of the LES, and maintain an average pressure of the LES above a pressure level which reduces at least one of a frequency of occurrence or an intensity of transient lower esophageal sphincter relaxation (tLESR) symptoms in the patient both during and after stimulation by controlling the waveform generator to repeatedly;
a) generate and apply an electrical pulse train to the LES through the electrodes for a stimulation period, and b) terminate the electrical pulse train for a rest period, wherein at least one of an amplitude, frequency, or duration of said pulse train is defined such that pressure of the LES normalizes after at least five minutes from when stimulation is initiated.
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Abstract
The present specification discloses devices and methodologies for the treatment of transient lower esophageal sphincter relaxations (tLESRs). Individuals with tLESRs may be treated by implanting a stimulation device within the patient'"'"'s lower esophageal sphincter and applying electrical stimulation to the patient'"'"'s lower esophageal sphincter, in accordance with certain predefined protocols. The presently disclosed devices have a simplified design because they do not require sensing systems capable of sensing when a person is engaged in a wet swallow and have improved energy storage requirements.
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Citations
98 Claims
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1. A system for increasing pressure of a patient'"'"'s lower esophageal sphincter (LES), comprising:
- at least one electrode configured to contact the LES;
a waveform generator coupled to the electrodes; and
a controller configured to electrically stimulate the LES to increase the pressure of the LES, and maintain an average pressure of the LES above a pressure level which reduces at least one of a frequency of occurrence or an intensity of transient lower esophageal sphincter relaxation (tLESR) symptoms in the patient both during and after stimulation by controlling the waveform generator to repeatedly;
a) generate and apply an electrical pulse train to the LES through the electrodes for a stimulation period, and b) terminate the electrical pulse train for a rest period, wherein at least one of an amplitude, frequency, or duration of said pulse train is defined such that pressure of the LES normalizes after at least five minutes from when stimulation is initiated. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
- at least one electrode configured to contact the LES;
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17. A system for normalizing functionality of a patient'"'"'s lower esophageal sphincter (LES), comprising:
- at least one electrode configured to contact the LES;
a waveform generator coupled to the electrodes; and
a controller configured to control the waveform generator to generate and apply an electrical pulse train to the LES through the electrodes during a stimulation period to produce said normalization of function in the LES during a rest period after termination of the electrical pulse train, which reduces at least one of a frequency of occurrence or an intensity of transient lower esophageal sphincter relaxation (tLESR) symptoms in the patient, wherein at least one of an amplitude, frequency, or duration of said pulse train is defined such that swallowing of the patient is not hindered by said stimulation. - View Dependent Claims (18, 19, 20, 21)
- at least one electrode configured to contact the LES;
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22. A system for normalizing a function of a patient'"'"'s lower esophageal sphincter (LES), comprising:
- at least one electrode configured to contact the LES;
a waveform generator coupled to the electrodes; and
a controller configured to control the waveform generator to generate and apply an electrical pulse train to the LES through the electrodes to normalize the function of the LES, which reduces at least one of a frequency of occurrence or an intensity of tLESR symptoms in the patient while allowing the patient to swallow during electrical stimulation wherein at least one of an amplitude, frequency, or duration of said pulse train is defined such that said function of the LES normalizes after at least five minutes from when stimulation is initiated. - View Dependent Claims (23, 24, 25, 26)
- at least one electrode configured to contact the LES;
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27. A system for increasing pressure of a patient lower esophageal sphincter (LES), comprising:
- at least one electrode configured to contact the LES;
a waveform generator coupled to the electrodes;
a battery powering the waveform generator; and
a controller configured to control the waveform generator to generate and apply an electrical pulse train to the LES through the electrodes to increase the pressure of the LES, the electrical pulse train being controlled by the controller so that an amount of electrical energy consumed from the battery when stimulating the LES is an energy amount that maintains an average pressure of the LES above a pressure level which reduces at least one of a frequency of occurrence or an intensity of tLESR symptoms in the patient while maintaining at least a minimum charge on the battery to electrically power the waveform generator for a predetermined time period, wherein the controller is configured to control the waveform generator so that the increased pressure level of the LES is below a pressure level that prevents the patient from swallowing a bolus. - View Dependent Claims (28, 29, 30, 31)
- at least one electrode configured to contact the LES;
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32. A method of treating a patient with transient lower esophageal sphincter relaxation (tLESR) symptoms, wherein said patient has a lower esophageal sphincter (LES) and wherein said LES has a pressure, the method comprising:
- maintaining an average pressure of the LES above a pressure level which reduces at least one of a frequency of occurrence or an intensity of the tLESR symptoms both during and after stimulation by applying an electrical pulse train to the LES through electrodes for a stimulation period to increase the pressure of the LES above the pressure level, and terminating the electrical pulse train for a rest period wherein at least one of an amplitude, frequency, or duration of said pulse train is defined such that the increased pressure of the LES is below a pressure level that prevents the patient from swallowing a bolus.
- View Dependent Claims (33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74)
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75. A method of treating a patient with transient lower esophageal sphincter relaxation (tLESR) symptoms, the method comprising:
- (a) implanting a stimulation device in the patient to contact the patient LES, (b) applying electrical stimulation to the patient LES, and (b) maintaining an average pressure of the LES above a pressure level both during and after electrical stimulation for a stimulation period to increase the pressure of the LES above the pressure level, and terminating the electrical stimulation for a rest period wherein at least one of an amplitude, frequency, or duration of said electrical stimulation is defined such that the increased pressure of the LES is below a pressure level that prevents the patient from swallowing a bolus.
- View Dependent Claims (76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97)
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98. A method of treating a patient with transient lower esophageal sphincter relaxation (tLESR) symptoms, the method comprising:
- (a) implanting the stimulation device in the patient to contact the patient LES;
(b) applying electrical stimulation to the patient LES;
(b) measuring one or more parameters selected from the group consisting of patient feed state including type of feed;
patient position;
patient activity;
patient reflux profile;
LES pressure;
LES electrical activity;
LES mechanical activity gastric pressure;
gastric electrical activity;
gastric chemical activity;
gastric temperature;
gastric mechanical activity;
patient intuition;
vagal neural activity; and
, splanchnic neural activity;
(c) inputting the collected data into an algorithm; and
(d) applying electrical stimulation based upon a summary score calculated by said algorithm to maintain an average pressure of the LES above a pressure level both during and after electrical stimulation for a stimulation period to increase the pressure of the LES above the pressure level, and terminating the electrical stimulation for a rest period wherein at least one of an amplitude, frequency, or duration of said electrical stimulation is defined such that the average pressure of the LES is below a pressure level that prevents the patient from swallowing a bolus.
- (a) implanting the stimulation device in the patient to contact the patient LES;
Specification