Controlled titration of neurostimulation therapy
First Claim
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1. An implantable device for delivering neurostimulation, comprising:
- a pulse generator for outputting neural stimulation pulses to one or more stimulation electrodes for delivering electrical stimulation to a selected neural site;
a controller connected to the pulse generator for controlling the output of neural stimulation pulses in accordance with a defined schedule and in accordance with specified stimulation parameters;
one or more sensing modalities for sensing a physiological variable reflective of a patient'"'"'s autonomic balance; and
,wherein the controller is programmed to adjust the amount of neurostimulation delivered in accordance with a determination of the patient'"'"'s autonomic balance; and
,wherein the controller is programmed to monitor the impedance of a lead connecting the stimulation electrode to the pulse generator by charging an output capacitor of the pulse generator to a specified voltage level, delivering a stimulation pulse, and measuring the time it takes for the capacitor voltage to decay by a specified amount.
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Abstract
Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient'"'"'s autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient'"'"'s autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion.
40 Citations
20 Claims
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1. An implantable device for delivering neurostimulation, comprising:
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a pulse generator for outputting neural stimulation pulses to one or more stimulation electrodes for delivering electrical stimulation to a selected neural site; a controller connected to the pulse generator for controlling the output of neural stimulation pulses in accordance with a defined schedule and in accordance with specified stimulation parameters; one or more sensing modalities for sensing a physiological variable reflective of a patient'"'"'s autonomic balance; and
,wherein the controller is programmed to adjust the amount of neurostimulation delivered in accordance with a determination of the patient'"'"'s autonomic balance; and
,wherein the controller is programmed to monitor the impedance of a lead connecting the stimulation electrode to the pulse generator by charging an output capacitor of the pulse generator to a specified voltage level, delivering a stimulation pulse, and measuring the time it takes for the capacitor voltage to decay by a specified amount. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A method for operating an implantable device to deliver neurostimulation, comprising:
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outputting neural stimulation pulses to one or more stimulation electrodes connected to a pulse generator for delivering electrical stimulation to a selected neural site; controlling the output of neural stimulation pulses in accordance with a defined schedule and in accordance with specified stimulation parameters; enabling user input of a defined schedule for delivering neurostimulation and specified stimulation parameters; sensing a physiological variable reflective of a patient'"'"'s autonomic balance; and
,adjusting the amount of neurostimulation delivered in accordance with a determination of the patient'"'"'s autonomic balance; and
,monitoring the impedance of a lead connecting the stimulation electrode to the pulse generator by charging an output capacitor of the pulse generator to a specified voltage level, delivering a stimulation pulse, and measuring the time it takes for the capacitor voltage to decay by a specified amount. - View Dependent Claims (18, 19, 20)
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Specification