Neural stimulation modulation based on monitored cardiovascular parameter

• US 8,805,513 B2
• Filed: 04/23/2013
• Issued: 08/12/2014
• 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): ANTHONY, JESSICA LYNN
• Application Number:
  US13/868,287
• Publication Number:
  US 20130231717A1
• Time in Patent Office: 476 Days
• Field of Search: 607/9, 607 17- 27, 607/44, 607/62
• US Class Current: 607/44
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• 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 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

A system example may include a vagus nerve stimulator, a physiological parameter monitor and a controller. The stimulator may be configured to deliver vagus nerve stimulation in a recurring succession of stimulation cycles, where the vagus nerve stimulation is provided for a portion of each cycle and not provided for another portion each stimulation cycle. The monitor may be configured to monitor a physiological parameter within the portion of each cycle when the stimulation is generated and within another portion of each cycle when the stimulation is not generated. The controller may be configured to determine a change in the sensed physiological parameter where the change reflects a difference in the sensed physiological parameter between the portions of a stimulation cycle, compare the detected change to a target change to provide a comparison result, and adjust the vagus nerve stimulation based on the comparison result.

Claims

1. A method, comprising:

delivering vagus nerve stimulation in a recurring succession of stimulation cycles, wherein the vagus nerve stimulation is provided for a portion of each cycle and not provided for another portion each stimulation cycle;

sensing a physiological parameter within the portion of each cycle when the stimulation is generated and within another portion of each cycle when the stimulation is not generated;

determining a change in the sensed physiological parameter, wherein the change reflects a difference in the sensed physiological parameter between the portions of a stimulation cycle;

comparing the change to a target change to provide a comparison result; and

adjusting the vagus nerve stimulation based on the comparison result.

2. The method of claim 1, wherein sensing the physiological parameter includes sensing heart rate.

3. The method of claim 1, wherein sensing the physiological parameter includes sensing blood pressure.

4. The method of claim 1, wherein sensing the physiological parameter includes sensing respiration.

5. The method of claim 1, further comprising detecting an adverse event, and adjusting the target change in response to detecting the adverse event, wherein detecting the adverse event includes:

detecting an arrhythmia;

detecting dyspnea;

detecting angina;

detecting decompensation;

or

detecting activity.

6. The method of claim 1, further comprising programming the target change that is compared to the detected change.

7. The method of claim 1, further comprising implementing a programmed algorithm to determine the target change that is compared to the detected change.

8. The method of claim 1, further comprising changing the target change using a circadian rhythm.

9. A method, comprising:

delivering vagus nerve stimulation in a recurring succession of stimulation cycles, wherein the vagus nerve stimulation is provided for a portion of each cycle and not provided for another portion each stimulation cycle;

sensing a physiological parameter within the portion of each cycle when the stimulation is generated and within another portion of each cycle when the stimulation is not generated, wherein sensing the physiological parameter includes;

sensing heart rate;

sensing blood pressure;

or sensing respiration;

determining a change in the sensed physiological parameter, wherein the change reflects a difference in the sensed physiological parameter between the portions of a stimulation cycle;

implementing a programmed algorithm to determine a target change for the sensed physiological parameter;

comparing the detected change to the target change to provide a comparison result; and

adjusting the vagus nerve stimulation based on the comparison result.

10. The method of claim 9, further comprising detecting an adverse event, and adjusting the target change in response to detecting the adverse event.

11. The method of claim 9, further comprising changing the target change using a circadian rhythm.

12. A system, comprising:

a vagus nerve stimulator configured to deliver vagus nerve stimulation in a recurring succession of stimulation cycles, wherein the vagus nerve stimulation is provided for a portion of each cycle and not provided for another portion each stimulation cycle;

a physiological parameter monitor configured to monitor a physiological parameter within the portion of each cycle when the stimulation is generated and within another portion of each cycle when the stimulation is not generated;

a controller configured to;

determine a change in the sensed physiological parameter, wherein the change reflects a difference in the sensed physiological parameter between the portions of a stimulation cycle;

compare the detected change to a target change to provide a comparison result; and

adjust the vagus nerve stimulation based on the comparison result.

13. The system of claim 12, wherein the physiological parameter monitor is configured to monitor heart rate.

14. The system of claim 12, wherein the physiological parameter monitor is configured to monitor blood pressure.

15. The system of claim 12, the physiological parameter monitor is configured to monitor respiration.

16. The system of claim 12, further comprising an adverse event detector, wherein the controller is configured to adjust the target change in response to detecting the adverse event.

17. The system of claim 12, wherein the adverse event detector is configured to:

detect an arrhythmia;

detect dyspnea;

detect angina;

detect decompensation;

or

detect activity.

18. The system of claim 12, wherein the controller is configured to change the target change using a circadian rhythm.

19. The system of claim 12, wherein the controller is configured to implement a programmed algorithm to determine the target change that is compared to the detected change.

20. The system of claim 12, wherein the target change is a programmed target change within the system.