Method for treating hypertension via electrical stimulation of neural structures

• US 8,868,188 B2
• Filed: 09/13/2013
• Issued: 10/21/2014
• Est. Priority Date: 09/20/2012
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Inventors: Hershey, Bradley L.
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US14/026,646
• Publication Number:
  US 20140081345A1
• Time in Patent Office: 403 Days
• Field of Search: 607/5, 607/30
• US Class Current: 607/30
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36 for stimulation
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36117 for treating hypertension

Abstract

A neuromodulation system comprises a sensor configured for sensing a blood pressure of a patient, modulation output circuitry configured for conveying electrical modulation energy to at least one electrode, and a controller/processor coupled to the sensor and the modulation output circuitry. The controller/processor is configured for comparing the blood pressure sensed by the sensor to a first threshold blood pressure, and instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode if the sensed blood pressure is greater than the first threshold blood pressure. A method for treating chronic hypertension comprises applying electrical modulation energy to a neural target site, thereby modulating an afferent nerve innervating a patient'"'"'s kidney, thereby treating the chronic hypertension.

Claims

1. A neuromodulation system, comprising:

a sensor configured for sensing a blood pressure of a patient;

modulation output circuitry configured for conveying electrical modulation energy to at least one electrode; and

a controller/processor coupled to the sensor and the modulation output circuitry, the controller/processor configured for comparing the sensed blood pressure to a first threshold, instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode if the sensed blood pressure is greater than the first threshold blood pressure, comparing the sensed blood pressure to a second threshold blood pressure, and instructing the modulation output circuitry to cease conveying the electrical modulation energy to the at least one electrode if the sensed blood pressure is less than the second threshold blood pressure.

2. The neuromodulation system of claim 1, wherein the first threshold blood pressure is 140 mm Hg systolic/90 mm Hg diastolic.

3. The neuromodulation system of claim 1, wherein the second threshold blood pressure is less than the first threshold blood pressure.

4. The neuromodulation system of claim 3, wherein the second threshold blood pressure is in the range of 100-140 mm Hg systolic/60-90 mm Hg.

5. The neuromodulation system of claim 1, further comprising a biocompatible casing housing the modulation output circuitry and the controller/processor.

6. The neuromodulation system of claim 1, further comprising the at least one electrode.

7. A method for treating a patient suffering from chronic hypertension using the neuromodulation system of claim 1, wherein the at least one electrode is adjacent a neural target site, the method comprising:

sensing the blood pressure;

comparing the sensed blood pressure to the first threshold;

applying electrical modulation energy from the neuromodulation system to the neural target site if the sensed blood pressure is greater than the first threshold blood pressure, thereby modulating an afferent nerve fiber innervating a kidney of the patient, thereby treating the chronic hypertension;

comparing the sensed blood pressure to a second threshold blood pressure; and

ceasing applying electrical modulation energy from the neuromodulation system to the neural target site if the sensed blood pressure is less than the second threshold blood pressure.

8. The method of claim 7, wherein the neural target site is located on the afferent nerve fiber.

9. The method of claim 7, wherein the neural target site is located on an efferent nerve fiber that synapses to the afferent nerve fiber.

10. The method of claim 7, wherein the neural target site is on a spinal cord of the patient.

11. The method of claim 10, wherein the neural target site is on a dorsal column (DC) nerve fiber.

12. The method of claim 7, wherein the neural target site is on a dorsal root (DR) nerve fiber.

13. The method of claim 7, wherein the neural target site is on a peripheral nerve fiber.

14. The method of claim 7, wherein the modulating the afferent nerve fiber comprises evoking action potentials along the afferent nerve fiber.

15. The method of claim 7, wherein the modulating the afferent nerve fiber comprises blocking action potentials along the afferent nerve fiber.

16. The method of claim 7, wherein the afferent nerve fiber is an autonomic nerve fiber.

17. The method of claim 7, wherein the afferent nerve fiber is a sympathetic nerve fiber.

18. The method of claim 17, wherein the neural target site is located at an L1-L3 spinal level.

19. The method of claim 7, wherein the afferent nerve fiber is a parasympathetic nerve fiber.

20. The method of claim 19, wherein the neural target site is located at an S2-S4 spinal level.

21. The method of claim 7, wherein the electrical modulation energy is epidurally applied to the target site on the afferent nerve fiber.

22. The method of claim 7, wherein the electrical modulation energy is transcutaneously applied to the target site.

23. The method of claim 7, wherein the patient has a blood pressure greater than 140 mm Hg systolic/90 mm Hg diastolic prior to the application of the modulation energy to the target site on the afferent nerve fiber.

24. The method of claim 23, wherein the patient has a blood pressure in the range of 100-140 mm Hg systolic/60-90 mm Hg diastolic during the application of the modulation energy to the target site on the afferent nerve fiber.

25. The neuromodulation system of claim 1, wherein the controller/processor is configured for instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode only if the electrical modulation energy is not being currently conveyed to the at least one electrode and if the sensed blood pressure is greater than the first threshold blood pressure, and instructing the modulation output circuitry to cease conveying the electrical modulation energy to the at least one electrode only if the electrical modulation energy is currently being conveyed to the at least one electrode and if the sensed blood pressure is less than the second threshold blood pressure.