Renal neuromodulation for treatment of patients with chronic heart failure

• US 8,880,186 B2
• Filed: 04/11/2013
• Issued: 11/04/2014
• Est. Priority Date: 04/08/2002
• Status: Expired due to Fees

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Levin, Howard R., Gelfand, Mark
• Primary Examiner(s): BOCKELMAN, MARK
• Application Number:
  US13/861,178
• Publication Number:
  US 20130253603A1
• Time in Patent Office: 572 Days
• Field of Search: 607/2, 607/3, 607/44, 607/62, 607/117, 607/118
• US Class Current: 607/62
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61M 1/3627 Degassing devices; Buffer reservoirs; Drip chambers; Blood filters
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00

Abstract

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Claims

1. A method comprising:

sensing a physiologic parameter of a human patient diagnosed with chronic heart failure;

generating a stimulation signal based, at least in part, on the sensed physiological parameter; and

delivering the stimulation signal from an electrical stimulator to a nerve that provides neural control of a function of a kidney of the patient, the signal causing a decrease in renal sympathetic activity of the patient,

wherein decreasing renal sympathetic nerve activity results in a therapeutically beneficial reduction in clinical symptoms of chronic heart failure in the patient.

2. The method of claim 1 wherein sensing the physiological parameter comprises sensing a physiological parameter indicative of sympathetic activity within the patient, the method further comprising identifying an increase in sympathetic activity based on the physiological parameter, and wherein generating the stimulation signal comprises generating the stimulation signal in response to the increase in sympathetic activity.

3. The method of claim 1 wherein generating the stimulation signal includes generating the stimulation signal with an implantable electrode, and delivering the stimulation signal includes delivering the stimulation signal from the implantable electrode.

4. The method of claim 1, further comprising transmitting information regarding the physiological parameter to an external device outside of the patient.

5. The method of claim 1 wherein the physiological parameter comprises at least one of blood pressure and blood oxygen saturation.

6. A system comprising:

a sensor configured to sense a physiological parameter of a human patient diagnosed with chronic heart failure; and

an electrical stimulator configured to communicate with the sensor, wherein the electrical stimulator comprises a stimulation generator for generating a stimulation signal based on a physiological parameter sensed by the sensor and for delivering the stimulation signal to block or inhibit neural traffic along a nerve that provides neural control of a function of a kidney of the patient,

wherein blocking or inhibiting neural traffic results in a therapeutically beneficial reduction in clinical symptoms of chronic heart failure in the patient.

7. The system of claim 6 wherein the physiological parameter is indicative of sympathetic activity within the patient, and wherein the system further comprises a processor configured to identify an increase in sympathetic activity based on the physiological parameter and controls the electrical stimulator to generate the stimulation signal in response to the increase in sympathetic activity.

8. The system of claim 6, further comprising an external device configured to receive information regarding the physiological parameter.

9. The system of claim 8 wherein the information comprises information regarding at least one of blood pressure and blood oxygen saturation.

10. A method comprising:

sensing a physiological parameter indicative of sympathetic activity within a human patient diagnosed with chronic heart failure;

identifying an increase in sympathetic activity based on the physiological parameter; and

delivering a stimulation signal to reduce neural traffic along a nerve to the identified increased in sympathetic activity,

wherein reducing traffic results in a therapeutically beneficial reduction in clinical symptoms of chronic heart failure in the patient.

11. The method of claim 10 wherein the physiological parameter is indicative of renal activity.

12. The method of claim 10 wherein the physiological parameter comprises at least one of blood pressure and blood oxygen saturation.

13. The method of claim 10 wherein sensing the physiological parameter comprises sensing a first physiological parameter, and wherein the method further comprises sensing a second physiological parameter when the first physiological parameter indicates the increase in sympathetic activity, and further wherein identifying the increase in sympathetic activity is based on the first and second physiological parameters.

14. The method of claim 10, further comprising transmitting information regarding the physiological parameter to an external device outside of the patient.

15. A system comprising:

a sensor configured to sense a physiological parameter indicative of sympathetic activity within a human patient diagnosed with chronic heart failure;

a processor electronically coupled to the sensor and configured to identify an increase in sympathetic activity based on the physiological parameter; and

an electrical stimulator electrically coupled to the processor and configured to deliver a stimulation signal to a nerve that provides neural control of a function of a kidney of the patient, the stimulation signal being adapted to inhibit neural communication along the nerve in response to the increase in sympathetic activity,

wherein inhibiting neural communication results in a therapeutically beneficial reduction in clinical symptoms of chronic heart failure in the patient.

16. The system of claim 15, wherein the processor comprises a processor of the electrical stimulator.

17. The system of claim 15, further comprising a lead, wherein the electrical stimulator delivers the stimulation signal to the nerve via one or more electrodes carried by the lead.

18. The system of claim 15 wherein the physiological parameter is indicative of renal activity.

19. The system of claim 15 wherein the physiological parameter comprises at least one of blood pressure and blood oxygen saturation.