Therapy using perturbation and effect of physiological systems

• US 8,888,699 B2
• Filed: 04/26/2011
• Issued: 11/18/2014
• Est. Priority Date: 04/29/2010
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Buschman, Hendrik Peter Johan, Cornelussen, Richard N. M., Hill, Michael Roland Scott, Kornet, Lilian, Ordelman, Simone Cornelia Maria Anna, Veltink, Petrus Hermanus
• Primary Examiner(s): GETZOW, SCOTT M
• Application Number:
  US13/094,327
• Publication Number:
  US 20110270343A1
• Time in Patent Office: 1,302 Days
• Field of Search: 607/1, 607/2, 607 68- 74, 600544-548, 600/300, 600/508
• US Class Current: 600/300
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371

Abstract

Methods for treating a patient and further to devices for performing such treatment, e.g., methods and devices to perturb at least one physiological system and deliver therapy to the patient based on the effects of such perturbation. For example, a method for using an implantable medical device is disclosed that involves a method for using an implantable medical device delivering electrical stimuli to an afferent nerve associated with the selected organ. The efferent electrical activity is monitored in an efferent nerve responsive to delivering electrical stimuli to the afferent nerve, the monitored efferent electrical activity includes an indirect component of a compound action potential (CAP). A status of the selected organ is assessed based upon the indirect component.

Claims

1. A method for using an implantable medical device, the method comprising:

delivering electrical stimuli to an afferent nerve associated with the selected organ;

monitoring efferent electrical activity in an efferent nerve responsive to delivering electrical stimuli to the afferent nerve, wherein the monitored efferent electrical activity includes an indirect component of a compound action potential (CAP), wherein the indirect component is not in direct response to the delivered electrical stimuli; and

assessing a status of the selected organ based upon the indirect component.

2. The method of claim 1, wherein assessing a status of the selected organ based upon the indirect component comprises assessing one of expected latency and dispersion of the indirect component.

3. The method of claim 2, wherein the expected latency is associated with a fourth peak in the CAP.

4. The method of claim 2, wherein an expected time constant of latency correlates to a time constant of an initial change in a cardiac parameter.

5. The method of claim 2, wherein the expected latency is represented by a time constant of latency.

6. The method of claim 2, wherein an expected time constant of dispersion correlates to a time constant of an initial change in a cardiac parameter.

7. The method of claim 1, wherein the electrical stimuli is burst pacing.

8. The method of claim 7, wherein the burst pacing treats a condition.

9. The method of claim 1, wherein the electrical stimuli is a single pulse.

10. The method of claim 9, wherein the single pulse provides data related to a status of a nerve-organ system.

11. The method of claim 10, wherein the single pulse does not provide treatment.

12. The method of claim 1, wherein the efferent electrical activity is associated with dispersion of a fourth component in a compound action potential.

13. The method of claim 12, wherein the dispersion forms multiple peaks in response to a single pulse of electrical stimuli.

14. The method of claim 13, wherein the dispersion is represented by a time constant of dispersion.

15. The method of claim 1, wherein the afferent electrical activity is associated with a burst pattern during a predetermined phase of a cardiac cycle.

16. The method of claim 1, wherein a status of the selected organ is not permanently affected by the delivered electrical stimuli.

17. A method for determining a fullness of a stomach using an implantable medical device, the method comprising:

delivering electrical stimuli to an afferent nerve associated with the stomach;

monitoring efferent electrical activity responsive to delivering electrical stimuli to the afferent nerve;

assessing a status of the stomach in response to the monitored efferent electrical activity; and

amplifying a signal to the vagal nerve to indicate the stomach is partially full.

18. The method of claim 17, wherein the electrical stimuli is burst pacing.

19. The method of claim 17, wherein the electrical stimuli is a single pulse.

20. The method of claim 19, wherein the single pulse provides data related to a status of the stomach.