Neural stimulation system for cardiac fat pads

• US 8,918,172 B2
• Filed: 12/04/2013
• Issued: 12/23/2014
• Est. Priority Date: 03/11/2005
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Moffitt, Julia, Libbus, Imad
• Primary Examiner(s): Bertram, Eric D.
• Application Number:
  US14/096,807
• Publication Number:
  US 20140088676A1
• Time in Patent Office: 384 Days
• Field of Search: 607/9
• US Class Current: 607/9
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0587 Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36135 using physiological parameters
• 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 1/3962 in combination with another heart therapy
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein.

Claims

1. A method, comprising:

implanting a lead comprising at least two electrodes;

stimulating, via at least one of the at least two electrodes, an IVC-LA cardiac fat pad associated with an atrioventricular (AV) node to change the AV conduction time of the heart without changing the sinus rate, the IVC-LA cardiac fat pad being located proximate to a junction between an inferior vena cava and a left atrium; and

delivering, via another one of the at least two electrodes, myocardial pacing.

2. The method of claim 1, wherein implanting the lead includes implanting an epicardial lead.

3. The method of claim 1, wherein implanting the lead includes implanting an intravascular lead for transvascular stimulation of the IVC-LA fat pad.

4. The method of claim 1, wherein implanting the lead includes implanting an intravascular lead for puncturing a vessel to place the at least one of the at least two electrodes outside of the vessel proximate to the IVC-LA fat pad.

5. A method, comprising:

using an implanted lead with at least two electrodes to deliver myocardial pacing and to stimulate an IVC-LA cardiac fat associated with an atrioventricular (AV) node to change the AV conduction time of the heart without changing the sinus rate, the IVC-LA cardiac fat pad being located proximate to a junction between an inferior vena cava and a left atrium, including;

stimulating the IVC-LA fat pad using at least one of the at least two electrodes; and

delivering myocardial pacing using another one of the at least two electrodes on the lead.

6. The method of claim 5, wherein using the implanted lead includes using an epicardial lead with at least two electrodes.

7. The method of claim 5, wherein using the implanted lead includes using an intravascular lead.

8. The method of claim 5, wherein using the implanted lead includes using an intravascular lead configured to puncture a vessel to place the at least one of the at least two electrodes outside of the vessel proximate to the IVC-LA fat pad.

9. The method of claim 5, further comprising using another electrode to stimulate an SVC-AO cardiac fat pad to change ventricular contractility, the SVC-AO fat pad being located proximate to a junction between a superior vena cava and an aorta.

10. The method of claim 5, further comprising using another electrode to stimulate a PV cardiac fat pad associated with a sinoatrial (SA) node.

11. The method of claim 5, further comprising delivering an electrical shock to terminate a shockable tachyarrhythmia.

12. The method of claim 5, wherein delivering the myocardial pacing includes delivering anti-tachycardia pacing.

13. A method, comprising:

stimulating, via at least one of at least two electrodes on a lead, an IVC-LA cardiac fat pad associated with an atrioventricular (AV) node to change the AV conduction time of the heart without changing the sinus rate, the IVC-LA cardiac fat pad being located proximate to a junction between an inferior vena cava and a left atrium; and

delivering, via another one of the at least two electrodes on the lead, myocardial pacing.

14. The method of claim 13, wherein the lead includes an implanted epicardial lead.

15. The method of claim 13, wherein the lead includes an implanted intravascular lead.

16. The method of claim 13, wherein the implanted lead includes an implanted intravascular lead configured to puncture a vessel to place the at least one of the at least two electrodes outside of the vessel proximate to the IVC-LA fat pad.

17. The method of claim 13, further comprising using another electrode to stimulate an SVC-AO cardiac fat pad to change ventricular contractility, the SVC-AO fat pad being located proximate to a junction between a superior vena cava and an aorta.

18. The method of claim 13, further comprising using another electrode to stimulate a PV cardiac fat pad associated with a sinoatrial (SA) node.

19. The method of claim 13, further comprising delivering an electrical shock to terminate a shockable tachyarrhythmia.

20. The method of claim 13, wherein delivering the myocardial pacing includes delivering anti-tachycardia pacing.