Methods for treating heart arrhythmia

• US 8,948,865 B2
• Filed: 11/15/2013
• Issued: 02/03/2015
• Est. Priority Date: 04/08/2002
• Status: Expired due to Term

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Zarins, Denise, Gifford, Hanson III
• Primary Examiner(s): Kahelin, Michael
• Application Number:
  US14/081,634
• Publication Number:
  US 20140107539A1
• Time in Patent Office: 445 Days
• Field of Search: 607/9, 607/44
• US Class Current: 607/9
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• 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 2018/0022 Balloons
• 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: A61F 7/007 characterised by electric heating
• CPC Class Codes: A61K 38/4893 Botulinum neurotoxin (3.4.24.69)
• CPC Class Codes: A61M 2025/0085 Multiple injection needles protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2202/0007 introduced into the body
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 25/0084 being one or more injection needles
• CPC Class Codes: A61M 5/00 Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests vaccination appliances for veterinary use A61D1/025 ; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; containers specially adapted for medical or pharmaceutical purposes A61J1/00; combinations of vial and syringe for mixing or transferring their contents A61J1/20; holders for containers for collecting, storing or administering blood or medical fluids A61J1/16
• 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 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: C12Y 304/24069 : Bontoxilysin (3.4.24.69), i.e. botulinum neurotoxin

Abstract

Methods and apparatus are provided for treatment of heart arrhythmia via renal neuromodulation. Such neuromodulation may effectuate irreversible electroporation or electrofusion, ablation, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, such neuromodulation is achieved through application of an electric field. In some embodiments, such neuromodulation is achieved through application of neuromodulatory agents, of thermal energy and/or of high intensity focused ultrasound. In some embodiments, such neuromodulation is performed in a bilateral fashion.

Claims

1. A method for treating heart arrhythmia, in a patient in need thereof the method comprising:

introducing a modulation instrument proximate a neural fiber that contributes to renal function of a kidney of the patient; and

delivering energy and/or a neuromodulatory agent to the neural fiber via the modulation instrument in order to modulate a function of the neural fiber, thereby systemically reducing sympathetic tone in the patient.

2. The method of claim 1, wherein delivering energy further comprises delivering an electric field.

3. The method of claim 2, wherein delivering the electric field further comprises delivering a pulsed electric field.

4. The method of claim 2, wherein delivering the electric field further comprises delivering a continuous electric field.

5. The method of claim 1, wherein delivering a neuromodulatory agent further comprises delivering a drug to the neural fiber.

6. The method of claim 1, wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney.

7. The method of claim 1, wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation, electrofusion, ablation, necrosis, apoptosis, gene expression alteration, cytokine up-regulation alteration, and combinations thereof.

8. The method of claim 1, wherein delivering energy further comprises delivering thermal energy.

9. The method of claim 1, wherein delivering energy further comprises delivering high intensity focused ultrasound.

10. The method of claim 1, wherein systemically reducing sympathetic tone in the patient further comprises decreasing a load on a heart of the patient.

11. A method for treating heart arrhythmia, in a patient in need thereof the method comprising:

introducing a modulation instrument proximate a neural fiber that contributes to renal function of a kidney of the patient; and

delivering energy and/or a neuromodulatory agent to the neural fiber via the modulation instrument in order to modulate a function of the neural fiber, thereby decreasing a load on a heart of the patient.

12. The method of claim 11, wherein delivering energy further comprises delivering an electric field.

13. The method of claim 12, wherein delivering the electric field further comprises delivering a pulsed electric field.

14. The method of claim 12, wherein delivering the electric field further comprises delivering a continuous electric field.

15. The method of claim 11, wherein delivering the neuromodulatory agent further comprises delivering a drug to the neural fiber.

16. The method of claim 11, wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney.

17. The method of claim 11, wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation, electrofusion, ablation, necrosis, apoptosis, gene expression alteration, cytokine up-regulation alteration, and combinations thereof.

18. The method of claim 11, wherein delivering the energy further comprises delivering thermal energy.

19. The method of claim 11, wherein delivering the energy further comprises delivering high intensity focused ultrasound.

20. The method of claim 11, wherein decreasing the load on the heart of the patient further comprises systemically reducing sympathetic tone in the patient.