Renal neuromodulation for treatment of patients with chronic heart failure

• US 8,983,595 B2
• Filed: 11/21/2013
• Issued: 03/17/2015
• 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: Levin, Howard R., Gelfand, Mark
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US14/086,607
• Publication Number:
  US 20140088561A1
• Time in Patent Office: 481 Days
• Field of Search: 607/2, 607/17, 607/101, 607/116, 607/118
• US Class Current: 607/2
• 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:

positioning a catheter having a therapeutic element within a renal blood vessel of a human patient diagnosed with chronic heart failure; and

reducing neural traffic to and/or from a kidney of the patient via the therapeutic element,

wherein reducing the neural traffic to and/or from the kidney results in a therapeutically beneficial reduction in clinical symptoms of chronic heart failure in the patient.

2. The method of claim 1 wherein positioning a catheter having a therapeutic element within a renal blood vessel comprises intravascularly positioning a catheter comprising one or more electrodes within a renal artery of the patient.

3. The method of claim 2 wherein intravascularly positioning the catheter comprising one or more electrodes within the renal artery comprises placing the one or more electrodes in apposition with an inner wall of the renal artery.

4. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient comprises blocking neural traffic to and/or from the kidney.

5. The method of claim 1 wherein reducing neural traffic to and/or from a kidney comprises delivering electrical energy via the therapeutic element to renal nerves proximate to the renal blood vessel.

6. The method of claim 5 wherein delivering electrical energy via the therapeutic element comprises delivering radiofrequency (RF) energy via the therapeutic element to the renal nerves.

7. The method of claim 5 wherein delivering electrical energy via the therapeutic element comprises ablating at least a portion of the renal nerves.

8. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient comprises ablating a renal nerve of the patient.

9. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient comprises partially ablating a renal nerve of the patient.

10. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient comprises denervating the kidney of the patient.

11. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient comprises modulating sympathetic nerves that innervate the kidney of the patient.

12. The method of claim 1 wherein positioning a catheter having a therapeutic element within a renal blood vessel of a human patient comprises positioning the catheter via a guide catheter.

13. The method of claim 1 wherein positioning a catheter having a therapeutic element within a renal blood vessel of a human patient comprises intravascularly positioning the catheter via a guide wire.

14. The method of claim 1 wherein positioning a catheter having a therapeutic element within a renal blood vessel of a human patient comprises positioning a drug delivery device within a renal artery of the patient.

15. The method of claim 1 wherein reducing neural traffic to and/or from a kidney of the patient via the therapeutic element comprises at least partially ablating renal nerves of the patient via delivery of chemical agents to the renal nerves.

16. The method of claim 1 wherein positioning a catheter having a therapeutic element within a renal blood vessel of a human patient comprises positioning a bipolar electrode pair within a renal artery of the patient.

17. The method of claim 16 wherein reducing neural traffic to and/or from a kidney comprises delivering electrical energy via the bipolar electrode pair to renal nerves proximate the renal artery.

18. A method of treating a patient diagnosed with chronic heart failure, the method comprising:

percutaneously delivering a renal denervation catheter through an abdominal aorta of a human patient to a renal blood vessel of the patient and proximate to neural fibers that innervate a kidney of the patient; and

at least partially ablating the neural fibers via the catheter,

wherein at least partially ablating the neural fibers results in a therapeutically beneficial reduction in clinical symptoms of heart failure in the patient.

19. The method of claim 18 wherein at least partially ablating the neural fibers comprises reducing afferent neural signals along the neural fibers.

20. The method of claim 18 wherein at least partially ablating the neural fibers comprises reducing efferent neural signals along the neural fibers.

21. The method of claim 18, further comprising removing the renal denervation catheter from the patient after therapy.

22. The method of claim 18, further comprising monitoring a parameter of the catheter and/or a physiological parameter of the patient before and during ablation of the neural fibers.

23. The method of claim 22 wherein at least partially ablating the neural fibers via the catheter comprises delivering energy to the neural fibers via the catheter to at least partially ablate the neural fibers, and wherein the method further comprises regulating energy delivery based, at least in part, on the monitored parameter.