Acquiring nerve activity from carotid body and/or sinus

• US 9,002,446 B2
• Filed: 10/30/2012
• Issued: 04/07/2015
• Est. Priority Date: 12/27/2007
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Wenzel, Brian J., Farazi, Taraneh Ghaffari
• Primary Examiner(s): Eiseman, Adam
• Assistant Examiner(s): ABOUELELA, MAY A
• Application Number:
  US13/663,725
• Publication Number:
  US 20130190645A1
• Time in Patent Office: 889 Days
• Field of Search: 600/547, 604/504, 607/2, 607/42, 607/344
• US Class Current: 607/2
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/4866 Evaluating metabolism A61B5/083 takes precedence
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

An exemplary embodiment includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

Claims

1. An implantable device comprising:

a lead including one or more electrodes positionable at or proximate to at least one of a right carotid sinus nerve or a left carotid sinus nerve to sense an electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve; and

a processor configured to analyze the sensed electroneurogram signal for chemosensory information,

wherein the processor is also configured to

determine a relationship between at least one of PaO₂, blood oxygen concentration, PCO₂, pH or blood glucose concentration and the chemosensory information analyzed from the electroneurogram signal indicative of electrical activity sensed using the lead during a first time period; and

detect a change in at least one of PaO₂, blood oxygen concentration, PCO₂, pH or blood glucose concentration based on chemosensory information analyzed from an electroneurogram signal indicative of electrical activity sensed using the lead during a second time period and the determined relationship between the at least one of PaO₂, blood oxygen concentration, PCO₂, pH or blood glucose concentration and chemosensory information.

2. The implantable device of claim 1 wherein the one or more electrodes allow for sensing nerve activity in a neural pathway between the right carotid body and the brain, or between the left carotid body and the brain.

3. The implantable device of claim 1 wherein the processor calls for acquisition of respiratory information and detects respiratory sinus arrhythmia based on both the respiratory information and the sensed electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

4. The implantable device of claim 1 wherein the processor calls for acquisition of heart rate and measures autonomic tone based on both the heart rate and the electroneurogram signal indicative of sensed electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

5. The implantable device of claim 4 wherein the processor determines one or more respiratory characteristics based at least in part on heart rate.

6. The implantable device of claim 1 wherein the processor detects an episode of sleep apnea based on the sensed electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

7. The implantable device of claim 1 wherein the processor detects an increase in metabolic demand based on the sensed electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

8. The implantable device of claim 1 wherein the processor detects an episode of hypoglycemia based on the sensed electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

9. The implantable device of claim 1 wherein the processor detects an episode of hypertension based on the sensed electroneurogram signal indicative of electrical activity of at least one of the right carotid sinus nerve or the left carotid sinus nerve.

10. The implantable device of claim 1, wherein:

the processor uses the chemosensory information for one or more of performing diagnostics, triggering therapy or adjusting therapy.

11. The implantable device of claim 1, wherein the processor configured to analyze the sensed electrical activity to detect one or more characteristic frequency of the sensed electrical activity and associate a type of receptor with a type of nerve activity in dependence on the one or more characteristic frequency detected from the sensed electrical activity.

12. The implantable device of claim 1, wherein the processor configured to analyze the electroneurogram signal indicative of sensed electrical activity to detect one or more fascicle location based on the sensed electrical activity, and associate a type of receptor with a type of nerve activity in dependence on the one or more fascicle location detected from the electroneurogram signal indicative of sensed electrical activity.

14. The implantable device of claim 1, wherein the processor determine a relationship between blood pressure and the chemosensory information analyzed from the electroneurogram signal indicative of electrical activity sensed using the lead during a first time period;

and detect an episode of hypertension based on chemosensory information analyzed from an electroneurogram signal indicative of electrical activity sensed using the lead during a second time period and the determined relationship between blood pressure and chemosensory information.

16. The implantable device of claim 1, wherein the processor analyzes the sensed electroneurogram signal for chemosensory information to detect at least one of a metabolic poison or a drug.

17. The implantable device of claim 1, wherein the lead includes one or more electrodes positionable at or proximate to the right carotid sinus nerve, and one or more further electrodes positionable at or proximate to the left carotid sinus nerve, and further comprising:

a patient alert; and

a circuit that acquires a differential signal indicative of a difference between nerve activity at the right carotid sinus nerve and nerve activity at the level carotid sinus nerve;

wherein the processor detects, based on the differential signal, when there is an imbalance in blood flow; and

wherein the patient alert is triggered in response to an imbalance in blood flow being detected.

13. The An implantable device comprising:

at least one lead including one or more electrodes positionable at or proximate to the right carotid sinus nerve to sense a first electroneurogram signal indicative of electrical activity of the right carotid sinus nerve, and one or more further electrodes positionable at or proximate to the left carotid sinus nerve to sense a second electroneurogram signal indicative of electrical activity of the left carotid sinus nerve; and

a processor that detects, based on a differential signal, when there is an imbalance in blood flow; and

a patient alert;

wherein the differential signal is indicative of one of the first and second electroneurogram signal subtracted from the other one of the first and second electroneurogram signals; and

wherein the patient alert is triggered in response to an imbalance in blood flow being detected.

15. A method for use with an implantable device comprising:

(a) sensing a first electroneurogram signal indicative of electrical activity of at least one of a right carotid sinus nerve or a left carotid sinus nerve during a first time period, said sensing performing during the first time period using a lead including one or more electrodes positionable at or proximate to at least one of a right carotid sinus nerve or a left carotid sinus nerve;

(b) analyzing the first electroneurogram signal for chemosensory information;

(c) determining a relationship between at least one of PaO2, blood oxygen concentration, PCO2, pH or blood glucose concentration and the chemosensory information analyzed from the first electroneurogram signal indicative of electrical activity sensed during the first time period; and

(d) sensing a second electroneurogram signal indicative of electrical activity of at least one of a right carotid sinus nerve or a left carotid sinus nerve during a second time period, said sensing performing during the second time period using a lead including one or more electrodes positionable at or proximate to at least one of a right carotid sinus nerve or a left carotid sinus nerve;

(e) analyzing the second electroneurogram signal for chemosensory information; and

(f) detecting a change in at least one of PaO2, blood oxygen concentration, PCO2, pH or blood glucose concentration based on chemosensory information analyzed from the second electroneurogram signal indicative of electrical activity sensed during the second time period and the determined relationship between the at least one of PaO2, blood oxygen concentration, PCO2, pH or blood glucose concentration and chemosensory information;

wherein steps (b), (c), (e) and (f) are performed using a processor of the implantable device.