System for transvascularly stimulating autonomic targets

• US 9,031,669 B2
• Filed: 08/12/2013
• Issued: 05/12/2015
• Est. Priority Date: 12/12/2007
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Zhang, Yunlong, Sachanandani, Haresh G., Li, Dan, Mi, Bin
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US13/964,807
• Publication Number:
  US 20130331919A1
• Time in Patent Office: 638 Days
• Field of Search: 607/116, 607/36, 607/62, 607/40
• US Class Current: 607/116
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/6862 Stents
• CPC Class Codes: A61B 5/6876 Blood vessel
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• 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 1/36117 for treating hypertension
• 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 1/37211 Means for communicating with stimulators
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient

Abstract

Various implantable medical device embodiments stimulate an autonomic neural target from within a pulmonary artery, and comprise at least one electrode, a power supply, a neural stimulator connected to the power supply, and an anchor structure. The neural stimulator is configured to generate a neural stimulation signal for delivery to the neural stimulation target through the at least one electrode. The anchor structure is configured to chronically and securely implant the neural stimulator, the power supply and the at least one electrode within the pulmonary artery. The anchor structure, the neural stimulator, the power supply and the at least one electrode are configured to be implanted through a pulmonary valve into the pulmonary artery. In various embodiments, the neural stimulator is configured to be operational to implement a neural stimulation protocol when chronically implanted within the pulmonary artery without a wired connection through the pulmonary valve.

Claims

1. A system, comprising:

an implantable first structure and a separately implantable second structure, each of the first and second structures configured to be intravascularly implanted within a patient;

intravascular electrodes, wherein the first structure includes at least a first one of the intravascular electrodes and the second structure includes at least a second one of the intravascular electrodes;

a neural stimulator configured to generate neural stimulation signals for delivery through the intravascular electrodes to transvascularly stimulate at least two autonomic neural targets, the at least two autonomic neural stimulation targets including a first autonomic neural stimulation target at a first neural stimulation site and a second autonomic neural stimulation target at a second neural stimulation site separate from the first neural stimulation site, the neural stimulator configured to use;

at least the first one of the intravascular electrodes to transvascularly stimulate the first neural stimulation target at the first neural stimulation site, wherein the first one of the intravascular electrodes is not used to transvascularly stimulate the second neural stimulation target at the second neural stimulation site; and

at least the second one of the intravascular electrodes to transvascularly stimulate the second neural stimulation target at the second neural stimulation site, wherein the second one of the intravascular electrodes is not used to transvascularly stimulate the first neural stimulation target at the first neural stimulation site, the at least two autonomic neural stimulation targets including at least one baroreceptor region or at least one autonomic nerve target; and

an anchor structure configured to chronically and securely implant both the neural stimulator and the intravascular electrodes within vasculature of the patient and operably position the intravascular electrodes to stimulate the at least two autonomic neural targets.

2. The system of claim 1, wherein the at least two autonomic neural targets includes at least two baroreceptor regions.

3. The system of claim 2, wherein:

the at least two baroreceptor regions includes a left pulmonary artery baroreceptor region and a right pulmonary artery baroreceptor region; and

the intravascular electrodes include a left pulmonary artery electrode configured to be intravascularly implanted within a left pulmonary artery and to transvascularly stimulate the left pulmonary artery baroreceptor region and a right pulmonary artery electrode configured to be intravascularly implanted within a right pulmonary artery and to transvascularly stimulate the right pulmonary artery baroreceptor region.

4. The system of claim 1, wherein the at least two autonomic neural targets includes at least two autonomic nerve targets.

5. The system of claim 4, wherein the at least two autonomic nerve targets includes at least two vagal nerve branches.

6. The system of claim 5, wherein the intravascular electrodes include a left pulmonary artery electrode configured to be intravascularly implanted within a left pulmonary artery and to transvascularly stimulate a first one of the at least two vagal nerve branches and a right pulmonary artery electrode configured to be intravascularly implanted within a right pulmonary artery and to transvascularly stimulate a second one of the at least two vagal nerve branches.

7. The system of claim 4, wherein the at least two autonomic neural targets includes a baroreceptor region and a vagus nerve branch.

8. The system of claim 1, further comprising a pressure sensor configured to be intravascularly implanted within the patient and to sense intravascular pressure, the neural stimulator configured to use the sensed intravascular pressure to control the neural stimulation signals.

9. The system of claim 1, further comprising a heart rate sensor configured to be intravascularly implanted within the patient and to sense heart rate, the neural stimulator configured to use the sensed heart rate to control the neural stimulation signals.

10. The system of claim 1, further comprising a power source configured to be intravascularly implanted within the patient and operably connected to the neural stimulator to provide power to the neural stimulator, wherein the power source is a rechargeable power source configured to be recharged while intravascularly implanted within the patient.