Responsive neurostimulation for the treatment of chronic cardiac dysfunction
First Claim
Patent Images
1. An implantable medical device (IMD), comprising:
- an electrode assembly;
a neurostimulator coupled to the electrode assembly, said neurostimulator adapted to deliver a stimulation signal to a patient in the patient'"'"'s neural fulcrum zone, said stimulation signal comprising an ON time and an OFF time;
a heart rate sensor configured to acquire a heart rate signal from the patient;
a control system coupled to the neurostimulator and the heart rate sensor, said control system being programmed to;
monitor a baseline heart rate signal acquired by the heart rate sensor during the OFF time periods of the stimulation signal;
monitor a heart rate response signal acquired by the heart rate sensor during the ON time periods of the stimulation signal; and
in response to the monitored baseline signal and the monitored response signal, adjust one or more parameters of the stimulation signal to deliver the stimulation signal in the patient'"'"'s neural fulcrum zone, the neural fulcrum zone corresponds to a stimulation intensity during which a transition heart rate response is detected, said transition heart rate response being between tachycardia and bradycardia and comprising a heart rate change of between 0% and 5%.
8 Assignments
0 Petitions
Accused Products
Abstract
Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. The implanted stimulation device includes a physiological sensor for monitoring the patient'"'"'s response to the neurostimulation therapy on an ambulatory basis over extended periods of time, and a control system for adjusting stimulation parameters to maintain stimulation in the neural fulcrum zone based on detected changes in the physiological response to stimulation.
268 Citations
18 Claims
-
1. An implantable medical device (IMD), comprising:
-
an electrode assembly; a neurostimulator coupled to the electrode assembly, said neurostimulator adapted to deliver a stimulation signal to a patient in the patient'"'"'s neural fulcrum zone, said stimulation signal comprising an ON time and an OFF time; a heart rate sensor configured to acquire a heart rate signal from the patient; a control system coupled to the neurostimulator and the heart rate sensor, said control system being programmed to; monitor a baseline heart rate signal acquired by the heart rate sensor during the OFF time periods of the stimulation signal; monitor a heart rate response signal acquired by the heart rate sensor during the ON time periods of the stimulation signal; and in response to the monitored baseline signal and the monitored response signal, adjust one or more parameters of the stimulation signal to deliver the stimulation signal in the patient'"'"'s neural fulcrum zone, the neural fulcrum zone corresponds to a stimulation intensity during which a transition heart rate response is detected, said transition heart rate response being between tachycardia and bradycardia and comprising a heart rate change of between 0% and 5%. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
-
-
12. A method of operating an implantable medical device (IMD) comprising a heart rate sensor configured to acquire a heart rate signal from the patient and a neurostimulator coupled to an electrode assembly, said neurostimulator adapted to deliver a stimulation signal to a patient, the method comprising:
-
activating the neurostimulator to deliver a stimulation signal in a patient'"'"'s neural fulcrum zone, said stimulation signal comprising an ON time and an OFF time; monitoring a baseline heart rate signal acquired by the heart rate sensor during the OFF time periods of the stimulation signal; monitoring a heart rate response signal acquired by the heart rate sensor during the ON time periods of the stimulation signal; and in response to the monitored baseline signal and the monitored response signal, adjusting one or more parameters of the stimulation signal to deliver the stimulation signal in the patient'"'"'s neural fulcrum zone, wherein the neural fulcrum zone corresponds to a stimulation intensity during which a transition heart rate response is detected, said transition heart rate response being between tachycardia and bradycardia and comprising a heart rate change of between 0% and 5%. - View Dependent Claims (13, 14, 15, 16, 17, 18)
-
Specification