Neural stimulation modulation based on monitored cardiovascular parameter

• US 9,440,078 B2
• Filed: 07/01/2014
• Issued: 09/13/2016
• Est. Priority Date: 12/24/2003
• Status: Expired due to Term

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Libbus, Imad
• Primary Examiner(s): Stice, Paula J
• Application Number:
  US14/321,406
• Publication Number:
  US 20140316488A1
• Time in Patent Office: 805 Days
• Field of Search: 607/2, 607/3, 607/6, 607/14, 607/9, 607 17- 18
• US Class Current: 1/1
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• 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 1/36139 with automatic adjustment
• 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 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.

Claims

1. A method, comprising:

delivering vagus nerve stimulation in a recurring succession of stimulation cycles, each cycle including a stimulation on portion and a stimulation off portion, wherein a burst of pulses is delivered during the stimulation on portion and no stimulation is delivered during the stimulation off portion, wherein a duty cycle of the stimulation cycles represents a ratio of a duration of the stimulation on portion to a cycle duration;

sensing a physiological parameter selected from a group of parameters consisting of;

heart rate, blood pressure and respiration; and

adjusting the duty cycle of the stimulation cycles based on the sensed physiological parameter.

2. The method of claim 1, wherein sensing the physiological parameter includes sensing heart rate.

3. The method of claim 1, wherein sensing the physiological parameter includes sensing blood pressure.

4. The method of claim 1, wherein sensing the physiological parameter includes sensing respiration.

5. The method of claim 1, wherein sensing the physiological parameter includes sensing the physiological parameter within the portion of each cycle when the stimulation is generated and within another portion of each cycle when the stimulation is not generated, the method further comprising determining a change in the sensed physiological parameter between the portions of a stimulation cycle, and comparing the detected change to a target change to provide a comparison result, wherein adjusting the duty cycle includes adjusting the duty cycle based on the comparison result.

6. The method of claim 5, further comprising implementing a programmed algorithm to determine the target change that is compared to the detected change.

7. The method of claim 6, further comprising changing the target change using a circadian rhythm.

8. The method of claim 1, further comprising changing a target value for the physiological parameter using a circadian rhythm.

9. A method, comprising:

delivering vagus nerve stimulation in a recurring succession of stimulation cycles, each cycle including a stimulation on portion and a stimulation off portion, wherein a burst of pulses is delivered during the stimulation on portion and no stimulation is delivered during the stimulation off portion, wherein a duty cycle of the stimulation cycles represents a ratio of a duration of the stimulation on portion to a cycle duration;

sensing heart rate;

implementing a programmed algorithm to determine a target heart rate; and

adjusting the duty cycle of the stimulation cycles based on the sensed heart rate and the target heart rate.

10. The method of claim 9, wherein implementing the programmed algorithm to determine the target heart rate includes determining the target change using a circadian rhythm.

11. The method of claim 9, further comprising sensing blood pressure, wherein adjusting the duty cycle further includes adjusting the duty cycle based on the sensed blood pressure.

12. The method of claim 9, further comprising sensing respiration, wherein adjusting the duty cycle further includes adjusting the duty cycle based on the sensed respiration.

13. The method of claim 9, further comprising sensing activity, wherein adjusting the duty cycle includes further adjusting the duty cycle based on the sensed activity.

14. A system, comprising:

a vagus nerve stimulator configured to deliver vagus nerve stimulation in a recurring succession of stimulation cycles, each cycle including a stimulation on portion and a stimulation off portion, wherein a burst of pulses is delivered during the stimulation on portion and no stimulation is delivered during the stimulation off portion, wherein a duty cycle of the stimulation cycles represents a ratio of a duration of the stimulation on portion to a cycle duration;

a physiological parameter monitor configured to monitor a physiological parameter selected from a group of parameters consisting of;

heart rate, blood pressure and respiration; and

a controller configured to adjust the duty cycle of the stimulation cycles based on the sensed physiological parameter.

15. The system of claim 14, wherein the physiological parameter monitor is configured to monitor heart rate.

16. The system of claim 14, wherein the physiological parameter monitor is configured to monitor blood pressure.

17. The system of claim 14, the physiological parameter monitor is configured to monitor respiration.

18. The system of claim 14, wherein the controller is configured to change a target value for the physiological parameter using a circadian rhythm.

19. The system of claim 14, wherein the physiological parameter monitor is configured to further monitor activity, and the controller is configured to change a target value for the physiological parameter using the monitored activity.

20. The system of claim 14, wherein:

the physiological parameter monitor is configured to monitor at least two parameters selected from the group of parameters consisting of;

heart rate, blood pressure, and respiration; and

the controller is configured to adjust the duty cycle based on the at least two parameters monitored by the physiological parameter monitor.