Erythropoeitin production by electrical stimulation

• US 10,201,705 B2
• Filed: 02/17/2017
• Issued: 02/12/2019
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Bharmi, Rupinder, Rosenberg, Stuart, Rooke, Ryan, Karst, Edward, Farazi, Taraneh Ghaffari
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US15/436,397
• Publication Number:
  US 20170165488A1
• Time in Patent Office: 725 Days
• Field of Search: None
• 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: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14535 for measuring haematocrit
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/201 Assessing renal or kidney functions
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61N 1/36031 using physiological parameters for adjustment
• CPC Class Codes: A61N 1/36034 specified by the stimulation parameters
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36121 Production of neurotransmitters; Modulation of genes expression
• CPC Class Codes: A61N 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36139 : with automatic adjustment
• CPC Class Codes: A61N 1/3702 : Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

Described herein are methods, devices, and systems for treating human anemia. The methods, devices, and systems generally include monitoring a patient'"'"'s hemoglobin level and at least one of autonomic balance and inflammatory state to determine the etiology of the anemic state, modulating at least one of a sympathetic or parasympathetic nerve based on the cause of the anemia, monitoring for changes in the patient'"'"'s cardiac activity and state of inflammation, and hemoglobin level. An external neurostimulation system is describes, and well as a chronic implantable system. A method for treating a patient for anemia in conjunction with a renal denervation ablation catheter is also disclosed.

Claims

1. A method of triggering neurostimulation to treat anemia in a heart failure patient, the method comprising:

using a microprocessor within a neuromodulation device to determine triggering conditions, wherein the triggering conditions comprise;

the patient'"'"'s heart rate is within a specific heart range;

the patient'"'"'s heart condition is stable; and

cardiac ischemia is not ongoing; and

initiating neurostimulation using the neuromodulation device to treat anemia when the triggering conditions are determined to be met.

2. The method of claim 1, wherein neurostimulation comprises stimulation of a sympathetic nerve affecting erythropoietin (EPO) production.

3. The method of claim 1, wherein neurostimulation comprises stimulation of a parasympathetic nerve affecting inflammation.

4. The method of claim 3, wherein the parasympathetic nerve is a vagus nerve.

5. The method of claim 4, wherein the vagus nerve innervates the celiac-superior mesenteric plexus ganglion.

6. The method of claim 4, wherein the vagus nerve is a cervical vagus nerve.

7. The method of claim 1, wherein the triggering conditions further comprise:

bleeding is not ongoing.

8. The method of claim 1, wherein the triggering conditions further comprise:

a preprogrammed time of day.

9. The method of claim 1 further comprising:

obtaining cardiogenic impedance measurements from a plurality of vectors;

using the cardiogenic impedance measurements to determine cardiac integrity; and

using the cardiac integrity for feedback in determining stimulation parameters for nuerostimulation of a sympathetic nerve affecting erythropoietin (EPO) production.

10. The method of claim 1 further comprising ablating renal nerves of the patient using an ablation catheter.