Depletion block to block nerve communication

• US 10,201,709 B2
• Filed: 01/14/2015
• Issued: 02/12/2019
• Est. Priority Date: 01/17/2014
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Franke, Manfred, Ternes, David J., Hincapie Ordonez, Juan Gabriel, Ruble, Stephen B., Hamann, Jason J., Sharma, Arjun D.
• Primary Examiner(s): Giuliani, Thomas
• Application Number:
  US14/597,137
• Publication Number:
  US 20150202441A1
• Time in Patent Office: 1,490 Days
• Field of Search: 606 33, 606 34, 606 41, 607 46
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/36067 Movement disorders, e.g. tremor or Parkinson disease stimulating motor muscle A61N1/36003
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36171 Frequency
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3787 from an external energy source

Abstract

An example of a system may include a depletion block neural stimulator and a depletion block controller. The depletion block neural stimulator may be configured to deliver a depletion block stimulation to a nerve. The depletion block stimulation may include a series of pulses at a pulse frequency within a range between about 100 Hz to about 1000 Hz. The depletion block controller may be configured to communicate with the depletion block neural stimulator and control the depletion block stimulation. The depletion block controller may be configured to receive a start depletion block signal and respond to the received start depletion block signal by initiating the delivery of the depletion block stimulation to the nerve, and the depletion block controller may be configured to receive a stop depletion block signal and respond to the received stop depletion block signal by terminating the delivery of the depletion block stimulation to the nerve.

Claims

1. A system, comprising:

a depletion block neural stimulator configured to deliver a depletion block stimulation to a nerve; and

a depletion block controller configured to communicate with the depletion block neural stimulator and control the depletion block stimulation to provide a series of pulses at a pulse frequency within a range between 100 Hz to 700 Hz, the series of pulses including an amplitude and a pulse width to depolarize the nerve such that the depletion block stimulation induces action potentials in the nerve and depletes neurotransmitters to prevent action potentials from being communicated across a synaptic cleft, the depletion block controller configured to receive a start depletion block signal and respond to the received start depletion block signal by initiating the delivery of the depletion block stimulation to the nerve, and the depletion block controller configured to receive a stop depletion block signal and respond to the received stop depletion block signal by terminating the delivery of the depletion block stimulation to the nerve, wherein the depletion block controller is configured to change the pulse frequency of the depletion block stimulation, and is further configured to initiate the depletion block stimulation with a first pulse frequency and maintain the depletion block stimulation with a second pulse frequency less than the first pulse frequency.

2. The system of claim 1, further comprising:

an electrical therapy stimulator configured to generate and apply electrical stimulation to a patient; and

a therapy controller configured to communicate with the electrical therapy stimulator and control the electrical stimulation, the therapy controller configured to send the start depletion block signal and the stop depletion block signal, and further configured to control the electrical therapy stimulator to generate and apply the electrical stimulation during a time period between sending the start and stop depletion block signals.

3. The system of claim 2, wherein the electrical therapy stimulator includes an ablation system configured to ablate tissue using the electrical stimulation during an ablation procedure, and the depletion block neural stimulator is configured to reduce pain during the ablation procedure.

4. The system of claim 2, wherein the electrical therapy stimulator includes a kilohertz high frequency alternating current (KHFAC) nerve block stimulator configured to deliver an KHFAC nerve block stimulation to the nerve, the nerve block stimulation including a series of pulses at a pulse frequency over 1 kHz to arrest action potentials in the axon;

and the therapy controller is configured to send the start and stop depletion block signals near the beginning of the KHFAC nerve block stimulation to alleviate an onset response for the KHFAC nerve block stimulation.

5. The system of claim 1, wherein the depletion block stimulator is configured to deliver the depletion block stimulation to the nerve selected to relieve spasmodic peripheral nerve pain, the system further comprising a patient input configured to receive a patient-initiatedsignal, the depletion block controller configured to send the start depletion block signal in response to receiving the patient-initiated signal.

6. The system of claim 1, wherein the depletion block stimulator is configured to deliver the depletion block stimulation to the nerve selected to relieve spasmodic peripheral nerve pain, the system further comprising a muscle spasm detector configured to detect a spasmodic episode, the depletion block controller configured to send the start depletion block signal in response to detecting a spasmodic episode.

7. The system of claim 1, wherein the depletion block stimulator is configured to deliver the depletion block stimulation to the nerve selected to relieve spasmodic peripheral nerve pain, the depletion block controller configured to adjust at least one of the amplitude or the pulse width of the depletion block stimulation to control a graded depletion block to allow some neurotransmitters to be released from the presynaptic terminal into the extracellular space.

8. The system of claim 1, wherein the depletion block controller is configured to implement a process to automatically transition through at least two frequency stages, wherein a first pulse frequency stage includes the first pulse frequency and a second pulse frequency stage includes the second pulse frequency, and the first pulse frequency stage has a duration corresponding to a time period such that the depletion block controller transitions from the first pulse frequency stage to the second pulse frequency stage after the time period.