Electrical Treatment Of Bronchial Constriction

• US 20090281593A9
• Filed: 03/20/2009
• Published: 11/12/2009
• Est. Priority Date: 11/10/2005
• Status: Active Grant

• Current Assignee: electroCore, Inc.
• Original Assignee: electroCore, Inc.
• Inventors: Errico, Joseph P., Mendez, Steven, Pastena, James R., Ross, Arthur, Simon, Bruce, Hu, Hecheng
• Granted Patent: US 8,812,112 B2
• Time in Patent Office: Days
• US Class Current: 607/42
• CPC Class Codes: A61N 1/0517 Esophageal electrodes
• CPC Class Codes: A61N 1/0519 Endotracheal electrodes
• CPC Class Codes: A61N 1/0526 Head electrodes A61N1/0551 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36053 adapted for vagal stimulation A61N1/36114 takes precedence
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601
• CPC Class Codes: A61N 1/36146 specified by the stimulation parameters

Abstract

Devices, systems and methods for treating bronchial constriction related to asthma, anaphylaxis or chronic obstructive pulmonary disease wherein the treatment includes stimulating selected nerve fibers responsible for smooth muscle dilation at a selected region within a patient'"'"'s neck, thereby reducing the magnitude of constriction of bronchial smooth muscle.

Claims

1. A method of treating bronchial constriction in a patient comprising stimulating selected nerve fibers responsible for smooth muscle dilation to increase the activity of said nerve fibers.

2. The method of claim 1 wherein the selected nerve fibers are in a neck of the patient.

3. The method of claim 1 wherein the selected nerve fibers are within a carotid sheath of the patient.

4. The method of claim 1 wherein the selected nerve fibers are associated with the vagus nerve.

5. The method of claim 1 wherein the selected nerve fibers are efferent parasympathetic nerve fibers.

6. The method of claim 1 wherein the selected nerve fibers are afferent parasympathetic nerve fibers.

7. The method of claim 1 wherein the selected nerve fibers are nonadrenergic noncholinergic nerve fibers.

8. The method of claim 1 wherein the selected nerve fibers are efferent sympathetic nerves that directly innervate the smooth muscle.

9. The method of claim 1 wherein the selected nerve fibers are efferent sympathetic nerves that directly modulate parasympathetic ganglia transmission.

10. The method of claim 1 wherein the stimulating step is carried out by applying at least one electrical impulse to a target location adjacent to or in close proximity with a carotid sheath of a patient.

11. The method of claim 10 further comprising introducing one or more electrodes to the target location.

12. The method of claim 10 wherein the introducing step is carried out by introducing the electrodes through a percutaneous penetration in the patient'"'"'s neck.

13. The method of claim 10 wherein the introducing step is carried out by introducing the electrodes through the esophagus of the patient.

14. The method of claim 10 wherein the introducing step is carried out by introducing the electrodes through the trachea of a patient.

15. The method of claim 10 wherein the introducing step is carried out by implanting the electrodes in the target region.

16. The method of claim 1 wherein the stimulating step is carried out without substantially stimulating a second set of nerve fibers responsible for increasing the magnitude of constriction of smooth muscle.

17. The method of claim 1 further comprising blocking or inhibiting a second set of nerve fibers responsible for increasing the magnitude of constriction of smooth muscle.

18. The method of claims 16 or 17 wherein the second set of nerve fibers are associated with the vagus nerve.

19. The method of claims 16 or 17 wherein the second set of nerve fibers are parasympathetic cholinergic nerve fibers.

20. The method of claim 10 wherein the electrical impulse is of a frequency between about 15 Hz to 50 Hz.

21. The method of claim 10 wherein the electrical impulse is of a frequency about 25 Hz.

22. The method of claim 10 wherein the electrical impulse is of an amplitude of between about 1 to 12 volts.

23. The method of claim 10 wherein the electrical impulse has a pulsed on-time of between about 50 to 500 microseconds.

24. The method of claim 10 wherein the electrical impulse has a frequency of about 25 Hz, a pulsed on-time of about 200-400 microseconds, and an amplitude of about 6-12 volts.

25. The method of claim 1 wherein the bronchial constriction is associated with an acute symptom of asthma.

26. The method of claim 1 wherein the bronchial condition is associated with an acute symptom of anaphylaxis.

27. The method of claim 1 wherein the bronchial condition is associated with an acute symptom of chronic obstructive pulmonary disease.

28. A method of treating bronchial constriction in a patient comprising applying an electrical impulse of a frequency of about 15 Hz to 50 Hz to a selected region of a neck of the patient to reduce a magnitude of constriction of bronchial smooth muscle.

29. The method of claim 28 wherein the frequency is about 25 Hz.

30. The method of claim 28 wherein the electrical impulse is sufficient to stimulate a first set of nerve fibers that are responsible for bronchodilation to increase the activity of the first set of nerve fibers.

31. The method of claim 28 wherein the electrical impulse is insufficient to substantially stimulate a second set of nerve fibers that are responsible for increasing the magnitude of constriction of smooth muscle.

32. The method of claim 30 wherein the first set of nerve fibers are nonadrenergic noncholinergic nerve fibers.

33. The method of claim 31 wherein the second set of nerve fibers are parasympathetic cholinergic nerve fibers.

34. The method of claim 28 wherein the electrical impulse is of an amplitude of at least 6 volts.

35. The method of claim 28 wherein the electrical impulse has a pulsed on-time of between about 50 to 500 microseconds.

36. The method of claim 28 wherein the electrical impulse has a pulsed on-time of about 200-400 microseconds.

37. A method for treating bronchial constriction in a patient comprising applying an electrical impulse to a target region in the patient and acutely reducing a magnitude of bronchial constriction in the patient.

38. The method of claim 37 further comprising reducing a magnitude of bronchial constriction in the patient in less than about 2 hours.

39. The method of claim 37 further comprising reducing a magnitude of bronchial constriction in the patient in less than 1 hour.

40. The method of claim 37 further comprising reducing a magnitude of bronchial constriction in the patient in less than 15 minutes.

41. The method of claim 37 wherein the electrical impulse is sufficient to increase an FEV₁ of the patient by a clinically significant amount in a period of time less than about 6 hours.

42. The method of claim 37 wherein the electrical impulse is sufficient to increase an FEV₁ of the patient by at least 12% in a period of time less than about 3 hours.

43. The method of claim 37 wherein the electrical impulse is sufficient to increase an FEV₁ of the patient by at least 12% in a period of time less than about 90 minutes.

44. The method of claim 37 wherein the electrical impulse is sufficient to increase an FEV₁ of the patient by at least 19%.

45. A device for treating bronchial constriction in a patient comprising:

a source of electrical energy; and

an introducer configured for introduction to a target region of a patient'"'"'s neck and having one or more electrodes coupled to the source of electrical energy, wherein the source of electrical energy is configured to apply an electrical impulse to the electrodes to reduce a magnitude of constriction of bronchial smooth muscle.

46. The device of claim 45 wherein the introducer further comprises one or more electrical leads coupling the electrodes to the source of electrical energy, the electrodes lead being configured for insertion through a percutaneous penetration in the patient'"'"'s neck.

47. The device of claim 45 wherein the introducer comprises a nasogastral tube configured for introduction into the patient'"'"'s esophagus.

48. The device of claim 45 wherein the introducer comprises an endotracheal tube configured for introduction into the patient'"'"'s trachea.

49. The device of claim 45 wherein the electrical impulses has a frequency of about 15 Hz to 50 Hz.

50. The device of claim 49 wherein the frequency is about 25 Hz.

51. The device of claim 45 wherein the electrical impulse is sufficient to stimulate selected nerve fibers that are responsible for bronchodilation to increase the activity of the first set of nerve fibers.

52. The device of claim 51 wherein the selected nerve fibers are nonadrenergic noncholinergic nerve fibers.

53. The method of claim 45 wherein the electrical impulse is of an amplitude of at least 6 volts.

54. The method of claim 45 wherein the electrical impulse has a pulsed on-time of between about 50 to 500 microseconds.

55. The method of claim 45 wherein the electrical impulse has a pulsed on-time of about 200-400 microseconds.