AUTOMATIC BAROREFLEX MODULATION RESPONSIVE TO ADVERSE EVENT

• US 20100191303A1
• Filed: 03/24/2010
• Published: 07/29/2010
• Est. Priority Date: 09/27/2000
• Status: Abandoned Application

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Serdar, David J., Burns, Matthew M., Kieval, Robert S.
• Application Number:
  US12/731,104
• Publication Number:
  US 20100191303A1
• Time in Patent Office: Days
• US Class Current: 607/44
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• 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 1/36114 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A system for providing baroreflex stimulation comprises a sensor to detect a parameter and provide a signal indicative of the parameter, and a baroreflex stimulator. The baroreflex stimulator includes a driver to provide a control signal adapted to deliver a baroreflex therapy, and a controller to receive the signal indicative of the parameter and modulate the control signal based on the signal indicative of the parameter to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

Claims

1. A baroreflex stimulator, comprising:

an electrode adapted to be positioned proximate to sensory nerve endings for a receptor sensitive to pressure;

an implantable pulse generator configured to provide a baroreflex stimulation signal through the electrode to the sensory nerve endings to control blood pressure through a baroreflex response that reduces coronary vascular resistance and increases blood flow;

means for receiving a signal regarding a detected adverse event; and

means for controlling blood pressure using the implantable device and the electrode. wherein the means for controlling blood pressure includes;

means for performing a first baroreflex therapy when the adverse event is not detected, wherein the means for performing the first baroreflex therapy includes means for delivering a first baroreflex stimulation signal through the electrode to the sensory nerve endings; and

means for adjusting blood pressure for the predetermined adverse event when the adverse event is detected, wherein the means for adjusting blood pressure includes means for automatically performing a second baroreflex therapy when the adverse event is detected, and wherein the means for automatically performing the second baroreflex therapy includes means for delivering a second baroreflex stimulation signal through the electrode to the sensory nerve endings.

2. The baroreflex stimulator of claim 1, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected adverse cardiac event; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the adverse cardiac event is not detected, and means for automatically performing the second baroreflex therapy when the cardiac event is detected.

3. The baroreflex stimulator of claim 2, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected arrhythmia; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the arrhythmia is not detected, and means for automatically performing the second baroreflex therapy when the arrhythmia is detected.

4. The baroreflex stimulator of claim 3, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected tachycardia; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the tachycardia is not detected, and means for automatically performing the second baroreflex therapy when the tachycardia is detected.

5. The baroreflex stimulator of claim 3, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected fibrillation; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the fibrillation is not detected, and means for automatically performing the second baroreflex therapy when the fibrillation is detected.

6. The baroreflex stimulator of claim 2, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected non-arrhythmic cardiac event; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the non-arrhythmic cardiac event is not detected, and means for automatically performing the second baroreflex therapy when the non-arrhythmic cardiac event is detected.

7. The baroreflex stimulator of claim 1, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a detected non-cardiac event; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the non-cardiac event is not detected, and means for automatically performing the second baroreflex therapy when the non-cardiac event is detected.

8. The baroreflex stimulator of claim 7, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a stroke; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the stroke is not detected, and means for automatically performing the second baroreflex therapy when the stroke is detected.

9. The baroreflex stimulator of claim 7, wherein:

the means for receiving a signal regarding a detected adverse event includes means for receiving a signal regarding a precursor to a cardiac arrhythmia; and

the means for controlling blood pressure includes means for performing the first baroreflex therapy when the precursor to the cardiac arrhythmia is not detected, and means for automatically performing the second baroreflex therapy when the precursor to the cardiac arrhythmia is detected.

10. The baroreflex stimulator of claim 1, wherein the baroreflex stimulation signal has an amplitude, and the means for modulating the baroreflex stimulation signal includes means for adjusting the amplitude of the baroreflex stimulation signal.

11. The baroreflex stimulator of claim 1, wherein the baroreflex stimulation signal has a frequency, and the means for modulating the baroreflex stimulation signal includes means for adjusting the frequency of the baroreflex stimulation signal.

12. The baroreflex stimulator of claim 1, wherein the baroreflex stimulation signal has a duty cycle, and the means for modulating the baroreflex stimulation signal includes means for adjusting the duty cycle of the baroreflex stimulation signal.

13. The baroreflex stimulator of claim 1, wherein the baroreflex stimulation signal has a morphology, and the means for modulating the baroreflex stimulation signal includes means for adjusting the morphology of the baroreflex stimulation signal.

14. The stimulator of claim 1, wherein the electrode and the implantable pulse generator are configured to target the sensory nerve endings with the baroreflex stimulation signal while avoiding other neural pathways to stimulate a desired response while reducing undesired effects of the stimulation.

28. The system of claim 14, wherein the non-cardiac event includes a stroke.

15. A system for providing baroreflex stimulation, comprising:

an adverse event detector to sense a predetermined adverse event and provide a signal indicative of the adverse event; and

a baroreflex stimulator, including;

a pulse generator to provide a baroreflex stimulation signal for baroreflex therapy; and

a modulator to receive the signal indicative of the adverse event and to modulate the baroreflex stimulation signal based on the signal indicative of the adverse event, wherein the pulse generator and modulator are configured to cooperate to adjust blood pressure for the adverse event by providing a first baroreflex therapy when the adverse event is not detected and providing and a second baroreflex therapy when the adverse event is detected, wherein the baroreflex stimulation signal for the first baroreflex therapy is different than the baroreflex therapy for the second baroreflex therapy.

16. The system of claim 15, wherein the baroreflex signal has an amplitude, and the modulator includes a modulator to modulate the amplitude based on the signal indicative of the adverse event.

17. The system of claim 15, wherein the baroreflex signal has a frequency, and the modulator includes a modulator to modulate the frequency based on the signal indicative of the adverse event.

18. The system of claim 15, wherein the baroreflex signal has a burst frequency, and the modulator includes a modulator to modulate the burst frequency based on the signal indicative of the adverse event.

19. The system of claim 15, further comprising a waveform generator to produce baroreceptor signals of a desired morphology, wherein the modulator includes a modulator to change the morphology of the baroreflex stimulation signal based on the signal indicative of the adverse event.

20. The system of claim 15, further comprising an implantable medical device, wherein the implantable medical device includes the adverse event detector and the baroreflex stimulator.

21. The system of claim 15, wherein the adverse event includes an arrhythmia.

22. The system of claim 21, wherein the arrhythmia includes ventricular tachycardia.

23. The system of claim 21, wherein the arrhythmia includes atrial tachycardia.

24. The system of claim 21, wherein the arrhythmia includes ventricular fibrillation.

25. The system of claim 21, wherein the arrhythmia includes atrial fibrillation.

26. The system of claim 15, wherein the adverse cardiac event includes a non-arrhythmic cardiac event.

27. The system of claim 15, wherein the adverse event includes a non-cardiac event.