METHODS AND SYSTEMS FOR TREATING ACUTE HEART FAILURE BY NEUROMODULATION

• US 20170036014A1
• Filed: 10/25/2016
• Published: 02/09/2017
• Est. Priority Date: 09/12/2005
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Machado, Sandra, Penn, Marc, Rezai, Ali R.
• Granted Patent: US 9,878,150 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/00892 Voltage
• CPC Class Codes: A61M 5/14212 Pumping with an aspiration and an expulsion action
• CPC Class Codes: A61N 1/0565 Electrode heads
• CPC Class Codes: A61N 1/0568 with drug delivery
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• 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 1/36585 controlled by two or more physical parameters

Abstract

Methods of treating acute heart failure in a patient in need thereof. Methods include inserting a therapy delivery device into a pulmonary artery of the patient and applying a therapy signal to autonomic cardiopulmonary fibers surrounding the pulmonary artery. The therapy signal affects heart contractility more than heart rate. Specifically, the application of the therapy signal increases heart contractility and treats the acute heart failure in the patient. The therapy signal can include electrical or chemical modulation.

Claims

1. (canceled)

2. A method of treating acute heart failure by applying an electrical therapy signal from an intraluminal electrode, the method comprising:

introducing a therapy signal delivery device through an internal jugular vein and into a pulmonary artery with aid of a Swan-Ganz catheter, the therapy signal delivery device comprising;

the intraluminal electrode;

an expandable frame comprising a superelastic material, the expandable frame comprising;

a first collapsed configuration; and

a second expanded configuration designed to contact a wall of the pulmonary artery against which the intraluminal electrode is positioned,

the pulmonary artery including at least one of;

a pulmonary trunk; and

a right pulmonary artery; and

treating the acute heart failure,

increasing the left ventricle contractility comprising applying the electrical therapy signal to the intraluminal electrode positioned in the pulmonary artery to modulate a sympathetic cardiopulmonary fiber surrounding the pulmonary artery,

the sympathetic cardiopulmonary fiber comprising at least one of;

a right dorsal lateral cardiopulmonary nerve,

a left dorsal lateral cardiopulmonary nerve, and

a left stellate cardiopulmonary nerve,

the electrical therapy signal being a monopolar biphasic square wave having a frequency between 2 Hz and 200 Hz and a voltage between 1 V and 15 V, and

treating the acute heard failure comprising increasing left ventricle contractility between 13.9% and 37.5%.

3. The method of claim 2, wherein a property of the electrical therapy signal is adjustable at least partially based on a sensed parameter associated with cardiac function, the parameter comprising pulmonary artery wedge pressure, the property comprising at least one of:

polarity, pulse width, amplitude, frequency, voltage, current, intensity, duration, wavelength, and waveform.

4. The method of claim 2, wherein the collapsible frame is configured to be in the second expanded configuration when deployed from a lumen and to be in the first collapsed configuration when retracted into the lumen.

5. A method of treating acute heart failure by applying an electrical therapy signal from an intraluminal electrode, the method comprising:

introducing a therapy signal delivery device through a vein and into a pulmonary artery, the therapy signal delivery device comprising;

the intraluminal electrode;

an expandable frame comprising a superelastic material, the expandable frame comprising;

a first collapsed configuration; and

a second expanded configuration designed to contact a wall of the pulmonary artery against which the intraluminal electrode is positioned,

the pulmonary artery including at least one of;

a pulmonary trunk; and

a right pulmonary artery; and

modulating a sympathetic cardiopulmonary fiber surrounding the pulmonary artery, modulating the sympathetic cardiopulmonary fiber comprising applying the electrical therapy signal to the intraluminal electrode positioned in the pulmonary artery.

6. The method of claim 5, wherein introducing the therapy signal delivery device is with aid of a Swan-Ganz catheter.

7. The method of claim 5, wherein introducing the therapy signal delivery device is with aid of fluoroscopy.

8. The method of claim 5, wherein the vein is an internal jugular vein.

9. The method of claim 5, wherein modulating the sympathetic cardiopulmonary fiber increases left ventricle contractility between 13.9% and 37.5%.

10. The method of claim 5, wherein the sympathetic cardiopulmonary fiber comprises at least one of:

a right dorsal lateral cardiopulmonary nerve,

a left dorsal lateral cardiopulmonary nerve, and

a left stellate cardiopulmonary nerve.

11. The method of claim 5, wherein the collapsible frame is configured to be in the second expanded configuration when deployed from a lumen and to be in the first collapsed configuration when retracted into the lumen.

12. The method of claim 5, wherein the electrical therapy signal comprises monopolar biphasic square wave having a frequency between 2 Hz and 200 Hz and a voltage between 1 V and 15 V, and wherein a property of the electrical therapy signal is adjustable at least partially based on a sensed parameter associated with cardiac function, the parameter comprising pulmonary artery wedge pressure, the property comprising at least one of:

polarity, pulse width, amplitude, frequency, voltage, current, intensity, duration, wavelength, and waveform, wherein the vein is an internal jugular vein, wherein the collapsible frame is configured to be in the second expanded configuration when deployed from a lumen and to be in the first collapsed configuration when retracted into the lumen, and wherein modulating the sympathetic cardiopulmonary fiber increases left ventricle contractility between 13.9% and 37.5%.

18. The method of claim 5, wherein the electrical therapy signal comprises monopolar biphasic square wave having a frequency between 2 Hz and 200 Hz and a voltage between 1 V and 15 V, and wherein a property of the electrical therapy signal is adjustable at least partially based on a sensed parameter associated with cardiac function, the parameter comprising pulmonary artery wedge pressure, the property comprising at least one of:

polarity, pulse width, amplitude, frequency, voltage, current, intensity, duration, wavelength, and waveform, wherein introducing the therapy signal delivery device is through an internal jugular vein, wherein the pulmonary artery includes at least one of a pulmonary trunk and a right pulmonary artery, and wherein applying the electrical therapy signal increases left ventricle contractility between 13.9% and 37.5%.

13. A method of treating acute heart failure by applying an electrical therapy signal from an intraluminal electrode, the method comprising:

introducing a therapy signal delivery device into a pulmonary artery, the therapy signal delivery device comprising;

the intraluminal electrode;

an expandable frame comprising;

a first collapsed configuration; and

a second expanded configuration designed to contact a wall of the pulmonary artery against which the intraluminal electrode is positioned; and

applying the electrical therapy signal to the intraluminal electrode positioned in the pulmonary artery to modulate a sympathetic cardiopulmonary fiber surrounding the pulmonary artery.

14. The method of claim 13, wherein introducing the therapy signal delivery device is with aid of a Swan-Ganz catheter.

15. The method of claim 13, wherein introducing the therapy signal delivery device is with aid of fluoroscopy.

16. The method of claim 13, wherein introducing the therapy signal delivery device is through an internal jugular vein.

17. The method of claim 13, wherein the sympathetic cardiopulmonary fiber comprises at least one of:

a right dorsal lateral cardiopulmonary nerve,

a left dorsal lateral cardiopulmonary nerve, and

a left stellate cardiopulmonary nerve.

19. The method of claim 13, wherein the pulmonary artery includes at least one of a pulmonary trunk and a right pulmonary artery.

20. The method of claim 13, wherein the therapy signal increases heart contractility.

21. The method of claim 20, wherein the heart contractility comprises left ventricle contractility.