Neurostimulation with signal duration determined by a cardiac cycle

• US 8,457,747 B2
• Filed: 10/20/2008
• Issued: 06/04/2013
• Est. Priority Date: 10/20/2008
• Status: Active Grant

• Current Assignee: LivaNova USA, Inc. (LivaNova Plc)
• Original Assignee: Cyberonics, Inc
• Inventors: Terry, Reese S. Jr.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/254,595
• Publication Number:
  US 20100100151A1
• Time in Patent Office: 1,688 Days
• Field of Search: None
• US Class Current: 607/45
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36135 using physiological parameters

Abstract

We disclose a method of providing an electrical signal to a cranial nerve of a patient for treating a medical condition, comprising providing an electrical signal generator, coupling at least a first electrode to a cranial nerve of the patient and to the electrical signal generator, generating an electrical signal with the electrical signal generator, and applying the electrical signal to the cranial nerve, using the at least a first electrode, for a duration less than a cardiac period of the patient and during the cardiac period of the patient. We also disclose an implantable medical device capable of implementing the method.

Claims

1. A method of providing an electrical signal to a cranial nerve of a patient for treating a medical condition, comprising:

a) determining a cardiac cycle duration of at least a portion of a cardiac cycle;

b) determining a stimulation duration which is based on a predetermined fraction of the determined cardiac cycle duration, wherein the predetermined fraction is less than one;

c) generating an electrical signal based on the stimulation duration;

d) applying the electrical signal to the cranial nerve for the stimulation duration,

wherein the electrical signal is operative to deliver an electrical signal stimulation to a patient'"'"'s brain via the cranial nerve; and

e) repeating a-d to automatically adjust the stimulation duration based on changes in the at least a portion of the cardiac cycle.

2. The method of claim 1 wherein at least the portion of the cardiac cycle includes at least one of an R-R interval, a P-P interval, a T-T interval, a P wave interval, a PR segment interval, a PQ segment interval, a QRS interval, an ST segment interval, and an interbeat interval of the patient.

3. The method of claim 2, wherein the stimulation duration is less than the interbeat interval.

4. The method of claim 3, wherein the stimulation duration is determined by reference to the interbeat interval based on at least one of the R-R interval immediately preceding a most recently detected R-wave, and a moving average R-R interval calculated over a last n R-R intervals, where n is an integer from 2 to about 10.

5. The method of claim 2, wherein the stimulation duration is greater than the interbeat interval.

6. The method of claim 1, wherein the stimulation duration is from 10% of an interbeat interval to 50% of the interbeat interval.

7. The method of claim 1, wherein applying the electrical signal to the cranial nerve comprises beginning to apply the electrical signal at a particular point in the cardiac cycle of the patient.

8. The method of claim 7, wherein the particular point in the cardiac cycle is based on at least one of a detected P-wave, a detected Q-wave, a detected R-wave, a detected S-wave, a detected T-wave, and a detected U-wave.

9. The method of claim 7, wherein the particular point in the cardiac cycle follows a point in the cardiac cycle based on a period which includes a delay period and at least one of a detected P-wave, a detected Q-wave, a detected R-wave, a detected S-wave, a detected T-wave, and a detected U-wave.

10. The method of claim 9, wherein the delay period is from 0.1 msec to about 1000 msec.

11. The method of claim 1, wherein applying the electrical signal to the cranial nerve comprises beginning to apply the electrical signal after a selected number of occurrences of at least one of a detected P-wave, a detected Q-wave, a detected R-wave, a detected S-wave, a detected T-wave, and a detected U-wave.

12. The method of claim 11, wherein applying the electrical signal to the cranial nerve comprises beginning to apply the electrical signal after a predetermined number of R-waves ranging from two R-waves to 1000 R-waves.

13. The method of claim 1, further comprising:

sensing at least one parameter of the cardiac cycle of the patient based on at least one of a P-wave, a Q-wave, an R-wave, an S-wave, a T-wave, and a U-wave, and

determining the stimulation duration at least partially based on at least one sensed parameter of the cardiac cycle.

14. An implantable medical device (IMD), comprising:

an electrical signal generator; and

a cardiac cycle determination module configured to determine a cardiac cycle duration of at least a portion of a cardiac cycle of a patient;

wherein;

the electrical signal generator is configured to provide an electrical signal to a target tissue via a first electrode for a stimulation duration, wherein the stimulation duration is based on a predetermined fraction of a determined cardiac cycle duration, wherein the predetermined fraction is less than one, the stimulation duration being automatically adjusted in response to changes in the at least a portion of the cardiac cycle of the patient; and

wherein the electrical signal is operative to deliver an electrical signal stimulation to a patient'"'"'s brain.

15. The implantable medical device of claim 14, wherein the electrical signal is initiated at a time determined by at least one cardiac cycle parameter.

16. The implantable medical device of claim 14, wherein the stimulation duration is determined by reference to an interbeat interval based on at least one of an R-R interval immediately preceding a most recently detected R-wave, and a moving average R-R interval calculated over a last n R-R intervals, where n is an integer from 2 to about 10.

17. An implantable medical device, comprising:

an electrical signal generator; and

a cardiac cycle determination module adapted to determine a cardiac cycle duration of a patient; and

wherein the electrical signal generator is configured to generate and to deliver at least one electrical signal to a target tissue via a first electrode; and

wherein a stimulation duration of a delivery of the at least one electrical signal is a predetermined fraction of a determined cardiac cycle duration, wherein the predetermined fraction is less than one, the stimulation duration being automatically adjusted in response to changes in a heart parameter of the patient.

18. The implantable medical device of claim 17, wherein the cardiac cycle duration is an interbeat interval which is based on at least one of a last detected interbeat interval and a moving average interbeat interval calculated over a last n interbeat intervals, where n is an integer from 2 to about 10.

19. The implantable medical device of claim 17, wherein the predetermined fraction may be automatically adjusted based on a determined condition of the patient.