System and method for bronchial dilation

• US 8,483,831 B1
• Filed: 02/17/2009
• Issued: 07/09/2013
• Est. Priority Date: 02/15/2008
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Holaira, Inc. (Nuvaira, Inc.)
• Inventors: Hlavka, Edwin J., Elliott, Lynn
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US12/372,607
• Time in Patent Office: 1,603 Days
• Field of Search: 607/2, 607/42, 607/116, 607/118, 600/529
• US Class Current: 607/42
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0823 Detecting or evaluating cough events
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61N 1/3601 of respiratory organs
• CPC Class Codes: A61N 1/3611 Respiration control stimulating respiratory organs A61N1/3601

Abstract

An implantable signal generator can be configured to generate a blocking signal to be delivered to at least a portion of a bronchus. The blocking signal can be configured to inhibit nerve traffic both to and from the lungs, to relieve bronchial smooth muscle contraction, and to inhibit cough. The implantable signal generator can be communicatively coupled to a processor configured to control delivery of the blocking signal, using received information about an indication of cough, to inhibit cough.

Claims

1. A system, comprising:

an implantable signal generator configured to generate a cough inhibiting blocking signal to be delivered to at least a portion of nerve tissue positioned along a bronchus or trachea of a subject, wherein the cough inhibiting blocking signal is configured to inhibit at least one of nerve traffic to or from a lung of the subject to relieve bronchial smooth muscle contraction and to inhibit cough;

an electrode operatively coupled to the signal generator and configured to be coupled to tissue proximate the bronchus or trachea to deliver energy from the implantable signal generator directly to a pulmonary nerve near the bronchus or trachea; and

a processor, communicatively coupled to the implantable signal generator, the processor configured to receive information about an indication of cough and, using the received information about the indication of cough, to cause the implantable signal generator to deliver the cough inhibiting blocking signal through the electrode to the pulmonary nerve to inhibit cough.

2. The system of claim 1, wherein the information about the indication of cough includes information from a sensor configured to detect an indication of cough.

3. The system of claim 2, including a cough sensor configured to detect an indication of cough;

and

wherein the processor is configured to receive information about an indication of cough from the cough sensor.

4. The system of claim 3, wherein the cough sensor includes at least one of:

(1) a pressure sensor to detect a pressure signal indicative of cough;

(2) a respiration sensor to detect a respiration signal indicative of cough;

(3) a sound sensor to detect a sound signal indicative of cough;

(4) a physical activity sensor to detect physical activity indicative of cough;

(5) an impedance sensor to detect an impedance signal indicative of cough;

or

(6) a phrenic nerve sensor to detect phrenic nerve activity indicative of cough.

5. The system of claim 1, wherein the information about the indication of cough includes information from a user identified cough indication.

6. The system of claim 5, including a user-interface communicatively coupled to the processor, the user-interface configured to receive information about an indication of cough of the subject from a user, and to provide information about the indication of cough to the processor.

7. The system of claim 1, wherein the information about the indication of cough includes information from a sensor configured to detect an indication of cough and information from a user identified cough indication.

8. The system of claim 1, wherein the processor is configured to receive information about an indication of mucus buildup in at least a portion of the bronchus and to control delivery of the blocking signal using the received information about the indication of mucus buildup, to allow mucus clearance.

9. The system of claim 8, wherein the blocking signal is configured to inhibit mucus production.

10. The system of claim 8, wherein the processor is configured to stop delivery of the blocking signal, using the information about the indication of mucus buildup, to allow mucus clearance.

11. The system of claim 10, wherein the processor is configured to stop delivery of the blocking signal for a period of time, allowing cough to clear mucus from the at least a portion of the bronchus.

12. The system of claim 10, wherein the processor is configured to deliver the blocking signal following the mucus clearance.

13. The system of claim 10, wherein the information about an indication of mucus buildup is received from a mucus sensor that includes an impedance sensor, configured to sense an impedance signal indicative of mucus buildup in the at least a portion of the bronchus.

14. The system of claim 1, wherein the processor is configured to receive a user-identified time period to allow cough to clear mucus from at least a portion of the bronchus, and to control delivery of the blocking signal, using the received user-identified time period, to allow mucus clearance.

15. The system of claim 14, wherein the user includes a clinician, and wherein the time period includes a clinician-prescribed time period for mucus clearance.

16. The system of claim 14, wherein the processor is configured to stop delivery of the blocking signal for the received time period to allow cough to clear mucus from at least a portion of the bronchus.

17. The system of claim 1, wherein the implantable signal generator is configured to generate a blocking signal to be delivered to at least a portion of a post-ganglionic ascending afferent pulmonary nerve or a post-ganglionic descending efferent pulmonary nerve of a pulmonary trunk.

18. The system of claim 1, wherein the implantable signal generator is configured to generate a blocking signal to be delivered to at least a portion of a pre-ganglionic vagus nerve of a pulmonary trunk.

19. The system of claim 1, wherein the implantable signal generator is configured to generate a blocking signal to be delivered to at least a portion of at least one of a pulmonary plexus or a pulmonary ganglia.

20. The system of claim 1, wherein the implantable signal generator is located outside a thoracic cavity of the subject.

21. The system of claim 1, including:

a lead, coupled to the electrode and the implantable signal generator, the lead configured to deliver the energy from the implantable signal generator to the trachea or the bronchus using the electrode.

22. The system of claim 1, wherein the electrode is a wireless electrode, communicatively coupled to the implantable signal generator, the wireless electrode configured to deliver the blocking signal to the trachea or the bronchus.

23. The system of claim 22, wherein the wireless electrode is configured to wirelessly receive the blocking signal from the implantable signal generator.

24. The system of claim 22, wherein the wireless electrode is configured to be located within at least a portion of the bronchi.

25. The system of claim 21, wherein the electrode includes at least one electrode configured to be coupled to a post-ganglionic ascending afferent pulmonary nerve and a post-ganglionic descending efferent pulmonary nerve of a pulmonary trunk.

26. The system of claim 21, wherein the electrode includes an electrode configured to be coupled to a pre-ganglionic vagus nerve of a pulmonary trunk.

27. The system of claim 21, wherein the electrode includes at least one electrode configured to be coupled to at least one of a pulmonary plexus or a pulmonary ganglia.

28. The system of claim 21, wherein the electrode includes a cuff electrode configured to at least partially surround at least a portion of the bronchus.

29. The system of claim 1, wherein the implantable signal generator includes the processor.

30. The system of claim 1, wherein the blocking signal is configured to inhibit nerve traffic to a lung of the subject.

31. The system of claim 1, wherein the blocking signal is configured to inhibit nerve traffic from a lung of the subject.

54. The system of claim 1, further including an electrode coupled to the implantable signal generator, the electrode being configured to be placed along the bronchus.

55. The system of claim 1, wherein the processor is configured to receive information about an indication of an expected cough and to control delivery of the blocking signal using the received information so as to inhibit expected cough, wherein the indication of expected cough includes information obtained during a period of non-therapy.

56. The system of claim 1, further comprising:

at least one electrode coupled to the implantable signal generator, the at least one electrode is configured to be placed on the bronchus such that energy from the at least one electrode is delivered to the nerve tissue positioned along the bronchus.

57. The system of claim 1, wherein the processor is configured to cause delivery of a sufficient amount of energy to the nerve tissue so as to cause cessation of cough and stop delivery of energy to the nerve tissue after detection of cough cessation.

32. A method, comprising:

delivering a blocking signal to at least a portion of nerve tissue positioned along a bronchus or trachea of a subject using an implantable signal generator, the blocking signal configured to inhibit nerve traffic to at least one of to or from a lung of the subject to inhibit, to block, or to reduce the ability of the subject to cough;

receiving information about an indication of cough; and

controlling delivery of the blocking signal, using the received information about the indication of cough, to inhibit, to block, or to reduce the ability of the subject to cough.

33. The method of claim 32, wherein the receiving information about an indication of cough includes receiving information from a sensor configured to detect an indication of cough.

34. The method of claim 33, including detecting an indication of cough using a cough sensor, and providing information about the indication of cough to the implantable signal generator.

35. The method of claim 34, wherein the detecting the indication of cough using the cough sensor includes using at least one of:

(1) detecting a pressure signal indicative of cough using a pressure sensor;

(2) detecting a respiration signal indicative of cough using a respiration sensor;

(3) detecting a sound signal indicative of cough using a sound sensor;

(4) detecting physical activity indicative of cough using a physical activity sensor;

(5) detecting an impedance signal indicative of cough using an impedance sensor;

or

(6) detecting phrenic nerve activity indicative of cough using a phrenic nerve sensor.

36. The method of claim 32, wherein the receiving information about an indication of cough includes receiving information from a user identified cough indication.

37. The method of claim 36, including:

receiving information about an indication of cough of the subject from a user using a user-interface;

wherein the controlling the delivery of the blocking signal includes using the information received from the user-interface.

38. The method of claim 32, wherein the receiving information about an indication of cough includes receiving information from a sensor configured to detect an indication of cough and receiving information from a user identified cough indication.

39. The method of claim 32, including:

receiving information about an indication of mucus buildup in at least a portion of the bronchus;

wherein the controlling the delivery of the blocking signal includes using the information about the indication of mucus buildup, to allow mucus clearance.

40. The method of claim 39, wherein the controlling delivery of the blocking signal includes generating a blocking signal configured to inhibit mucus production.

41. The method of claim 39, wherein the controlling the delivery of the blocking signal includes stopping delivery of the blocking signal, using the information about the indication of mucus buildup, to allow mucus clearance.

42. The method of claim 41, wherein the stopping the delivery of the blocking signal includes stopping for a period of time to allow cough to clear mucus from the at least a portion of the bronchus.

43. The method of claim 41, wherein the controlling the delivery of the blocking signal includes delivering the blocking signal following the clearance of mucus.

44. The method of claim 41, including detecting an indication of mucus buildup using a mucus sensor, and providing information about the indication of mucus buildup to the implantable signal generator.

45. The method of claim 44, wherein the mucus sensor includes an impedance sensor configured to sense an impedance signal indicative of mucus buildup in at least a portion of the bronchus.

46. The method of claim 32, including:

receiving a user-identified time period to allow cough to clear mucus from at least a portion of the bronchus; and

wherein the controlling the delivery of the blocking signal includes using the received user-identified time period.

47. The method of claim 46, wherein the receiving the user-identified time period includes receiving a clinician-prescribed time period for mucus clearance.

48. The method of claim 46, wherein the controlling the delivery of the blocking signal includes stopping delivery of the blocking signal for the received time period to allow cough to clear mucus from at least a portion of the bronchus.

49. The method of claim 32, including delivering the blocking signal using an electrode coupled to at least a portion of the bronchus.

50. The method of claim 49, wherein the delivering the blocking signal includes using a wireless electrode communicatively coupled to the implantable signal generator.

51. The method of claim 50, wherein the using the wireless electrode includes using a wireless electrode configured to be located within at least a portion of the bronchi.

52. The method of claim 32, wherein the controlling delivery of the blocking signal includes generating a blocking signal configured to inhibit nerve traffic to a lung of the subject.

53. The method of claim 32, wherein the controlling delivery of the blocking signal includes generating a blocking signal configured to inhibit nerve traffic from a lung of the subject.

58. A system, comprising:

at least one internal electrode configured to deliver cough inhibiting energy to nerve tissue positioned along a bronchus or trachea; and

a signal generator configured to generate a cough inhibiting blocking signal to be delivered to the at least one electrode to cause the at least one electrode to deliver the cough inhibiting energy to the nerve tissue, the blocking signal configured to inhibit nerve traffic along one or more of the bronchi to block, inhibit, or reduce the ability of the subject to cough.

59. The system of claim 58, wherein the at least one internal electrode is configured to be placed on the bronchus.

60. The system of claim 58, further comprising a processor, wherein the processor, the signal generator, and the at least one electrode are operable to cause delivery of a sufficient amount of energy to the nerve tissue to cause cessation of cough and to stop delivery of energy to the nerve tissue based on detection of a cessation of cough.