Automatic baroreflex modulation responsive to adverse event

• US 8,712,531 B2
• Filed: 05/24/2012
• Issued: 04/29/2014
• Est. Priority Date: 09/27/2000
• Status: Expired due to Fees

• Current Assignee: CVRx, Inc.
• Original Assignee: CVRx, Inc.
• Inventors: Kieval, Robert S, Burns, Matthew M, Serdar, David J
• Primary Examiner(s): Koharski, Christopher D
• Assistant Examiner(s): Patel, Natasha
• Application Number:
  US13/480,063
• Publication Number:
  US 20120232613A1
• Time in Patent Office: 705 Days
• Field of Search: 607/44, 607/117
• US Class Current: 607/42
• 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 method for operating an implantable medical device, the medical device having a control system contained within an implantable housing, and an electrode coupled to the control system and implanted in contact with a blood vessel, the method comprising:

performing a first therapy using the medical device according to a program stored in the control system, including delivering a first baroreflex stimulation signal through the electrode to stimulate a baroreceptor within a wall of the blood vessel, the first therapy programmed to treat a physiological condition through a baroreflex response; and

in response to detecting a predetermined threshold value, automatically performing a second therapy using the medical device according to a program stored in the control system, including delivering a second baroreflex stimulation signal through the electrode to stimulate the baroreceptor, the second therapy programmed to treat the physiological condition through a baroreflex response, wherein the second therapy is different from the first therapy.

2. The method of claim 1, wherein performing the first therapy includes withholding therapy and performing the second therapy includes providing baroreflex stimulation.

3. The method of claim 1, wherein performing the first therapy includes providing baroreflex stimulation and performing the second therapy includes withholding therapy.

4. The method of claim 1, wherein the electrode is positioned within a blood vessel.

5. The method of claim 1, wherein the electrode is positioned at least partially surrounding a blood vessel.

8. The method of claim 1, wherein the predetermined threshold value is selected from the group consisting of:

blood pressure, heart rate, body movement, activity levels, respiration, and nerve activity.

9. The method of claim 1,

wherein each of the first therapy and the second therapy include at least one characteristic selected from the group consisting of:

pulse amplitude, pulse frequency, pulse width, pulse duration, pulse waveform, pulse polarity and pulse phase, and

wherein the difference between the second therapy and the first therapy comprises a difference in the at least one characteristic.

10. The method of claim 1, wherein the physiological condition is selected from the group consisting of:

hypertension, heart failure, cardiovascular disorders, renal disorders, nervous system disorders and low blood pressure.

11. The method of claim 1, wherein the electrode is implanted in contact with a wall of a blood vessel selected from the group consisting of:

a carotid sinus, an aortic arch, a common carotid artery, a subclavian artery, a brachiocephalic artery, and a heart.

6. A method for operating an implantable medical device, the medical device having a control system contained within an implantable housing, and an electrode coupled to the control system and implanted in contact with a blood vessel, the method comprising:

performing a first therapy using medical device according to a program stored in the control system, including delivering a first baroreflex stimulation signal through the electrode to stimulate a baroreceptor within a wall of the blood vessel, the first therapy programmed to treat a physiological condition through a baroreflex response; and

in response to detecting a predetermined parameter, automatically performing a second therapy using the medical device according to a program stored in the control system, including delivering a second baroreflex stimulation signal through the electrode to stimulate the baroreceptor, the second therapy programmed to treat the physiological condition through a baroreflex response, wherein the second therapy is different from the first therapy.

7. The method of claim 6, wherein the predetermined parameter is selected from the set consisting of:

a blood pressure below a lower predetermined threshold, a blood pressure above a higher predetermined threshold, and a specific physiologic event indicative of a need for therapy to treat hypertension and/or heart failure.

12. The method of claim 6, wherein the predetermined parameter is selected from the group consisting of:

blood pressure, heart rate, body movement, activity levels, respiration, and nerve activity.

13. The method of claim 6,

wherein each of the first therapy and the second therapy include at least one characteristic selected from the group consisting of:

pulse amplitude, pulse frequency, pulse width, pulse duration, pulse waveform, pulse polarity and pulse phase, and

wherein the difference between the second therapy and the first therapy comprises a difference in the at least one characteristic.

14. The method of claim 6, wherein the physiological condition is selected from the group consisting of:

hypertension, heart failure, cardiovascular disorders, renal disorders, nervous system disorders and low blood pressure.

15. The method of claim 6, wherein the electrode is implanted in contact with a wall of a blood vessel selected from the group consisting of:

a carotid sinus, an aortic arch, a common carotid artery, a subclavian artery, a brachiocephalic artery, and a heart.