Neurostimulation in a neural fulcrum zone for the treatment of chronic cardiac dysfunction
AssigneesLivaNova USA, Inc., East Tennessee State University
InventorsBruce H. KenKnight, Jeffrey L. Ardell, Imad Libbus, Badri Amurthur
Life of this patent
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Abstract
Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. This neural fulcrum zone corresponds to a combination of stimulation parameters at which autonomic engagement is achieved, while the tachycardia-inducing stimulation effects are offset by the bradycardia-inducing effects, thereby minimizing side effects such as significant heart rate changes while providing a therapeutic level of stimulation.
Claims20
A method of operating an implantable medical device (IMD), the method comprising:
- generating a plurality of stimulation signals configured to stimulate a nerve of a patient, each stimulation signal of the plurality of stimulation signals having a frequency and a parameter setting, generating the plurality of stimulation signals comprising adjusting the parameter setting while maintaining a fixed frequency across the plurality of stimulation signals for both a first frequency and a second frequency;
- detecting a heart rate response of the patient during the generation of the plurality of stimulation signals;
- for each of the first frequency and the second frequency, identifying a range of parameter settings that result in a heart rate response between a baseline heart rate and a heart rate decrease threshold;
- selecting either the first frequency or the second frequency for generating subsequent stimulation signals based at least in part on sizes of the ranges of parameter settings that result in the heart rate response between the baseline heart rate and the heart rate decrease threshold for the first frequency and the second frequency;
- and
- delivering a plurality of stimulation signals to the patient at the selected first frequency or second frequency.
An implantable medical device (IMD), comprising:
- a neurostimulator configured to deliver a stimulation signal to a nerve of a patient;
- and
- a control system programmed to:
- generate a plurality of stimulation signals, each stimulation signal of the plurality of stimulation signals having a frequency and a parameter setting, generating the plurality of stimulation signals comprising adjusting the parameter setting while maintaining a fixed frequency across the plurality of stimulation signals for both a first frequency and a second frequency;
- detect a heart rate response of the patient during the generation of the plurality of stimulation signals;
- for each of the first frequency and the second frequency, identify a range of parameter settings that result in a heart rate response between a baseline heart rate and a heart rate decrease threshold;
- select either the first frequency or the second frequency for generating subsequent stimulation signals based at least in part on sizes of the ranges of parameter settings that result in the heart rate response between the baseline heart rate and the heart rate decrease threshold for the first frequency and the second frequency;
- and
- deliver a plurality of stimulation signals to the patient at the selected first frequency or second frequency.
A non-transitory computer-readable medium having instructions stored thereon that, when executed by a processor of an implantable medical device, cause the implantable medical device to:
- generate a plurality of stimulation signals configured to stimulate a nerve of a patient, each stimulation signal of the plurality of stimulation signals having a frequency and a parameter setting, the instructions configured to cause the implantable medical device to adjust the parameter setting while maintaining a fixed frequency across the plurality of stimulation signals for both a first frequency and a second frequency;
- detect a heart rate response of the patient during the generation of the plurality of stimulation signals;
- for each of the first frequency and the second frequency, identify a range of parameter settings that result in a heart rate response between a baseline heart rate and a heart rate decrease threshold;
- select either the first frequency or the second frequency for generating subsequent stimulation signals based at least in part on sizes of the ranges of parameter settings that result in the heart rate response between the baseline heart rate and the heart rate decrease threshold for the first frequency and the second frequency;
- and
- generate a plurality of stimulation signals for delivery to the patient at the selected first frequency or second frequency.
Dependencies are inferred from the claim text.