# US 2014/0194866 A1 · System and method for locating and identifying the functional nerves innervating the wall of arteries

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- Number: US 2014/0194866 A1
- Document ID: US20140194866A1
- Status: Published application
- Kind: A1
- Application number: 14/241,058
- Filed: 2012-08-24
- Published: 2014-07-10
- Earliest claimed: 2011-08-26
- Assignees: Symap Holding Limited
- Inventors: Jie Wang
- Web page: https://patentgrep.com/patent/US20140194866A1

## CPC

- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 5/0036: {including treatment, e.g., using an implantable medical device, ablating, ventilating}
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/0215: by means inserted into the body
- A61B 5/201: {Assessing renal or kidney functions}
- A61B 5/4833: {Assessment of subject's compliance to treatment}
- A61B 5/4836: {Diagnosis combined with treatment in closed-loop systems or methods (A61B5/0036 takes precedence)}
- A61B 5/4893: {Nerves}
- A61B 5/6852: {Catheters}
- A61B 5/6853: {with a balloon}
- A61B 18/24: with a catheter (A61B18/26, A61B18/28 take precedence)
- A61N 7/02: Localised ultrasound hyperthermia
- G16Z 99/00: Subject matter not provided for in other main groups of this subclass
- A61B 5/024: Measuring pulse rate or heart rate
- A61B 5/0538: invasively, e.g. using a catheter
- A61B 5/24: Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B 18/18: by applying electromagnetic radiation, e.g. microwaves
- A61B 2018/00404: {Blood vessels other than those in or around the heart}
- A61B 2018/00434: {Neural system}
- A61B 2018/00505: {Urinary tract}
- A61B 2018/00511: {Kidney}
- A61B 2018/00577: {Ablation}
- A61B 2018/00642: {with feedback, i.e. closed loop control}
- A61B 2018/00708: {switching the power on or off}
- A61B 2018/00791: {Temperature}
- A61B 2018/00839: {Bioelectrical parameters, e.g. ECG, EEG}
- A61B 2018/00875: {Resistance or impedance}
- A61N 1/36117: {for treating hypertension}
- A61N 2007/003: {Destruction of nerve tissue}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- G16Z: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR

## Abstract

System and method for locating and identifying nerves innervating the wall of arteries such as the renal artery are disclosed. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether a dose of energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of the energy delivered to the nerve. The method includes at least the steps to evaluate a change in physiological parameters after a dose of energy is delivered to an arterial wall; and to determine the type of nerve that the energy was directed to (none, sympathetic or parasympathetic) based on the results of the evaluation. The system includes at least a device for delivering a dose of energy to the wall of an artery; sensors for detecting physiological signals from a subject; and indicators to display the results obtained using the said method.

## Claims

### Claim at position 1

1-14. (canceled)

### Claim 15

A method of mapping a parasympathetic nerve innervating the wall of renal artery, comprising the steps of:
a) introducing a catheter into the lumen of a renal artery such that the tip of said catheter contacts a site on the inner renal artery wall;
b) measuring one or more physiological parameters to obtain baseline measurements before introducing electrical current to the site, said physiological parameters are selected from the group consisting of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate;
c) applying electrical stimulation by introducing electrical current to the site via the catheter, wherein said electrical current is controlled to be sufficient to elicit changes in said physiological parameters when there is an underlying nerve at the site; and
d) measuring said physiological parameters at a specific time interval after each electrical stimulation, wherein a decrease of said physiological parameters over the baseline measurements after said electrical stimulation would indicate that a parasympathetic renal nerve has been mapped at said site.

### Claim 16 (depends on 15)

The method of claim 15, wherein said catheter is an ablative catheter currently in use to treat cardiac arrhythmias.

### Claim 17 (depends on 15)

The method of claim 15, wherein said catheter is an ablative catheter designed specifically for mapping renal nerves for ablative procedures.

### Claim 18 (depends on 15)

The method of claim 15, further comprises the step of applying radiofrequency energy through the catheter to the site identified in step (d) for ablation of the underlying nerve to treat disease caused by systemic renal nerve hyperactivity.

### Claim 19 (depends on 18)

The method of claim 18, further comprises the repetition of the steps (b) to (d) on the ablated site, wherein a lack of change in said physiological parameters confirms nerve ablation.

### Claim 20

A method of mapping a sympathetic nerve innervating the wall of renal artery, comprising the steps of:
a) introducing a catheter into the lumen of a renal artery such that the tip of said catheter contacts a site on the inner renal artery wall;
b) measuring one or more physiological parameters to obtain baseline measurements before introducing electrical current to the site, said physiological parameters are selected from the group consisting of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate;
c) applying electrical stimulation by introducing electrical current to the site via the catheter, wherein said electrical current is controlled to be sufficient to elicit changes in said physiological parameters when there is an underlying nerve at the site; and
d) measuring said physiological parameters at a specific time interval after each electrical stimulation, wherein an increase of said physiological parameters over the baseline measurements after said electrical stimulation would indicate that a sympathetic renal nerve has been mapped at said site.

### Claim 21 (depends on 20)

The method of claim 20, wherein said catheter is an ablative catheter currently in use to treat cardiac arrhythmias.

### Claim 22 (depends on 20)

The method of claim 20, wherein said catheter is an ablative catheter designed specifically for mapping renal nerves for ablative procedures.

### Claim 23 (depends on 20)

The method of claim 20, further comprises the step of applying radiofrequency energy through the catheter to the site identified in step (d) for ablation of the underlying nerve to treat disease caused by systemic renal nerve hyperactivity.

### Claim 24 (depends on 23)

The method of claim 23, further comprises the repetition of the steps (b) to (d) on the ablated site, wherein a lack of change in said physiological parameters confirms nerve ablation.