Neurostimulation in a neural fulcrum zone for the treatment of chronic cardiac dysfunction

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;
• and
• select either the first frequency or the second frequency for generating subsequent stimulation signals based at least in part on 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.

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;
• and
• select either the first frequency or the second frequency for generating subsequent stimulation signals based at least in part on 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.