Baroreflex modulation with carotid sinus nerve stimulation for the treatment of heart failure

A system for coordinating the stimulation of nerves for controlling the level of neurohormonal activation in a living body having a heart subject to potential or actual pathologic stress levels comprising:

• an implantable pulse generator with a microprocessor and memory adapted and disposed to run a plurality of processes,
• a sensor for sensing and measuring the value of an indicator of SVR in said body, adapted and disposed to provide readings to said microprocessor for use by said processes,
• a bradycardia pacer control process included within said pulse generator for pacing the heart when a condition of bradycardia is present so as to prevent insufficient heart rate by said heart,
• at least one stimulation electrode connected to effectively deliver electrical stimulation output to a baroreceptor nerve site,
• a process for monitoring heart rate and estimating SVR from said sensor in order to modify said stimulation output.

A method of automatically optimizing the cardiovascular responsiveness of a patient for the patient's condition through controlled application of electrical stimulation of nerves emanating from baroreceptors of said patient comprising:

• providing electrical stimulation to said nerves of sufficient intensity and duration so as to reduce neurohormonal activation and induce peripheral blood vessel dilation and a drop in heart rate,
• determining the responsiveness of the patient's body to said stimulation by sensing a feedback parameter of patient's responsiveness indicating altered cardiovascular function;
• and
• adjusting said electrical stimulation provided to the nerves based on said feedback and an optimization algorithm until the patient's cardiovascular system is optimized for his/her condition,
• sensing activity of said patient using an activity sensor, and
• if said activity sensor indicates periods of activity, suspending or lowering intensity of said electrical stimulation until a period of time after the sensed activity has ceased.