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US 9,808,626 B2Granted
Responsive neurostimulation for the treatment of chronic cardiac dysfunction
AssigneesCyberonics, Inc., East Tennessee State University
InventorsImad Libbus, Badri Amurthur, Bruce H. KenKnight, Jeffrey L. Ardell
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. The implanted stimulation device includes a physiological sensor for monitoring the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time and a control system for adjusting stimulation parameters to maintain stimulation in the neural fulcrum zone based on detected changes in the physiological response to stimulation.
Claims20
A neurostimulation system, comprising:
- an electrode assembly;
- and
- a neurostimulator coupled to the electrode assembly, the neurostimulator comprising:
- a control circuit;
- and
- a memory operably coupled to the control circuit and comprising instructions that, when executed by the control circuit, cause the control circuit to:
- deliver stimulation pulses via the electrode assembly using a first set of stimulation parameters to cause a heart rate response in a neural fulcrum zone, the neural fulcrum zone being defined by a heart rate reduction between a baseline heart rate and a predefined threshold;
- detect whether the heart rate response caused by the first set of stimulation parameters has deviated from the neural fulcrum zone by comparing the heart rate response to the baseline heart rate and the predefined threshold detecting whether the heart rate response has deviated from the neural fulcrum zone comprising detecting that the heart rate response has deviated from the neural fulcrum zone in response to detecting either a heart rate reduction of greater than the predefined threshold or a heart rate at or above the baseline heart rate;
- continue to deliver the stimulation pulses using the first set of stimulation parameters in response to detecting the heart rate response remains within the neural fulcrum zone;
- and
- deliver the stimulation pulses using a second set of stimulation parameters in response to determining the heart rate response has deviated from the neural fulcrum zone, the stimulation pulses using second set of parameters configured to modify the heart rate response back to the neural fulcrum zone.
8 more elements
A neurostimulator comprising:
- a control circuit;
- and
- a memory operably coupled to the control circuit and comprising instructions that, when executed by the control circuit, cause the control circuit to:
- deliver stimulation pulses using a first set of stimulation parameters to cause a heart rate response in a neural fulcrum zone, the neural fulcrum zone being defined by a heart rate reduction between a baseline heart rate and a predefined threshold;
- detect whether the heart rate response caused by the first set of stimulation parameters has deviated from the neural fulcrum zone by comparing the heart rate response to the baseline heart rate and the predefined threshold, detecting whether the heart rate response has deviated from the neural fulcrum zone comprising detecting that the heart rate response has deviated from the neural fulcrum zone in response to detecting either a heart rate reduction of greater than the predefined threshold or a heart rate at or above the baseline heart rate;
- continue to deliver the stimulation pulses using the first set of stimulation parameters in response to detecting the heart rate response remains within the neural fulcrum zone;
- and
- deliver the stimulation pulses using a second set of stimulation parameters in response to determining the heart rate response has deviated from the neural fulcrum zone, the stimulation pulses using second set of parameters configured to modify the heart rate response back to the neural fulcrum zone.
5 more elements
A method of delivering neurostimulation, the method comprising:
- delivering stimulation pulses using a first set of stimulation parameters to cause a heart rate response in a neural fulcrum zone, the neural fulcrum zone being defined by a heart rate reduction between a baseline heart rate and a predefined threshold;
- detecting whether the heart rate response caused by the first set of stimulation parameters has deviated from the neural fulcrum zone by comparing the heart rate response to the baseline heart rate and the predefined threshold, detecting whether the heart rate response has deviated from the neural fulcrum zone comprising detecting that the heart rate response has deviated from the neural fulcrum zone in response to detecting either a heart rate reduction of greater than the predefined threshold or a heart rate at or above the baseline heart rate;
- continuing to deliver the stimulation pulses using the first set of stimulation parameters in response to detecting the heart rate response remains within the neural fulcrum zone;
- and
- delivering the stimulation pulses using a second set of stimulation parameters in response to determining the heart rate response has deviated from the neural fulcrum zone, the stimulation pulses using second set of parameters configured to modify the heart rate response back to the neural fulcrum zone.
2 more elements
Dependencies are inferred from the claim text.