Patent application number | Description | Published |
20080200959 | System and method to deliver therapy in presence of another therapy - Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein. | 08-21-2008 |
20080200960 | SYSTEMS AND METHODS FOR TREATING SUPRAVENTRICULAR ARRHYTHMIAS - In various method embodiments, a supraventricular arrhythmia event is detected, and a supraventricular arrhythmia treatment, including neural stimulation to elicit a sympathetic response, is delivered in response to a detected supraventricular arrhythmia event. Some embodiments detect a precursor for a supraventricular arrhythmia episode, and deliver prophylactic neural stimulation to avoid the supraventricular arrhythmia event. Some embodiments detect a supraventricular arrhythmia episode, and deliver therapeutic neural stimulation for the supraventricular arrhythmia event. | 08-21-2008 |
20080228238 | AUTOMATIC BAROREFLEX MODULATION BASED ON CARDIAC ACTIVITY - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a cardiac activity monitor to sense cardiac activity and provide a signal indicative of the cardiac activity, and a baroreflex stimulator. The stimulator includes a pulse generator and a modulator. The pulse generator provides a baroreflex stimulation signal adapted to provide a baroreflex therapy. The modulator receives the signal indicative of the cardiac activity and modulates the baroreflex stimulation signal based on the signal indicative of the cardiac activity to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy. | 09-18-2008 |
20080234780 | SELECTIVE NERVE STIMULATION WITH OPTIONALLY CLOSED-LOOP CAPABILITIES - Systems and methods for steering one or more stimulation fields to a selected nerve target, thereby optimizing one or a combination of low stimulation thresholds, desired therapy outcomes, or a minimization of adverse stimulation side-effects. An array of electrodes disposed, at least in part, on two or more neural stimulation leads are used for steering the stimulation fields to the selected nerve target and are positioned adjacent the selected target. The stimulation may be titrated based on, among other things, a detected physiologic response to the applied stimulation. | 09-25-2008 |
20080243196 | UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter. | 10-02-2008 |
20080243212 | SYSTEMS AND METHODS FOR THERMAL NEUROINHIBITION - Disclosed herein, among other things, is system for thermal neuroinhibition. According to an embodiment, the system includes at least one implantable fluid-filled conduit adapted to be placed adjacent to a neural target. The system also includes an implantable housing including a power source, a heat pump deriving power from the source and connected to the conduit, and a controller within the housing. The controller is connected to the heat pump, and is adapted to control the heat pump to effect fluid flow in the conduit to cool the neural target using electromechanical refrigeration to reversibly inhibit neural activity as part of a medical treatment. | 10-02-2008 |
20080281372 | NEURAL STIMULATION SYSTEM ANALYZER - Various embodiments relate to a device to analyze an implantable neural stimulation system that includes an implantable neural stimulation lead for an implantable neural stimulator to be implanted into a patient. Various device embodiments comprise an external housing, a pacing circuit in the housing, and a sensing circuit in the housing. The pacing circuit is adapted to deliver a test neural stimulation signal. At least one test lead cable is adapted to electrically connect the pacing circuit and the implantable neural stimulation lead to enable the test neural stimulation signal to be delivered to a neural target through the test lead cable and the implantable neural stimulation lead. At least one physiological sensor is adapted to sense a physiological response to stimulation of the neural target. At least one sensor cable is adapted to electrically connect the sensing circuit and the at least one physiological sensor. | 11-13-2008 |
20080288016 | SYSTEMS AND METHODS FOR STIMULATING NEURAL TARGETS - Disclosed herein, among other things, is a method for stimulating neural targets in the vicinity of a human ear. According to an embodiment, a device is clipped on a patient ear lobe, the device including a neural stimulation electrode. A neural stimulation signal is applied to the electrode to transcutaneously stimulate neural targets in the vicinity of the ear lobe, according to an embodiment. A physiological parameter is sensed using a sensor connected to the device. According to an embodiment, the neural stimulation signal is adjusted in response to the sensed parameter. The method is used is a variety of treatment regimens, including anti-hypertensive and cardiac improvement therapy. | 11-20-2008 |
20090048641 | BAROREFLEX STIMULATION TO TREAT ACUTE MYOCARDIAL INFARCTION - An aspect of the present subject relates to an implantable medical system. An embodiment of the system includes a baroreflex stimulator, a myocardial infarction detector, and a controller. The baroreflex stimulator applies a baroreflex stimulation signal through an electrode. The myocardial infarction detector detects an event indicative of myocardial infarction. The controller is connected to the baroreflex stimulator and to the myocardial infarction detector, and is adapted to apply a baroreflex therapy in response to a detected event indicative of myocardial infarction. Other aspects are provided herein. | 02-19-2009 |
20090076405 | Adherent Device for Respiratory Monitoring - A respiratory monitoring system is provided. A measuring system is provided that includes, (i) an adherent device configured to be coupled to a patient, the adherent device including a plurality of sensors that monitor respiratory status, at least one of the sensors configured to monitor the patient's respiration, and (ii) a wireless communication device coupled to the plurality of sensors and configured to transfer patient data directly or indirectly from the plurality of sensors to a remote monitoring system. A remote monitoring system is coupled to the wireless communication device. | 03-19-2009 |
20090076561 | Systems and methods for avoiding neural stimulation habituation - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 03-19-2009 |
20090143834 | AUTOMATIC BAROREFLEX MODULATION RESPONSIVE TO ADVERSE EVENT - An aspect of the present subject matter relates to a system for providing baroreflex stimulation. An embodiment of the system comprises an adverse event detector to sense an adverse event and provide a signal indicative of the adverse event, and a baroreflex stimulator. The stimulator includes a pulse generator to provide a baroreflex stimulation signal adapted to provide a baroreflex therapy, and a modulator to receive the signal indicative of the adverse event and modulate the baroreflex stimulation signal based on the signal indicative of the adverse event to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy. Other aspects are provided herein. | 06-04-2009 |
20090143838 | Baroreflex modulation to gradually decrease blood pressure - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein. | 06-04-2009 |
20090149900 | TRANSVASCULAR NEURAL STIMULATION DEVICE - This document discusses, among other things, apparatus, systems, and methods for transvascularly stimulation of a nerve or nerve trunk. In an example, an apparatus is configured to transvascularly stimulate a nerve trunk through a blood vessel. The apparatus includes an expandable electrode that is chronically implantable in a blood vessel proximate a nerve trunk. The expandable electrode is configured to abut a predetermined surface area of the vessel wall along a predetermined length of the vessel. An electrical lead is coupled to the expandable electrode. An implantable pulse generator is coupled to the lead and configured to deliver an electrical stimulation signal to the electrode through the lead. In an example method, an electrical signal is delivered from an implanted medical device to an electrode chronically implanted in a blood vessel proximate a nerve trunk to transvascularly deliver neural stimulation from the electrode to the nerve trunk. | 06-11-2009 |
20090248119 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 10-01-2009 |
20090306734 | COMBINED NEURAL STIMULATION AND CARDIAC RESYNCHRONIZATION THERAPY - Methods and devices for delivering cardiac therapy to a patient are provided. Various implantable device embodiments comprise a plurality of leads and a controller. The leads include at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity. The controller controls delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and controls delivery of the neural stimulation. The controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further is programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. Other embodiments are provided herein. | 12-10-2009 |
20100010553 | SYSTEM AND METHOD FOR FILTERING NEURAL STIMULATION - Various aspects of the present subject matter provide a filter module. In various embodiments, the filter module comprises an input, an output, a signal path from the input to the output, a filter and a switch. The filter has a transfer response to attenuate a frequency of a neural stimulation signal. The switch is adapted to place the filter in the signal path when the neural stimulation signal is applied and to remove the filter from the signal path when the neural stimulation signal is not applied. Other aspects are provided herein. | 01-14-2010 |
20100049281 | SYSTEMS FOR PROVIDING NEURAL MARKERS FOR SENSED AUTONOMIC NERVOUS SYSTEM ACTIVITY - In various method embodiments, a neural activity signal is sensed, a feature from the sensed neural activity signal is extracted, and a neural marker for the extracted feature is created. The neural marker includes information regarding the extracted feature. Various device embodiments comprise a port to receive a neural activity signal, and a feature extractor adapted to receive and process the neural activity signal to produce a neural marker that includes information for the neural activity signal. Various device embodiments comprise a display, a memory adapted to store a neural marker associated with a sensed neural activity signal, and a controller adapted to communicate with the memory and the display to provide a representation of the neural marker on the display. | 02-25-2010 |
20100056881 | Method and Apparatus For Acute Cardiac Monitoring - A device for monitoring a patient from the back of the patient comprises a support configured to adhere to the back of the patient, at least two electrodes supported with the support, circuitry coupled to the at least two electrodes to measure a signal from the at least two electrodes, and circuitry to transmit the signal wirelessly. The support and the at least two electrodes may be placed on at least one of a lower back or between shoulder blades of the patient, which can help to reduce pressure on the patient when the device is worn for an extended period, for example 1 week. Placement of the adherent device in at least one of these locations can improve patient comfort, for example by decreasing pressure to the skin of the patient from the device when the patient lies supine. The device may also provide lumbar support, for example when placed on the lumbar of the patient. | 03-04-2010 |
20100063564 | PHYSICAL CONDITIONING SYSTEM, DEVICE AND METHOD - Various system embodiments comprise a neural stimulator and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to elicit sympathetic activity at a neural target. The controller is adapted to control the neural stimulator to provide a physical conditioning therapy. The controller is adapted to control the neural stimulator to intermittently elicit sympathetic activity at the neural target. Other aspects and embodiments are provided herein. | 03-11-2010 |
20100076511 | BAROREFLEX STIMULATION SYSTEM TO REDUCE HYPERTENSION - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein. | 03-25-2010 |
20100106226 | NEURAL STIMULATION MODULATION BASED ON MONITORED CARDIOVASCULAR PARAMETER - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate. | 04-29-2010 |
20100114226 | SYSTEM TO PROVIDE MYOCARDIAL AND NEURAL STIMULATION - Various aspects provide an implantable device. In various embodiments, the device comprises at least one port, where each port is adapted to connect a lead with an electrode to the device. The device further includes a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode. The stimulation circuit is adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy. The sensing and stimulation circuits are adapted to perform CRM functions. The device further includes a controller connected to the sensing circuit and the stimulation circuit to control the neural stimulation therapy and the CRM therapy. Other aspects and embodiments are provided herein. | 05-06-2010 |
20100121399 | CLOSED LOOP NEURAL STIMULATION SYNCHRONIZED TO CARDIAC CYCLES - Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein. | 05-13-2010 |
20100121406 | NEURAL STIMULATOR TO TREAT SLEEP DISORDERED BREATHING - Various aspects relate to an implantable device. Various device embodiments include at least one sensor for use in detecting sleep disordered breathing, a pulse generator adapted to deliver a first electrical signal through at least one electrode to stimulate a neural target, and a controller adapted to communicate with the at least one sensor and with the pulse generator. The controller is adapted to detect sleep disordered breathing using the at least one sensor and provide a therapy for sleep disordered breathing in response to a detected apneic event. The therapy for sleep disordered breathing is adapted to deliver the first electrical signal through the at least one electrode to induce a cough reflex to terminate the apneic event. Various embodiments stimulate a superior laryngeal nerve, various embodiments stimulate a recurrent laryngeal nerve, and various embodiments stimulate a vagus nerve. Other aspects and embodiments are provided herein. | 05-13-2010 |
20100185255 | BAROREFLEX STIMULATION SYNCHRONIZED TO CIRCADIAN RHYTHM - An aspect relates to a baroreflex stimulator. An embodiment of the stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. | 07-22-2010 |
20100211148 | IMPLANTABLE NEUROSTIMULATOR FOR MODULATING CARDIOVASCULAR FUNCTION - An implantable medical device includes an implantable capsule housing a circuit that delivers neurostimulation to modulate one or more cardiovascular functions. To limit displacement after implantation, a fixation device is coupled to the implantable capsule to fix the miniature implantable medical device to a position in the body of a patient. In various embodiments, the fixation device include one or more of a suture loop, a cuff to wrap around a cylindrical structure such as a nerve of a vessel, and a transmural fixation device anchoring on the interior surface of a wall defining a cavity in the body. | 08-19-2010 |
20100228317 | ADAPTIVE BAROREFLEX STIMULATION THERAPY FOR DISORDERED BREATHING - An approach to providing disordered breathing therapy includes delivering electrical stimulation therapy modifying a patient's baroreflex response. Disordered breathing therapy may be delivered in response to prediction or detection of disordered breathing events. Various conditions affecting the patient may be evaluated and the baroreflex therapy modified. The therapy may be modified to improve therapy efficacy, to reduce an impact to the patient and/or to mitigate therapy interactions. | 09-09-2010 |
20100274321 | BAROREFLEX ACTIVATION THERAPY WITH CONDITIONAL SHUT OFF - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. Other aspects are provided herein. | 10-28-2010 |
20100286738 | INTERMITTENT HIGH-ENERGY CARDIAC STIMULATION FOR THERAPEUTIC EFFECT - A device and method for delivering high-energy electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The high-energy stimulation mimics the effects of exercise and improves symptoms even in patients who are exercise intolerant. The high-energy stimulation may be delivered on an intermittent basis either as pacing pulses in accordance with a programmed pacing mode and with a higher pacing pulse energy than used for conventional pacing or as low energy shock pulses. | 11-11-2010 |
20100286740 | AUTOMATIC NEURAL STIMULATION MODULATION BASED ON MOTION AND PHYSIOLOGICAL ACTIVITY - According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. | 11-11-2010 |
20100286741 | CARDIAC RHYTHM MANAGEMENT DEVICE WITH NEURAL SENSOR - Various aspects of the present subject matter relate to a device. In various embodiments, the device comprises at least one port adapted to connect at least one lead, a CRM functions module connected to the port and adapted to provide at least one CRM function using the lead, a neural function module, and a controller connected to the CRM functions module and the neural function module. The at least one CRM function includes a function to provide an electrical signal to the lead to capture cardiac tissue. The neural function module includes a signal processing module connected to the port and adapted to receive and process a nerve traffic signal from the lead into a signal indicative of the nerve traffic. The controller is adapted to implement a CRM therapy based on the signal indicative of the nerve traffic. Other aspects are provided herein. | 11-11-2010 |
20100298898 | BAROREFLEX ACTIVATION FOR ARRHYTHMIA TREATMENT - An aspect of the present subject matter relates to a system for providing baroreflex stimulation. An embodiment of the system comprises an adverse event detector to sense an adverse event and provide a signal indicative of the adverse event, and a baroreflex stimulator. The stimulator includes a pulse generator to provide a baroreflex stimulation signal adapted to provide a baroreflex therapy, and a modulator to receive the signal indicative of the adverse event and modulate the baroreflex stimulation signal based on the signal indicative of the adverse event to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy. Other aspects are provided herein. | 11-25-2010 |
20100305634 | NEURAL STIMULATION SYSTEM FOR CARDIAC FAT PADS - Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein. | 12-02-2010 |
20100318154 | SYSTEM AND METHOD FOR TESTING NEURAL STIMULATION THRESHOLD - Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein. | 12-16-2010 |
20100324620 | PERCUTANEOUS NEUROSTIMULATOR FOR MODULATING CARDIOVASCULAR FUNCTION - A neurostimulation device includes an external neurostimulator worn by a patient using a bracing element that braces a portion of the patient's body. The external neurostimulator delivers neurostimulation to modulate a cardiovascular function of the patient. In one embodiment, the external stimulator delivers neurostimulation percutaneously to a stimulation target in the patient's body using at least one percutaneous stimulation electrode having a distal end lodged on or near the stimulation target. | 12-23-2010 |
20100324621 | TRANSCUTANEOUS NEUROSTIMULATOR FOR MODULATING CARDIOVASCULAR FUNCTION - A neurostimulation device includes an external neurostimulator worn by a patient using a bracing element that braces a portion of the patient's body. The external neurostimulator delivers neurostimulation to modulate a cardiovascular function of the patient. In one embodiment, the external stimulator delivers the neurostimulation transcutaneously to a stimulation target in the patient's body using surface stimulation electrodes placed on the body approximately over the stimulation target. | 12-23-2010 |
20110009914 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 01-13-2011 |
20110015692 | COMBINED REMODELING CONTROL THERAPY AND ANTI-REMODELING THERAPY BY IMPLANTABLE CARDIAC DEVICE - A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy. | 01-20-2011 |
20110040347 | INTEGRATED LEAD FOR APPLYING CARDIAC RESYNCHRONIZATION THERAPY AND NEURAL STIMULATION THERAPY - An embodiment includes a main lead assembly having a proximal portion adapted for connection to a device and a distal portion adapted for placement in a coronary sinus, the distal portion terminating in a distal end for placement proximal a left ventricle. Additionally, the main lead assembly includes a left ventricular electrode located at its distal end which is adapted to deliver cardiac resynchronization therapy to reduce ventricular wall stress. The main lead assembly also includes a fat pad electrode disposed along the main lead assembly a distance from the distal end to position the fat pad electrode proximal to at least one parasympathetic ganglia located in a fat pad bounded by an inferior vena cava and a left atrium. The fat pad electrode is adapted to stimulate the parasympathetic ganglia to reduce ventricular wall stress. | 02-17-2011 |
20110082514 | HYPERTENSION THERAPY BASED ON ACTIVITY AND CIRCADIAN RHYTHM - According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. | 04-07-2011 |
20110082515 | TRANSCUTANEOUS NEUROSTIMULATOR FOR TREATING HYPERTENSION - A neurostimulation device includes an external neurostimulator worn by a patient using a bracing element that braces a portion of the patient's body. The external neurostimulator delivers neurostimulation to modulate a cardiovascular function of the patient. In one embodiment, the external stimulator delivers the neurostimulation transcutaneously to a stimulation target in the patient's body using surface stimulation electrodes placed on the body approximately over the stimulation target. | 04-07-2011 |
20110082537 | TRANSVASCULAR NEURAL STIMULATION DEVICE - This document discusses, among other things, apparatus, systems, and methods for transvascularly stimulation of a nerve or nerve trunk. In an example, an apparatus is configured to transvascularly stimulate a nerve trunk through a blood vessel. The apparatus includes an expandable electrode that is chronically implantable in a blood vessel proximate a nerve trunk. The expandable electrode is configured to abut a predetermined surface area of the vessel wall along a predetermined length of the vessel. An electrical lead is coupled to the expandable electrode. An implantable pulse generator is coupled to the lead and configured to deliver an electrical stimulation signal to the electrode through the lead. In an example method, an electrical signal is delivered from an implanted medical device to an electrode chronically implanted in a blood vessel proximate a nerve trunk to transvascularly deliver neural stimulation from the electrode to the nerve trunk. | 04-07-2011 |
20110106199 | CLOSED LOOP NEURAL STIMULATION SYNCHRONIZED TO CARDIAC CYCLES - Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein. | 05-05-2011 |
20110106216 | BAROREFLEX STIMULATOR WITH INTEGRATED PRESSURE SENSOR - An aspect relates to an implantable medical device. An embodiment of the device comprises a pulse generator, sensor circuitry, a lead, and a controller. The pulse generator generates baroreflex stimulation pulses. The lead is adapted to be electrically connected to the pulse generator and to the sensor circuitry. The lead includes an electrode to distribute the baroreflex stimulation pulses to a baroreflex site and a pressure sensor to provide a signal indicative of blood pressure to the sensor circuitry. The controller is connected to the pulse generator and the sensor circuitry. The controller adapted to adjust the baroreflex stimulation pulses based on the blood pressure. Other aspects are provided herein. | 05-05-2011 |
20110112592 | NEURAL STIMULATION SYSTEM TO PREVENT SIMULTANEOUS ENERGY DISCHARGES - Various aspects of the present subject matter relate to a system. Various embodiments of the system comprise at least one port to connect to at least one lead with at least one electrode, at least one stimulator circuit and at least one controller. The at least one stimulator circuit is connected to the at least one port and is adapted to deliver neural stimulation to a neural stimulation target using the at least one electrode. The at least one controller is adapted to determine when another energy discharge other than the neural stimulation to the neural stimulation target is occurring and to prevent delivery of the neural stimulation simultaneously with the other energy discharge. Other aspects and embodiments are provided herein. | 05-12-2011 |
20110130802 | SYSTEM AND METHOD FOR TESTING NEURAL STIMULATION THRESHOLD - Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein. | 06-02-2011 |
20110245711 | METHOD AND APPARATUS FOR PERSONALIZED PHYSIOLOGIC PARAMETERS - Methods and apparatus combine patient measurement data with demographic or physiological data of the patient to determine an output that can be used to diagnose and treat the patient. A customized output can be determined based the demographics of the patient, physiological data of the patient, and data of a population of patients. In another aspect, patient measurement data is used to predict an impending cardiac event, such as acute decompensated heart failure. At least one personalized value is determined for the patient, and a patient event prediction output is generated based at least in part on the personalized value and the measurement data. For example, bioimpedance data may be used to establish a baseline impedance specific to the patient, and the patient event prediction output generated based in part on the relationship of ongoing impedance measurements to the baseline impedance. Multivariate prediction models may enhance prediction accuracy. | 10-06-2011 |
20110295333 | IMPLANTABLE SYSTEMS AND DEVICES FOR PROVIDING CARDIAC DEFIBRILLATION AND APNEA THERAPY - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a cardiac activity monitor to sense cardiac activity and provide a signal indicative of the cardiac activity, and a baroreflex stimulator. The stimulator includes a pulse generator and a modulator. The pulse generator provides a baroreflex stimulation signal adapted to provide a baroreflex therapy. The modulator receives the signal indicative of the cardiac activity and modulates the baroreflex stimulation signal based on the signal indicative of the cardiac activity to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy. | 12-01-2011 |
20110301660 | HEART FAILURE MANAGEMENT SYSTEM - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 12-08-2011 |
20110307025 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 12-15-2011 |
20110319959 | SYSTEM FOR NEURAL CONTROL OF RESPIRATION - A system, device and method for neural control of respiration are provided. One aspect of this disclosure relates to an implantable medical device for sensing and controlling respiration during incidence of central respiratory diseases. According to various embodiments, the device includes a sensing circuit to receive sensed signals representative of an incidence of a central respiratory disease. The device also includes a neural stimulator adapted to generate neural stimulation signals, and a controller to communicate with the sensing circuit and to control the neural stimulator to stimulate a desired neural target in response to the detection of the incidence of a central respiratory disease. In an embodiment, the device includes a plurality of sensors which are adapted to monitor physiological parameters to detect the incidence of a central respiratory disease and to send signals to the sensing circuit. Other aspects and embodiments are provided herein. | 12-29-2011 |
20110319960 | LEAD FOR STIMULATING THE BARORECEPTORS IN THE PULMONARY ARTERY - An apparatus includes a flexible lead body extending from a proximal end to a distal end, an expandable electrode coupled proximate the distal end, the expandable electrode having an expanded diameter dimensioned to abut a wall of a pulmonary artery, and an implantable pulse generator electrically coupled to the expandable electrode. The expandable electrode includes a plurality of electrode zones. The implantable pulse generator is adapted to deliver a baroreflex stimulation signal to a baroreceptor in the pulmonary artery via the electrode. | 12-29-2011 |
20120022608 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 01-26-2012 |
20120035432 | MEDICAL DEVICE AND METHODS OF MONITORING A PATIENT WITH RENAL DYSFUNCTION - Embodiments relate to a method of monitoring physiological parameters of a patient with renal dysfunction. The method includes electrically connecting one or more medical device electrodes with a measurement site of a patient, generating one or more first stimulation signals sufficient to provide input physiological parameters specific to the patient, measuring one or more first bioimpedance values from the generated signals, analyzing at least one of the input physiological parameters within the one or more first bioimpedance values and generating a personalized dialysis program. The systems and methods can further provide essentially real-time data of patient undergoing treatment and control of treatment to a patient. | 02-09-2012 |
20120035494 | MULTIFREQUENCY BIOIMPEDENCE DEVICE AND RELATED METHODS - Embodiments relate to a device and a method of monitoring and analyzing physiological parameters of a patient. The method includes electrically connecting one or more electrodes with a measurement site of a patient, generating a stimulation signal or signals sufficient to provide multiple stimulation frequencies, multiple waveforms or a combination thereof, measuring a one or more bioimpedance values from the generated signals and analyzing at least one of a fluid bioimpedance contribution, fat bioimpedance contribution or ion bioimpedance contribution within the one or more bioimpedance values sufficient to generate a physiological report. | 02-09-2012 |
20120035682 | SYSTEM AND METHOD FOR TESTING NEURAL STIMULATION THRESHOLD - Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein. | 02-09-2012 |
20120041519 | SAFETY CONTROL SYSTEM FOR IMPLANTABLE NEURAL STIMULATOR - A neural stimulation system includes a safety control system that prevents delivery of neural stimulation pulses from causing potentially harmful effects. The neural stimulation pulses are delivered to one or more nerves to control the physiological functions regulated by the one or more nerves. Examples of such harmful effects include unintended effects in physiological functions associated with autonomic neural stimulation and nerve injuries caused by excessive delivery of the neural stimulation pulses. | 02-16-2012 |
20120046703 | METHOD AND DEVICE FOR COMPREHENSIVE ANTI-TACHYARRHYTHMIA THERAPY - A method and apparatus for delivering therapy to treat ventricular tachyarrhythmias is described. In one embodiment, neural stimulation, anti-tachycardia pacing, and shock therapy are employed in a progressive sequence upon detection of a ventricular tachycardia. | 02-23-2012 |
20120046709 | METHOD AND APPARATUS FOR CONTROLLING NEURAL STIMULATION DURING DISORDERED BREATHING - A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea. | 02-23-2012 |
20120108917 | PATIENT MONITORING SYSTEMS AND METHODS - An adherent patient device is configured to adhere to the skin of the patient and measure electrocardiogram data, impedance data, accelerometer data, blood oxygen data and temperature data. The adherent device can communicate wirelessly with gateways and a local processor system, such that the patient can wander about the hospital and update the monitoring station with the patient data when the patient is ambulatory. The local processor system can be configured to customize alerts for the patient, for example to notify automatically a specialist in response to a special condition of the patient. The adherent device may comprise a unique adherent device identifier such that the customized alert can be sent based on the unique device identifier. Each of the gateways can be carried and may comprise a unique gateway identifier, such that the unique device identifier and the unique gateway identifier can be used to locate the ambulatory patient. | 05-03-2012 |
20120123494 | SYSTEM FOR ABATING NEURAL STIMULATION SIDE EFFECTS - Various system embodiments comprise a neural stimulation delivery system adapted to deliver a neural stimulation signal for use in delivering a neural stimulation therapy, a side effect detector, and a controller. The controller is adapted to control the neural stimulation delivery system, receive a signal indicative of detected side effect, determine whether the detected side enact is attributable to delivered neural stimulation therapy, and automatically titrate the neural stimulation therapy to abate the side effect. In various embodiments, the side effect detector includes a cough detector. In various embodiments, the controller is adapted to independently adjusting at least one stimulation parameter for at least one phase in the biphasic waveform as part of a process to titrate the neural stimulation therapy. Other aspects and embodiments are provided herein. | 05-17-2012 |
20120123495 | BAROREFLEX STIMULATION TO TREAT ACUTE MYOCARDIAL INFARCTION - An aspect of the present subject relates to an implantable medical system. An embodiment of the system includes a baroreflex stimulator, a myocardial infarction detector, and a controller. The baroreflex stimulator applies a baroreflex stimulation signal through an electrode. The myocardial infarction detector detects an event indicative of myocardial infarction, The controller is connected to the baroreflex stimulator and to the myocardial infarction detector, and is adapted to apply a baroreflex therapy in response to a detected event indicative of myocardial infarction. Other aspects are provided herein. | 05-17-2012 |
20120130446 | METHOD AND APPARATUS FOR NEURAL STIMULATION WITH RESPIRATORY FEEDBACK - A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder. | 05-24-2012 |
20120143275 | NEURAL STIMULATION WITH AVOIDANCE OF INAPPROPRIATE STIMULATION - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a first monitor and a controller. The pulse generator is adapted to generate a neural stimulation signal for a neural stimulation therapy. The neural stimulation signal has at least one adjustable parameter. The first monitor is adapted to detect an undesired effect. In some embodiments, the undesired effect is myocardial infarction. The controller is adapted to respond to the first monitor and automatically adjust the at least one adjustable parameter of the neural stimulation signal to avoid the undesired effect of the neural stimulation therapy. Other aspects are provided herein. | 06-07-2012 |
20120150250 | SYSTEM AND METHOD TO DELIVER THERAPY IN PRESENCE OF ANOTHER THERAPY - Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein. | 06-14-2012 |
20120165888 | BAROREFLEX STIMULATION SYNCHRONIZED TO CIRCADIAN RHYTHM - An embodiment of a baroreflex stimulator comprises a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator to modulate the baroreflex stimulation signal based on a circadian rhythm template. According to an embodiment of a method for operating an implantable medical device, comprising a baroreflex stimulation therapy is applied at a stimulation intensity using a baroreflex stimulator in the implantable medical device, and the baroreflex stimulation therapy is modulated based on a circadian rhythm template stored within the implantable medical device. Modulating the baroreflex stimulation therapy includes using the circadian rhythm template to change the stimulation intensity to mimic natural blood pressure fluctuations during the day. | 06-28-2012 |
20120172764 | PHYSIOLOGICAL RESPONSE TO POSTURE CHANGE - In an embodiment, an implantable medical device includes a controller circuit, a posture sensing circuit, and a physiological sensing circuit. The controller circuit senses a change in a physiological signal as a result of a change in posture, and generates a response as a function of that change. In another embodiment, the controller circuit identifies a heart failure condition as a function of the change in the physiological signal. | 07-05-2012 |
20120179216 | NEURAL STIMULATION SYSTEM FOR CARDIAC FAT PADS - Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein. | 07-12-2012 |
20120215276 | SYSTEMS, DEVICES AND METHODS USED IN VERIFYING NEURAL STIMULATION CAPTURE - Various system embodiments comprise a neural stimulator, a premature ventricular contraction (PVC) event detector, a heart rate detector, an analyzer, and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to stimulate an autonomic neural target. The analyzer is adapted to, in response to a PVC event signal from the PVC event detector, generate an autonomic balance indicator (ABI) as a function of pre-PVC heart rate data and post-PVC heart rate data. Other aspects and embodiments are provided herein. | 08-23-2012 |
20120215279 | SYSTEM AND METHOD FOR SUSTAINED BAROREFLEX STIMULATION - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a baroreflex stimulator and a controller. The baroreflex stimulator is adapted to generate a stimulation signal to stimulate a baroreflex. The controller is adapted to communicate with the baroreflex stimulator and implement a baroreflex stimulation protocol to vary an intensity of the baroreflex stimulation provided by the stimulation signal to abate baroreflex adaptation. According to various embodiments, the controller is adapted to implement the baroreflex stimulation protocol to periodically modulate the baroreflex stimulation to produce an effect that mimics an effect of pulsatile pressure. Other aspects are provided herein. | 08-23-2012 |
20120232604 | SYSTEM TO TREAT AV-CONDUCTED VENTRICULAR TACHYARRHYTHMIA - Various aspects of the present subject matter provide devices and methods to treat AV-conducted ventricular tachyarrhythmia (AVCVT). According to various embodiments of the method, an AVCVT is sensed, an IVC-LA fat pad is stimulated when the AVCVT is sensed to block AV conduction, and bradycardia support pacing is provided while the IVC-LA fat pad is stimulated. Other aspects and embodiments are provided herein. | 09-13-2012 |
20120239099 | SYSTEM AND METHOD FOR DELIVERING MYOCARDIAL AND AUTONOMIC NEURAL STIMULATION - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a lead, a sensor, and a controller. The pulse generator generates a baroreflex stimulation signal as part of a baroreflex therapy. The lead is adapted to be electrically connected to the pulse generator and to be intravascularly fed into a heart. The lead includes an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart. The sensor senses a physiological parameter regarding an efficacy of the baroreflex therapy and provides a signal indicative of the efficacy. The controller is connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy. Other aspects are provided herein. | 09-20-2012 |
20120239101 | SYSTEM AND METHOD FOR FILTERING NEURAL STIMULATION - Various aspects of the present subject matter provide a filter module. In various embodiments, the filter module comprises an input, an output, a signal path from the input to the output, a filter and a switch. The filter has a transfer response to attenuate a frequency of a neural stimulation signal. The switch is adapted to place the filter in the signal path when the neural stimulation signal is applied and to remove the filter from the signal path when the neural stimulation signal is not applied. Other aspects are provided herein. | 09-20-2012 |
20120245656 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 09-27-2012 |
20120265273 | UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter. | 10-18-2012 |
20120290026 | SYSTEMS AND METHODS FOR TREATING SUPRAVENTRICULAR ARRHYTHMIAS - In various method embodiments, a supraventricular arrhythmia event is detected, and a supraventricular arrhythmia treatment, including neural stimulation to elicit a sympathetic response, is delivered in response to a detected supraventricular arrhythmia event. Some embodiments detect a precursor for a supraventricular arrhythmia episode, and deliver prophylactic neural stimulation to avoid the supraventricular arrhythmia event. Some embodiments detect a supraventricular arrhythmia episode, and deliver therapeutic neural stimulation for the supraventricular arrhythmia event. | 11-15-2012 |
20120310295 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 12-06-2012 |
20120323292 | SYSTEM FOR NEURAL CONTROL OF RESPIRATION - A system, device and method for neural control of respiration are provided. One aspect of this disclosure relates to an implantable medical device for sensing and controlling respiration during incidence of central respiratory diseases. According to various embodiments, the device includes a sensing circuit to receive sensed signals representative of an incidence of a central respiratory disease. The device also includes a neural stimulator adapted to generate neural stimulation signals, and a controller to communicate with the sensing circuit and to control the neural stimulator to stimulate a desired neural target in response to the detection of the incidence of a central respiratory disease. In an embodiment, the device includes a plurality of sensors which are adapted to monitor physiological parameters to detect the incidence of a central respiratory disease and to send signals to the sensing circuit. Other aspects and embodiments are provided herein. | 12-20-2012 |
20130030504 | METHOD AND APPARATUS FOR ELECTRONICALLY SWITCHING ELECTRODE CONFIGURATION - A method and apparatus for selecting neural stimulation electrode configuration is provided. One aspect of this disclosure relates to an implantable medical device including a neural stimulator adapted to generate neural stimulation signals and an electrode configuration tester for testing a first electrode configuration for stimulating a desired neural target. The device includes a controller to control the neural stimulator to selectively provide a first neural stimulation signal with appropriate signal characteristics to stimulate the desired neural target using the first electrical configuration and a second neural stimulation signal with appropriate signal characteristics to stimulate the desired neural target using a second electrode configuration, and adapted to communicate with the electrode configuration tester and to respond to an indication that an efficacy of the first electrode configuration is lower than a threshold by providing the neural stimulation using the second neural stimulation signal. Other aspects and embodiments are provided herein. | 01-31-2013 |
20130053924 | SYSTEMS AND METHODS FOR TESTING NEURAL STIMULATION SITES - Various system embodiments comprise a medical device, comprising a flexible tether, a neural stimulation circuit, and a controller. The flexible tether is adapted to be fed into a patient's throat. The flexible tether includes a plurality of electrodes. The neural stimulation circuit is adapted to deliver neural stimulation. The controller is adapted to control the neural stimulation circuit to provide a neural stimulation therapy using at least one electrode from the plurality of electrodes, and to implement a neural stimulation test routine. The neural stimulation test routine is adapted to assess neural stimulation efficacy for electrode subsets of the plurality of electrodes to identify a desired electrode subset for use in delivering the neural stimulation therapy to elicit a desired response. | 02-28-2013 |
20130079838 | BAROREFLEX MODULATION TO GRADUALLY CHANGE A PHYSIOLOGICAL PARAMETER - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein. | 03-28-2013 |
20130096395 | METHOD AND APPARATUS FOR PERSONALIZED PHYSIOLOGIC PARAMETERS - Methods and apparatus combine patient measurement data with demographic or physiological data of the patient to determine an output that can be used to diagnose and treat the patient. A customized output can be determined based the demographics of the patient, physiological data of the patient, and data of a population of patients. In another aspect, patient measurement data is used to predict an impending cardiac event, such as acute decompensated heart failure. At least one personalized value is determined for the patient, and a patient event prediction output is generated based at least in part on the personalized value and the measurement data. For example, bioimpedance data may be used to establish a baseline impedance specific to the patient, and the patient event prediction output generated based in part on the relationship of ongoing impedance measurements to the baseline impedance. Multivariate prediction models may enhance prediction accuracy. | 04-18-2013 |
20130123873 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 05-16-2013 |
20130150927 | SAFETY CONTROL SYSTEM FOR IMPLANTABLE NEURAL STIMULATOR - A neural stimulation system includes a safety control system that prevents delivery of neural stimulation pulses from causing potentially harmful effects. The neural stimulation pulses are delivered to one or more nerves to control the physiological functions regulated by the one or more nerves. Examples of such harmful effects include unintended effects in physiological functions associated with autonomic neural stimulation and nerve injuries caused by excessive delivery of the neural stimulation pulses. | 06-13-2013 |
20130158616 | Implantable Device For Evaluating Autonomic Cardiovascular Drive In A Patient Suffering From Chronic Cardiac Dysfunction - An implantable device for evaluating autonomic cardiovascular drive in a patient suffering from chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. The neurostimulator includes a recordable memory storing a baseline heart rate. The neurostimulator includes an integrated leadless heart rate sensor configured to continually monitor heart rate in light of the baseline heart rate. | 06-20-2013 |
20130158617 | Implantable Device For Providing Electrical Stimulation Of Cervical Vagus Nerves For Treatment Of Chronic Cardiac Dysfunction With Bounded Titration - An implantable device for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. The neurostimulator includes an integrated leadless heart rate sensor configured to sense heart rate and alter the triggering in response to the sensed heart rate falling outside a predetermined range. | 06-20-2013 |
20130158618 | Computer-Implemented System And Method For Selecting Therapy Profiles Of Electrical Stimulation Of Cervical Vagus Nerves For Treatment Of Chronic Cardiac Dysfunction - A computer-implemented system and method for selecting therapy profiles of electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. An external programmer includes a plurality of therapy profiles stored in memory. The therapy profiles include different sets of stimulation parameters that cooperatively define alternating cycles of stimuli application and stimuli inhibition for a neurostimulator that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes. A programming wand is configured to provide the set of stimulation parameters chosen by the user to the neurostimulator through wireless telemetry. Finally, an implantable neurostimulator device includes a stimulation therapy lead terminated by helical electrodes and electrically coupled to the neurostimulator. The implantable neurostimulator is configured to therapeutically stimulate the cervical vagus nerve through the helical electrodes by triggering bi-directional action potentials as specified by the selected set of stimulation parameters. | 06-20-2013 |
20130158622 | Implantable Device For Facilitating Control Of Electrical Stimulation Of Cervical Vagus Nerves For Treatment Of Chronic Cardiac Dysfunction - An implantable device for facilitating control of electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. Finally, the neurostimulator includes a programmable switch configured to alter the triggering of the bi-directional action potentials in response to a magnetic signal received from outside the housing. | 06-20-2013 |
20130165998 | SYSTEM AND METHOD FOR CLOSED-LOOP NEURAL STIMULATION - Various device embodiments comprise a pulse generator, a signal processing module and a controller. The pulse generator is adapted to provide a neural stimulation signal to be applied at a neural simulation site within an autonomic nervous system (ANS). The signal processing module is adapted to receive and process sensed neural traffic at a neural sensing site within the ANS. The controller is connected to the pulse generator and adapted to provide a neural stimulation control signal to the pulse generator to generate the neural stimulation signal, and to the signal processing module to receive a feedback control signal indicative of the sensed neural traffic. The controller is adapted to adjust the neural stimulation control signal to adjust at least one parameter of the neural stimulation signal to converge on desired sensed neural traffic at the neural sensing site. Other aspects and embodiments are provided herein. | 06-27-2013 |
20130184773 | Vagus Nerve Neurostimulator With Multiple Patient-Selectable Modes For Treating Chronic Cardiac Dysfunction - A vagus nerve neurostimulator system with multiple patient-selectable modes for treating chronic cardiac dysfunction is provided. An implantable neurostimulator includes a pulse generator coupled to a therapy lead terminated by a pair of helical electrodes positioned over a cervical vagus nerve. The pulse generator is configured to deliver through the helical electrodes continuously-cycling, intermittent and periodic electrical stimulation that is parametrically defined to bi-directionally propagate through nerve fibers in the cervical vagus nerve. The implantable neurostimulator includes a magnetic switch configured to switch the pulse generator between a plurality of operating modes that are each separately selectable in response to a unique and remotely-applied magnetic signal. An external controller includes patient-actuatable controls configured to enable selection of one of the operating modes of the pulse generator. The external controller includes an electromagnetic transmitter configured to output the magnetic signal uniquely associated with the operating mode as selected with the controls. | 07-18-2013 |
20130190837 | SYSTEM AND METHOD FOR CLOSED-LOOP NEURAL STIMULATION - Various aspects of the present subject matter provide a device. In various embodiments, the device comprises a port adapted to connect a lead, a pulse generator connected to the port and adapted to provide a neural stimulation signal to the lead, and a signal processing module connected to the port and adapted to receive and process a nerve traffic signal from the lead into a signal indicative of the nerve traffic. The device includes a controller connected to the pulse generator and the signal processing module. The controller is adapted to implement a stimulation protocol to provide the neural stimulation signal with desired neural stimulation parameters based on the signal indicative of the nerve traffic. Other aspects are provided herein. | 07-25-2013 |
20130190840 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 07-25-2013 |
20130197594 | CLOSED LOOP NEURAL STIMULATION SYNCHRONIZED TO CARDIAC CYCLES - Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein. | 08-01-2013 |
20130211471 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 08-15-2013 |
20130231717 | NEURAL STIMULATION MODULATION BASED ON MONITORED CARDIOVASCULAR PARAMETER - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate. | 09-05-2013 |
20130238047 | IMPLANTABLE DEVICE FOR PROVIDING ELECTRICAL STIMULATION OF CERVICAL VAGUS NERVES FOR TREATMENT OF CHRONIC CARDIAC DYSFUNCTION WITH LEADLESS HEART RATE MONITORING - An implantable device for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with leadless heart rate monitoring is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. Finally, the neurostimulator includes an integrated leadless heart rate sensor configured to sense heart rate and to record the sensed heart rate as data into a memory. | 09-12-2013 |
20130238052 | METHOD AND SYSTEM FOR TREATING CONGESTIVE HEART FAILURE - An approach to treating congestive heart failure includes monitoring pulmonary congestion. Monitoring pulmonary congestion includes sensing a physiologic parameter using a sensor implanted within the patient. The method further comprises delivering a congestive heart failure therapy using a stimulator implanted within the patient. Delivering the congestive heart failure therapy includes delivering electrical stimulation to the patient using the sensed parameter to control the congestive heart failure therapy. | 09-12-2013 |
20130253616 | METHOD AND APPARATUS FOR SYNCHRONIZING NEURAL STIMULATION TO CARDIAC CYCLES - A neural stimulator senses a reference signal indicative of cardiac cycles each including a predetermined type timing reference event using a sensor external to the heart and blood vessels. The delivery of the neural stimulation pulses are synchronized to that timing reference event. Examples of the timing reference event include a predetermined cardiac event such as a P-wave or an R-wave detected from a subcutaneous ECG signal, a predetermined type heart sound detected from an acoustic signal, and a peak detected from a hemodynamic signal related to blood flow or pressure. | 09-26-2013 |
20130261691 | SYSTEM AND METHOD FOR NEURAL STIMULATION - Various aspects provide an implantable device. In various embodiments, the device comprises at least one port, where each port is adapted to connect a lead with an electrode to the device. The device further includes a stimulation platform, including a sensing circuit connected to the at least one port to sense an intrinsic cardiac signal and a stimulation circuit connected to the at least one port via a stimulation channel to deliver a stimulation signal through the stimulation channel to the electrode. The stimulation circuit is adapted to deliver stimulation signals through the stimulation channel for both neural stimulation therapy and CRM therapy. The sensing and stimulation circuits are adapted to perform CRM functions. The device further includes a controller connected to the sensing circuit and the stimulation circuit to control the neural stimulation therapy and the CRM therapy. Other aspects and embodiments are provided herein. | 10-03-2013 |
20130267893 | IMPLANTABLE NEURAL STIMULATOR WITH MODE SWITCHING - Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein. | 10-10-2013 |
20130268027 | AUTOMATIC BAROREFLEX MODULATION BASED ON CARDIAC ACTIVITY - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a cardiac activity monitor to sense cardiac activity and provide a signal indicative of the cardiac activity, and a baroreflex stimulator. The stimulator includes a pulse generator and a modulator. The pulse generator provides a baroreflex stimulation signal adapted to provide a baroreflex therapy. The modulator receives the signal indicative of the cardiac activity and modulates the baroreflex stimulation signal based on the signal indicative of the cardiac activity to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy. | 10-10-2013 |
20130268030 | METHOD AND APPARATUS FOR CONTROLLING NEURAL STIMULATION DURING DISORDERED BREATHING - A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea. | 10-10-2013 |
20130289646 | IMPLANTABLE NEUROSTIMULATOR FOR PROVIDING ELECTRICAL STIMULATION OF CERVICAL VAGUS NERVES FOR TREATMENT OF CHRONIC CARDIAC DYSFUNCTION WITH BOUNDED TITRATION - A system for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. The system includes a patient-operable external controller to transmit a plurality of unique signals. The system further includes an implantable neurostimulator, which includes a pulse generator to deliver electrical therapeutic stimulation tuned to restore autonomic balance through continuously-cycling, intermittent and periodic electrical pulses that result in creation and propagation (in both afferent and efferent directions) of action potentials within the cervical vagus nerve of a patient through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead. The neurostimulator also includes a recordable memory storing an autotitration operating mode that includes a maximum stimulation intensity and is configured to increase an intensity of the delivered electrical therapeutic stimulation up to a level not exceeding the maximum stimulation intensity upon receipt of one of the unique signals. | 10-31-2013 |
20130296958 | COMBINED REMODELING CONTROL THERAPY AND ANTI-REMODELING THERAPY BY IMPLANTABLE CARDIAC DEVICE - A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy. | 11-07-2013 |
20130317561 | SYSTEM AND METHOD TO DELIVER THERAPY IN PRESENCE OF ANOTHER THERAPY - Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein. | 11-28-2013 |
20130345776 | SYSTEM FOR ABATING NEURAL STIMULATION SIDE EFFECTS - Various system embodiments comprise a neural stimulation delivery system adapted to deliver a neural stimulation signal for use in delivering a neural stimulation therapy, a side effect detector, and a controller. The controller is adapted to control the neural stimulation delivery system, receive a signal indicative of detected side effect, determine whether the detected side effect is attributable to delivered neural stimulation therapy, and automatically titrate the neural stimulation therapy to abate the side effect. In various embodiments, the side effect detector includes a cough detector. In various embodiments, the controller is adapted to independently adjusting at least one stimulation parameter for at least one phase in the biphasic waveform as part of a process to titrate the neural stimulation therapy. Other aspects and embodiments are provided herein. | 12-26-2013 |
20140025132 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING BRADYCARDIA THROUGH VAGUS NERVE STIMULATION - A method for managing bradycardia through vagus nerve stimulation is provided. An implantable neurostimulator configured to deliver electrical therapeutic stimulation in both afferent and efferent directions of a patient's cervical vagus nerve is provided. An operating mode is stored, which includes parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. The maintenance dose is delivered via a pulse generator through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead independent of cardiac cycle. The patient's physiology is monitored, and upon sensing a condition indicative of bradycardia, the delivery of the maintenance dose is suspended. A progressively increasing amount of time is spent waiting via a controller and, upon sensing a condition indicative of an absence or termination of the bradycardia, a progressively increasing partial maintenance dose is delivered via the pulse generator. | 01-23-2014 |
20140025141 | METHOD AND APPARATUS FOR NEURAL STIMULATION WITH RESPIRATORY FEEDBACK - A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder. | 01-23-2014 |
20140088676 | NEURAL STIMULATION SYSTEM FOR CARDIAC FAT PADS - Various aspects relate to a device which, in various embodiments, comprises a header, a neural stimulator, a detector and a controller. The header includes at least one port to connect to at least one lead, and includes first and second channels for use to provide neural stimulation to first and second neural stimulation sites for a heart. The controller is connected to the detector and the neural stimulator to selectively deliver a therapy based on the feedback signal. A first therapy signal is delivered to the first neural stimulation site to selectively control contractility and a second therapy signal is delivered to the second neural stimulation site to selectively control one of a sinus rate and an AV conduction. Other aspects and embodiments are provided herein. | 03-27-2014 |
20140114370 | HEART FAILURE MANAGEMENT - Various system embodiments comprise a stimulator adapted to deliver a stimulation signal for a heart failure therapy, a number of sensors adapted to provide at least a first measurement of a heart failure status and a second measurement of the heart failure status, and a controller. The controller is connected to the stimulator and to the number of sensors. The controller is adapted to use the first and second measurements to create a heart failure status index, and control the stimulator to modulate the signal using the index. Other aspects and embodiments are provided herein. | 04-24-2014 |
20140121729 | BAROREFLEX MODULATION TO GRADUALLY CHANGE A PHYSIOLOGICAL PARAMETER - An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein. | 05-01-2014 |
20140135862 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING TACHYARRHYTHMIA THROUGH VAGUS NERVE STIMULATION - An implantable neurostimulator-implemented method for managing tachyarrhythmias through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers of a patient's cervical vagus nerve. Operating modes of the pulse generator are stored. A maintenance dose of the electrical therapeutic stimulation is delivered to the vagus nerve via the pulse generator to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. A restorative dose of the electrical therapeutic stimulation is delivered to prevent initiation of or disrupt tachyarrhythmia through periodic electrical pulses delivered at higher intensity than the maintenance dose. The patient's normative physiology is monitored via a physiological sensor, and upon sensing a condition indicative of tachyarrhythmia, is switched to delivering the restorative dose to the vagus nerve. | 05-15-2014 |
20140135863 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR ENHANCING POST-EXERCISE RECOVERY THROUGH VAGUS NERVE STIMULATION - An implantable neurostimulator-implemented method for enhancing post-exercise recovery through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers including a patient's cervical vagus nerve. An operating mode is stored in the pulse generator. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent or disrupt tachyarrhythmia through continuously-cycling, intermittent and periodic electrical pulses. The patient's physiological state is monitored during physical exercise via at least one sensor included in the implantable neurostimulator, and upon sensing a condition indicative of cessation of the physical exercise, the enhanced dose is delivered for a period of time the enhanced dose to the vagus nerve. | 05-15-2014 |
20140135864 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR ENHANCING HEART FAILURE PATIENT AWAKENING THROUGH VAGUS NERVE STIMULATION - An implantable neurostimulator-implemented method for managing tachyarrhythmias upon a patient's awakening from sleep through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers comprising the cervical vagus nerve of a patient. Operating modes of the pulse generator are stored. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent initiation of or disrupt tachyarrhythmia upon the patient's awakening from a sleep state through at least one of continuously-cycling, intermittent and periodic ON-OFF cycles of electrical pulses. Other operating modes, including a maintenance dose and a restorative dose are defined. The patient's physiological state is monitored via at least one sensor to detect the patient's awakening, which activates the delivery of the enhanced dose. | 05-15-2014 |
20140155949 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING BRADYCARDIA THROUGH VAGUS NERVE STIMULATION - A method for managing bradycardia through vagus nerve stimulation is provided. An implantable neurostimulator configured to deliver electrical therapeutic stimulation in both afferent and efferent directions of a patient's cervical vagus nerve is provided. An operating mode is stored, which includes parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. The maintenance dose is delivered via a pulse generator through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead independent of cardiac cycle. The patient's physiology is monitored, and upon sensing a condition indicative of bradycardia, the delivery of the maintenance dose is suspended. A progressively increasing amount of time is spent waiting via a controller and, upon sensing a condition indicative of an absence or termination of the bradycardia, a progressively increasing partial maintenance dose is delivered via the pulse generator. | 06-05-2014 |
20140188191 | IMPLANTABLE NEUROSTIMULATOR FOR PROVIDING ELECTRICAL STIMULATION OF CERVICAL VAGUS NERVES FOR TREATMENT OF CHRONIC CARDIAC DYSFUNCTION WITH BOUNDED TITRATION - A system for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. The system includes a patient-operable external controller to transmit a plurality of unique signals. The system further includes an implantable neurostimulator, which includes a pulse generator to deliver electrical therapeutic stimulation tuned to restore autonomic balance through continuously-cycling, intermittent and periodic electrical pulses that result in creation and propagation (in both afferent and efferent directions) of action potentials within the cervical vagus nerve of a patient through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead. The neurostimulator also includes a recordable memory storing an autotitration operating mode that includes a maximum stimulation intensity and is configured to increase an intensity of the delivered electrical therapeutic stimulation up to a level not exceeding the maximum stimulation intensity upon receipt of one of the unique signals. | 07-03-2014 |
20140194952 | METHOD AND APPARATUS FOR CONTROLLING AUTONOMIC BALANCE USING NEURAL STIMULATION - A neural stimulation system senses autonomic activities and applies neural stimulation to sympathetic and parasympathetic nerves to control autonomic balance. The neural stimulation system is capable of delivering neural stimulation pulses for sympathetic excitation, sympathetic inhibition, parasympathetic excitation, and parasympathetic inhibition. | 07-10-2014 |
20140200634 | INTERMITTENT NEURAL STIMULATION WITH PHYSIOLOGIC RESPONSE MONITOR - Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a pulse generator, a first monitor and a controller. The pulse generator is adapted to generate a neural stimulation signal for a neural stimulation therapy. The neural stimulation signal has at least one adjustable parameter. The first monitor is adapted to detect an undesired effect. In some embodiments, the undesired effect is myocardial infarction. The controller is adapted to respond to the first monitor and automatically adjust the at least one adjustable parameter of the neural stimulation signal to avoid the undesired effect of the neural stimulation therapy. Other aspects are provided herein. | 07-17-2014 |
20140207203 | NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - Various system embodiments comprise circuitry to determine when an arrhythmia has terminated, and a neural stimulator adapted to temporarily deliver neural stimulation therapy to assist with recovering from the arrhythmia in response to termination of the arrhythmia. | 07-24-2014 |
20140222100 | SYSTEMS AND METHODS FOR AVOIDING NEURAL STIMULATION HABITUATION - An embodiment relates to a method for delivering a vagal stimulation therapy to a vagus nerve, including delivering a neural stimulation signal to non-selectively stimulate both afferent axons and efferent axons in the vagus nerve according to a predetermined schedule for the vagal stimulation therapy, and selecting a value for at least one parameter for the predetermined schedule for the vagal stimulation therapy to control the neural stimulation therapy to avoid physiological habituation to the vagal stimulation therapy. The parameter(s) include at least one parameter selected from the group of parameters consisting of a predetermined therapy duration parameter for a predetermined therapy period, and a predetermined intermittent neural stimulation parameter associated with on/off timing for the intermittent neural stimulation parameter. | 08-07-2014 |
20140243929 | CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY - Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion. | 08-28-2014 |
20140243932 | UNIDIRECTIONAL NEURAL STIMULATION SYSTEMS, DEVICES AND METHODS - An embodiment relates to a method for delivering a unidirectional afferent nerve stimulation treatment. A test neural stimulation is delivered, and a physiologic response to the test neural stimulation is monitored. At least one neural stimulation parameter for the test neural stimulation is adjusted if the test neural stimulation does not elicit a desired physiologic response. If the test neural stimulation does elicit the desired physiologic response, at least one treatment parameter for a unidirectional afferent nerve stimulation is determined using the at least one neural stimulation parameter for the test neural stimulation that provided the desired physiologic response. The unidirectional afferent nerve stimulation is delivered using the at least one treatment parameter. | 08-28-2014 |
20140277232 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR MANAGING TACHYARRHYTHMIC RISK DURING SLEEP THROUGH VAGUS NERVE STIMULATION - A patient suffering from congestive heart failure is at increased risk of cardiac arrhythmogenesis during sleep, particularly if experiencing central sleep apnea as a co-morbidity. Low intensity peripheral neurostimulation therapies that target imbalance of the autonomic nervous system have been shown to improve clinical outcomes. Thus, bi-directional autonomic regulation therapy is delivered to the cervical vagus nerve at an intensity that is insufficient to elicit pathological or acute physiological side effects and without the requirement of an enabling physiological feature or triggering physiological marker. The patient's physiology is monitored to identify periods of sleep. In one embodiment, upon sensing a condition indicative of tachyarrhythmia following a period of bradycardia, as naturally occurs during sleep, an enhanced “boost” dose of bi-directional neural stimulation intended to “break” the tachyarrhythmic condition is delivered. In a further embodiment, the boost dose is delivered upon sensing a physiological pattern indicative of Cheyne-Stokes respiration. | 09-18-2014 |
20140316487 | VAGAL NERVE STIMULATOR WITH MODE SWITCHING - Various aspects of the present subject matter relate to an implantable device. Various device embodiments comprise at least one port to connect to at least one lead with at least electrode, stimulation circuitry connected to the at least one port and adapted to provide at least one neural stimulation therapy to at least one neural stimulation target using the at least one electrode, sensing circuitry connected to the at least one port and adapted to provide a sensed signal, and a controller connected to the stimulation circuitry to provide the at least one neural stimulation therapy and to the sensing circuitry to receive the sensed signal. In response to a triggering event, the controller is adapted to switch between at least two modes. Other aspects and embodiments are provided herein. | 10-23-2014 |
20140316488 | NEURAL STIMULATION MODULATION BASED ON MONITORED CARDIOVASCULAR PARAMETER - An aspect relates to a system for providing baroreflex stimulation. An embodiment of the system comprises a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate, and a baroreflex stimulator. The stimulator includes a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy, and further includes a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate. | 10-23-2014 |
20140323821 | INJECTABLE DEVICE FOR PHYSIOLOGICAL MONITORING - An injectable detecting device is provided for use in physiological monitoring. The device includes a plurality of sensors axially spaced along a body that provide an indication of at least one physiological event of a patient, a monitoring unit within the body coupled to the plurality of sensors configured to receive data from the plurality of sensors and create processed patient data, a power source within the body coupled to the monitoring unit, and a communication antenna external to the body coupled to the monitoring unit configured to transfer data to/from other devices. | 10-30-2014 |
20140324114 | SYSTEM AND METHOD TO DELIVER THERAPY IN PRESENCE OF ANOTHER THERAPY - Various aspects relate to a method. In various embodiments, a therapy of a first therapy type is delivered, and it is identified whether a therapy of a second therapy type is present to affect the therapy of the first therapy type. Delivery of the therapy is controlled based on the presence of the therapy of the second therapy type. Some embodiments deliver the therapy of the first type using one set of parameters in the presence of a therapy of a second type, and deliver the therapy of the first type using another set of parameters when the therapy of the second type is not present. In various embodiments, one of the therapy types includes a cardiac rhythm management therapy, and the other includes a neural stimulation therapy. Other aspects and embodiments are provided herein. | 10-30-2014 |
20140330136 | ADHERENT DEVICE WITH MULTIPLE PHYSIOLOGICAL SENSORS - An adherent device to monitor a patient comprises an adhesive patch to adhere to a skin of the patient, and at least four electrodes connected to the patch and capable of electrically coupling to the patient. The adherent device further includes impedance circuitry coupled to the at least four electrodes to measure a hydration signal of the patient and electrocardiogram circuitry coupled to at least two of the at least four electrodes to measure an electrocardiogram signal of the patient. | 11-06-2014 |
20150015417 | PATIENT MONITORING SYSTEMS AND METHODS - An adherent patient device is configured to adhere to the skin of the patient and measure electrocardiogram data, impedance data, accelerometer data, blood oxygen data and temperature data. The adherent device can communicate wirelessly with gateways and a local processor system, such that the patient can wander about the hospital and update the monitoring station with the patient data when the patient is ambulatory. The local processor system can be configured to customize alerts for the patient, for example to notify automatically a specialist in response to a special condition of the patient. The adherent device may comprise a unique adherent device identifier such that the customized alert can be sent based on the unique device identifier. Each of the gateways can be carried and may comprise a unique gateway identifier, such that the unique device identifier and the unique gateway identifier can be used to locate the ambulatory patient. | 01-15-2015 |
20150032188 | AUTOMATIC NEURAL STIMULATION MODULATION BASED ON ACTIVITY - According to an embodiment of a method for providing neural stimulation, activity is sensed, and neural stimulation is automatically controlled based on the sensed activity. An embodiment determines periods of rest and periods of exercise using the sensed activity, and applies neural stimulation during rest and withdrawing neural stimulation during exercise. Other embodiments are provided herein. | 01-29-2015 |
20150073511 | IMPLANTABLE NEUROSTIMULATOR-IMPLEMENTED METHOD FOR ENHANCING HEART FAILURE PATIENT AWAKENING THROUGH VAGUS NERVE STIMULATION - An implantable neurostimulator-implemented method for managing tachyarrhythmias upon a patient's awakening from sleep through vagus nerve stimulation is provided. An implantable neurostimulator, including a pulse generator, is configured to deliver electrical therapeutic stimulation in a manner that results in creation and propagation (in both afferent and efferent directions) of action potentials within neuronal fibers comprising the cervical vagus nerve of a patient. Operating modes of the pulse generator are stored. An enhanced dose of the electrical therapeutic stimulation is parametrically defined and tuned to prevent initiation of or disrupt tachyarrhythmia upon the patient's awakening from a sleep state through at least one of continuously-cycling, intermittent and periodic ON-OFF cycles of electrical pulses. Other operating modes, including a maintenance dose and a restorative dose are defined. The patient's physiological state is monitored via at least one sensor to detect the patient's awakening, which activates the delivery of the enhanced dose. | 03-12-2015 |
20150073512 | IMPLANTABLE DEVICE FOR EVALUATING AUTONOMIC CARDIOVASCULAR DRIVE IN A PATIENT SUFFERING FROM CHRONIC CARDIAC DYSFUNCTION - An implantable device ( | 03-12-2015 |