СИСТЕМА И СПОСОБ ОПРЕДЕЛЕНИЯ МЕСТА РАСПОЛОЖЕНИЯ И ИДЕНТИФИКАЦИИ ФУНКЦИОНАЛЬНЫХ НЕРВОВ, ИННЕРВИРУЮЩИХ СТЕНКУ АРТЕРИЙ, И КАТЕТЕРЫ ДЛЯ НИХ

Группа изобретений относится к области медицины и медицинской техники. Система содержит: катетер, выполненный с возможностью подачи электрического тока на внутреннюю стенку почечной артерии для стимуляции нерва, иннервирующего почечную артерию; измерительное устройство для измерения физиологических параметров, связанных с иннервацией почечной артерии; вычислительное устройство, связанное с измерительными устройствами для вычисления значений физиологических параметров; отображающее устройство для идентификации парасимпатического или симпатического нерва, иннервирующего внутреннюю стенку почечной артерии. Для картирования нерва, иннервирующего стенку почечной артерии, катетер вводят в полость артерии таким образом, что кончик катетера контактирует с участком, расположенным на внутренней стенке почечной артерии. Измеряют значения физиологических параметров перед приложением электрического тока. Осуществляют стимуляцию. При этом управляют электрическим током таким образом, что он имеет значение ...

СИСТЕМА И СПОСОБ ОПРЕДЕЛЕНИЯ МЕСТА РАСПОЛОЖЕНИЯ И ИДЕНТИФИКАЦИИ ФУНКЦИОНАЛЬНЫХ НЕРВОВ, ИННЕРВИРУЮЩИХ СТЕНКУ АРТЕРИЙ, И КАТЕТЕРЫ ДЛЯ НИХ

... 1. Система для картирования парасимпатического или симпатического нерва, иннервирующего стенку почечной артерии, причем указанная система содержит:(i) катетер, выполненный с возможностью подачи электрического тока в одно или более мест на внутренней стенке почечной артерии, достаточного для стимуляции нерва, иннервирующего указанную почечную артерию,(ii) одно или более измерительных устройств для измерения одного или более физиологических параметров, связанных с указанной иннервацией почечной артерии, причем указанные физиологические параметры выбраны из группы, содержащей: систологическое давление крови, диастолическое давление крови, среднее артериальное давление и частота сердечных сокращений,(iii) вычислительное устройство, выполненное с возможностью связи с указанным одним или более измерительных устройств для вычисления любого увеличения или уменьшения в значениях указанных физиологических параметров по отношению к исходному уровню,(iv) отображающее устройство для отображения указанного ...

Method and device for deep brain stimulation

Precision delivery of electrical therapy

The invention relates to a device for the treatment of hypertension, asthma or chronic obstructive pulmonary disease. The device comprises an implantable receiving coil 31 connected to implantable leads 32, 33, the ends of which are fitted with electrodes 34, 35. The electrodes are implanted over the carotid bodies and are adapted to deliver electrical energy to the carotid body or bodies of the patient. The implanted receiving coil is arranged to receive electrical energy which may be pulsed radio frequency energy (RF) from an external generator 37 connected to an external transmitting coil 36. The radio frequency energy is supplied to the implanted receiving coil by magnetic induction. The device thus enables the delivery of electrical currents which modify the function of neural tissue, particularly where repeated treatments are needed or where positioning of a percutaneous needle is difficult.

MECHANISM FOR THE CONTROLLING OF A SMOOTH MUSCLE

LINE FOR STIMULATION THAT BAROREZEPTOREN IN THE PULMONALARTERIE

DEVICES FOR CARDIOVASCULAR REFLEX CONTROL

MECHANISM FOR THE CONTROLLING OF A SMOOTH MUSCLE

Regulation of blood pressure by coded nerve signals

Modulator apparatus configured for implantation

An implant unit according to some embodiments may include a flexible carrier, at least one pair of modulation electrodes on the flexible carrier, and at least one implantable circuit in electrical communication with the at least one pair of modulation electrodes. The at least one pair of modulation electrodes and the at least one circuit may be configured for implantation through derma on an underside of a subject's chin and for location proximate to terminal fibers of the medial branch of the subject's hypoglossaS nerve, such that an electric field extending from the at least one pair of modulation electrodes can modulate one or more of the terminal fibers of the medial branch of the hypoglossal nerve.

Treatment of atrial fibrillation using high-frequency pacing and ablation of renal nerves

A method for the treatment of a patient for the purpose of lowering blood pressure and/or treating cardiac arrhythmias, particularly atrial fibrillation includes the insertion of an ablation catheter into the lumen of a renal artery. The ablation catheter is equipped with an electrode that can stimulate the wall tissue in the renal artery to help identify the location of a renal nerve. High-frequency stimulation of the renal nerve causes a decrease in the blood pressure of the patient thereby indicating that a renal nerve is nearby. The ablation catheter is used to ablate the renal nerve using radiofrequency, ultrasound, microwave energy or cryogenic cooling. An irrigated ablation catheter may be used to decrease damage to cells in the wall of the lumen of the renal artery other than the renal nerve, such as the endothelial cells. In order to treat atrial fibrillation an ablation catheter would be used to isolate one or more pulmonary veins in order to reduce propagation of the aberrant ...

TECHNIQUE FOR BLOOD PRESSURE REGULATION

Expandable balloon or an electrode pad with a heat sensing device

A medical device includes an expandable balloon including an outer surface. At least one flexible circuit is mounted on the outer surface of the expandable balloon. The at least one flexible circuit includes a first insulating layer (202), at least one heat sensing device positioned at least partially within the first insulating layer, a conductive layer (204) above the first insulating layer, at least a portion of which is electrically coupled to the heat sensing device, a second insulating layer (206) above the conductive layer and at least one electrode (222) associated with the conductive layer.

Insert tool for selectively powering an implant unit

An implant unit delivery tool is disclosed having an implant tool and an implant activator. The implant tool may be configured to retain an implant unit during an implantation procedure in which the implant unit is fixated to tissue. The implant activator may be associated with the implant tool. Additionally, the implant activator may be configured to selectively transfer power to the implant unit during the implantation procedure to cause modulation of at least one nerve in the body of a subject prior to final fixation of the implant unit to the tissue.

APPARATUS AND METHODS FOR TREATING PULMONARY HYPERTENSION

Abstract A method is described for decreasing activity of at least one sympathetic nerve, nerve fiber or neuron innervating at least one blood vessel in the pulmonary vasculature of a patient to ameliorate pulmonary hypertension. In one embodiment, the method comprises advancing an intravascular treatment device to a target location in a target blood vessel within the pulmonary vasculature of the patient and using the treatment device to decrease activity of at least one sympathetic nerve, nerve fiber or neuron innervating the target blood vessel at or near the target location to ameliorate pulmonary hypertension.

Baroreceptor mapping system

A system including a mapping device, a stimulator, and a marker. The mapping device includes a plurality of electrodes to be situated on a baroreceptor region of a patient to map baroreceptors in the baroreceptor region. The stimulator is to stimulate selected electrodes of the plurality of electrodes to obtain physiological responses from the patient in response to stimulation of the selected electrodes. The marker is to be attached to the patient to mark a location of at least one of the selected electrodes based on an analysis of the physiological responses from the patient, where the marker is to maintain its location on the patient as the mapping device is removed from the patient.

IMPLANTS USING ULTRASONIC COMMUNICATION FOR MODULATING SPLENIC NERVE ACTIVITY

Described herein are methods for monitoring or modulating an immune system in a subject; treating, reducing or monitoring inflammation; monitoring blood pressure; treating hypertension; or administering or adjusting a therapy for inflammation or hypertension in a patient by electrically stimulating the splenic nerve or detecting splenic nerve activity using an implanted medical device. Also described herein are implantable medical devices for performing such methods. The implanted medical device includes an ultrasonic transducer configured to receive ultrasonic waves and convert energy from the ultrasonic waves into an electrical energy that powers the device, two or more electrodes in electrical communication with the ultrasonic transducer that are configured to electrically stimulate a splenic nerve or detect a splenic nerve activity, and optionally a splenic nerve attachment member.

METHOD AND SYSTEM FOR IMPROVING STIMULATION OF EXCITABLE TISSUE

A method for optimization of the stimulation pattern of a set of implanted electrodes in excitable tissue of a patient is disclosed, wherein it comprises the steps of: (a) choosing a first group of a certain number of from said set of implanted electrodes, (b) stimulating the excitable tissue electrically by said first group of electrodes, (c) registering information provided by the patient, (d) assigning each electrode of said first group of electrodes a value related to said information, wherein these steps are repeated for one or more further groups of said certain number of electrodes chosen from said set of implanted electrodes, wherein each electrode may be included in one or several groups, wherein the total assigned value for each electrode is calculated, and wherein electrodes having a total assigned value exceeding a predetermined value or a predetermined number of the electrodes having the highest total assigned value are chosen to be included in said stimulation pattern, as ...

INSERT TOOL FOR SELECTIVELY POWERING AN IMPLANT UNIT

An implant unit delivery tool is disclosed having an implant tool and an implant activator. The implant tool may be configured to retain an implant unit during an implantation procedure in which the implant unit is fixated to tissue. The implant activator may be associated with the implant tool. Additionally, the implant activator may be configured to selectively transfer power to the implant unit during the implantation procedure to cause modulation of at least one nerve in the body of a subject prior to final fixation of the implant unit to the tissue.

ANTENNA PROVIDING VARIABLE COMMUNICATION WITH AN IMPLANT

A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device.

DEVICE AND METHOD FOR MODULATING NERVES USING PARALLEL ELECTRIC FIELDS

A device may include at least one pair of modulation electrodes configured for implantation in the vicinity of a nerve to be modulated such that the electrodes are spaced apart from one another along a longitudinal direction of the nerve to be modulated. The electrodes may be further configured to facilitate an electric field in response to an applied electric signal, the electric field including field lines extending in the longitudinal direction of the nerve to be modulated. The device may further include at least one circuit in electrical communication with the at least one pair of modulation electrodes and being configured to cause application of the electric signal applied at the at feast one pair of modulation electrodes.

MODULATOR APPARATUS CONFIGURED FOR IMPLANTATION

An implant unit according to some embodiments may include a flexible carrier, at least one pair of modulation electrodes on the flexible carrier, and at least one implantable circuit in electrical communication with the at least one pair of modulation electrodes. The at least one pair of modulation electrodes and the at least one circuit may be configured for implantation through derma on an underside of a subject's chin and for location proximate to terminal fibers of the medial branch of the subject's hypoglossaS nerve, such that an electric field extending from the at least one pair of modulation electrodes can modulate one or more of the terminal fibers of the medial branch of the hypoglossal nerve.

METHODS AND APPARATUSES FOR REMODELING TISSUE OF OR ADJACENT TO A BODY PASSAGE

Medical devices and methods for using the same to treat tissue near a body passageway are disclosed. An apparatus includes a catheter (120, 130) having a plurality of electrodes, a radiofrequency energy generator and a controller for coupling the energy generator to the plurality of electrodes and configured to selectively energize the electrodes. The method includes using the apparatus to subject the tissue near the body passageway to a plurality of energy treatment cycles. The treatment cycle includes determining desired voltages for at least a subset of the electrodes to maintain a predetermined target temperature profile proximate the subset of electrodes, setting an output voltage of the energy generator to correspond to the desired voltage determined for one of the electrodes and energizing at least some of the electrodes at the output voltage to deliver energy to the body passageway.

Methods and apparatus for renal neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

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.

IMPLANT SLEEP APNEA TREATMENT DEVICE INCLUDING AN ANTENNA

A sleep apnea treatment device may include a flexible carrier configured to be implanted in a body of a subject. The device may also include at least one electrode disposed on the flexible carrier, the at least one electrode being configured to modulate nerve fibers of the subject. A flexible antenna may be disposed on the flexible carrier, the flexible antenna electrically connected to the at least one electrode in a manner permitting at least some energy received by the flexible antenna to be transferred to the at least one electrode. The flexible antenna may include: at least a first conductive trace arranged on a first side of the flexible carrier, the at least a first conductive trace defining at least a first elongated space between portions thereof: and at least a second conductive trace arranged on a second side of the flexible carrier, the at least a second conductive trace defining at least a second elongated space between portions thereof, wherein the at least a first conductive ...

SYSTEMS FOR REGULATION OF BLOOD PRESSURE AND HEART RATE

A method and apparatus for treating a condition associated with impaired blood pressure and/or heart rate in a subject comprising applying an electrical treatment signal, wherein the electrical treatment signal is selected to at least partially block nerve impulses, or in some embodiments, to augment nerve impulses.

IMPLANT ENCAPSULATION

An implant unit may include a substrate and an implantable circuit arranged on the substrate. An encapsulation structure may be disposed over at least a portion of the substrate and at least a portion of the implantable circuit, the encapsulation structure including a parylene layer and a silicon layer disposed over the parylene layer.

ELECTRICAL STIMULATION OF BLOOD VESSELS

Apparatus (20) is provided, including a bifurcation stent (50) comprising one or more electrodes (32), the stent (50) configured to be placed in a primary passage (52) and a secondary passage (54) of a blood vessel (30), and a control unit (34), configured to drive the electrodes (32) to apply a signal to a wall (36) of the blood vessel (30), and to configure the signal to increase nitric oxide (NO) secretion by the wall (36). Other embodiments are also described.

ANTENNA PROVIDING VARIABLE COMMUNICATION WITH AN IMPLANT

A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device.

ELECTRODE CONTACT CONFIGURATIONS FOR CUFF LEADS

A stimulation system for a nerve, including a cuff configured and arranged to be placed, at least partially, around the nerve, and a plurality of electrode contacts disposed on the cuff such that distances between a first electrode contact within the plurality of electrode contacts and each electrode contact immediately adjacent to the first electrode contact are different.

STIMULUS REGIMENS FOR CARDIOVASCULAR REFLEX CONTROL

Baroreflex activation is achieved by providing suitable control signals to a baroreflex activation device. A method comprises establishing a therapy interval (possibly on the order of minutes to hours, or possibly of indefinite duration), within the therapy interval, establishing a plurality of dose intervals, and generating an electrical output signal. The electrical output signal has a time dependence such that the average electrical power applied to the baroreflex activation device differs between first and second portions of at least some dose intervals. Another method comprises establishing a series of therapy interval portions, during at least some therapy intervals, establishing a plurality of burst intervals (perhaps having durations commensurate with an interval between heartbeats), and generating an electrical output signal. The electrical output signal has a time dependence such that the average electrical power applied to the baroreflex activation device differs between first ...

APPARATUS FOR INFLUENCING THE SYSTEMIC BLOOD PRESSURE IN A PATIENT BY CAROTID NERVE STIMULATION

METHOD AND SYSTEM FOR IMPROVING STIMULATION OF EXCITABLE TISSUE

A method for optimization of the stimulation pattern of a set of implanted electrodes in excitable tissue of a patient is disclosed, wherein it comprises the steps of: (a) choosing a first group of a certain number of from said set of implanted electrodes, (b) stimulating the excitable tissue electrically by said first group of electrodes, (c) registering information provided by the patient, (d) assigning each electrode of said first group of electrodes a value related to said information, wherein these steps are repeated for one or more further groups of said certain number of electrodes chosen from said set of implanted electrodes, wherein each electrode may be included in one or several groups, wherein the total assigned value for each electrode is calculated, and wherein electrodes having a total assigned value exceeding a predetermined value or a predetermined number of the electrodes having the highest total assigned value are chosen to be included in said stimulation pattern, as ...

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.

BIOELECTRIC BLOOD PRESSURE MANAGEMENT

Described are a system and method that utilize bioelectric signaling to balance electrical potentials in a subject's body via neuro-hormonal circuit loops, to increase elasticity of the subject's arteries to promote protein release to dampen arterial blood pressure, and to change arterial electrical charges to reduce narrowing of the arteries. The described system is designed to localize and stimulate the fibers inside the vagus nerve without inadvertent stimulation of non-baroreceptive fibers causing side effects like bradycardia and bradypnea. The system also controls release of specific proteins known to lower blood pressures including tropoelastin (known to increase elasticity in the aorta and other peripheral blood vessels). 1. A method of using a bioelectric stimulator to control blood pressure in a subject , wherein the bioelectric stimulator comprises: a power source and means for delivering an electrical signal to a subject's tissue , wherein the bioelectric stimulator utilizes the electrical signal to precisely control protein expression in the tissue on demand to control blood pressure in a subject , the method comprising:physically associating the bioelectric stimulator with the subject; anddelivering selected bioelectric signals to the subject's tissue from the bioelectric stimulator so as to control the release and/or expression of proteins, wherein the proteins comprise stromal cell-derived factor 1 (“SDF1”), vascular endothelial growth factor (“VEGF”), insulin-like growth factor 1 (“IGF1”), platelet-derived growth factor (“PDGF”), tropoelastin, and hepatocyte growth factor (“HGF”).2. The method according to claim 2 , further comprising:wherein the proteins further comprise a protein selected from the group consisting of IGF1, epidermal growth factor (“EGF”), CXCL5, hypoxia-inducible factor 1-alpha (“HIFα”), endothelial NOS (“eNOS”), follistatin, and a combination of any thereof3. The method according to claim 1 , wherein the subject's tissue ...

SYSTEM AND METHOD FOR NEUROMODULATION

A method of treating a patient having a blood pressure comprises delivering neuromodulation therapy to sustain or increase the blood pressure. The neuromodulation therapy includes placing a sympathetic therapy electrode in a posterior portion of a blood vessel and stimulating at least one extravascular cardiac sympathetic nerve fiber using said electrode.

Methods for renal neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation.

Implantable Electroacupuncture Device

An implantable electroacupuncture device (IEAD) treats a medical condition of a patient through application of electroacupuncture (EA) stimulation pulses applied at a target tissue location, such as an acupoint. The IEAD comprises an implantable, coin-sized, self-contained, leadless electroacupuncture device having at least two electrodes attached to an outside surface of its housing. The device generates EA stimulation pulses in accordance with a specified stimulation regimen. Power management circuitry within the device allows a primary battery, having a high internal impedance, to be used to power the device. The stimulation regimen generates stimulation pulses during a stimulation session of duration T3 minutes applied every T4 minutes. The duty cycle, or ratio T3/T4, is very low, no greater than 0.05. The low duty cycle and careful power management allow the IEAD to perform its intended function for several years.

HYPERTENSION TREATMENT DEVICE AND METHOD FOR MITIGATING RAPID CHANGES IN BLOOD PRESSURE

An implantable baroreflex activation device administers a special electrotherapy program that causes the device to apply electrotherapy to limit a rate of change of blood pressure increase associated with a blood pressure surge event such as a morning blood pressure surge (MBPS).

Electrode array structures and methods of use for cardiovascular reflex control

A tissue stimulation device includes an electrode array having at least four independently switchable electrodes. In one embodiment, the electrode array comprises a flexible base to which the electrodes are fixed that flexes to encompass at least a portion of an artery or other elongate biological structure. The electrodes are electrically coupled to and energized by a signal generator coupled to a control system. In one embodiment, the array of electrodes are configured such that a suitable signal pattern for stimulation pulses between or among a set of the switchable electrodes may be determined without having to reposition the electrode assembly by using a series of signal patterns activating different combinations of switchable electrodes in response to sub-stimulation test signals to determine a signal pattern that provides suitable patient response. In another embodiment, the array of electrodes includes an array of selectively activatable multi-polar electrodes.

Methods for extravascular renal neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation.

Method and apparatus for treating aneurysms by electrostimulation

An aneurysmal sac arterial wall electrostimulation system ( 11 ) comprises an array of electrical leads ( 4 and 5 ) placeable in contact with a portion of the arterial wall ( 12 ) to be electrostimulated and a source ( 3 ) of electrostimulation attached to the array of electrical leads. The source provides periodic electrostimulus to at least one of the array of leads in accordance with a treatment program and at least one of the array of leads senses the contraction condition of the aneurysmal sac arterial wall ( 10 ) which is provided as a feedback loop input signal to the treatment program. Repeated electrostimulation of a vascular passage using the system ( 11 ) provides increased muscle tone or pseudo permanent contraction of such vascular passage.

CONTROL OF NEURAL MODULATION THERAPY USING CERVICAL IMPEDANCE

An implantable apparatus can comprise an electrical test energy delivery circuit configured to provide an electrical test signal to a cervical location in a patient body. A detector circuit can use the electrical test signal to detect cervical impedance and generate a cervical impedance signal representing fluctuations in the detected cervical impedance. The implantable apparatus can comprise a therapy delivery circuit, such as configured to provide electrical neural modulation therapy using a neural modulation timing parameter, and a processor circuit that can be coupled to the electrical test energy delivery circuit, the detector circuit, and the therapy delivery circuit. The processor circuit can be configured to determine a pulsatile signal or pulse pressure signal, such as using the cervical impedance signal, identify a characteristic of the pulsatile signal or pulse pressure signal, and control a neural modulation therapy using the timing parameter and the identified pulse pressure ...

Methods and Apparatuses for Stimulating Blood Vessels in Order to Control, Treat, and/or Prevent a Hemorrhage

Methods of preventing, treating, and/or controlling a hemorrhage in an organ of a patient include providing electrical stimulation to the arteries, veins, nerves innervating the arteries or veins, or walls of the organ. The apparatus has at least one electrode operably connected to a stimulus generator and placed in electrical communication with an artery, vein, nerve, or organ wall. An electrical stimulus generator causes an electrical stimulus to be administered to the artery, vein, nerve, or wall through the at least one electrode, where the electrical stimulus is effective for preventing, treating, and/or controlling a hemorrhage.

Internal resonance matching between an implanted device and an external device

A unit configured for implantation in a subject's body may include a carrier, an implantable circuit associated with the carrier, an antenna arranged on the carrier and configured to wirelessly receive energy from a location external to the subject's body and to provide at least a portion of the energy to the implantable circuit, and at least one component associated with the carrier for receiving energy from the implantable circuit. Wherein the implantable circuit and the antenna have an internal resonant frequency mismatched from an external resonant frequency of an external circuit, to account for resonance frequency variation as a result of implantation in the subject's body.

Acquiring nerve activity from carotid body and/or sinus

An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed.

STIMULATION OF THE AMYGDALOHIPPOCAMPAL COMPLEX TO TREAT NEUROLOGICAL CONDITIONS

A system and/or method treating for a neurological disorder by brain region stimulation. The system and/or method comprises a probe and a device to provide stimulation. The probe has a stimulation portion implanted in communication with a predetermined brain region site. The stimulation portion of the probe may be implanted in contact with a predetermined brain region.

Neuromodulation Device

This invention relates to devices, methods and substances for use in the treatment of hypertension and/or elevated blood pressure in a subject.

APPARATUS AND METHOD FOR MODULATING THE BAROREFLEX SYSTEM

CONTROLLED TITRATION OF NEUROSTIMULATION THERAPY

ANTENNA PROVIDING VARIABLE COMMUNICATION WITH AN IMPLANT

EINRICHTUNG ZUR STEUERUNG EINES GLATTEN MUSKELS

STEERED TITRATION OF A NEURO STIMULATION THERAPY

GER�T F�R THE RENALE NEURO MODULATION

Systems for avoiding neural stimulation habituation

Systems for delivering vagal nerve stimulation

Various implantable system embodiments comprise a pulse generator adapted to deliver an electrical signal through the implantable electrodes to the vagus nerve to provide vagal stimulation therapy (VST) at a programmed intensity. The electrical signal has programmed parameters to provide the VST at the programmed intensity selected to provide therapeutically beneficial stimulation for the cardiovascular disease without substantially reducing an intrinsic heart rate of the patient during the VST in comparison to the intrinsic heart rate of the patient before the VST.

Remote sensing in an implantable medical device

An embodiment uses an accelerometer to sense heart sounds, and determines heart rate information using the sensed heart sounds. An embodiment uses an accelerometer to sense respiratory activity. An embodiment delivers a programmed neural stimulation therapy with a programmed duty cycle, where the programmed duty cycle includes a stimulation ON portion followed by a stimulation OFF portion. An electrode electrically connected to the implanted neural stimulation device is used to remotely detect cardiac activity. The remotely detected cardiac activity is used to detect heart rate information during the stimulation ON portion and to detect heart rate information during the stimulation OFF portion. The detected heart rate information and/or the detected respiration information are used to control a neural stimulation therapy performed by the neural stimulator device and/or are used to provide diagnostic information for the patient's condition.

Treatment of atrial fibrillation using high-frequency pacing and ablation of renal nerves

A method for the treatment of a patient for the purpose of lowering blood pressure and/or treating cardiac arrhythmias, particularly atrial fibrillation includes the insertion of an ablation catheter into the lumen of a renal artery. The ablation catheter is equipped with an electrode that can stimulate the wall tissue in the renal artery to help identify the location of a renal nerve. High-frequency stimulation of the renal nerve causes a decrease in the blood pressure of the patient thereby indicating that a renal nerve is nearby. The ablation catheter is used to ablate the renal nerve using radiofrequency, ultrasound, microwave energy or cryogenic cooling. An irrigated ablation catheter may be used to decrease damage to cells in the wall of the lumen of the renal artery other than the renal nerve, such as the endothelial cells. In order to treat atrial fibrillation an ablation catheter would be used to isolate one or more pulmonary veins in order to reduce propagation of the aberrant ...

Physiological vibration detection in an implanted medical device

An embodiment of an implantable system configured to be implanted in a patient includes an accelerometer, a neural stimulator, and a controller. The neural stimulator is configured to deliver neural stimulation to a neural target. The controller is configured to use the accelerometer to detect laryngeal vibration or coughing, and is configured to deliver a programmed neural stimulation therapy using the neural stimulator and using detected laryngeal vibration or detected coughing as an input to the programmed neural stimulation therapy.

METHOD OF REDUCING RENAL HYPERTENSION AND COMPUTER-READABLE MEDIUM

A method of reducing renal hypertension applied for electrically stimulating a target zone of an organism having a symptom of renal hypertension by using an electronic stimulation device. The electronic stimulation device comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode. The method includes the following steps. The electrical stimulation unit is placed near the target zone. The electrical stimulation unit generates an electrical stimulation signal and the electrical stimulation signal is introduced to the target zone so as to stimulate the target zone. An electric field is generated between the first electrode and the second electrode and covers the target zone. The strength of the electric field ranges from 100V/m to 1000V/m. The target zone is a dorsal root ganglion, a spinal cord, a dorsal root, a dorsal horn, a ventral root, or a nerve on a neurotransmission pathway causing the ...

Implantable electrode arrangement

Described here is an implantable electrode arrangement for spatially-selective detection of neuronal electrical signals, which propagate along at least one nerve fibre contained in a nerve fascicle, and for selective electrical stimulation of the at least one nerve fibre, comprising a biocompatible carrier substrate (1), which has at least one carrier substrate region that can be placed around the nerve fascicle in a cuff-like manner and has a straight cylinder-shaped carrier substrate surface (1') oriented facing the nerve fascicle in the implanted state, said carrier substrate surface having an axial (a) extent and an extent oriented in the circumferential direction (U) and a first electrode arrangement (2) being attached thereto, said electrode arrangement comprising, in an axial sequence, at least three first electrode structures (3) with in each case at least two first electrode surfaces (4) arranged in the circumferential direction and at least two first electrode strips (5), which ...

Methods and systems for lowering blood pressure through reduction of ventricle filling

Systems and methods for reducing ventricle filling volume are disclosed. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated at a consistent rate to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, a stimulation circuit may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Methods and systems for controlling blood pressure by controlling atrial pressure

METHODS AND SYSTEMS FOR CONTROLLING BLOOD PRESSURE BY CONTROLLING ATRIAL PRESSURE Abstract Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium.

Midfield transmitter and injectable midfield receiver

Generally discussed herein are systems, devices, and methods for providing a therapy (e.g., stimulation) and/or data signal using an implantable device. Systems, devices and methods for interacting with (e.g., communicating with, receiving power from) an external device are also provided.

Midfield transmitter and injectable midfield receiver

Generally discussed herein are systems, devices, and methods for providing a therapy (e.g., stimulation) and/or data signal using an implantable device. Systems, devices and methods for interacting with (e.g., communicating with, receiving power from) an external device are also provided for therapy devices that provide stimulation or other therapy to targeted locations within a body.

Method and device for deep brain stimulation

A method of treating Alzheimer's Disease and/or Multiple Sclerosis and/or Minimally Conscious State and/or Mood Disorders and/or vascular brain disorders where there is small vessel compromise in a subject in need thereof, comprising applying a neuromodulat ion signal to the IPAG or vlPAG of the subject.

Method and system for improving stimulation of excitable tissue

A method for optimization of the stimulation pattern of a set of implanted electrodes in excitable tissue of a patient is disclosed, wherein it comprises the steps of: (a) choosing a first group of a certain number of from said set of implanted electrodes, (b) stimulating the excitable tissue electrically by said first group of electrodes, (c) registering information provided by the patient, (d) assigning each electrode of said first group of electrodes a value related to said information, wherein these steps are repeated for one or more further groups of said certain number of electrodes chosen from said set of implanted electrodes, wherein each electrode may be included in one or several groups, wherein the total assigned value for each electrode is calculated, and wherein electrodes having a total assigned value exceeding a predetermined value or a predetermined number of the electrodes having the highest total assigned value are chosen to be included in said stimulation pattern, as ...

Electrical contacts on a medical device patch

A device for conveying power from a location external to a subject to a location within the subject may include a flexible carrier and an adhesive on a first side of the carrier. A coil of electrically conductive material may be associated with the flexible carrier. A mechanical connector may be associated with the carrier opposite the adhesive, wherein the mechanical connector is configured to retain a housing and permit the housing to rotate relative to the flexible carrier. At least one electrical portion may be associated with the carrier in a manner permitting electrical connection to be maintained between the flexible carrier and the housing as the housing is rotated.

Apparatus and methods for implant coupling indication

A device is disclosed that includes an external unit configured to communicate with an implant unit beneath the skin of a subject and an indicator associated with the external unit. The indicator is configured to produce an indicator signal when the external unit is within a predetermined range of the implant unit. In addition, the indicator may be configured to vary the indicator signal according to a distance between the external unit and the implant unit. Furthermore, a method of locating an external unit with respect to an implant unit is disclosed that includes detecting a distance between the external unit and the implanted unit located beneath the skin of a subject, producing an indicator signal when the external unit is within a predetermined range of the implant unit, and varying the indicator signal as a function of a distance between the external unit and the implant unit.

Electrode configuration for implantable modulator

A device according to some embodiments may include an implantable flexible carrier and a pair of electrodes located on the carrier. The electrodes may be spaced from each other by a distance greater than 3 mm, and may be configured to cause, when supplied with an electrical signal, a unidirectional electric field sufficient to modulate at least one nerve.

Apparatus and method for detecting a sleep disordered breathing precursor

A device according to some embodiments may include a primary antenna configured to be located external to a subject. The device may also include at least one processor in electrical communication with the primary antenna and configured to receive a condition signal from an implantable device, the condition signal indicative of a precursor to sleep disordered breathing, and cause transmission of a primary signal from the primary antenna to the implantable device, in response to the condition signal, to stimulate at least one nerve in response to the precursor to sleep disordered breathing.

Apparatus and methods for feedback-based nerve modulation

A device according to some embodiments may include a housing configured for location external to a body of a subject The device may also include at least one processor associated with the housing and configured to communicate with a circuit implanted in the subject within proximity to a tongue of the subject, wherein the circuit is in electrical communication with at least one electrode, receive a physiological signal from the subject via the circuit, and send a control signal to the implanted circuit in response to the physiological signal, wherein the control signal is predetermined to activate neuromuscular tissue within the tongue.

METHODS AND SYSTEMS FOR CONTROLLING BLOOD PRESSURE

Systems and methods for controlling blood pressure via electrical stimulation of the heart are disclosed. Embodiments may include at least two different stimulation patterns, each configured to reduce blood pressure to a different degree, and may alternate between stimulation patterns based on the need of a patient, for example, alternating between day and night or between periods of strenuous and light activity. Some embodiments may take advantage of a slow baroreflex response that occurs after treatment is stopped, suspending treatment for extended periods, and then resuming treatment before blood pressure levels reach pretreatment values. Embodiments may control blood pressure by controlling atrial pressure and atrial stretch.

DEEP BRAIN ELECTRODE PLACEMENT AND STIMULATION BASED ON BROWN ADIPOSE TISSUE TEMPERATURE

Systems and methods for deep brain electrode placement and deep brain stimulation (DBS) for treatment of conditions such as obesity are disclosed. In one example approach, during placement of a deep brain stimulating electrode in a target region of the brain of a patient, a temperature of brown adipose tissue (BAT) may be monitored, e.g., via a supraclavicular temperature sensor implanted in the patient, and used to identify an optimal location of electrode stimulation which causes an increase in BAT temperature. Additionally, BAT temperature measurements may be used to provide regulated closed-loop control to increase efficiency of DBS while reducing energy consumption of the pulse generator. Further, core temperature measurements may be obtained from the electrode in the brain and used to adjust DBS.

APPARATUS AND METHOD FOR CONTROLLING ENERGY DELIVERY AS A FUNCTION OF DEGREE OF COUPLING

CARDIAC CONTRACTILITY NEUROSTIMULATION SYSTEMS AND METHODS

A device includes a handle, an expandable structure including a plurality of splines extending from a proximal hub to a distal hub, a first electrode on a first spline of the plurality of splines, an outer tube extending from the handle to the proximal hub, and a shaft extending through the outer tube from the handle to the distal hub. The expandable structure has a collapsed state and a self-expanded state. The handle is configured to retract the shaft. Retracting the shaft may expand the expandable structure outward of the self-expanded state.

DEEP BRAIN ELECTRODE PLACEMENT AND STIMULATION BASED ON BROWN ADIPOSE TISSUE TEMPERATURE

Systems and methods for deep brain electrode placement and deep brain stimulation (DBS) for treatment of conditions such as obesity are disclosed. In one example approach, during placement of a deep brain stimulating electrode in a target region of the brain of a patient, a temperature of brown adipose tissue (BAT) may be monitored, e.g., via a supraclavicular temperature sensor implanted in the patient, and used to identify an optimal location of electrode stimulation which causes an increase in BAT temperature. Additionally, BAT temperature measurements may be used to provide regulated closed-loop control to increase efficiency of DBS while reducing energy consumption of the pulse generator. Further, core temperature measurements may be obtained from the electrode in the brain and used to adjust DBS.

EXPANDABLE BALLOON OR AN ELECTRODE PAD WITH A HEAT SENSING DEVICE

A medical device includes an expandable balloon including an outer surface. At least one flexible circuit is mounted on the outer surface of the expandable balloon. The at least one flexible circuit includes a first insulating layer (202), at least one heat sensing device positioned at least partially within the first insulating layer, a conductive layer (204) above the first insulating layer, at least a portion of which is electrically coupled to the heat sensing device, a second insulating layer (206) above the conductive layer and at least one electrode (222) associated with the conductive layer.

ELECTRICAL CONTACTS ON A MEDICAL DEVICE PATCH

A device for conveying power from a location external to a subject to a location within the subject may include a flexible carrier and an adhesive on a first side of the carrier. A coil of electrically conductive material may be associated with the flexible carrier. A mechanical connector may be associated with the carrier opposite the adhesive, wherein the mechanical connector is configured to retain a housing and permit the housing to rotate relative to the flexible carrier. At least one electrical portion may be associated with the carrier in a manner permitting electrical connection to be maintained between the flexible carrier and the housing as the housing is rotated.

ELECTRICAL CONTACTS ON A MEDICAL DEVICE PATCH

A device for conveying power from a location external to a subject to a location within the subject may include a flexible carrier and an adhesive on a first side of the carrier. A coil of electrically conductive material may be associated with the flexible carrier. A mechanical connector may be associated with the carrier opposite the adhesive, wherein the mechanical connector is configured to retain a housing and permit the housing to rotate relative to the flexible carrier. At least one electrical portion may be associated with the carrier in a manner permitting electrical connection to be maintained between the flexible carrier and the housing as the housing is rotated.

IMPLANT UNIT DELIVERY TOOL

An implant unit delivery tool is provided. The implant delivery tool may include a body, a holder disposed at a distal end of the body and adapted to hold an implant unit, and an implant activator associated with the body, the implant activator configured to receive power from a power source. The the implant activator may be configured to selectively and wirelessly transfer power from the power source to the implant unit during implantation of the implant unit into the body of a subject to cause modulation of at least one nerve in the body of the subject, and determine a degree of nerve modulation response resulting from the selective and wireless transfer of power from the power source to the implant unit claims.

APPARATUS AND METHODS FOR IMPLANT COUPLING INDICATION

A device is disclosed that includes an external unit configured to communicate with an implant unit beneath the skin of a subject and an indicator associated with the external unit. The indicator is configured to produce an indicator signal when the external unit is within a predetermined range of the implant unit. In addition, the indicator may be configured to vary the indicator signal according to a distance between the external unit and the implant unit. Furthermore, a method of locating an external unit with respect to an implant unit is disclosed that includes detecting a distance between the external unit and the implanted unit located beneath the skin of a subject, producing an indicator signal when the external unit is within a predetermined range of the implant unit, and varying the indicator signal as a function of a distance between the external unit and the implant unit.

APPARATUS AND METHODS FOR TREATING PULMONARY HYPERTENSION

A method is described for decreasing activity of at least one sympathetic nerve, nerve fiber or neuron innervating at least one blood vessel in the pulmonary vasculature of a patient to ameliorate pulmonary hypertension. In one embodiment, the method may involve advancing an intravascular treatment device to a target location in a target blood vessel within the pulmonary vasculature of the patient and using the treatment device to decrease activity of at least one sympathetic nerve, nerve fiber or neuron innervating the target blood vessel at or near the target location to ameliorate pulmonary hypertension.

SMOOTH MUSCLE CONTROLLER

A method of promoting the healing of a lesion in a smooth muscle (200), comprises selecting a smooth muscle portion having a lesion, and applying a non-excitatory electric field (210) to the portion, which reduces the mechanical activity of the portion.

Baroreceptor mapping system

SYSTEMS AND METHODS FOR ELECTROPORATION

AUTOMATIC NEURAL STIMULATION MODULATION BASED ON ACTIVITY

An embodiment senses activity, and automatically controls neural stimulation 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.

SYSTEMS FOR AVOIDING NEURAL STIMULATION HABITUATION

A neural stimulator embodiment includes a neural stimulation delivery system and a controller operationally connected to the neural stimulation delivery system. The neural stimulation delivery system is adapted to non-selectively stimulate both afferent axons and efferent axons in a vagus nerve. The controller includes a neural stimulation scheduler to control neural stimulation from the neural stimulation system according to a predetermined schedule. The predetermined schedule includes at least one parameter with a value selected to avoid physiological habituation to the neural stimulation. 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.

NEURAL MODULATION DEVICES AND METHODS

A system for designing a therapy or for treating a gastrointestinal disorder or a condition associated with excess weight in a subject comprising at least one electrode configured to be implanted within a body of the patient and placed at a vagus nerve, the electrode also configured to apply therapy to the vagus nerve upon application of a therapy cycle to the electrode; an implantable neuroregulator for placement in the body of the patient beneath the skin layer, the implantable neuroregulator being configured to generate a therapy cycle, wherein the therapy cycle comprises an on time during which an electrical signal is delivered, the electrical signal comprising: a) a set of pulses applied at a first selected frequency of about 150-10,000 Hz, wherein each pulse of the set of pulses has a pulse width of at least 0.01 milliseconds and less than the period of the first selected frequency.

OVARIAN NEUROMODULATION AND ASSOCIATED SYSTEMS AND METHODS

Methods for treating polycystic ovary syndrome with therapeutic ovarian neuromodulation and associated systems and methods are disclosed herein. Polycystic ovary syndrome can be associated, for example, with a condition including at least one of oligo/amenorrhea, infertility, hirsutism, obesity, metabolic syndrome, insulin resistance, and increased cardiovascular risk profile. One aspect of the present technology is directed to methods that at least partially inhibit sympathetic neural activity in nerves proximate an ovarian artery of an ovary of a patient. Sympathetic drive in the patient can thereby be reduced in a manner that treats the patient for the polycystic ovary syndrome. Ovarian sympathetic nerve activity can be modulated along afferent and/or efferent pathways. The modulation can be achieved, for example, using an intravascularly positioned catheter carrying a therapeutic assembly, e.g., a therapeutic assembly configured to use electrically-induced, thermally-induced, and/or ...

STIMULATION OF THE URINARY SYSTEM

Described are methods and apparatus for modifying bodily functions, including, for example, blood pressure or kidney function, via stimulation of the urinary tract. In some embodiments, a reno-renal reflex is used to affect a rate of urine production, GFR and/or other kidney functions and thereby affect blood pressure or other body physiology.

APPARATUS AND METHODS FOR FEEDBACK-BASED NERVE MODULATION

A device according to some embodiments may include a housing configured for location external to a body of a subject The device may also include at least one processor associated with the housing and configured to communicate with a circuit implanted in the subject within proximity to a tongue of the subject, wherein the circuit is in electrical communication with at least one electrode, receive a physiological signal from the subject via the circuit, and send a control signal to the implanted circuit in response to the physiological signal, wherein the control signal is predetermined to activate neuromuscular tissue within the tongue.

METHODS AND COMPOSITIONS FOR TREATING A DISEASE CONDITION IN A SUBJECT

Methods for treating a disease condition in a subject are provided. The subject methods are characterizing by enhancing at least one symptom of the disease condition in a manner effective to cause the subject to mount a compensatory response effective to treat the disease condition. Also provided are compositions, kits and systems for practicing the subject methods.

Implant tool and improved electrode design for minimally invasive procedure

Devices and methods of use for introduction and implantation of an electrode as part of a minimally invasive technique. An implantable baroreflex activation system includes a control system having an implantable housing, an electrical lead, attachable to the control system, and an electrode structure. The electrode structure is near one end of the electrical lead, and includes a monopolar electrode, a backing material having an effective surface area larger than the electrode, and a releasable pivotable interface to mate with an implant tool. The electrode is configured for implantation on an outer surface of a blood vessel and the control system is programmed to deliver a baroreflex therapy via the monopolar electrode to a baroreceptor within a wall of the blood vessel.

Implant encapsulation

An implant unit may include a substrate and an implantable circuit arranged on the substrate. An encapsulation structure may be disposed over at least a portion of the substrate and at least a portion of the implantable circuit, the encapsulation structure including a parylene layer and a silicon layer disposed over the parylene layer.

Expandable Stimulation Electrode with Integrated Pressure Sensor and Methods Related Thereto

An apparatus is provided having at least one fixation electrode adapted to abut a wall of a pulmonary artery, and a pressure sensor integrally supported by the at least one fixation electrode. The pressure sensor provides a signal indicative of a blood pressure in the pulmonary artery. The apparatus also includes a pulse generator coupled with the at least one fixation electrode, the pulse generator adapted to deliver a baroreflex stimulation signal to one or more baroreceptors in the pulmonary artery via the at least one fixation electrode. The pressure sensor is anchorable in the pulmonary artery via the at least one fixation electrode.

Method for Improving Functional Recovery After Stroke by Electrical Stimulation of a Cranial Nerve

According to some embodiments, a method for improving functional recovery after cerebro-vascular accidents, such as strokes, in humans and animals comprises stimulating a cranial nerve with electrical current. According to some embodiments, a method for improving functional recovery after stroke in a human or animal in need thereof comprises applying to the cranial nerve of the human or animal a stimulating electrical signal that causes neurophysiological, morphological, chemical, or neuronal connective alteration in the brain, where the alteration changes neural function in the brain so as to change functional recovery and functional dynamics in the human or animal. According to some embodiments, a method for improving functional recovery after stroke in a human or animal in need thereof comprises applying to a first cranial nerve a first stimulating electrical signal optimized so as to promote stroke recovery. The method may further comprise applying to one or more of the first cranial ...

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.

Methods and Systems for Lowering Blood Pressure Through Reduction of Ventricle Filling

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction. 1. A system for reducing blood pressure comprising:at least one stimulation electrode for stimulating at least one chamber of a heart of a patient; andat least one controller that executes a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart,wherein the at least one stimulation setting causes an atrium of the heart to be at maximum contraction when an atrioventricular valve of the heart is open.2. The system of claim 1 , wherein the at least one stimulation setting prevents at least one atrial contraction of the heart.3. The system of claim 1 , wherein the at least one stimulation setting comprises a first stimulation setting and a second stimulation setting claim 1 , andwherein the first stimulation setting has an atrioventricular delay different from an atrioventricular delay of the second stimulation setting.4. The system of claim 1 , wherein the at least one controller receives input relating to the patient's atrioventricular ...

Method of diagnosing and treatment of hypertension

A method for the provision of electrical, electromagnetic or magnetic stimulation to the T8 and T9 vertebrae and related off-shoot vertebrae of the human spine, through the use of probes, related induction coils and electrodes, imparting one or more of low frequency, high frequency, AC or magnetic fields and pulses, and their combinations, through the sympathetic and parasympathetic nervous systems, to diagnose and treat hypertension activity of the cells in any one or combination of the vascular wall, kidney or adrenal glands, to innervate and affect such cells to approximate normal function, inclusive of sodium regulation and regulated release of hormones from such cells of the adrenal gland as well as regulation of vascular tone through improved function of various ion channels and improved sympathic nervous system function.

Aortic pacing to control cardiac afterload

A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect cardiac afterload. Electrical stimulation is delivered proximate aortic arch tissue of a patient in order to reduce a patient's cardiac afterload. Electrical stimulation is terminated after a termination condition is met.

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.

Automatic baroreflex modulation responsive to adverse event

A system for providing baroreflex stimulation comprises a sensor to detect a parameter and provide a signal indicative of the parameter and a baroreflex stimulator. The baroreflex stimulator includes a driver to provide a control signal adapted to deliver a baroreflex therapy and a controller to receive the signal indicative of the parameter and modulate the control signal based on the signal indicative of the parameter to change the baroreflex therapy from a first baroreflex therapy to a second baroreflex therapy.

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.

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.

Electrical Stimulation Treatment of Hypotension

The present invention includes methods and devices for treating hypotension, such as in cases of shock, including septic shock, anaphylactic shock and hypovolemia. The method includes the step of applying at least one electrical impulse to at least one selected region of a parasympathetic nervous system of the patient. The electrical impulse is sufficient to modulate one or more nerves of the parasympathetic nervous system to increase the ratio of blood pressure to heart rate and relieve the condition and/or extend the patient's life.

Renal nerve stimulation lead, delivery system, and method

A lead for nerve modulation comprises an elongated body which includes a proximal end, a distal portion having a distal end, and an intermediate portion disposed between the proximal end and the distal portion. The distal portion includes a distal portion anchoring mechanism to anchor the distal portion to a first biological cavity of a patient. The intermediate portion includes an intermediate portion anchoring mechanism to anchor the intermediate portion to a second biological cavity of the patient. The intermediate portion anchoring mechanism is larger in lateral dimension than and is spaced from the distal portion anchoring mechanism. The distal portion and/or the intermediate portion includes a plurality of modulation electrodes. The distal portion anchoring mechanism and/or the intermediate portion anchoring mechanism is configured to position the modulation electrodes to contact tissue of the patient at multiple locations.

Devices and methods for treatment of heart failure and associated conditions

Devices and methods of use for identification, treatment, and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system including a blood pressure sensor and a heart rate sensor, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including an electrode, providing a control system coupled to the baroreflex therapy system and the implantable measurement device, the control system programmed to automatically determine an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, determine arterial stiffness of the blood vessel based on the impedance, determine blood pressure and heart rate, and activate, deactivate or otherwise modulate the baroreflex therapy system to deliver a baroreflex therapy based on the blood pressure, heart rate and arterial stiffness.

Systems and Methods for Determining a Sleep Disorder Based on Positioning of the Tongue

Devices and methods are disclosed that include an external unit comprising at least one processor. The processor may be configured to receive a signal indicative of tongue movement in a subject from an implant unit implanted in the subject, determine whether the tongue movement is representative of sleep disordered breathing, generate a modulation control signal to correct the sleep disordered breathing when the at least one processor determines an occurrence of sleep disordered breathing.

IMPLANTABLE AND RECHARGEABLE NEURAL STIMULATOR

One aspect of the present subject matter relates to an implantable medical device. An embodiment of the device comprises a rechargeable power supply adapted to be recharged through an ultrasound signal, a neural stimulator connected to the rechargeable power supply, and a controller connected to the rechargeable power supply. The neural stimulator is adapted to generate a neural stimulation signal for delivery to a neural stimulation target through an electrode. The controller is further connected to the neural stimulator to control the neural stimulator according to a neural stimulation protocol. Other aspects are provided herein. 1. A system for therapeutically stimulating a neural stimulation target of a human , comprising:an implantable medical device, wherein the implantable medical device includes a neural stimulator configured to deliver neural stimulation for use in stimulating the neural stimulation target, the implantable device including an ultrasound transducer configured to convert an ultrasound energy into an electrical energy,wherein the implantable medical device is configured to power the neural stimulator using the electrical energy converted from the ultrasound energy.2. The system of claim 1 , wherein the implantable medical device is remotely powered through the ultrasound energy.3. The system of claim 1 , wherein the ultrasound power signal includes data encoded within the ultrasound power signal claim 1 , wherein the implantable device is further configured to receive and process the data encoded in the ultrasound power signal.4. The system of claim 1 , further comprising an external device configured to send the ultrasound energy.5. The system of claim 1 , further comprising another implantable device configured to send the ultrasound energy.6. The system of claim 1 , wherein the implantable medical device further comprises:a blood pressure sensor configured to sense blood pressure; anda controller configured to control the neural stimulator ...

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.

Devices and Methods for Delivering Energy as a Function of Condition Severity

A device for regulating energy delivery to an implanted circuit is disclosed. The device may include at least one implantable circuit and at least one pair of implantable electrodes in electrical communication with the circuit. The at least one pair of implantable electrodes may be configured to modulate at least one nerve. The at least one implantable circuit may be configured deliver a signal to the at least one pair of implantable electrodes. The signal may have at least one of a power level or a duration determined based on a severity of a detected physiologic condition.

Apparatus and Method to Control an Implant

A device according to some embodiments of the present disclosure includes a housing configured to retain a battery, a primary antenna associated with the housing, and at least one processor in electrical communication with the battery and the primary antenna. In some embodiments, the at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device during a treatment session of at least three hours in duration, wherein the primary signal is generated using power supplied by the battery and includes a pulse train, the pulse train including a plurality of modulation pulses.

Electrode Configuration for Implantable Modulator

A device according to some embodiments may include an implantable flexible carrier and a pair of electrodes located on the carrier. The electrodes may be spaced from each other by a distance greater than 3 mm, and may be configured to cause, when supplied with an electrical signal, a unidirectional electric field sufficient to modulate at least one nerve. 1. A sleep disordered breathing therapy device , comprising:an implantable flexible carrier configured for implantation proximal to a genioglossus muscle of a subject; anda pair of electrodes located on the carrier, wherein the electrodes are spaced from each other by a distance greater than 3 mm, and are configured to facilitate, when supplied with an electrical signal, a substantially unidirectional electric field sufficient to modulate a hypoglossal nerve.2. The sleep disordered breathing therapy device of claim 1 , wherein the modulation of the hypoglossal nerve includes a stimulation signal sufficient to cause a contraction of the genioglossus muscle.3. The sleep disordered breathing therapy device of claim 1 , wherein the pair of electrodes are further configured to modulate the hypoglossal nerve when tissue of the genioglossus muscle is interposed between the electrodes and the hypoglossal nerve.4. The sleep disordered breathing therapy device of claim 3 , wherein the genioglossus muscle tissue interposed between the electrodes and the hypoglossal nerve is greater than 5 mm in thickness.5. The sleep disordered breathing therapy device of claim 3 , wherein the electrodes and the hypoglossal nerve are spaced apart by a distance greater than 5 mm.6. The sleep disordered breathing therapy device of claim 1 , wherein the flexible carrier comprises attachment points configured for securing the flexible carrier to a surface of the genioglossus muscle tissue.7. The sleep disordered breathing therapy device of claim 1 ,wherein the flexible carrier comprises an insulative material, andwherein the pair of electrodes ...

Apparatus and Methods for Modulating Nerves Using Parallel Electric Fields

A device may include at least one pair of modulation electrodes configured for implantation in the vicinity of a nerve to be modulated such that the electrodes are spaced apart from one another along a longitudinal direction of the nerve to be modulated. The electrodes may be further configured to facilitate an electric field in response to an applied electric signal, the electric field including field lines extending in the longitudinal direction of the nerve to be modulated. The device may further include at least one circuit in electrical communication with the at least one pair of modulation electrodes and being configured to cause application of the electric signal applied at the at least one pair of modulation electrodes. 1. A device , comprising:at least one pair of modulation electrodes configured for implantation in the vicinity of a nerve to be modulated such that the electrodes are spaced apart from one another along a longitudinal direction of the nerve to be modulated, the electrodes being further configured to facilitate an electric field in response to an applied electric signal, the electric field including field lines extending in the longitudinal direction of the nerve to be modulated; andat least one circuit in electrical communication with the at least one pair of modulation electrodes and being configured to cause application of the electric signal applied at the at least one pair of modulation electrodes.2. The device of claim 1 , wherein the electric field includes field lines extending in a direction substantially parallel to a longitudinal direction of at least a portion of the nerve to be modulated.3. The device of claim 1 , wherein the at least one pair of modulation electrodes is supported by a flexible carrier.4. The device of claim 3 , wherein the flexible carrier includes a biocompatible polymer including at least one of silicone claim 3 , phenyltrimethoxysilane (PTMS) claim 3 , polymethyl methacrylate (PMMA) claim 3 , parylene C claim ...

Device and Method for Modulating Nerves Using Parallel Electric Fields

A device may include at least one pair of modulation electrodes configured for implantation in the vicinity of a nerve to be modulated such that the electrodes are spaced apart from one another along a longitudinal direction of the nerve to be modulated. The electrodes may be further configured to facilitate an electric field in response to an applied electric signal, the electric field including field lines extending in the longitudinal direction of the nerve to be modulated. The device may further include at least one circuit in electrical communication with the at least one pair of modulation electrodes and being configured to cause application of the electric signal applied at the at least one pair of modulation electrodes.

System and Method for Nerve Modulation Using Noncontacting Electrodes

An implant unit configured for implantation into a body of a subject may include an antenna configured to receive a signal. The implant unit may also include at least one pair of modulation electrodes configured to be implanted into the body of the subject in the vicinity of at least one nerve to be modulated, the at least one pair of modulation electrodes being configured to receive an applied electric signal in response to the signal received by the antenna and generate an electrical field to modulate the at least one nerve from a position where the at least one pair of modulation electrodes does not contact the at least one nerve.

ELECTRODE STRUCTURES AND METHODS FOR THEIR USE IN CARDIOVASCULAR REFLEX CONTROL

Devices, systems and methods are described by which the blood pressure, nervous system activity, and neurohormonal activity may be selectively and controllably reduced by activating baroreceptors. A baroreceptor activation device is positioned near a baroreceptor, preferably a baroreceptor located in the carotid sinus. A control system may be used to modulate the baroreceptor activation device. The control system may utilize an algorithm defining a stimulus regimen which promotes long term efficacy and reduces power requirements/consumption. The baroreceptor activation device may utilize electrodes to activate the baroreceptors. The electrodes may be adapted for connection to the carotid arteries at or near the carotid sinus, and may be designed to minimize extraneous tissue stimulation. 1. A baroreflex modification system comprising:a baroreceptor activation device arranged to be coupled to a vascular wall, the vascular wall containing at least one baroreceptor; anda control system comprising a driver coupled to the baroreceptor activation device, the driver being configured to drive mechanical motion of at least a portion of the activation device, wherein the mechanical motion causes indirect activation of the baroreceptor by stretching or deforming the vascular wall surrounding the baroreceptor.2. The system of claim 1 , wherein the control system includes a processor and a programmable memory claim 1 , the control system programmed to generate a control signal and deliver the control signal to the driver.3. The system of claim 2 , comprising a user interface coupled to the control system claim 2 , the user interface being arranged to receive a value or a command in relation to the generated control signal claim 2 , wherein the memory is configured to store data related to the generated control signal and/or the value or command received by the user interface.4. The system of claim 2 , wherein the memory stores a stimulus regimen claim 2 , wherein the control ...

DEVICES AND METHODS FOR TREATMENT OF HEART FAILURE AND ASSOCIATED CONDITIONS

Devices and methods for use of identification, treatment and/or management of heart failure and/or associated conditions. Methods may include providing a baroreflex therapy system, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes, determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, generating at least one signal representative of a pressure waveform based on the impedance, activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform. 1. A system , comprising:a means for measuring blood pressure of a patient;a means for measuring heart rate of the patient;an implantable baroreflex activation device including an electrode, the device configured to be implanted such that the electrode is in contact with a blood vessel of the patient; and determine an impedance of the blood vessel with the electrode;', 'determine one or more vessel properties based on impedance of the blood vessel;', 'determine a blood pressure based on the means for measuring blood pressure;', 'determine a heart rate based on the means for measuring heart rate; and', 'activate, deactivate or otherwise modulate the baroreflex activation device to deliver a first baroreflex therapy in response to each of blood pressure, heart rate and vessel properties being within their respective predetermined ranges, and deliver a second baroreflex therapy in response to one or more of blood pressure, heart rate and vessel properties being outside their respective predetermined ranges., 'a control system coupled to the means for measuring blood pressure, the means for measuring heart rate, and the baroreflex activation device, the control system including predetermined ranges for each ...

AUTONOMIC MODULATION USING PERIPHERAL NERVE FIELD STIMULATION

Some embodiments provide a system, comprising a peripheral nerve field modulation (PNFM) therapy delivery system, PNFM electrodes configured to be implanted subcutaneously, and a controller. The PNFM electrodes are electrically connected to the PNFM therapy system. The PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields. The controller is configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields. The controller includes a scheduler configured to control timing of the PNFM therapy. 1. A system , comprising:a peripheral nerve field modulation (PNFM) therapy delivery system;PNFM electrodes configured to be implanted subcutaneously, wherein the PNFM electrodes are electrically connected to the PNFM therapy system, and the PNFM therapy delivery system and the PNFM electrodes are configured to deliver current and/or control the field potentials at one or more peripheral nerve fields; anda controller configured to control the PNFM therapy delivery system to deliver a PNFM therapy to the one or more peripheral nerve fields, wherein the controller includes a scheduler configured to control timing of the PNFM therapy.2. The system of claim 1 , further comprising:spinal cord modulation (SCM) therapy delivery system; andSCM electrodes configured to be implanted in an epidural space and modulate one or more neural targets in the spinal cord from the epidural space, wherein the SCM therapy delivering system and the SCM electrodes are configured to deliver current and/or control the filed potentials at one or more neural targets in the spinal cord when the SCM electrodes are positioned in the epidural space,wherein the controller is configured to control the SCM therapy delivery system.3. The system of claim 2 , wherein the controller is configured to coordinate the SCM therapy and the PNFM therapy.4. The ...

Methods and apparatuses for remodeling tissue of or adjacent to a body passage

Medical devices and methods for making and using the same are disclosed. An example medical device may include a catheter shaft. An expandable member may be coupled to the catheter shaft. A plurality of flexible electrode assemblies may be coupled to the expandable member. A control unit may be coupled to the electrode assemblies. The control unit may be configured to energize the electrode assemblies for approximately 10 seconds to less than approximately 1 minute.

METHODS AND APPARATUSES FOR REMODELING TISSUE OF OR ADJACENT TO A BODY PASSAGE

Medical devices and methods for making and using the same are disclosed. An example method may include a method for treating a patient having congestive heart failure. The method may include positioning an expandable balloon in a renal artery of the patient. The expandable balloon may include a plurality of electrode assemblies. At least some of the electrode assemblies each may include at least two bipolar electrode pairs. The two bipolar electrode pairs may be longitudinally and circumferentially offset from one another. The method may also include expanding the balloon in the renal artery such that at least some of the bipolar electrode pairs are electrically coupled to a wall of the renal artery and energizing at least some of the bipolar electrode pairs so as to therapeutically alter at least one nerve proximate the renal artery to treat the patient's congestive heart failure. 1. A method for treating a patient having congestive heart failure , the method comprising:positioning an expandable balloon in a renal artery of the patient, the expandable balloon including a plurality of electrode assemblies, at least some of the electrode assemblies each including at least two bipolar electrode pairs, the two bipolar electrode pairs being longitudinally and circumferentially offset from one another;expanding the balloon in the renal artery such that at least some of the bipolar electrode pairs are electrically coupled to a wall of the renal artery; andenergizing at least some of the bipolar electrode pairs so as to therapeutically alter at least one nerve proximate the renal artery to treat the patient's congestive heart failure.2. The method of claim 1 , wherein energizing at least some of the bipolar electrode pairs comprises using a plurality of temperature sensors to adjust an energy output of the bipolar electrode pairs claim 1 , each sensor positioned between one of the bipolar electrode pairs.3. The method of claim 1 , wherein positioning the expandable balloon ...

ACQUIRING NERVE ACTIVITY FROM CAROTID BODY AND/OR SINUS

An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed. 1. A method for diagnosing an increase in metabolic demand comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least one member of the group consisting of a decrease in ventilation rate, an increase in blood carbon dioxide concentration, a decrease in blood oxygen concentration and a decrease in blood glucose concentration; andbased at least in part on the analyzing, determining if metabolic demand increased.2. The method of further comprising claim 1 , if metabolic demand increased claim 1 , delivering a therapy to increase heart rate.3. A method for diagnosing hypoglycemia comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least one member of the group consisting of a decrease in blood glucose concentration and a decrease in blood pH; andbased at least in part on the analyzing, determining if hypoglycemia exists.4. The method of further comprising claim 3 , if hypoglycemia exists claim 3 , issuing an alert.5. The method of further comprising claim 3 , if hypoglycemia exists claim 3 , delivering a therapy to increase sympathetic tone.6. A method for diagnosing hypertension comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least a change in blood pressure; andbased at least in part on the analyzing, determining if hypertension exists.7. The ...

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. 1. A device for delivering a closed-loop neural stimulation therapy with neural response feedback to a desired neural target in an autonomic nervous system to elicit a desired neural response , comprising:a pulse generator configured to generate a neural stimulation signal for delivery to the desired neural target in the autonomic nervous system;a nerve sensor configured to sense a nerve traffic signal from the autonomic nervous system, and a signal processor the nerve traffic signal into a signal indicative of the detected neural response to stimulating the neural target; anda controller connected to the pulse generator and the signal processing module, wherein the controller is configured to control the pulse generator to generate the neural stimulation signal to cause a sympathetic or parasympathetic neural response for the neural stimulation therapy, and use the detected neural response to adjust at least one stimulation parameter of the neural stimulation signal based on the detected neural response to provide the desired neural response to the neural stimulation therapy.2. The device of claim 1 , wherein the nerve sensor is configured to sense nerve traffic at the desired neural target.3. The device of claim 1 , wherein ...

STIMULATION DESIGN FOR NEUROMODULATION

The present application relates to a new stimulation design which can be utilized to treat neurological conditions. The stimulation system produces a burst mode stimulation which alters the neuronal activity of the predetermined site, thereby treating the neurological condition or disorder. The burst stimulus comprises a plurality of groups of spike pulses having a maximum inter-spike interval of 100 milliseconds. The burst stimulus is separated by a substantially quiescent period of time between the plurality of groups of spike pulses. This inter-group interval may comprise a minimum of 5 seconds. 1. A method of stimulating nerve tissue of a patient using an implantable pulse generator , the method comprising:generating, by the implantable pulse generator, a burst stimulus that comprises a plurality of groups of spike pulses, wherein the burst stimulus is substantially quiescent between the plurality of groups, wherein each spike within each group is separated by a maximum inter-spike interval and each group of spikes is separated by a minimum inter-group interval, wherein the maximum inter-spike interval is 5 milliseconds and the minimum inter-group interval is 20 milliseconds;providing the burst stimulus from the implantable pulse generator to a medical lead; andapplying the burst stimulus to nerve tissue of the patient via one or several electrodes of the medical lead.2. The method of further comprising: controlling a number of spikes within a group of spikes of the burst stimulus according a parameter stored in the implantable pulse generator.3. The method of further comprising: controlling a spike amplitude according to a parameter stored in the implantable pulse generator.4. The method of further comprising: controlling an inter-spike interval according to a parameter stored in the implantable pulse generator.5. The method of further comprising: controlling an inter-group interval according to a parameter stored in the implantable pulse generator.6. The ...

Systems and methods for monitoring for nerve damage

Various device embodiments may comprise an implantable medical device for implantation in a body and for applying neural stimulation to a neural target in the body. The device may comprise a neural stimulation electrode configured for use in stimulating the neural target, a neural stimulator configured to deliver neural stimulation through the electrode to the neural target, a sensor configured to sense a physiological response to stimulation of motor fibers at the neural target, and a controller operatively connected to the neural stimulator to control the neural stimulation and operatively connected to the sensor to receive a signal indicative of the physiological response. The controller may be configured to detect a potential neural injury and perform an action in response to the detected potential neural injury.

Renal Nerve Stimulation Method for Treatment of Patients

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based. 143-. (canceled)44. A method comprising:sensing a physiological parameter of a patient;generating a stimulation signal with an electrical stimulator based, at least in part, on the physiological parameter; anddelivering the stimulation signal from the electrical stimulator to a renal nerve of the patient to decrease renal sympathetic activity of the patient.45. The method of wherein sensing the physiological parameter comprises sensing a physiological parameter indicative of sympathetic activity within the patient claim 44 , the method further comprising identifying an increase in sympathetic activity based on the physiological parameter claim 44 , and wherein generating the stimulation signal comprises generating the stimulation signal in response to the increase in sympathetic activity.46. The method of wherein generating the stimulation signal includes generating the stimulation signal with an implantable electrode claim 44 , and delivering the stimulation signal includes delivering the stimulation signal from the implantable electrode.47. The method of claim 44 , further comprising transmitting information regarding the physiological parameter to an external device outside of the patient.48. The method of wherein the physiological parameter comprises at least one of blood pressure and blood oxygen saturation.49. A system comprising:a sensor that senses a physiological parameter of a patient; andan electrical stimulator that communicates with the sensor, wherein the electrical stimulator comprises a stimulation generator that generates a stimulation signal based on the physiological parameter and delivers the ...

Method for blood pressure modulation using electrical stimulation of the coronary baroreceptors

An apparatus comprises a first stimulation circuit and a control circuit. The stimulation circuit is configured to be electrically coupled to a first electrode assembly that is configured to deliver electrical sub-myocardial activation stimulation to a coronary baroreceptor from a location within a left atrial appendage of a heart. The stimulation circuit is further configured to generate the electrical stimulation for delivery to the coronary baroreceptor via the first electrode assembly. The control circuit is wirelessly or conductively coupled to the first stimulation circuit and is configured to control delivery of the electrical stimulation.

Methods and Apparatus to Stimulate Heart Atria

A method and apparatus for treatment of hypertension and heart failure by increasing secretion of endogenous atrial hormones by pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in premature atrial contraction that does not result in ventricular contraction. Pacing results in the atrial wall stress, peripheral vasodilation, ANP secretion. Concomitant reduction of the heart rate is monitored and controlled as needed with backup pacing.

Systems and methods to reduce syncope risk during neural stimulation therapy

Some embodiments, by way of example, provide a system, comprising a posture change detector configured to detect a posture transition indicative of an increased risk of syncope, and a neural stimulator configured to deliver a neural stimulation therapy. The neural stimulator may include a syncope avoidance module configured to respond to a detected posture transition by temporarily overriding the neural stimulation therapy to ameliorate the risk of increased syncope.

Apparatuses for Renal Neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation. 165-. (canceled)66. An apparatus for renal neuromodulation , the apparatus comprising:a probe configured for insertion in proximity to renal nerves along a renal artery or renal vein; an anchoring mechanism having—', 'a first collar;', 'a second collar located distally relative to the first collar; and', 'an expandable member connected to the first and second collars,', 'wherein the expandable member is reversibly transformable from a collapsed configuration to an expanded configuration by moving at least one of the first and second collars toward the other to reduce the distance between the collars; and, 'a catheter configured to move through the probe, wherein the catheter comprises'}a plurality of electrodes at the expandable member, wherein the electrodes are configured to deliver an electric field to the renal nerves.67. The apparatus of wherein the probe is configured for percutaneous placement adjacent to the renal artery or renal vein.68. The apparatus of wherein the probe is configured for insertion in proximity to the renal nerves along the renal artery or renal vein under guidance claim 66 , and wherein the guidance is chosen from the group consisting of visual claim 66 , computed tomographic claim 66 , radiographic claim 66 , ultrasonic claim 66 , angiographic claim 66 , laparoscopic claim 66 , and combinations thereof.69. The apparatus of wherein the expandable member comprises ...

METHODS FOR MONOPOLAR RENAL NEUROMODULATION

Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally. 1. A method for renal neuromodulation of a patient , the method comprising:placing a monopolar electrode in proximity to a neural fiber that contributes to renal function of a kidney of a patient;electrically coupling a ground electrode to an exterior of the patient; anddelivering an electric field between the monopolar electrode and the ground electrode to modulate a function of the neural fiber.2. The method of claim 1 , wherein delivering the electric field further comprises delivering a pulsed electric field.3. The method of claim 1 , wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney.4. The method of claim 1 , wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation claim 1 , electrofusion claim 1 , necrosis claim 1 , apoptosis claim 1 , gene expression alteration claim 1 , cytokine up-regulation alteration claim 1 , and combinations thereof.5. The method of claim 1 , wherein modulating the function of the neural fiber further comprises thermally modulating the function of the neural fiber.6. The method of claim 1 , wherein modulating the function of the neural fiber further comprises claim 1 , on average during delivery of the electric field claim 1 , modulating the function of the neural fiber substantially athermally.7 ...

Implant holder and suture guide

A delivery system is disclosed having an implant retainer configured to releasably hold an implant unit and maintain the implant unit in a fixation location relative to target tissue in a subject's body during an implantation procedure. A first suture guide portion may be disposed on a first side of the implant retainer and configured to guide a suture needle during the implantation procedure. A second suture guide portion may be disposed on a second side of the implant retainer, opposite the first side, and configured to guide the suture needle after the suture needle exits the first suture guide portion.

Methods and Compositions for Treating a Renal Associated Condition in a Subject

Methods for treating a renal associated condition in a subject are provided. Aspects of the subject methods include paradoxically enhancing renal sympathetic bias in the subject in a manner effective to treat the renal associated condition. Also provided are compositions, kits and systems for practicing the subject methods.

System and method for autonomic blood pressure regulation

A system for regulating blood pressure by stimulating an afferent pathway to the brain which produces an efferent output in kidneys includes a electrode device adapted for implantation in the cervical region, a stimulator generator, a cable connecting the electrode device and the stimulator generator, wherein the cervical region is generally located between a pair of common carotid arteries, above an aortic arch and in front of cervical vertebrae C2 and C3. A method of implantation includes placing the electrode device in the cervical region, selectively energizing the device in accordance with a stimulation scheme, assessing any changes in the patient's blood pressure, selectively energizing the device in accordance with another stimulation scheme, and assessing any changes in the patient's blood, for determining an optical stimulation scheme, wherein stimulation scheme involves parameters including, for example, position, placement and configuration of the electrode device in relation to surrounding tissue and/or organs, selection of electrodes energized, width, frequency and amplitude of stimulation current.

Methods and apparatus for renal neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

METHOD FOR TREATING HYPERTENSION VIA ELECTRICAL STIMULATION OF NEURAL STRUCTURES

A neuromodulation system comprises a sensor configured for sensing a blood pressure of a patient, modulation output circuitry configured for conveying electrical modulation energy to at least one electrode, and a controller/processor coupled to the sensor and the modulation output circuitry. The controller/processor is configured for comparing the blood pressure sensed by the sensor to a first threshold blood pressure, and instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode if the sensed blood pressure is greater than the first threshold blood pressure. A method for treating chronic hypertension comprises applying electrical modulation energy to a neural target site, thereby modulating an afferent nerve innervating a patient's kidney, thereby treating the chronic hypertension. 1. A neuromodulation system , comprising:a sensor configured for sensing a parameter correlatable to blood pressure of a patient;modulation output circuitry configured for conveying electrical modulation energy to at least one electrode; anda controller/processor coupled to the sensor and the modulation output circuitry, the controller/processor configured for comparing the sensed parameter to a first threshold, and instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode based on the comparison.2. The neuromodulation system of claim 1 , wherein the sensed parameter comprises the blood pressure claim 1 , the first threshold comprises a first threshold blood pressure claim 1 , and the controller/processor is configured for instructing the modulation output circuitry to convey the electrical modulation energy to the at least one electrode if the sensed blood pressure is greater than the first threshold blood pressure.3. The neuromodulation system of claim 2 , wherein the first threshold blood pressure is 140 mm Hg systolic/90 mm Hg diastolic.4. The neuromodulation system ...

NEURAL STIMULATION WITH RESPIRATORY RHYTHM MANAGEMENT

A system embodiment comprises at least one respiration sensor, a neural stimulation therapy delivery module, and a controller. The respiration sensor is adapted for use in monitoring respiration of the patient. The neural stimulation therapy delivery module is adapted to generate a neural stimulation signal for use in stimulating the autonomic neural target of the patient for the chronic neural stimulation therapy. The controller is adapted to receive a respiration signal from the at least one respiration sensor indicative of the patient's respiration, and adapted to control the neural stimulation therapy delivery module using a respiratory variability measurement derived using the respiration signal. 1. (canceled)2. An implantable neural stimulator for delivering chronic neural stimulation therapy , the stimulator comprising:at least one respiration sensor configured to be used in monitoring respiration of the patient;a neural stimulation therapy delivery module configured to generate a neural stimulation signal for use in stimulating an autonomic neural target of the patient for the chronic neural stimulation therapy; and control the neural stimulation therapy delivery module to deliver the chronic neural stimulation therapy, wherein the chronic neural stimulation therapy is configured to treat the non-respiratory disorder of the patient and is delivered over a period of time that includes a plurality of low activity periods and a plurality of non-low activity periods;', ["receive a respiration signal from the at least one respiration sensor indicative of the patient's respiration;", 'monitor the respiration signal during one of the plurality of low activity periods within the period of time; and', 'determine a respiration variability measurement over a plurality of respiration cycles for the one of the plurality of low activity periods using the monitored respiration signal, wherein the respiratory variability measurement for the one of the plurality of low ...

Apparatus and Method for Extending Implant Life Using a Dual Power Scheme

A device according to some embodiments may include a housing configured for location external to a body of a subject. The device may also include at least one processor associated with the housing and configured for electrical communication with a power source, and an antenna associated with the at least one processor. The at least one processor may be configured to communicate with an implant circuit located within the body of the subject, cause the implant circuit to receive power in a first power mode and in a second power mode, wherein a first level of power delivered in the first power mode is less than a second level of power delivered in the second power mode, and wherein during a therapy period, power delivery in the first mode occurs over a total time that is greater than about 50% of the therapy period. 111-. (canceled)12. A device comprising:a housing configured for location external to a body of a subject; andat least one processor associated with the housing and configured for electrical communication with a power source; andan antenna associated with the at least one processor; communicate with an implant circuit located within the body of the subject,', 'cause the implant circuit to receive power in a first power mode and in a second power mode, wherein a first level of power delivered in the first power mode is less than a second level of power delivered in the second power mode, and wherein during a therapy period, power delivery in the first mode occurs over a total time that is greater than about 50% of the therapy period., 'the at least one processor being configured to1320-. (canceled)21. The device of claim 12 , wherein the implant circuit is associated with electrodes claim 12 , and wherein during the first power mode claim 12 , the at least one processor causes a first alternating current signal to supply power to the implant circuit while the implant circuit is substantially restricted from supplying direct current to the electrodes claim 12 ...

Antenna Providing Variable Communication With An Implant

A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device. 114-. (canceled)15. A device , comprising:a primary antenna configured to be located external to a subject,at least one processor in electrical communication with the primary antenna, the at least one processor configured to:cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes,wherein the processor is further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted to cause a current at the at least one pair of modulation electrodes below a neuromuscular modulation threshold when received by the implantable device and to generate a modulation control signal adapted to cause a current at the at least one pair of modulation electrodes above a neuromuscular modulation threshold when received by the implantable device.16. The device of claim 15 , wherein the at least one processor is further configured to receive via the primary antenna claim 15 , a condition signal from an implantable device in ...

Modulator Apparatus Configured for Implantation

An implant unit according to some embodiments may include a flexible carrier, at least one pair of modulation electrodes on the flexible carrier, and at least one implantable circuit in electrical communication with the at least one pair of modulation electrodes. The at least one pair of modulation electrodes and the at least one circuit may be configured for implantation through derma on an underside of a subject's chin and for location proximate to terminal fibers of the medial branch of the subject's hypoglossal nerve, such that an electric field extending from the at least one pair of modulation electrodes can modulate one or more of the terminal fibers of the medial branch of the hypoglossal nerve.

System and method for nerve modulation using noncontacting electrodes

An implant unit configured for implantation into a body of a subject may include an antenna configured to receive a signal. The implant unit may also include at least one pair of modulation electrodes configured to be implanted into the body of the subject in the vicinity of at least one nerve to be modulated, the at least one pair of modulation electrodes being configured to receive an applied electric signal in response to the signal received by the antenna and generate an electrical field to modulate the at least one nerve from a position where the at least one pair of modulation electrodes does not contact the at least one nerve.

METHODS AND APPARATUS FOR THERMALLY-INDUCED RENAL NEUROMODULATION

Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy. 117-. (canceled)18. A method for treating a hypertensive human patient , the method comprising:intravascularly positioning a thermal apparatus carried by a renal denervation catheter at least proximate to renal nerves of the patient;delivering thermal energy via the thermal apparatus to modulate a function of the renal nerves via thermal effects; andintravascularly removing the renal denervation catheter from the patient after delivering the thermal energy to conclude the procedure.19. The method of wherein intravascularly positioning a thermal apparatus comprises intravascularly positioning the thermal apparatus within a renal artery of the patient proximate to the renal nerves.20. The method of wherein the renal denervation catheter comprises an expandable element at a distal region of the catheter claim 18 , and wherein the thermal apparatus is carried by the expandable element claim 18 , and wherein the method further comprises:transforming the expandable element from a low-profile delivery configuration to an expanded treatment configuration within a renal artery of the patient after intravascularly positioning the thermal apparatus at least proximate to renal nerves and before delivering ...

Implantable Electroacupuncture System and Method

A method comprises generating, by an implantable stimulator, stimulation sessions at a duty cycle that is less than 0.05 and applying, by the implantable stimulator, the stimulation sessions to a patient. The duty cycle is a ratio of T3 to T4. Each stimulation session included in the stimulation sessions has a duration of T3 minutes and occurs at a rate of once every T4 minutes. The implantable stimulator is powered by a primary battery having an internal impedance greater than 5 ohms. 1. A method comprising: the duty cycle is a ratio of T3 to T4,', 'each stimulation session included in the stimulation sessions has a duration of T3 minutes and occurs at a rate of once every T4 minutes, and', 'the implantable stimulator is powered by a primary battery having an internal impedance greater than 5 ohms; and, 'generating, by an implantable stimulator, stimulation sessions at a duty cycle that is less than 0.05, wherein'}applying, by the implantable stimulator, the stimulation sessions to a patient.2. The method of claim 1 , wherein:a housing of the implantable stimulator is coin-sized and coin-shaped; andthe primary battery located within the implantable stimulator is a coin-cell battery.3. The method of claim 1 , wherein the applying of the stimulation sessions to the patient comprises applying the stimulation sessions to a location within the patient that comprises at least one of acupoints ST36 claim 1 , SP4 claim 1 , ST37 claim 1 , ST40 claim 1 , SP6 claim 1 , SP9 claim 1 , K16 claim 1 , and LR8.4. The method of claim 1 , wherein T3 is at least 10 minutes and less than 60 minutes claim 1 , and wherein T4 is at least 1440 minutes.5. The method of claim 1 , wherein the primary battery located within the implantable stimulator has a capacity of less than 60 milliamp-hours (mAh).6. The method of claim 1 , wherein the applying of the stimulation sessions to the patient is configured to treat at least one of obesity claim 1 , dyslipidemia claim 1 , a genitourinary disease ...

METHODS AND APPARATUSES FOR REMODELING TISSUE OF OR ADJACENT TO A BODY PASSAGE

Medical devices and methods for making and using the same are disclosed. An example device may include an expandable balloon including an outer surface. At least one flexible circuit may be mounted on the outer surface of the expandable balloon. The at least one flexible circuit may include a first insulating layer, at least one heat sensing device positioned at least partially within the first insulating layer, a conductive layer above the first insulating layer, at least a portion of which is electrically coupled to the heat sensing device, a second insulating layer above the conductive layer, and at least one electrode associated with the conductive layer. 120.-. (canceled)21. A method of treatment comprising: (i) an expandable balloon coupled to the catheter and including an outer surface; and', '(ii) at least one flexible circuit mounted on the outer surface of the expandable balloon, the at least one flexible circuit including: (1) a first insulating layer, (2) at least one heat sensing method positioned at least partially within the first insulating layer, (3) a conductive layer above the first insulating layer, at least a portion of which is electrically coupled to the heat sensing method, (4) a second insulating layer above the conductive layer, and (5) at least one electrode associated with the conductive layer;, '(a) inserting a catheter into a renal artery of a patient, the catheter comprising(b) expanding the balloon in the renal artery; and(c) driving energy through the at least one electrode so as to therapeutically affect one nerve proximate the renal artery.22. The method of claim 21 , wherein the at least one electrode comprises at least a pair of bipolar electrodes23. The method of claim 22 , wherein the heat sensing method is positioned between the pair of bipolar electrodes.24. The method of claim 22 , wherein the heat sensing method is electrically coupled to one of the pair of bipolar electrodes.25. The method of claim 22 , wherein the pair of ...

IMPLANT TOOL AND IMPROVED ELECTRODE DESIGN FOR MINIMALLY INVASIVE PROCEDURE

Devices and methods of use for introduction and implantation of an electrode as part of a minimally invasive technique. An implantable baroreflex activation system includes a control system having an implantable housing, an electrical lead, attachable to the control system, and an electrode structure. The electrode structure is near one end of the electrical lead, and includes a monopolar electrode, a backing material having an effective surface area larger than the electrode, and a releasable pivotable interface to mate with an implant tool. The electrode is configured for implantation on an outer surface of a blood vessel and the control system is programmed to deliver a baroreflex therapy via the monopolar electrode to a baroreceptor within a wall of the blood vessel. 1. An implantable baroreflex activation system , comprising:a control system having an implantable housing;an electrical lead, coupleable to the control system; andan electrode structure proximate a distal end of the electrical lead, the electrode structure including a monopolar electrode, a backing material having an effective surface area larger than and proximal of the monopolar electrode, and a means for releasably and pivotably interfacing with an implant tool positioned proximal of the backing material, wherein the electrode is configured for implantation on an outer surface of a blood vessel and the control system is programmed to deliver a baroreflex therapy via the monopolar electrode to a baroreceptor within a wall of the blood vessel, the baroreflex therapy having a pulse frequency between 25-80 Hz, a pulse width between 60-200 microseconds, and a pulse amplitude between 3-10 milliamps.2. A method of implanting a baroreflex activation system , comprising:creating an incision in a patient; releasably coupling an electrode structure to an implant tool, the electrode structure including a monopolar electrode, a backing material having an effective surface area larger than the monopolar ...

ELECTRODE STRUCTURES AND METHODS FOR THEIR USE IN CARDIOVASCULAR REFLEX CONTROL

Devices, systems, and methods are described by which the blood pressure, nervous system activity, and neurohormonal activity may be selectively and controllably reduced by activating baroreceptors. A baroreceptor activation device is positioned near a baroreceptor, preferably a baroreceptor located in the carotid sinus. A control system may be used to modulate the baroreceptor activation device. The control system may utilize an algorithm defining a stimulus regimen which promotes long term efficacy and reduces power requirements/consumption. The baroreceptor activation device may utilize electrodes to activate the baroreceptors. The electrodes may be adapted for connection to the carotid arteries at or near the carotid sinus, and may be designed to minimize extraneous tissue stimulation. 1. A system , comprising:an extravascular electrode configured for chronic implantation on a blood vessel proximate a baroreceptor within a vascular wall;a controller coupled to the electrode, the controller programmed to deliver a baroreflex therapy to the baroreceptor via the extravascular patch electrode; andan electrical lead coupled between the electrode and the controller.2. The system of claim 1 , wherein the electrode comprises a patch electrode.3. The system of claim 1 , wherein the electrode comprises a monopolar electrode.4. The system of claim 1 , wherein the electrode comprises a cathode.5. The system of claim 1 , wherein the controller is further programmed to locally stimulate baroreceptors in the vascular wall and to limit stimulation outside the vascular wall.6. The system of claim 1 , further comprising a sensor coupled to the controller claim 1 , wherein the sensor is configured for generating a sensor signal indicative of a need for baroreflex therapy claim 1 , and wherein the controller is further programmed to deliver a baroreflex therapy to the baroreceptor based at least in part on the sensor signal.7. A baroreceptor activation system claim 1 , comprising:a ...

Neuromodulation catheters having jacketed neuromodulation elements and related devices, systems, and methods

A neuromodulation catheter in accordance with a particular embodiment includes an elongate shaft and a neuromodulation element operably connected to the shaft. The shaft includes a proximal hypotube segment at its proximal end portion and a jacket disposed around at least a portion of an outer surface of the hypotube segment. The jacket may be made at least partially of a polymer blend including polyether block amide and polysiloxane. The neuromodulation element includes a distal hypotube segment and a tubular jacket disposed around at least a portion of an outer surface of the distal hypotube segment. The jacket has reduced-diameter segments spaced apart along its longitudinal axis. The neuromodulation element further includes band electrodes respectively seated in the reduced-diameter segments and respectively forming closed loops extending circumferentially around the jacket.

RENAL NEUROMODULATION FOR TREATMENT OF PATIENTS

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based. 150-. (canceled)51. A method of treating a disease of a human patient diagnosed with at least one of heart failure , hypertension , acute myocardial infarction , impaired renal function , or chronic renal failure , the method comprising:positioning an energy transfer device within a renal blood vessel and in a vicinity of post-ganglionic neural fibers that innervate a kidney of the patient; andthermally modulating the neural fibers with the device, wherein thermally modulating the neural fibers results in a therapeutically beneficial reduction in blood pressure of the patient.52. The method of wherein thermally modulating the neural fibers with the device comprises thermally modulating one or more afferent neural fibers.53. The method of wherein thermally modulating the neural fibers with the device comprises thermally modulating one or more efferent neural fibers.54. The method of wherein thermally modulating the neural fibers with the device comprises at least partially ablating at least one of an efferent neural fiber and an afferent neural fiber with the device.55. The method of wherein thermally modulating the neural fibers comprises reducing neural activity along the neural fibers with the device within the renal blood vessel.56. The method of wherein reducing neural activity along the neural fibers with the device from within the renal blood vessel comprises reducing afferent neural activity along the neural fibers.57. The method of wherein reducing neural activity across the neural fibers with the device from within the renal blood vessel comprises reducing efferent neural activity across the neural fibers. ...

RENAL NEUROMODULATION FOR TREATMENT OF PATIENTS

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based. 143-. (canceled)44. A method of treating a human patient diagnosed with at least one of heart failure , hypertension , acute myocardial infarction , renal disease , or chronic renal failure , the method comprising:positioning an electrode within a renal blood vessel and proximate to post-ganglionic neural fibers that innervate a kidney of the patient; andgenerating an electric field via the electrode such that at least a portion of the neural fibers are in the electric field,wherein the electric field reduces neural communication along the neural fibers and significantly improves a measurable physiological parameter corresponding to the disease of the patient.45. The method of wherein positioning an electrode within a renal blood vessel and proximate to post-ganglionic neural fibers comprises placing the electrode in a renal artery of the patient.46. The method of wherein generating an electric field comprises generating a monopolar electric field.47. The method of wherein generating an electric field via the electrode comprises generating a bipolar electric field.48. The method of wherein the electrode is a first electrode claim 44 , and wherein the method further comprises positioning a second electrode within the renal blood vessel and proximate to the post-ganglionic neural fibers claim 44 , and wherein generating an electric field comprises generating a bipolar electric field between the first and second electrodes.49. The method of wherein generating an electric field via the electrode such that at least a portion of the neural fibers are in the electric field comprises at least partially ablating the neural ...

IMPLANT TOOL AND IMPROVED ELECTRODE DESIGN FOR MINIMALLY INVASIVE PROCEDURE

Devices and methods of use for introduction and implantation of an electrode as part of a minimally invasive technique. An implantable baroreflex activation system includes a control system having an implantable housing, an electrical lead, attachable to the control system, and an electrode structure. The electrode structure is near one end of the electrical lead, and includes a monopolar electrode, a backing material having an effective surface area larger than the electrode, and a releasable pivotable interface to mate with an implant tool. The electrode is configured for implantation on an outer surface of a blood vessel and the control system is programmed to deliver a baroreflex therapy via the monopolar electrode to a baroreceptor within a wall of the blood vessel. 113-. (canceled)14. An implantable electrode structure configured for implantation on an outer surface of a blood vessel and comprising:a first side having an electrode, the first side configured to be placed in contact with the blood vessel;a second side opposite the first side, the second side including a backing material having an effective surface area larger than the electrode; anda mesh layer at least partially exposed around or through the backing material,wherein the electrode structure is configured to facilitate application of an adhesive for fixation of the electrode structure to the blood vessel.15. The implantable electrode structure of claim 14 , wherein the first side includes the mesh layer.16. The implantable electrode structure of claim 14 , wherein the mesh layer is disposed between the first side and the second side.17. The implantable electrode structure of claim 16 , wherein the mesh layer is at least partially exposed around or through the first side.18. The implantable electrode structure of claim 14 , wherein the backing material includes at least one aperture that exposes the mesh layer.19. The implantable electrode structure of claim 14 , wherein the implantable electrode ...

Methods and Apparatus to Increase Secretion of Endogenous Naturetic Hormones

A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon. 1. A method for treating a patient comprising:determining that the patient is suffering from a condition comprising one or more of hypertension, excessive fluid retention, or excessive sodium retention;treating the condition by stressing a wall of at least one atrium of a heart of the patient beyond a natural stress condition of the wall, such that the stressed wall secretes a hormone at an elevated level above a natural secretion level occurring naturally when the wall of the at least one atrium is not stressed by the stressing,wherein stressing the wall of the at least one atrium of the heart comprises stretching the at least one atrium by one or more of pulling on an atrial appendage, pulling on the at least one atrium, or pulling on a junction between the at least one atrium and a vessel; andachieving a beneficial therapeutic effect in the patient by the hormone secreted at the elevated level,wherein the beneficial therapeutic effect includes a reduction in blood pressure.2. The method of claim 1 , wherein stretching the at least one atrium comprises temporarily stretching the wall of the at least one atrium.3. The method of claim 1 , wherein stressing the wall of the at least one atrium of the heart comprises stretching the wall and then restoring the wall to a substantially pre-stretched condition.4. The method of claim 1 , wherein stressing the wall of the at least one atrium comprises mechanical stimulation of a right atrial appendage of the heart.5. The method of claim 1 , wherein ...

Method For Reducing Hypertension Using An Implantable Electroacupuncture Device

Disclosed is an implantable, coin-sized, self-contained, leadless electroacupuncture (EA) device having at least two electrode contacts attached to the surface of its housing. The electrodes include a central cathode electrode on a bottom side of the housing, and a circumferential anode electrode that surrounds the cathode electrode. In one embodiment, the anode annular electrode is a ring electrode placed around the perimeter edge of the coin-shaped housing. The EA device is adapted to be implanted through a very small incision, e.g., less than about 2-3 cm in length, directly adjacent to a selected acupuncture site known to moderate or affect a hypertension condition of a patient. Appropriate power management circuitry within the device allows a primary battery having a relatively high internal impedance to be used without causing unacceptable dips in battery voltage when the instantaneous battery current surges. Stimulation pulses are generated during a stimulation session that has a duration of T3 minutes and which is applied every T4 minutes. The duty cycle, or ratio of T3 to T4, is very low, not greater than 0.05. This low duty cycle, along with careful power management, allows the EA device to perform its intended function for several years. 1. A method of treating hypertension in a patient using a leadless electrode configuration integrated into a self-contained , implantable coin-sized electroacupuncture (EA) device , the EA device having a longest linear dimension D2 no greater than 25 mm , and a thickness W2 no greater than 2.5 mm , wherein the thickness W2 is measured in a plane orthogonal to the longest dimension D2 , and wherein the ratio of W2 to D2 is no greater than about 0.13 , the method comprising:(a) making a short incision no longer than about 25 mm in a limb of the patient near at least one of acupoints PC5, PC6, ST36 or ST37;(b) forming a tissue pocket under the skin adjacent the incision;(c) implanting the thin EA device in the patient by ...

Implantable Electroacupuncture Device For Reducing Hypertension

Disclosed is an implantable, coin-sized, self-contained, leadless electroacupuncture (EA) device having at least two electrode contacts attached to the surface of its housing. The electrodes include a central cathode electrode on a bottom side of the housing, and a circumferential anode electrode that surrounds the cathode electrode. In one embodiment, the anode annular electrode is a ring electrode placed around the perimeter edge of the coin-shaped housing. The EA device is adapted to be implanted through a very small incision, e.g., less than about 2-3 cm in length, directly adjacent to a selected acupuncture site known to moderate or affect a hypertension condition of a patient. Appropriate power management circuitry within the device allows a primary battery having a relatively high internal impedance to be used without causing unacceptable dips in battery voltage when the instantaneous battery current surges. Stimulation pulses are generated during a stimulation session that has a duration of T3 minutes and which is applied every T4 minutes. The duty cycle, or ratio of T3 to T4, is very low, not greater than 0.05. This low duty cycle, along with careful power management, allows the EA device to perform its intended function for several years. 1. An Implantable ElectroAcupuncture Device (IEAD) for treating hypertension through application of electroacupuncture (EA) stimulation pulses applied substantially at a specified acupoint of a patient , wherein the specified acupoint is selected from the group of acupoints that includes: PC5 , PC6 , ST36 , and ST37 , the IEAD comprising:a small, coin-shaped IEAD housing having an electrode configuration thereon that includes at least two electrodes/arrays, the longest linear dimension of the small, coin-shaped IEAD housing being no greater than about 25 mm, wherein at least one of said at least two electrodes/arrays comprises a central electrode/array located substantially in the center of a first surface of the IEAD ...

System and method for relieving hypertension

A system and method for relieving hypertension includes an energy wave generator set an energy wave's frequency control mode for controlling and generating energy waves with correspond energy densities in multiple energy wave generation periods to effect on a body with hypertension, so as to relieve hypertension by the specific energy wave.

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. 1. (canceled)2. An implantable device , comprising: a pulse generator configured to generate the neural stimulation pulses for the neural stimulation therapy; and', 'a modulator to adjust the neural stimulation therapy;, 'a neural stimulator configured to deliver a programmed intermittent neural stimulation therapy for an extended therapy application, the programmed intermittent neural stimulation therapy including a programmed series of stimulation ON times and stimulation OFF times, each programmed stimulation ON time for the programmed intermittent neural stimulation therapy including a programmed neural stimulation burst of neural stimulation pulses, the neural stimulator includinga monitor to monitor at least one parameter during stimulation ON times and during stimulation OFF times of the programmed intermittent neural stimulation therapy, the at least one parameter being affected by depolarization of a non-targeted nerve;a controller operably connected to the monitor, and configured to detect a change for the at least one parameter between the stimulation ON and stimulation OFF times and provide a therapy control signal to the modulator to avoid the depolarization of the non-targeted nerve.3. The implantable device of claim 2 , ...

Methods and Compositions for Treating a Renal Associated Condition in a Subject

Methods for treating a renal associated condition in a subject are provided. Aspects of the subject methods include paradoxically enhancing renal sympathetic bias in the subject in a manner effective to treat the renal associated condition. Also provided are compositions, kits and systems for practicing the subject methods. 1. A method of treating a renal associated condition in a subject , said method comprising:paradoxically enhancing renal sympathetic bias in said subject in a manner effective to treat said renal associated condition.2. The method according to claim 1 , wherein said enhancing comprises applying a stimulus to said subject.3. The method according to claim 2 , wherein said stimulus is an electrical stimulus.4. The method according to claim 3 , wherein said method comprises monitoring said subject.5. The method according to claim 4 , wherein said method comprises applying a first stimulus to said subject and monitoring said subject for a response thereto; and applying a second stimulus to said subject claim 4 , wherein said second stimulus is determined based on said monitored response to said first stimulus.6. The method of claim 1 , wherein said renal associated condition comprises a member selected from the group consisting of acute renal failure claim 1 , chronic renal failure claim 1 , contrast nephropathy claim 1 , and cardiorenal syndrome [would add hypertension both as listed claim and as explicit separate claim].7. The method of claim 6 , wherein said renal condition is cardiorenal syndrome.8. The method of claim 6 , wherein said renal condition is contrast nephropathy.9. The method of claim 8 , wherein said contrast nephropathy is iodine-based contrast nephropathy.10. An algorithm recorded on a computer-readable medium for administering a stimulus to said subject in accordance with method of .11. A system comprising:{'claim-ref': {'@idref': 'CLM-00002', 'claim 2'}, 'an algorithm recorded on a computer-readable medium for administering a ...

Methods and Apparatus for Multi-Vessel Renal Neuromodulation

Methods and apparatus are provided for multi-vessel neuromodulation, e.g., via a pulsed electric field. Such multi-vessel neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, the multi-vessel neuromodulation is applied to neural fibers that contribute to renal function. Such multi-vessel neuromodulation optionally may be performed bilaterally. 132-. (canceled)33. A renal neuromodulation apparatus for treating a human patient , the apparatus comprising:a catheter including a first electrode sized and shaped for intravascular placement within a first renal blood vessel of the patient, wherein the first electrode is electrically coupleable to an electric field generator external to the patient; anda second electrode carried by the catheter, wherein the second electrode is sized and shaped for intravascular placement within a second renal blood vessel of the patient different than the first renal blood vessel, and wherein the second electrode is electrically coupleable to the electric field generator,wherein the apparatus is configured for delivery of an electric field between the first electrode and the second electrode to at least partially denervate a single kidney while the first electrode is located within the first renal blood vessel and the second electrode is located within the second renal blood vessel.34. The renal neuromodulation apparatus of wherein the catheter further comprises a positioning element adjacent the first electrode.35. The renal neuromodulation apparatus of wherein the positioning element is configured to alter impedance within the first renal blood vessel of the patient.36. The renal neuromodulation apparatus of wherein the positioning element is configured to occlude blood flow within the first renal blood ...

Methods and Systems for Treating Hypertension Using An Implantable Electroacupuncture Device

An electroacupuncture device for treating hypertension in a patient includes 1) a housing configured to be implanted beneath a skin surface of the patient at an acupoint corresponding to a target tissue location within the patient, the acupoint comprising at least one of PC5, PC6, ST36, and ST37, 2) a central electrode of a first polarity and centrally located and substantially planar on a first surface of the housing, 3) an annular electrode of a second polarity and that surrounds the central electrode on the first surface of the housing, the annular electrode being spaced apart from the central electrode, and 4) pulse generation circuitry located within the housing and electrically coupled to the annular and central electrodes. 1. An electroacupuncture device for treating hypertension in a patient , comprising:a housing configured to be implanted beneath a skin surface of the patient at an acupoint corresponding to a target tissue location within the patient, the acupoint comprising at least one of PC5, PC6, ST36, and ST37;a central electrode of a first polarity and centrally located and substantially planar on a first surface of the housing;an annular electrode of a second polarity and that surrounds the central electrode on the first surface of the housing, the annular electrode being spaced apart from the central electrode; and generates stimulation sessions at a duty cycle that is less than 0.05, and', 'applies the stimulation sessions to the target tissue location by way of the central electrode and the annular electrode in accordance with the duty cycle,', each stimulation session included in the plurality of stimulation sessions comprises a series of stimulation pulses,', {'b': 3', '4, 'the duty cycle is a ratio of T to T, and'}, {'b': 3', '4, 'each stimulation session included in the stimulation sessions has a duration of T minutes and occurs at a rate of once every T minutes.'}], 'wherein'}], 'pulse generation circuitry located within the housing and ...

Methods and Apparatus for Multi-Vessel Renal Neuromodulation

Methods and apparatus are provided for multi-vessel neuromodulation, e.g., via a pulsed electric field. Such multi-vessel neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, the multi-vessel neuromodulation is applied to neural fibers that contribute to renal function. Such multi-vessel neuromodulation optionally may be performed bilaterally. 132-. (canceled)33. A method of assessing efficacy of a renal neuromodulation procedure in a human patient , the method comprising:determining a baseline level of one or more biomarkers in plasma or urine collected from the patient;attenuating neural traffic along a renal nerve of the patient via energy delivery from an intravascularly-positioned neuromodulation assembly;determining a post-neuromodulation level for the biomarker(s) in plasma or urine collected from the human patient; andcomparing the post-neuromodulation level to the baseline level,wherein the neuromodulation procedure is classified as at least partially successful if the post-neuromodulation level differs from the baseline level.34. The method of wherein the one or more biomarkers includes a catecholamine.35. The method of wherein the one or more biomarkers includes norepinephrine.36. The method of wherein the one or more biomarkers includes norepinephrine in urine collected from the human patient.37. The method of wherein:determining a baseline level of one or more biomarkers includes determining a baseline level of one or more catecholamines in urine collected from the human patient; anddetermining a post-neuromodulation level for the biomarker(s) includes determining a post-neuromodulation level of the one or more catecholamines in urine collected from the human patient.38. The method of wherein the one or more ...

VAGUS NERVE AND CAROTID BARORECEPTOR STIMULATION SYSTEM

Systems and methods are provided for delivering vagus nerve stimulation and carotid baroreceptor stimulation to patients for treating chronic heart failure and hypertension. The vagus nerve stimulation and carotid baroreceptor stimulation therapies may be provided using a single implantable pulse generator, which can coordinate delivery of the therapies. 1. A method of operating an implantable neurostimulation system , comprising:delivering a vagus nerve stimulation (VNS) therapy to a vagus nerve of a patient, according to a first set of parameters, with a VNS subsystem of a pulse generator; anddelivering a carotid baroreceptor stimulation (CBS) therapy to carotid baroreceptors of the patient, according to a second set of parameters different from the first set of parameters, with a CBS subsystem of the pulse generator.2. The method according to claim 1 , further comprising:detecting subcutaneous electrocardiographic (ECG) signals; anddetermining, based on the ECG signals, a change in a heart rate in response to at least one of the VNS therapy or the CBS therapy.3. The method according to claim 1 , further comprising:estimating when the patient is in a sleep state; andmodifying at least one of the first set of parameters of the VNS therapy or the second set of parameters of the CBS therapy when the patient is estimated to be in a sleep state.4. The method according to claim 1 , further comprising:determining an activity level of the patient; andmodifying at least one of the first set of parameters of the VNS therapy or the second set of parameters of the CBS therapy based on the determined activity level.5. The method according to claim 1 , wherein:delivering the VNS therapy comprises delivering the VNS therapy via a VNS electrode assembly coupled to the vagus nerve; anddelivering the CBS therapy comprises delivering the CBS therapy via a CBS electrode assembly electrically coupled to the carotid baroreceptors.6. The method according to claim 5 , wherein the VNS ...

Apparatus and Methods for Feedback-Based Nerve Modulation

A device according to some embodiments may include a housing configured for location external to a body of a subject. The device may also include at least one processor associated with the housing and configured to communicate with a circuit implanted in the subject within proximity to a tongue of the subject, wherein the circuit is in electrical communication with at least one electrode, receive a physiological signal from the subject via the circuit, and send a control signal to the implanted circuit in response to the physiological signal, wherein the control signal is predetermined to activate neuromuscular tissue within the tongue. 114-. (canceled)15. A hypertension therapy device for affecting blood pressure , the hypertension therapy device comprising , comprising:a housing configured for location external to a body of a subject; and communicate with a circuit implanted in a blood vessel of the subject within proximity to at least one of a renal nerve, a baroreceptor, and a glossopharyngeal nerve, wherein the circuit is in electrical communication with at least one electrode;', 'receive a physiological signal from the subject and', 'send a control signal to the implanted circuit in response to the physiological signal, wherein the control signal is predetermined to modulate nerve tissue to affect blood pressure., 'at least one processor associated with the housing and further configured to16. The hypertension therapy device of claim Error! Reference source not found.5 , wherein the processor is configured to send the control signal within a response time between 1 millisecond and 10 minutes.17. The hypertension therapy device of claim Error! Reference source not found.5 , further comprising an antenna configured to transmit the control signal from the location outside of the subject's body to an antenna associated with the implanted circuit.18. The hypertension therapy device of claim Error! Reference source not found.5 , wherein the physiological signal ...

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. 1an activity monitor to sense activity and provide a signal indicative of the activity; and a pulse generator to provide a neural stimulation signal adapted to provide a neural stimulation therapy; and', 'a modulator to receive the signal indicative of the activity and modulate the neural stimulation signal based on the signal indicative of the activity to change the neural stimulation therapy., 'a neural stimulator, including. A system for providing neural stimulation, comprising: This application is a continuation of and claims the benefit of priority under 35 U.S.C. §120 to U.S. patent application Ser. No. 12/968,797, entitled “Automatic Neural Stimulation Modulation Based On Motion and Physiological Activity,” filed on Dec. 15, 2010, published as US 2011/0082514 on Apr. 7, 2011, which is a continuation of and claims the benefit of priority under 35 U.S.C. §120 to U.S. patent application Ser. No. 12/840,981, entitled “Automatic Neural Stimulation Modulation Based On Motion and Physiological Activity,” filed on Jul. 21, 2010, published as US 2010/0286740 on Nov. 11, 2010, now U.S. Pat. No. 8,285,389, which is a continuation of and claims the benefit of priority under 35 U.S.C. §120 to U.S. patent application Ser. No. 11/558,083, entitled “Automatic Neural Stimulation Modulation Based On Activity,” filed on Nov. 9, 2006, published as US 2007/0142864 on Jun. 21, 2007, now U.S. Pat. No. 7,783,353, which application is a continuation-in-part and claims the benefit of priority under 35 U.S.C. §120 of U.S. patent application Ser. No. 10/746,846, filed on Dec. 24, 2003, entitled ...

Implantable Electroacupuncture System and Method

A method comprises generating, by an implantable stimulator, stimulation sessions at a duty cycle that is less than 0.05 and applying, by the implantable stimulator, the stimulation sessions to a patient. The duty cycle is a ratio of T3 to T4. Each stimulation session included in the stimulation sessions has a duration of T3 minutes and occurs at a rate of once every T4 minutes. 1. A method comprising: the duty cycle is a ratio of T3 to T4,', 'each stimulation session included in the stimulation sessions has a duration of T3 minutes and occurs at a rate of once every T4 minutes, and', 'the implantable stimulator comprises a central electrode of a first polarity centrally located on a first surface of a housing of the implantable stimulator and an annular electrode of a second polarity and that is spaced apart from the central electrode; and, 'generating, by an implantable stimulator, stimulation sessions at a duty cycle that is less than 0.05, wherein'}applying, by the implantable stimulator, the stimulation sessions by way of the central electrode and the annular electrode to a patient.2. The method of claim 1 , wherein the implantable stimulator is powered by a rechargeable battery.3. The method of claim 2 , further comprising receiving claim 2 , by the implantable stimulator from an external controller claim 2 , a power signal configured to recharge the rechargeable battery.4. The method of claim 1 , wherein the implantable stimulator is powered by a primary battery.5. The method of claim 4 , wherein the primary battery has an internal impedance greater than 5 ohms.6. The method of claim 1 , wherein the housing of the implantable stimulator is coin-sized and coin-shaped.7. The method of claim 1 , wherein the annular electrode is located on the first surface of the housing.8. The method of claim 1 , wherein the annular electrode comprises a ring electrode located around a perimeter edge of the housing.9. The method of claim 1 , wherein the applying of the ...

Insert Tool for Selectively Powering an Implant Unit

An implant unit delivery tool is disclosed having an implant tool and an implant activator. The implant tool may be configured to retain an implant unit during an implantation procedure in which the implant unit is fixated to tissue. The implant activator may be associated with the implant tool. Additionally, the implant activator may be configured to selectively transfer power to the implant unit during the implantation procedure to cause modulation of at least one nerve in the body of a subject prior to final fixation of the implant unit to the tissue. 112-. (canceled)13. A method of testing the functionality of an implant unit , the method comprising:moving an implant activator from a first position to a second position on a delivery tool, prior to final fixation of an implant unit by the delivery tool; andtransferring power from the implant activator to the implant unit when the implant activator is in the second position,wherein transferring power to the implant unit causes modulation of at least one nerve in the body of a subject.14. The method of claim 13 , wherein power is wirelessly transferred from the implant activator to the implant unit.15. The method of claim 13 , wherein the implant activator includes a power source configured to supply the power to the implant unit.16. The method of claim 15 , wherein the power source is a battery.17. The method of claim 13 , wherein the second position is closer to the implant unit than the first position.18. The method of claim 13 , wherein moving the implant activator from the first position to the second position includes sliding the implant activator along a track on the delivery tool.19. The method of claim 18 , further including selectively activating the implant activator and causing the implant activator to move toward and away from the implant unit with a slidable engagement portion.20. The method of claim 13 , further including:determining that an implant location is suitable based on one or more patient ...

METHODS AND APPARATUSES FOR REMODELING TISSUE OF OR ADJACENT TO A BODY PASSAGE

Medical devices and methods for making and using the same are disclosed. An example method may include a method for treating a patient having congestive heart failure. The method may include positioning an expandable balloon in a renal artery of the patient. The expandable balloon may include a plurality of electrode assemblies. At least some of the electrode assemblies each may include at least two bipolar electrode pairs. The two bipolar electrode pairs may be longitudinally and circumferentially offset from one another. The method may also include expanding the balloon in the renal artery such that at least some of the bipolar electrode pairs are electrically coupled to a wall of the renal artery and energizing at least some of the bipolar electrode pairs so as to therapeutically alter at least one nerve proximate the renal artery to treat the patient's congestive heart failure. 1. A method for treating a patient , the method comprising:positioning an expandable balloon within a lumen of the patient's body, the expandable balloon including a plurality of electrode assemblies, at least some of the electrode assemblies each including at least two bipolar electrode pairs, the two bipolar electrode pairs being longitudinally and circumferentially offset from one another;expanding the balloon in the lumen so that at least some of the bipolar electrode pairs are electrically coupled to a wall of the lumen; andenergizing at least some of the bipolar electrode pairs so as to therapeutically alter at least one nerve proximate the lumen so that a condition of the patient is mitigated,wherein energizing includes using a plurality of temperature sensors to adjust an energy output of the bipolar electrode pairs, each temperature sensor positioned between one of the bipolar electrode pairs, andwherein energizing includes using a processor to adjust the energy output of the bipolar electrode pairs in response to monitoring feedback from the plurality of temperature sensors.2. ...

VAGUS NERVE AND CAROTID BARORECEPTOR STIMULATION SYSTEM

Systems and methods are provided for delivering vagus nerve stimulation and carotid baroreceptor stimulation to patients for treating chronic heart failure and hypertension. The vagus nerve stimulation and carotid baroreceptor stimulation therapies may be provided using a single implantable pulse generator, which can coordinate delivery of the therapies. 1. An implantable neurostimulation system , comprising:a pulse generation module comprising a control system, a vagus nerve stimulation (VNS) subsystem, and an implantable carotid baroreceptor stimulation (CBS) subsystem;a first VNS electrode assembly coupled to the pulse generation module, said first VNS electrode assembly configured to couple to and deliver electrical stimulation to a vagus nerve; anda first CBS electrode assembly coupled to the pulse generation module, said first CBS electrode assembly configured to couple to and deliver electrical stimulation to carotid baroreceptors.2. The system according to claim 1 , wherein:the control system is configured to activate the VNS subsystem to deliver electrical energy to the first VNS electrode assembly and to activate the CBS subsystem to deliver electrical energy to the first CBS electrode assembly.3. The system according to claim 1 , further comprising:a first lead assembly coupled to the pulse generation module, said first lead assembly comprising the first VNS electrode assembly and the first CBS electrode assembly.4. The system according to claim 3 , wherein:the first lead assembly comprises a bifurcated portion coupled to a first VNS lead portion and a first CBS lead portion, wherein the first VNS electrode assembly is provided at a distal end of the first VNS lead portion and the first CBS electrode assembly is provided at a distal end of the first CBS lead portion.5. The system according to claim 3 , wherein:the first lead assembly comprises a cuff portion configured to wrap around both the vagus nerve and a carotid artery, said first VNS electrode ...

Head pain management device having an antenna

A device may include a primary antenna configured to be located external to a subject and at least one processor in electrical communication with the primary antenna. The at least one processor may be configured to cause transmission of a primary signal from the primary antenna to an implantable device, wherein the implantable device includes at least one pair of modulation electrodes. The at least one processor may be further configured to adjust one or more characteristics of the primary signal to generate a sub-modulation control signal adapted so as not to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device and to generate a modulation control signal adapted so as to cause a neuromuscular modulation inducing current at the at least one pair of modulation electrodes when received by the implantable device.

MODULATING AFFERENT SIGNALS TO TREAT MEDICAL CONDITIONS

This document provides methods and materials for modulating afferent nerve signals to treat medical conditions such as CHF, CHF respiration, dyspnea, peripheral vascular disease (e.g., peripheral arterial disease or venous insufficiency), hypertension (e.g., age-associated hypertension, resistant hypertension, or chronic refractory hypertension), COPD, sleep apnea, and chronic forms of lung disease where muscle dysfunction is a part of the disease pathophysiology. For example, methods and materials involved in using electrical and/or chemical techniques to block or reduce afferent nerve signals (e.g., nerve signals of group III and/or IV afferents coming from skeletal muscle and/or the kidneys) are provided.

Methods and Apparatuses for Stimulating Blood Vessels in Order to Control, Treat, and/or Prevent a Hemorrhage

Methods of preventing, treating, and/or controlling a hemorrhage in an organ of a patient include providing electrical stimulation to the arteries, veins, nerves innervating the arteries or veins, or walls of the organ. The apparatus has at least one electrode operably connected to a stimulus generator and placed in electrical communication with an artery, vein, nerve, or organ wall. An electrical stimulus generator causes an electrical stimulus to be administered to the artery, vein, nerve, or wall through the at least one electrode, where the electrical stimulus is effective for preventing, treating, and/or controlling a hemorrhage. 1. A method of treating a gastrointestinal condition in a subject , the method comprising:providing an apparatus comprising at least one electrode operably connected to a stimulus generator;placing the at least one electrode in direct contact with a portion of a hepatic artery in order to electrically stimulate the hepatic artery; andcausing the stimulus generator to generate an electrical stimulus administered to the portion of the hepatic artery through the at least one electrode, wherein the electrical stimulus is effective to alter a flow of blood into the subject's gastrointestinal tract.2. The method of further comprising the steps of:providing a second electrode operably connected to a stimulus generator; an artery, other than the hepatic artery, of the gastrointestinal vasculature of the subject,', 'a vein of the gastrointestinal vasculature of the subject,', 'a nerve supplying an artery of the gastrointestinal vasculature of the subject, and', 'a nerve supplying a vein of the gastrointestinal vasculature of the subject; and, 'placing the second electrode in electrical communication with a target comprising one or more of the followingcausing the stimulus generator to generate an electrical stimulus administered to the target through the second electrode, wherein the electrical stimulus is effective for treating the ...

IMPLANTABLE BLOOD PRESSURE MONITOR

A method for monitoring blood pressure includes sensing and storing sympathetic nerve activity data of a patient via a recording lead of an implantable medical device. Changes in sympathetic nerve activity from the nerve activity data are determined. Corresponding changes in blood pressure are determined from the changes in sympathetic nerve activity. An alert signal and/or modification of therapy can be provided. 120-. (canceled)21. A method for monitoring blood pressure of a human patient , the method comprising:implanting in the patient a medical device including a processor and a storage module, wherein the medical device is operably coupled to a recording lead;positioning a distal end of the recording lead adjacent a post-ganglionic nerve ending for a kidney of the patient;receiving, via the recording lead, sympathetic nerve activity of the patient;comparing changes in sympathetic nerve activity to a patient-specific threshold value; andproviding an alert signal indicative of a blood pressure status of the patient via the medical device.22. The method of wherein providing an alert signal indicative of a blood pressure status of the patient comprises providing an alert signal to the patient.23. The method of wherein providing an alert signal indicative of a blood pressure status of the patient comprises wirelessly transmitting data to a medical center.24. The method of wherein receiving claim 21 , via the recording lead claim 21 , sympathetic nerve activity of the patient further comprises storing the received sympathetic nerve activity as stored nerve activity data in the storage module claim 21 , and wherein the method further comprises:wirelessly transmitting the stored nerve activity data from the medical device to a medical center via an external handheld medical monitor.25. The method of claim 21 , further comprising wirelessly communicating with the medical device via a telemetry programmer external to the patient.26. The method of claim 21 , further ...

MODULATING AFFERENT SIGNALS TO TREAT MEDICAL CONDITIONS

This document provides methods and materials for modulating afferent nerve signals to treat medical conditions such as CHF, CHF respiration, dyspnea, peripheral vascular disease (e.g., peripheral arterial disease or venous insufficiency), hypertension (e.g., age-associated hypertension, resistant hypertension, or chronic refractory hypertension), COPD, sleep apnea, and chronic forms of lung disease where muscle dysfunction is a part of the disease pathophysiology. For example, methods and materials involved in using electrical and/or chemical techniques to block or reduce afferent nerve signals (e.g., nerve signals of group III and/or IV afferents coming from skeletal muscle and/or the kidneys) are provided. 1. A method for increasing exercise tolerance of a mammal having heart failure , wherein said method comprises:(a) identifying a mammal having heart failure and reduced exercise tolerance, and(b) applying an electrical therapy signal to a muscle or kidney afferent nerve of said mammal under conditions wherein afferent nerve signals of said muscle or kidney afferent nerve are reduced or blocked.2. The method of claim 1 , wherein said mammal is a human.3. The method of claim 1 , wherein said method comprises implanting an electrode device within said mammal.4. The method of claim 1 , wherein said electrical therapy signal comprises a frequency between about 1 and about 100 Hz claim 1 , a current intensity between about 1 and about 10 μA claim 1 , and a pulse width of about 1 to about 10 milliseconds.5. The method of claim 1 , wherein said method comprises applying said electrical therapy signal to a muscle afferent nerve.67-. (canceled)8. The method of claim 1 , wherein said method comprises applying said electrical therapy signal to a kidney afferent nerve.910-. (canceled)11. The method of claim 1 , wherein said electrical therapy signal is delivered by an electrode connected to an implanted neurostimulator control unit.12. The method of claim 1 , wherein said ...

METHODS FOR MODULATING RENAL NERVE TISSUE AND ASSOCIATED SYSTEMS AND DEVICES

Methods for treating a patient using therapeutic renal neuromodulation and associated devices, system, and methods are disclosed herein. One aspect of the present technology is directed to neuromodulating nerve tissue in selected anatomical regions. In one embodiment, the method can include intravascularly positioning a neuromodulation element of a catheter within renal vasculature of a human patient and modulating nerve tissue within an anatomical region extending circumferentially around a branch vessel along a proximal-most longitudinal length of the branch vessel (e.g., between about 1 mm to about 12 mm distal to a bifurcation). The method can also include positioning the neuromodulation element within a second branch vessel and modulating nerve tissue within an anatomical region extending circumferentially around the second branch vessel along a proximal-most longitudinal length of the second branch vessel (e.g., between about 1 mm to about 12 mm distal to a bifurcation). 1. A method , comprising: a main vessel directly connected to an aorta of the patient and extending distally toward a kidney,', 'a bifurcation at a distal end of the main vessel, and', 'a branch vessel distal to the bifurcation;, 'intravascularly positioning a neuromodulation element of a catheter within renal vasculature of a human patient, the renal vasculature including—'}modulating nerve tissue within an anatomical region extending circumferentially around the branch vessel along a longitudinal length of the branch vessel between about 1 mm to about 7 mm distal to the bifurcation.2. The method of wherein intravascularly positioning a neuromodulation element of a catheter within renal vasculature of a human patient includes intravascularly positioning the neuromodulation element of the catheter within a first branch vessel claim 1 , and wherein the method further includes intravascularly positioning the neuromodulation element of the catheter within a second branch vessel.3. The method of ...

Devices and methods for control of blood pressure

Apparatus and methods are described including an implantable device shaped to define (a) at least two artery-contact regions, the artery-contact regions comprising struts that are configured to stretch an arterial wall by applying pressure to the arterial wall, and (b) at least two crimping regions that comprise locking mechanisms configured to prevent the crimping regions from becoming crimped due to pressure from the wall of the artery on the artery-contact regions. The crimping regions are configured to be crimped during insertion of the device, via a catheter, by the locking mechanisms being unlocked during insertion of the device. Other embodiments are also described.

PADDLE LEADS CONFIGURED FOR SUTURE FIXATION

Various embodiments concern an implantable paddle lead. The paddle can be attached to a distal portion of an elongate lead body. The paddle can comprise a main panel and a ridge that peripherally surrounds the main panel. The main panel can comprise a first face and a second face opposite the first face. One or more electrodes can be exposed on the first face but not exposed on the second face. The paddles can be sutured to anatomical structures. The sutures can be threaded through the main panel but not through the ridge. The paddle can be thicker along the ridge than along the main panel. 1. An implantable lead comprising:an elongated lead body having a proximal portion and a distal portion;at least one conductor extending within the elongated lead body;at least one electrode electrically connected to the at least one conductor; anda paddle attached to the distal portion of the lead body, the paddle comprising a main panel and a ridge on a periphery of the main panel, the main panel comprising a first face and a second face opposite the first face, the at least one electrode exposed on the first face, wherein the paddle is thicker along the ridge than along the main panel.2. The lead of claim 1 , wherein the ridge is raised from the first face of the main panel.3. The lead of either of or claim 1 , wherein the paddle comprises a distal side claim 1 , a first lateral side claim 1 , and a second lateral side opposite the first lateral side claim 1 , and wherein the ridge peripherally surrounds the main panel on the distal side claim 1 , the first lateral side claim 1 , and the second lateral side of the paddle.4. The lead of claim 3 , wherein the first and the second lateral sides are configured to wrap partially around an anatomical structure.5. The lead of claim 4 , wherein the anatomical structure is a blood vessel.6. The lead of any preceding claim claim 4 , wherein each of the at least one electrode is not exposed on the second face.7. The lead of any preceding ...

METHOD OF REDUCING RENAL HYPERTENSION AND COMPUTER-READABLE MEDIUM

A method of reducing renal hypertension applied for electrically stimulating a target zone of an organism having a symptom of renal hypertension by using an electronic stimulation device. The electronic stimulation device comprises at least one electronic stimulation unit. The electronic stimulation unit includes at least one first electrode and at least one second electrode. The method includes the following steps. The electrical stimulation unit is placed near the target zone. The electrical stimulation unit generates an electrical stimulation signal and the electrical stimulation signal is introduced to the target zone so as to stimulate the target zone. An electric field is generated between the first electrode and the second electrode and covers the target zone. The strength of the electric field ranges from 100V/m to 1000V/m. 1. A method for reducing renal hypertension applied to electrically stimulate a target zone of an organism by an electrical stimulation device , wherein the electrical stimulation device includes at least an electrical stimulation unit and the electrical stimulation unit includes at least a first electrode and a second electrode , the method comprising:placing the electrical stimulation unit near the target zone; anddelivering a first electrical stimulation signal by the electrical stimulation unit to electrically stimulate the target zone,wherein an electric field covering the target zone is generated between the first electrode and the second electrode according to the first electrical stimulation signal, and a strength of the electric field ranges from 100 V/m to 1000 V/m.2. The method according to claim 1 , wherein the first electrical stimulation signal is a pulse signal and its pulse repetition frequency ranges from 0 to 1 KHz.3. The method according to claim 1 , wherein the frequency of the first electrical stimulation signal ranges from 200 KHz to 1000 KHz.4. The method according to claim 3 , wherein the frequency of the first ...

DEVICES AND METHODS FOR REDUCING INTRATHORACIC PRESSURE

Devices and methods are provided to treat acute and chronic heart failure by using one or more implantable or non-implantable sensors along with phrenic nerve stimulation to reduce intrathoracic pressure and thereby reduce pulmonary artery, atrial, and ventricular pressures leading to reduced complications and hospitalization. 1. A method for treating respiratory disorders , comprising:sensing a subject undergoing intrinsic respiration via one or multiple sensors positioned internally or externally within the patient;stimulating a phrenic nerve of the subject via an electrode positioned within a subclavian vessel in proximity to the phrenic nerve at least during a portion of an exhalation and/or rest cycle to maintain the diaphragm contracted relative to a non-stimulated diaphragm during the exhalation and/or rest cycle over a sustained period of time via an electrode to increase a functional residual capacity of the subject such that the mean or average intrathoracic pressure is decreased.2. The method of further comprising further stimulating the phrenic nerve during the portion of the exhalation and/or rest cycle such that at least one breath is augmented to further increase the functional residual capacity of the subject.3. The method of wherein stimulating the phrenic nerve comprises positioning the electrode over a cardiac lead within the subclavian vessel.4. The method of further comprising monitoring of a cardiac output by monitoring one or more of a pulmonary artery claim 1 , right ventricle claim 1 , left atrium claim 1 , left ventricle pressures claim 1 , cardiac contractility claim 1 , and/or cardiac and intrathoracic impedances.5. The method of wherein the stimulating of the phrenic nerve comprises adjusting a stimulation applied to the phrenic nerve in response to the physiologic parameter such that an initial pressure within a thoracic chamber is reduced.6. The method of wherein the stimulating of the phrenic nerve comprises stimulating to improve a ...

ACQUIRING NERVE ACTIVITY FROM CAROTID BODY AND/OR SINUS

An exemplary includes acquiring an electroneurogram of the right carotid sinus nerve or the left carotid sinus nerve, analyzing the electroneurogram for at least one of chemosensory information and barosensory information and calling for one or more therapeutic actions based at least in part on the analyzing. Therapeutic actions may aim to treat conditions such as sleep apnea, an increase in metabolic demand, hypoglycemia, hypertension, renal failure, and congestive heart failure. Other exemplary methods, devices, systems, etc., are also disclosed. 1. A method for diagnosing an increase in metabolic demand comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least one member of the group consisting of a decrease in ventilation rate, an increase in blood carbon dioxide concentration, a decrease in blood oxygen concentration and a decrease in blood glucose concentration; andbased at least in part on the analyzing, determining if metabolic demand increased.2. The method of further comprising claim 1 , if metabolic demand increased claim 1 , delivering a therapy to increase heart rate.3. A method for diagnosing hypoglycemia comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least one member of the group consisting of a decrease in blood glucose concentration and a decrease in blood pH; andbased at least in part on the analyzing, determining if hypoglycemia exists.4. The method of further comprising claim 3 , if hypoglycemia exists claim 3 , issuing an alert.5. The method of further comprising claim 3 , if hypoglycemia exists claim 3 , delivering a therapy to increase sympathetic tone.6. A method for diagnosing hypertension comprising:acquiring an electroneurogram of carotid sinus nerve activity;analyzing the electroneurogram for at least a change in blood pressure; andbased at least in part on the analyzing, determining if hypertension exists.7. The ...

Neuromodulation systems having nerve monitoring assemblies and associated devices, systems, and methods

Neuromodulation systems with nerve monitoring assemblies and associated devices, systems, and methods are disclosed herein. A neuromodulation system configured in accordance with some embodiments of the present technology can include, for example, a generator, a nerve monitoring assembly configured to detect electroneurogram (ENG) signals, and a neuromodulation catheter. The neuromodulation catheter can include an elongated shaft with a distal portion and a proximal portion. The distal portion of the shaft can include an array of electrodes configured to detect nerve activity from within a blood vessel of a human. The proximal portion of the shaft can include at least one connector that operably couples the electrodes to the generator and to the nerve monitoring assembly.

Sympathetic ganglion stimulation apparatus for treatment of hyperhidrosis, Raynauds phenomenon, cerebral ischemia, asthma and hypertension

Apparatuses for treatment of hyperhidrosis, Raynaud's phenomenon, cerebral ischemia and asthma and hypertension by nerve stimulation are disclosed. In particular, the invention relates to the improvement of these conditions by stimulating at least one ganglion selected from the group consisting of T-1 through T-4 ganglia, cervical ganglia, renal nerve or combinations thereof with an implantable, wireless, battery-less and lead-less stimulator. Stimulations of the ganglion may be carried out with pulsed radiofrequency, thermal energy or optical irradiation. 1. A stimulator for treating a disease of a patient diagnosed with at least one of hyperhidrosis , Raynaud's phenomenon , cerebral ischemia , asthma or hypertension , the stimulator comprises:a remote controller;a plurality of electrodes;a telemetry circuit configured for bilateral data transmission that provides pulsed radiofrequency via the plurality of electrodes to stimulate at least one ganglion along the sympathetic nerve chain;a coil that allows the telemetry circuit to be wirelessly controlled and charged by the remote controller; andan electrical sensor means that monitors the electrical states of the at least one ganglion and the telemetry circuit wherein the stimulation parameters of the pulsed radiofrequency are adjusted based on the monitored electrical states.2. The stimulator as in claim 1 , wherein the at least one ganglion is selected from the group consisting of T-1 through T-4 ganglia claim 1 , stellate ganglia claim 1 , renal ganglia and combinations thereof.3. The stimulator of claim 1 , wherein the stimulation parameters comprise the pulse frequency claim 1 , pulse width duration claim 1 , current amplitude claim 1 , voltage amplitude claim 1 , duty cycle and waveform of the pulsed radio frequency.4. The stimulator of claim 1 , wherein the telemetry circuit is implemented with CMOS technology.5. The stimulator of claim 1 , wherein the remote controller comprises a Class-E power amplifier.6. ...

METHODS FOR THERAPEUTIC RENAL NEUROMODULATION

Methods and apparatus are provided for treating hypertension, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney. 1. A method for treating hypertension , the method comprising:modulating a function of a neural fiber that contributes to renal function of a kidney of a patient,wherein modulating the function of the neural fiber further comprises modulating the function without completely physically severing the neural fiber.2. The method of claim 1 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber via an electric field.3. The method of claim 2 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a pulsed electric field.4. The method of claim 2 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a stimulation electric field.5. The method of claim 1 , wherein modulating the function of the neural fiber further comprises delivering a neuromodulatory agent to the neural fiber.6. The method of claim 1 , wherein modulating the function of the neural fiber further comprises at ...

METHODS FOR CATHETER-BASED RENAL NEUROMODULATION

Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally. 125-. (canceled)26. A method for catheter-based renal neuromodulation , the method comprising:intravascularly positioning a catheter in a reduced profile delivery configuration within a renal artery of a human patient and adjacent to renal nerves that innervate a kidney of the patient;transforming an expandable electrode at a distal region of the catheter from the reduced profile delivery configuration to a treatment configuration,wherein the expandable electrode comprises a helical configuration, and wherein, in the treatment configuration, the expandable electrode is sized and shaped such that the helical electrode contacts an inner wall of the renal artery of the patient; anddelivering an electric field between the expandable electrode and a ground pad coupled to an exterior of the patient, thereby thermally inhibiting neural communication along the renal nerves,wherein delivering the electric field and thermally inhibiting neural communication along the renal nerves results in a therapeutically beneficial reduction in blood pressure of the patient.27. The method of wherein the helical member comprises a self-expanding material.28. The method of wherein the helical member comprises nitinol.29. The method of wherein the catheter further comprises an expandable element proximal of the expandable electrode claim 26 , and wherein the method further comprises expanding the expandable element into ...

Implant sleep apnea treatment device including an antenna

A sleep apnea treatment device may include a flexible carrier configured to be implanted in a body of a subject. The device may also include at least one electrode disposed on the flexible carrier, the at least one electrode being configured to modulate nerve fibers of the subject. A flexible antenna may be disposed on the flexible carrier, the flexible antenna electrically connected to the at least one electrode in a manner permitting at least some energy received by the flexible antenna to be transferred to the at least one electrode. The flexible antenna may include: at least a first conductive trace arranged on a first side of the flexible carrier, the at least a first conductive trace defining at least a first elongated space between portions thereof; and at least a second conductive trace arranged on a second side of the flexible carrier, the at least a second conductive trace defining at least a second elongated space between portions thereof, wherein the at least a first conductive trace is at least partially offset from the at least a second conductive trace such that portions of the first conductive trace overly the at least a second elongated space and wherein portions of the second conductive trace underlay the at least a first elongated space.

Contingent cardio-protection for epilepsy patients

Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase.

Circuits and Methods for Using a High Impedance, Thin, Coin-Cell Type Battery in an Implantable Electroacupuncture Device

An implantable electroacupuncture device for treating a medical condition of a patient through application of electroacupuncture stimulation pulses to a target tissue location within the patient includes 1) a housing configured to be implanted beneath a skin surface of the patient, 2) pulse generation circuitry located within the housing and electrically coupled to at least two electrodes, the pulse generation circuitry being adapted to deliver stimulation sessions by way of the at least two electrodes to the target tissue location in accordance with a stimulation regimen, and 3) a primary battery contained within the housing and electrically coupled to the pulse generation circuitry, the primary battery having an internal impedance greater than 5 ohms and a capacity of less than 60 mAh, wherein the primary battery is the only battery that provides power to the pulse generation circuitry. 1. An implantable electroacupuncture device for treating a medical condition of a patient through application of electroacupuncture stimulation pulses to a target tissue location within the patient , comprising:a housing configured to be implanted beneath a skin surface of the patient and having a first surface adapted to face inwardly into tissue of the patient at or near the target tissue location;pulse generation circuitry located within the housing and electrically coupled to at least two electrodes, the pulse generation circuitry being adapted to deliver stimulation sessions by way of the at least two electrodes to the target tissue location in accordance with a stimulation regimen, the stimulation sessions each including a plurality of the electroacupuncture stimulation pulses, the stimulation regimen requiring that each stimulation session included in the stimulation sessions have a duration of T3 minutes and a rate of occurrence of once every T4 minutes, wherein a ratio of T3 to T4 is no greater than 0.05; anda primary battery contained within the housing and electrically ...

A SYSTEM FOR DECREASING THE BLOOD PRESSURE

A blood pressure decreasing system that decreases blood pressure of a patient by noninvasively blocking the sympathetic innervation of the kidney, blocking all three pathways of the sympathetic nerves to adrenal gland medulla and expanding the renal artery of the patient. The blood pressure decreasing system has at least one sensor for measuring the blood pressure of the patient and generates systolic blood pressure value and/or diastolic blood pressure value; at least two electrodes that are placed to skin dermatomal of the patient; at least one stimulator that sends electrical signals to electrodes in order to block the sympathetic nerve innervation to arterial smooth muscle and kidney, all three pathways of the sympathetic nerves to adrenal medulla and expand renal artery of the patient; and at least one control unit, which receives the blood pressure values from said sensor, compares received values with predetermined threshold values and controls the stimulator. 1. A blood pressure decreasing system for decreasing blood pressure of a patient by blocking the sympathetic nerves to kidney and all three sympathetic pathways to adrenal gland medulla accompanied by expansion of the renal artery of the patient , characterized by comprising;at least one sensor for measuring the blood pressure of said patient and generating systolic blood pressure value and/or diastolic blood pressure value;at least two electrodes that are suitable to be placed over T10 and/or T12 and/or L4 and/or L5 dermatomes of said patient;at least one stimulator for sending electrical signals to said electrodes for blocking the sympathetic nerve innervation to arterial smooth muscle of the renal artery, kidney and all three pathways of the sympathetic branches to adrenal gland medulla, and also for expanding renal and suprarenal gland arteries of the patient andat least one control unit, for receiving the blood pressure values from said sensor, comparing received values with predetermined threshold ...

Methods and Apparatus for Adjusting Neurostimulation Intensity Using Evoked Responses

A neurostimulation system provides for capture verification and stimulation intensity adjustment to ensure effectiveness of vagus nerve stimulation in modulating one or more target functions in a patient. In various embodiments, stimulation is applied to the vagus nerve, and evoked responses are detected to verify that the stimulation captures the vagus nerve and to adjust one or more stimulation parameters that control the stimulation intensity.

CONTINGENT CARDIO-PROTECTION FOR EPILEPSY PATIENTS

Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase. 1. A system for treating a medical condition in a patient , comprising:a sensor for sensing at least one body data stream;a heart rate unit capable of determining a heart rate and a heart rate oscillation of the patient based on the at least one body data stream; anda logic unit configured via one or more processors to compare a monitored value which is determined based on one or more data points relating to the heart rate and to the heart rate oscillation to a threshold value, the logic unit further configured to determine a triggering event based on the comparison;wherein the one or more processors are configured to initiate one or more actions to change the heart rate of the patient based on the determination of the triggering event.2. The system of claim 1 , further comprising at least one electrode coupled to a vagus nerve of the patient and a programmable electrical signal generator.3. The system of claim 2 , wherein the one or more processors are configured to increase a sympathetic tone to increase the heart rate of the patient.4. The system of claim 2 , wherein the one or more processors are configured to decrease a parasympathetic tone to increase the heart rate of the patient.5. The system of claim 2 , wherein the one or more processors are configured to decrease a sympathetic tone to decrease the heart rate of the patient.6. The system of claim 2 , wherein the one or more processors are configured to increase a parasympathetic tone to decrease the heart rate of the patient.7. The system of claim 1 , further comprising a seizure ...

Methods for renal neuromodulation

Methods and apparatus are provided for treating contrast nephropathy, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney. 120-. (canceled)21. A method for treating hypertension , the method comprising:modulating a function of a neural fiber that contributes to renal function of a kidney of a patient,wherein modulating the function of the neural fiber further comprises modulating the function without completely physically severing the neural fiber.22. The method of claim 21 , wherein modulating the function of the neural fiber further comprises modulating the function of the neural fiber via an electric field.23. The method of claim 22 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a pulsed electric field.24. The method of claim 22 , wherein modulating the function of the neural fiber via an electric field further comprises exposing the neural fiber to a stimulation electric field.25. The method of claim 21 , wherein modulating the function of the neural fiber further comprises delivering a neuromodulatory agent to the neural fiber.26. The method of claim 21 , wherein modulating the function of ...

SYSTEM AND METHOD FOR LOCATING AND IDENTIFYING THE FUNCTIONAL NERVES INNERVATING THE WALL OF ARTERIES AND CATHETERS FOR SAME

System and method for locating and identifying nerves innervating the wall of arteries such as the renal artery are disclosed. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The method includes at least the steps to evaluate a change in physiological parameters after energy is delivered to an arterial wall; and to determine the type of nerve that the energy was directed to (none, sympathetic or parasympathetic) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using this method. Also provided are catheters for performing the mapping and ablating functions. 135-. (canceled)36. A method of mapping a parasympathetic renal nerve , comprising the steps of:a) introducing a catheter into the lumen of a renal vein such that a tip of said catheter contacts a site on an inner wall of said renal vein;b) measuring one or more physiological parameters to obtain baseline measurements before introducing an electrical current to the site, said physiological parameters are selected from the group consisting of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate;c) applying electrical stimulation by introducing said electrical current to the site via the catheter, wherein said electrical current is controlled to be sufficient to elicit changes in said physiological parameters when there is an underlying parasympathetic nerve at the site; andd) measuring said physiological parameters at a specific time interval after each electrical stimulation, wherein a decrease of said physiological parameters below the baseline measurements after said electrical ...

SYSTEM AND METHOD FOR MAPPING THE FUNCTIONAL NERVES INNERVATING THE WALL OF ARTERIES, 3-D MAPPING AND CATHETERS FOR SAME

Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods includes evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions. 120-. (canceled)21. A method for generating a map of innervated areas in a renal artery , said method comprises the steps of:a. introducing a catheter into said renal artery such that the tip of said catheter contacts a site on an inner wall of said renal artery;b. measuring one or more physiological parameters to obtain baseline measurements before introducing an electrical current to the site, said physiological parameters are selected from the group consisting of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate;c. applying an electrical stimulation by introducing an electrical current to the site via the catheter, wherein said electrical current is controlled to be sufficient to elicit changes in said physiological parameters when there is an underlying nerve at the site; andd. measuring said physiological parameters at a specific time interval after the electrical stimulation, wherein an increase of said physiological parameters over the baseline measurements after said electrical ...

SYSTEMS AND METHODS FOR MONITORING AUTONOMIC HEALTH

A system for monitoring autonomic health may include an autonomic nerve stimulation (ANS) dose delivery system and a response extractor. The response extractor may be configured to record physiological parameter values including first population data that includes evoked response (ER) values corresponding to evoked physiological responses, and second population data that includes reference values that include no effect (NE) values corresponding to times without a physiological response. The response monitor may calculate evoked response metrics (ERMs) using the first and second population data where each of the ERMs may be dependent on background autonomic activity. The response extractor may analyze the ERMs to provide ERM analysis, and provide an indication of autonomic health using the ERM analysis. 1. A method , comprising:delivering an autonomic neural stimulation (ANS) dose, including delivering stimulation pulses to evoke physiological responses; recording first population data, the first population data including evoked response (ER) values corresponding to the evoked physiological responses; and', 'recording second population data, the second population data including reference values that include no effect (NE) values corresponding to times without an evoked physiological response;, 'recording physiological parameter values, includingcalculating evoked response metrics (ERMs) using the first and second population data, each of the ERMs being dependent on background autonomic activity;analyzing the ERMs to provide ERM analysis; andproviding an indication of autonomic health using the ERM analysis.2. The method of claim 1 , wherein analyzing the ERMs includes comparing the ERMs to at least one reference value to provide the ERM analysis used to provide the indication of autonomic health.3. The method of claim 1 , wherein analyzing the ERMs includes trending the ERMs to provide the ERM analysis used to provide the indication of autonomic health.4. The method ...

Methods for Renal Neuromodulation

Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation. 165-. (canceled)66. A method for reducing blood pressure in a human patient , the method comprising:implanting a neural stimulation system in the patient below the patient's skin, wherein the neural stimulation system includes an electric field generator electrically coupled to a ring-shaped electrode positioned adjacent to target nerves of the sympathetic nervous system; anddelivering generated electrical signals from the electric field generator to the target nerves via the ring-shaped electrode, thereby altering the naturally occurring neural signals propagating through the nerves,wherein delivering the generated electrical signals to the target nerves of the patient results in a therapeutically beneficial reduction in blood pressure of the patient.67. The method of wherein delivering generated electrical signals from the electric field generator to the target nerves via the ring-shaped electrode comprises delivering generated stimulation signals to the target nerves.68. The method of wherein delivering generated electrical signals from the electric field generator to the target nerves via the ring-shaped electrode comprises delivering at least two different levels of generated stimulation signals to the target nerves.69. The method of wherein delivering generated electrical signals from the electric field generator to the target nerves via the ring-shaped electrode comprises delivering ...

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. 1. (canceled)2. A vagus nerve stimulator , comprising:a lead with an electrode;a pulse generator configured to cooperate with the electrode to non-selectively stimulate a vagus nerve by propagating action potentials in both afferent axons and efferent axons along the vagus nerve and avoid side effects, including intermittently delivering a pulsed electrical signal as a train of pulses during signal ON times separated by signal OFF time when pulses are not delivered, wherein the train of pulses have a pulse frequency, and the intermittently-delivered pulsed electrical signal has a duty cycle represented as a signal ON time portion of a stimulation period; andat least one leadless electrode configured for use to detect heart rate.3. The vagus nerve stimulator of claim 2 , wherein the pulse generator is configured to use detected heart rate to titrate an intensity of the pulsed electrical signal.4. The vagus nerve stimulator of claim 2 , wherein the duty cycle comprises a value about 17%.5. The vagus nerve stimulator of claim 4 , wherein the pulsed electric signal includes 10 seconds on and 50 seconds off to provide the 17% duty cycle ...

Methods And Systems For Controlling Blood Pressure By Controlling Atrial Pressure

Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced. 1. A system for reducing blood pressure in a patient , the system comprising:a stimulation circuit configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of the patient; andat least one controller configured to execute the delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber,wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.2. The system of claim 1 , wherein the atrial pressure of the atrium resulting from the stimulation causes an increased atrial stretch of the atrium that ...

SYSTEM AND METHOD FOR LOCATING AND IDENTIFYING THE FUNCTIONAL NERVES INNERVATING THE WALL OF ARTERIES AND CATHETERS FOR SAME

System and method for locating and identifying nerves innervating the wall of arteries such as the renal artery are disclosed. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The method includes at least the steps to evaluate a change in physiological parameters after energy is delivered to an arterial wall; and to determine the type of nerve that the energy was directed to (none, sympathetic or parasympathetic) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using this method. Also provided are catheters for performing the mapping and ablating functions. 119-. (canceled)20. A system for mapping a parasympathetic or sympathetic nerve underlying the wall of renal vein , comprising:(i) a catheter configured to deliver electrical current to one or more locations on the inner renal vein wall sufficient to stimulate a nerve underlying said renal vein;(ii) one or more measuring devices for measuring one or more physiological parameters associated with said nerve underlying said renal vein, wherein said physiological parameters are selected from the group consisting of systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate;(iii) a computing device configured to couple to the one or more measuring devices for computing any increase or decrease in the physiological parameters against a baseline; and(iv) a display device for displaying the location or identity of the parasympathetic or sympathetic nerve underlying said renal vein.21. The system of claim 20 , wherein said catheter could also deliver ablative energy selected from the group consisting of ...