WO1997036637A1 - Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation - Google Patents
Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation Download PDFInfo
- Publication number
- WO1997036637A1 WO1997036637A1 PCT/US1997/004891 US9704891W WO9736637A1 WO 1997036637 A1 WO1997036637 A1 WO 1997036637A1 US 9704891 W US9704891 W US 9704891W WO 9736637 A1 WO9736637 A1 WO 9736637A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- rate
- ventricular
- pulse
- vagal stimulation
- vagal
- Prior art date
Links
- 230000002861 ventricular Effects 0.000 title claims abstract description 51
- 230000000638 stimulation Effects 0.000 title claims abstract description 43
- 230000001515 vagal effect Effects 0.000 title claims abstract description 32
- 206010003658 Atrial Fibrillation Diseases 0.000 title claims abstract description 25
- 238000000034 method Methods 0.000 title description 14
- 230000005284 excitation Effects 0.000 claims abstract description 24
- 230000006735 deficit Effects 0.000 claims abstract description 18
- 210000005036 nerve Anatomy 0.000 claims abstract description 8
- 230000004936 stimulating effect Effects 0.000 claims description 16
- 238000012545 processing Methods 0.000 claims description 5
- 238000005259 measurement Methods 0.000 claims 1
- 238000000718 qrs complex Methods 0.000 claims 1
- 210000001186 vagus nerve Anatomy 0.000 abstract description 26
- 230000001746 atrial effect Effects 0.000 description 20
- 230000004044 response Effects 0.000 description 7
- 210000001992 atrioventricular node Anatomy 0.000 description 6
- 230000036772 blood pressure Effects 0.000 description 5
- 230000000747 cardiac effect Effects 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 210000003205 muscle Anatomy 0.000 description 4
- 210000005245 right atrium Anatomy 0.000 description 4
- 238000013459 approach Methods 0.000 description 3
- 206010003119 arrhythmia Diseases 0.000 description 3
- 230000006793 arrhythmia Effects 0.000 description 3
- 210000001367 artery Anatomy 0.000 description 3
- 230000005540 biological transmission Effects 0.000 description 3
- 230000001713 cholinergic effect Effects 0.000 description 3
- 230000001276 controlling effect Effects 0.000 description 3
- 238000001514 detection method Methods 0.000 description 3
- 238000010586 diagram Methods 0.000 description 3
- 238000002474 experimental method Methods 0.000 description 3
- 230000006870 function Effects 0.000 description 3
- 230000036279 refractory period Effects 0.000 description 3
- 210000005241 right ventricle Anatomy 0.000 description 3
- 206010003673 Atrioventricular block complete Diseases 0.000 description 2
- 206010049765 Bradyarrhythmia Diseases 0.000 description 2
- 208000001871 Tachycardia Diseases 0.000 description 2
- 208000006218 bradycardia Diseases 0.000 description 2
- 238000013194 cardioversion Methods 0.000 description 2
- 210000002837 heart atrium Anatomy 0.000 description 2
- 230000001788 irregular Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 238000004904 shortening Methods 0.000 description 2
- 201000002931 third-degree atrioventricular block Diseases 0.000 description 2
- 206010002383 Angina Pectoris Diseases 0.000 description 1
- 206010003130 Arrhythmia supraventricular Diseases 0.000 description 1
- 206010003662 Atrial flutter Diseases 0.000 description 1
- 229920004934 Dacron® Polymers 0.000 description 1
- 208000010271 Heart Block Diseases 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- 208000009378 Low Cardiac Output Diseases 0.000 description 1
- 206010042600 Supraventricular arrhythmias Diseases 0.000 description 1
- 206010049447 Tachyarrhythmia Diseases 0.000 description 1
- 239000004809 Teflon Substances 0.000 description 1
- 229920006362 Teflon® Polymers 0.000 description 1
- OIPILFWXSMYKGL-UHFFFAOYSA-N acetylcholine Chemical compound CC(=O)OCC[N+](C)(C)C OIPILFWXSMYKGL-UHFFFAOYSA-N 0.000 description 1
- 229960004373 acetylcholine Drugs 0.000 description 1
- 230000036982 action potential Effects 0.000 description 1
- 230000003044 adaptive effect Effects 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 206010003668 atrial tachycardia Diseases 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 210000003748 coronary sinus Anatomy 0.000 description 1
- 230000001351 cycling effect Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000001934 delay Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 238000002651 drug therapy Methods 0.000 description 1
- 230000008030 elimination Effects 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 230000002600 fibrillogenic effect Effects 0.000 description 1
- 230000002496 gastric effect Effects 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000001976 improved effect Effects 0.000 description 1
- 230000005764 inhibitory process Effects 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 210000005240 left ventricle Anatomy 0.000 description 1
- 230000010534 mechanism of action Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 230000007383 nerve stimulation Effects 0.000 description 1
- 210000003516 pericardium Anatomy 0.000 description 1
- 239000005020 polyethylene terephthalate Substances 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
- 210000001147 pulmonary artery Anatomy 0.000 description 1
- 238000011160 research Methods 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- 230000033764 rhythmic process Effects 0.000 description 1
- 229920000260 silastic Polymers 0.000 description 1
- 210000001013 sinoatrial node Anatomy 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 210000003270 subclavian artery Anatomy 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000006794 tachycardia Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 210000001170 unmyelinated nerve fiber Anatomy 0.000 description 1
- 208000003663 ventricular fibrillation Diseases 0.000 description 1
- 238000010626 work up procedure Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36114—Cardiac control, e.g. by vagal stimulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36521—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure the parameter being derived from measurement of an electrical impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36585—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by two or more physical parameters
Definitions
- This invention relates to devices and methods for controlling ventricular rate during atrial fibrillation, and more particularly to such devices and methods employing nerve stimulation techniques.
- Atrial tachycardia, flutter and fibrillation are serious arrhythmias resulting in a low cardiac output and limited exercise tolerance.
- arrhythmias are treated with drugs, electric shock (cardioversion) , or surgical destruction of the atrioventricular (A-V) node and pacemaker implantation.
- Drug therapy is not always effective and there are undesirable side effects.
- cardioversion abolishes some of these atrial arrhythmias, they usually return because the cause for the arrhythmia is still present.
- Surgical treatment is successful but leaves the subject with a limited exercise tolerance unless a rate-responsive pacemaker is implanted.
- Acetylcholine hyperpolarizes the S-A node and atrial muscle embranes, reduces the refractory period of atrial muscle and weakens the force of atrial contraction. Cholinergic drive also delays or blocks the transmission of excitation across the A-V node.
- the cholinergic nerves to the heart are the right and left vagii.
- the right vagus innervates the S-A node, the atrial muscle and, to a much lesser degree, the A-V node.
- the left vagus nerve innervates the S-A node and atrial muscle to a lesser degree than it innervates the A-V node. It is well known to physiologists that stimulation of the right vagus nerve predominately slows the S-A node rate and thereby reduces heart rate. Stimulation of the left vagus nerve produces some slowing of the S-A node, prolongation of A-V conduction and partial or total A-V block.
- the A-V node In atrial fibrillation, the A-V node is bombarded with excitations and responds as rapidly as its refractory period will allow, resulting in rapid, irregular ventricular excitations, i.e., R waves, resulting in varying times for ventricular filling. This results in a rapid, irregular pulse with a pulse deficit.
- a pulse deficit exists when a ventricular excitation (R wave) does not produce a blood pressure pulse. The mean blood pressure and cardiac output are both reduced as a result of the pulse deficit.
- Bilgutay et al. Vagal Tuning, J. Thoracic Cardiovas. Surq. 56(l):71-82, July, 1968.
- Bilgutay et al. studied the use of vagal stimulation for treatment of supraventricular arrhythmias, angina pectoris, and heart failure.
- stimulation frequency may be varied in a predetermined pattern from an optimum stimulation frequency, amplitude and duration determined during patient workup, if the initial delivered therapy fails to convert the tachyarrhythmia; however, there is no indication of a suitable pattern or any method of implementing it.
- the device described is designed to generate nerve stimulating pulses having a frequency and amplitude that, while programmable, are fixed once programmed. In essence it is an ON/OFF device that switches state in response to, e.g., the crossing of a heart rate threshold. Such ON/OFF switching, with fixed pulse characteristics, is likely to produce a hunting response, i.e., cycling of the heart rate with episodes of tachycardia.
- the present invention overcomes the foregoing and other disadvantages of the prior art by providing a closed-loop, variable frequency vagal stimulation apparatus for control of ventricular rate during atrial fibrillation.
- the apparatus includes a stimulating means for stimulating a vagal nerve at a stimulation frequency which is varied automatically in response to sensed conditions, and a controller having an output connected to said stimulating means and including means for automatically and continuously adjusting said vagal stimulation frequency as a function of the difference between actual and desired ventricular excitation rates.
- an apparatus for automatically controlling ventricular rate by vagal stimulation to minimize pulse deficit during atrial fibrillation includes a stimulating means for stimulating a vagal nerve at a stimulation frequency which is varied automatically in response to sensed conditions, a means for detecting a ventricular excitation rate, a means for detecting an arterial pulse rate, and a processing means for comparing said ventricular excitation rate and said arterial pulse rate and automatically adjusting said vagal stimulation frequency as a function of the difference between said ventricular excitation rate and said arterial pulse rate.
- a general object of the present invention is to provide an improved method and apparatus for controlling ventricular rate in the presence of atrial fibrillation.
- a further object is to provide effective control of ventricular rate via vagal stimulation.
- Another object of the invention is to provide an effective method and apparatus for stimulating the vagus nerve and thereby reducing ventricular rate enough to eliminate or minimize the pulse deficit which typically occurs during atrial fibrillation.
- FIG. 1 is an illustration of an implanted control unit according to the present invention in its operating environment showing the heart and left and right vagus nerves.
- FIG. 2 is a block diagram of one form of the implanted control unit of FIG. 1.
- FIG. 3 is a block diagram of another form of the implanted control unit of FIG. 1.
- FIG. 4 is a graphical illustration of the relationship between ventricular rate and left vagal stimulation requency.
- FIG. 5 is a graphical illustration of the ratio of R wave rate to arterial pulse rate versus the frequency of left vagal stimulation.
- FIG. 1 illustrates an implantable device according to the present invention in its operating environment in a mammalian body, in which it is operatively connected to the heart and the left vagus nerve.
- Information on the electrical activity of the ventricles and the atria is obtained by a catheter having two pairs of electrodes: electrodes 1 and 2 in the right ventricle (RV) and electrodes 3 and 4 in the right atrium (RA) .
- Electrodes 1 and 2 are designed and positioned to detect a ventricular electrogram, which is supplied to the implanted controller unit 10 which processes the ventricular electrogram and derives therefrom the ventricular excitation rate.
- Electrodes 3 and 4 are designed and positioned to detect an atrial electrogram, which is supplied via the catheter to the implanted control unit, which processes the atrial electrogram.
- the implanted control unit includes logic circuitry or other circuit means for comparing the atrial and ventricular signals in terms of synchronization and rate, and on the basis of that comparison determining whether or not the patient is experiencing atrial fibrillation.
- the implantable device includes a pair of electrodes 5 and 6 attached or adjacent to the left vagus nerve for controlled stimulation thereof.
- One embodiment of the present invention, described below, also includes a sensor of instantaneous blood pressure, in the form of a monopolar impedance-measuring electrode applied to the surface of the subclavian (SC) artery.
- SC subclavian
- a piezoelectric pulse pickup placed alongside an artery could be used.
- a piezoelectric device would generate a voltage pulse and therefore save battery life in an implanted control unit dependent on a battery for operation.
- the two embodiments of the invention to be described below are desirably combined in a single implanted control unit operable in two modes respectively associated with the control algorithms for the first and second embodiments. Both embodiments use an adaptive control system which adjusts to changing cardiac states. It operates only during episodes of atrial fibrillation. It retains, in memory, parameters that were successful in previous episodes of required control and uses this previously learned information to improve controller responses under similar situations. It also uses this information to accelerate controller adjustments in newly encountered situations.
- FIG. 2 depicts in block diagram form, a controller 20 as an important aspect of the implanted control unit.
- the ventricular and atrial signals are supplied from their respective electrodes in the heart to a ventricular electrogram detector 22 and atrial electrogram detector 24, respectively, which digitize the electrograms and supply the digitized signals to controller 20, which responds to the detected ventricular and atrial signals. More specifically, atrial rate is determined on the basis of the interval between atrial waves and is compared to a threshold established as an indication of atrial fibrillation. If desired, the time interval itself may be measured and compared to a time interval threshold for the same purpose.
- the controller is enabled to compare the actual R-wave rate with a target rate 25 entered into the controller via an external programmer 26 (FIG. 1) and, based on the difference between those rates, to control the frequency of the pulses which are generated by a stimulator 28 connected via electrodes 5 and 6 to the left vagus nerve.
- the controller is preferably programmed to apply a low initial frequency, and consequently, to increase the stimulus frequency slowly and incrementally until the ventricular rate matches the operator-selected target rate, and to automatically and continuously adjust the vagal stimulation frequency as a function of the difference between the actual and desired ventricular excitation rates.
- FIG. 4 illustrates the smooth control of ventricular rate that can be exerted by vagal stimulation during atrial fibrillation.
- a steady increase in stimulation frequency enabled the ventricular rate to be decreased smoothly, in an almost linear manner, down to a rate of 35 bpm with a stimulation frequency of 10 pulses/second.
- a pulse width of 100 microseconds ( ⁇ sec.) has been found suitable, and pulse widths up to 2 msec, may also be effective in some applications.
- the pulse width is preferably in the range of 100-200 ⁇ sec. for A and B fibers, and in the range of 500-750 ⁇ sec. for C fibers.
- a suitable implantable stimulator is described in detail in U.S. Patent No. 5,154,172, which is hereby incorporated by reference. Referring to FIG.
- the second embodiment or mode of the present invention operates according to an algorithm designed for elimination of a pulse deficit, i.e., the condition in which an arterial pulse fails to occur in response to an R wave.
- This algorithm does not require the selection of a target ventricular rate and is therefore operator-independent.
- the objective of this closed-loop control method is to identify the lowest stimulus frequency required be applied to the left vagus nerve to achieve a ventricular rate with no pulse deficit.
- the controller 30 is designed and programmed to monitor the blood pressure signal for an arterial pulse after every ventricular excitation (as indicated by the R wave of the ECG) , and, in general terms, to use the pulse deficit to control the frequency of stimuli applied to the left vagus nerve in order to identify the minimum stimulus frequency for which each ventricular excitation produces a blood pressure pulse.
- the controller is programmed to implement an algorithm corresponding generally to the graph illustrated in FIG. 5, although it will be understood that the shape and values of such a graph will vary somewhat for individual patients and that the automatic control algorithm will be varied accordingly.
- the ventricular and atrial electrogram detectors 22 and 24 digitize the electrogram signals and supply them to the controller, which also receives digitized data from an arterial pulse detector 32, described in further detail below.
- the first is recognition that inhibition of impulses traveling from the atria to the ventricles using vagus stimulation is not instantaneous. From the initiation of a train of stimuli applied to the vagus nerve, the onset of slowing of the ventricular (R wave) rate depends somewhat on the frequency of the stimuli in the train; the higher the frequency, the sooner the onset of ventricular slowing. Another important consideration is adoption of an amplitude criterion for pulse counting. During atrial fibrillation, the arterial pulses vary widely in amplitude.
- a pulse should occur in a time window just after the R wave of the ECG, and so the R wave is preferably used to open a time window to measure the peak-to-peak amplitude of the arterial pulse in the window, which is sufficiently long to accommodate the isovolumic period and the pulse transit time to the arterial measuring site.
- the former is on the order of 150 msec, and with a measuring site close to the left ventricle, the latter may amount to 50-100 msec.
- a running average of the pulse amplitude is made, and each newly measured pulse is compared in amplitude to the mean pulse amplitude. Pulses less than a predetermined percentage (20% is presently preferred) of the mean pulse amplitude are treated as absent.
- the amount of pulse deficit is identified by the relationship between R waves and arterial pulse waves over a predetermined interval of time, for example, one minute.
- the controller's response to a pulse deficit is to apply low-frequency stimuli, e.g., initially 1 pulse per second, via stimulator 28. Controller 30 then counts and displays the ratio of R waves to arterial pulses. After 1 minute, if the pulse deficit has not been reduced, the controller increases the frequency of the stimuli applied to the vagus nerve to 2 pulses per second and evaluates the pulse deficit over the next one-minute period. This procedure of evaluating pulse deficit and incrementally increasing stimulus frequency continues until the pulse deficit disappears, or until a low R-wave rate safety limit is reached, at which point the controller maintains the current stimulus frequency.
- An arterial pulse detector 32 suitable for use with the present invention includes a monopolar arterial electrode made from a Teflon-coated stainless steel wire, insulated except at its distal end, which is sutured to a small sheet of Dacron-reinforced Silastic.
- the Dacron sheet carrying the electrode is wrapped around the subclavian artery as shown in FIG. 1, or other convenient artery, and sutured.
- the monopolar arterial electrode operates in conjunction with a reference electrode which is relatively large and located at any convenient site, for example, the metal case of the implanted control unit. Further details of an arterial pulse detector as described above are described in an article by Konrad et al.
- the arterial pulse may be measured directly, e.g., with a piezoelectric pulse pickup as indicated above.
- a suitable electrode presently preferred for attachment to the vagus nerves is a helical cuff electrode described in detail in U.S. Patent Nos. 4,573,481 and 5,154,172, which are hereby incorporated by reference.
- 1 and 2 employ a catheter electrode in the right atrium and ventricle and another electrode on the left vagus nerve.
- An alternate embodiment could use a catheter electrode in the right pulmonary artery to stimulate the left vagus nerve, as described by Cooper et al. (Circ. Res. 1980, 46:48-57). In this way, the principle can be applied using catheter electrodes.
- Another embodiment avoids blood contact by using electrodes applied to the pericardium to detect the atrial and ventricular electrograms.
Abstract
This invention is a closed loop variable frequency vagal stimulation apparatus for control of ventricular rate during atrial fibrillation. In one embodiment the apparatus includes a stimulator applied to the left vagus nerve via electrodes (5, 6) and a proportional controller (20) programmed to automatically and continuously adjust the vagal stimulation frequency proportionally as a function of the difference between actual and desired ventricular excitation rates. In a second embodiment the apparatus includes a vagal nerve stimulator and a controller which automatically adjusts the vagal stimulation frequency as a function of the difference between ventricular excitation rate and arterial pulse rate in order to eliminate or minimize pulse deficit.
Description
METHOD AND APPARATUS USING VAGAL STIMULATION FOR CONTROL OF VENTRICULAR RATE DURING ATRIAL FIBRILLATION
BACKGROUND OF THE INVENTION
This invention relates to devices and methods for controlling ventricular rate during atrial fibrillation, and more particularly to such devices and methods employing nerve stimulation techniques.
Atrial tachycardia, flutter and fibrillation are serious arrhythmias resulting in a low cardiac output and limited exercise tolerance. At present these arrhythmias are treated with drugs, electric shock (cardioversion) , or surgical destruction of the atrioventricular (A-V) node and pacemaker implantation. Drug therapy is not always effective and there are undesirable side effects. Although cardioversion abolishes some of these atrial arrhythmias, they usually return because the cause for the arrhythmia is still present. Surgical treatment is successful but leaves the subject with a limited exercise tolerance unless a rate-responsive pacemaker is implanted. These existing approaches are accepted by the medical community and bio edical engineers as the only practical choices, despite the existence of research reported in the literature for years on the subject of electrophysiological techniques involving stimulation of various nerves.
To understand the mechanism of action of an alternative system, proposed herein, for ventricular rate control by means of control of the number of atrial excitations reaching the ventricles, it is useful to review some aspects of the effect of cholinergic drive on the heart.
Acetylcholine hyperpolarizes the S-A node and atrial muscle
embranes, reduces the refractory period of atrial muscle and weakens the force of atrial contraction. Cholinergic drive also delays or blocks the transmission of excitation across the A-V node.
The cholinergic nerves to the heart are the right and left vagii. The right vagus innervates the S-A node, the atrial muscle and, to a much lesser degree, the A-V node. The left vagus nerve innervates the S-A node and atrial muscle to a lesser degree than it innervates the A-V node. It is well known to physiologists that stimulation of the right vagus nerve predominately slows the S-A node rate and thereby reduces heart rate. Stimulation of the left vagus nerve produces some slowing of the S-A node, prolongation of A-V conduction and partial or total A-V block. We have observed in monophasic atrial electrograms that low-frequency left vagal stimulation causes a dramatic shortening of the duration of the atrial monophasic action potential, indicating shortening of the refractory period. Although the left vagus nerve affects atrial rate to a lesser degree, transmission of excitation across the A-V node is largely regulated by the left vagus nerve.
In atrial fibrillation, the A-V node is bombarded with excitations and responds as rapidly as its refractory period will allow, resulting in rapid, irregular ventricular excitations, i.e., R waves, resulting in varying times for ventricular filling. This results in a rapid, irregular pulse with a pulse deficit. A pulse deficit exists when a ventricular excitation (R wave) does not produce a blood pressure pulse. The mean blood pressure and cardiac output are both reduced as a result of the pulse deficit.
There have been some reports of using electrodes to stimulate the vagus nerve, where such stimulation has an effect on heart rhythm. See, e.g., Bilgutay et al., Vagal Tuning, J. Thoracic Cardiovas. Surq. 56(l):71-82, July, 1968. Bilgutay et al. studied the use of vagal stimulation
for treatment of supraventricular arrhythmias, angina pectoris, and heart failure. Experiments were conducted to determine the effective amplitudes, frequencies, wave shapes and pulse length of the stimulating current to achieve an optimal slowing of the heart rate by stimulating the vagus nerve, the optimal heart rate being defined as the slowest heart rate that could be attained by vagal stimulation without causing A-V dissociation or complete heart block or lowering the ventricular and aortic pressures. The experiments involved the right vagus nerve and resulted in selection of a stimulation amplitude of 6 to 10 volts, a frequency of 10 pulses per second, and 0.2 msec, pulse duration. Voltage increases were noted to decrease heart rate, and a unit triggered by the R waves of the subject's electrocardiogram is described as operating on a servo principle, but apparently in all cases the amplitude and frequency settings are fixed whenever the unit is operating. Bilgutay et al. indicated that the right vagus nerve was stimulated because its distribution is known to be mostly to the sinus node area, but mentioned one experiment in which stimulation of the left vagus slowed the ventricular beats in a dog with complete heart block.
Recognizing the possibility of bradyarrhythmia, one recently proposed approach contemplates the inclusion of cardiac pacing with vagal stimulation. This latter approach to heart rate control, which entails a bradyarrhythmia pacemaker, is described in PCT International Publication No. WO 93/21824, published November 11, 1993. The addition of pacemaker circuitry and related components naturally increases the complexity and cost of the medical device.
The publication mentions that stimulation frequency may be varied in a predetermined pattern from an optimum stimulation frequency, amplitude and duration determined during patient workup, if the initial delivered therapy fails to convert the tachyarrhythmia; however, there is no
indication of a suitable pattern or any method of implementing it. The device described is designed to generate nerve stimulating pulses having a frequency and amplitude that, while programmable, are fixed once programmed. In essence it is an ON/OFF device that switches state in response to, e.g., the crossing of a heart rate threshold. Such ON/OFF switching, with fixed pulse characteristics, is likely to produce a hunting response, i.e., cycling of the heart rate with episodes of tachycardia.
Thus there remains the need for a system that effectively takes advantage of the phenomenon that transmission across the A-V node is largely, but not entirely, regulated by the left vagus nerve, and, more particularly, provides effective control of electrical stimulation of the vagus nerve to control the number of excitations that reach the ventricles during atrial fibrillation.
SUMMARY OF THE INVENTION
The present invention overcomes the foregoing and other disadvantages of the prior art by providing a closed-loop, variable frequency vagal stimulation apparatus for control of ventricular rate during atrial fibrillation. The apparatus includes a stimulating means for stimulating a vagal nerve at a stimulation frequency which is varied automatically in response to sensed conditions, and a controller having an output connected to said stimulating means and including means for automatically and continuously adjusting said vagal stimulation frequency as a function of the difference between actual and desired ventricular excitation rates.
According to another aspect of the present invention, there is provided an apparatus for automatically controlling ventricular rate by vagal stimulation to minimize pulse deficit during atrial fibrillation. The apparatus includes a stimulating means for stimulating a vagal nerve at a stimulation frequency which is varied automatically in response to sensed conditions, a means for detecting a ventricular excitation rate, a means for detecting an arterial pulse rate, and a processing means for comparing said ventricular excitation rate and said arterial pulse rate and automatically adjusting said vagal stimulation frequency as a function of the difference between said ventricular excitation rate and said arterial pulse rate.
A general object of the present invention is to provide an improved method and apparatus for controlling ventricular rate in the presence of atrial fibrillation. A further object is to provide effective control of ventricular rate via vagal stimulation.
Another object of the invention is to provide an effective method and apparatus for stimulating the vagus nerve and thereby reducing ventricular rate enough to eliminate or minimize the pulse deficit which typically occurs during atrial fibrillation.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an illustration of an implanted control unit according to the present invention in its operating environment showing the heart and left and right vagus nerves.
FIG. 2 is a block diagram of one form of the implanted control unit of FIG. 1.
FIG. 3 is a block diagram of another form of the implanted control unit of FIG. 1. FIG. 4 is a graphical illustration of the relationship between ventricular rate and left vagal stimulation requency.
FIG. 5 is a graphical illustration of the ratio of R wave rate to arterial pulse rate versus the frequency of left vagal stimulation.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
For the purposes of promoting an understanding of the principles of the invention, reference will now be made to the embodiment illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended, such alterations and further modifications in the illustrated device, and such further applications of the principles of the invention as illustrated therein being contemplated as would normally occur to one skilled in the art to which the invention relates .
FIG. 1 illustrates an implantable device according to the present invention in its operating environment in a mammalian body, in which it is operatively connected to the heart and the left vagus nerve. Information on the electrical activity of the ventricles and the atria is obtained by a catheter having two pairs of electrodes: electrodes 1 and 2 in the right ventricle (RV) and electrodes 3 and 4 in the right atrium (RA) . Electrodes 1 and 2 are designed and positioned to detect a ventricular electrogram, which is supplied to the implanted controller unit 10 which processes the ventricular electrogram and derives therefrom the ventricular excitation rate. Electrodes 3 and 4 are designed and positioned to detect an atrial electrogram, which is supplied via the catheter to the implanted control unit, which processes the atrial electrogram. The implanted control unit includes logic circuitry or other circuit means for comparing the atrial and ventricular signals in terms of synchronization and rate, and on the basis of that comparison determining whether or not the patient is experiencing atrial fibrillation. The implantable device includes a pair of electrodes 5 and 6 attached or adjacent to the left vagus
nerve for controlled stimulation thereof. One embodiment of the present invention, described below, also includes a sensor of instantaneous blood pressure, in the form of a monopolar impedance-measuring electrode applied to the surface of the subclavian (SC) artery. Alternately, a piezoelectric pulse pickup placed alongside an artery could be used. A piezoelectric device would generate a voltage pulse and therefore save battery life in an implanted control unit dependent on a battery for operation. The two embodiments of the invention to be described below are desirably combined in a single implanted control unit operable in two modes respectively associated with the control algorithms for the first and second embodiments. Both embodiments use an adaptive control system which adjusts to changing cardiac states. It operates only during episodes of atrial fibrillation. It retains, in memory, parameters that were successful in previous episodes of required control and uses this previously learned information to improve controller responses under similar situations. It also uses this information to accelerate controller adjustments in newly encountered situations.
The first embodiment and its associated algorithm will be described in connection with FIG. 2, which depicts in block diagram form, a controller 20 as an important aspect of the implanted control unit. The ventricular and atrial signals are supplied from their respective electrodes in the heart to a ventricular electrogram detector 22 and atrial electrogram detector 24, respectively, which digitize the electrograms and supply the digitized signals to controller 20, which responds to the detected ventricular and atrial signals. More specifically, atrial rate is determined on the basis of the interval between atrial waves and is compared to a threshold established as an indication of atrial fibrillation. If desired, the time interval itself may be measured and compared to a time interval threshold
for the same purpose. Other techniques and algorithms for detection of atrial fibrillation with a lead configuration of multiple catheters including one in the right atrium and another in the coronary sinus are disclosed in an article by Kim et al. entitled "An Atrial Fibrillation Detection Algorithm for an Implantable Atrial Defibrillator" , Computers in Cardiology. 1995, IEEE 1995: 169-172, which article is hereby incorporated by reference.
In the presence of atrial fibrillation, the controller is enabled to compare the actual R-wave rate with a target rate 25 entered into the controller via an external programmer 26 (FIG. 1) and, based on the difference between those rates, to control the frequency of the pulses which are generated by a stimulator 28 connected via electrodes 5 and 6 to the left vagus nerve. The controller is preferably programmed to apply a low initial frequency, and consequently, to increase the stimulus frequency slowly and incrementally until the ventricular rate matches the operator-selected target rate, and to automatically and continuously adjust the vagal stimulation frequency as a function of the difference between the actual and desired ventricular excitation rates. FIG. 4 illustrates the smooth control of ventricular rate that can be exerted by vagal stimulation during atrial fibrillation. A steady increase in stimulation frequency enabled the ventricular rate to be decreased smoothly, in an almost linear manner, down to a rate of 35 bpm with a stimulation frequency of 10 pulses/second. A pulse width of 100 microseconds (μsec.) has been found suitable, and pulse widths up to 2 msec, may also be effective in some applications. The pulse width is preferably in the range of 100-200 μsec. for A and B fibers, and in the range of 500-750 μsec. for C fibers. A suitable implantable stimulator is described in detail in U.S. Patent No. 5,154,172, which is hereby incorporated by reference.
Referring to FIG. 3, the second embodiment or mode of the present invention operates according to an algorithm designed for elimination of a pulse deficit, i.e., the condition in which an arterial pulse fails to occur in response to an R wave. This algorithm does not require the selection of a target ventricular rate and is therefore operator-independent. The objective of this closed-loop control method is to identify the lowest stimulus frequency required be applied to the left vagus nerve to achieve a ventricular rate with no pulse deficit. As will be described, the controller 30 is designed and programmed to monitor the blood pressure signal for an arterial pulse after every ventricular excitation (as indicated by the R wave of the ECG) , and, in general terms, to use the pulse deficit to control the frequency of stimuli applied to the left vagus nerve in order to identify the minimum stimulus frequency for which each ventricular excitation produces a blood pressure pulse. The controller is programmed to implement an algorithm corresponding generally to the graph illustrated in FIG. 5, although it will be understood that the shape and values of such a graph will vary somewhat for individual patients and that the automatic control algorithm will be varied accordingly. The ventricular and atrial electrogram detectors 22 and 24 digitize the electrogram signals and supply them to the controller, which also receives digitized data from an arterial pulse detector 32, described in further detail below.
There are several important considerations in achieving closed-loop control to eliminate the pulse deficit in atrial fibrillation. The first is recognition that inhibition of impulses traveling from the atria to the ventricles using vagus stimulation is not instantaneous. From the initiation of a train of stimuli applied to the vagus nerve, the onset of slowing of the ventricular (R wave) rate depends somewhat on the frequency of the stimuli in the train; the higher the frequency, the sooner the onset of ventricular slowing.
Another important consideration is adoption of an amplitude criterion for pulse counting. During atrial fibrillation, the arterial pulses vary widely in amplitude. However, a pulse should occur in a time window just after the R wave of the ECG, and so the R wave is preferably used to open a time window to measure the peak-to-peak amplitude of the arterial pulse in the window, which is sufficiently long to accommodate the isovolumic period and the pulse transit time to the arterial measuring site. In a typical situation the former is on the order of 150 msec, and with a measuring site close to the left ventricle, the latter may amount to 50-100 msec. A running average of the pulse amplitude is made, and each newly measured pulse is compared in amplitude to the mean pulse amplitude. Pulses less than a predetermined percentage (20% is presently preferred) of the mean pulse amplitude are treated as absent.
The amount of pulse deficit is identified by the relationship between R waves and arterial pulse waves over a predetermined interval of time, for example, one minute. The controller's response to a pulse deficit is to apply low-frequency stimuli, e.g., initially 1 pulse per second, via stimulator 28. Controller 30 then counts and displays the ratio of R waves to arterial pulses. After 1 minute, if the pulse deficit has not been reduced, the controller increases the frequency of the stimuli applied to the vagus nerve to 2 pulses per second and evaluates the pulse deficit over the next one-minute period. This procedure of evaluating pulse deficit and incrementally increasing stimulus frequency continues until the pulse deficit disappears, or until a low R-wave rate safety limit is reached, at which point the controller maintains the current stimulus frequency.
An arterial pulse detector 32 suitable for use with the present invention includes a monopolar arterial electrode made from a Teflon-coated stainless steel wire, insulated
except at its distal end, which is sutured to a small sheet of Dacron-reinforced Silastic. The Dacron sheet carrying the electrode is wrapped around the subclavian artery as shown in FIG. 1, or other convenient artery, and sutured. The monopolar arterial electrode operates in conjunction with a reference electrode which is relatively large and located at any convenient site, for example, the metal case of the implanted control unit. Further details of an arterial pulse detector as described above are described in an article by Konrad et al. entitled "A New Implantable Arterial Pulse Sensor for Detection of Ventricular Fibrillation," Medical Instrumentation 22(6) :304-311, December, 1988, which article is hereby incorporated by reference. Alternatively, and especially for experimental studies, the arterial pulse may be measured directly, e.g., with a piezoelectric pulse pickup as indicated above.
A suitable electrode presently preferred for attachment to the vagus nerves is a helical cuff electrode described in detail in U.S. Patent Nos. 4,573,481 and 5,154,172, which are hereby incorporated by reference.
While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes and modifications that come within the spirit of the invention are desired to be protected. For example, those skilled in the art will appreciate from the foregoing teachings of the present invention that other embodiments can be used to implement the principle of ventricular rate control during atrial fibrillation using controlled vagal stimulation. For example, both vagus nerves may be stimulated to obtain more A-V block. Alternately, only the cardiac branches of the vagus nerves (left and/or right) may be stimulated to minimize any possible gastrointestinal effects .
The embodiments illustrated in FIGS. 1 and 2 employ a catheter electrode in the right atrium and ventricle and another electrode on the left vagus nerve. An alternate embodiment could use a catheter electrode in the right pulmonary artery to stimulate the left vagus nerve, as described by Cooper et al. (Circ. Res. 1980, 46:48-57). In this way, the principle can be applied using catheter electrodes.
Another embodiment avoids blood contact by using electrodes applied to the pericardium to detect the atrial and ventricular electrograms.
Claims
1. A closed-loop variable frequency vagal stimulation apparatus for control of ventricular rate during atrial fibrillation, comprising: stimulating means for stimulating a vagal nerve at a variable stimulation frequency; and a controller having an output connected to said stimulating means and including means for automatically adjusting said vagal stimulation frequency as a function of the difference between actual and desired ventricular excitation rates.
2. The apparatus of claim 1, further comprising means for enabling generation of stimulating pulses only in the presence of atrial fibrillation.
3. The apparatus of claim 1, wherein said ventricular excitation rates are identified by QRS complexes.
4. An apparatus for automatically controlling ventricular rate by vagal stimulation to minimize pulse deficit during atrial fibrillation, comprising: stimulating means for stimulating a vagal nerve at a variable stimulation frequency; means for detecting a ventricular excitation rate; means for detecting an arterial pulse rate; processing means for comparing said ventricular excitation rate and said arterial pulse rate and automatically adjusting said vagal stimulation frequency as a function of the difference between said ventricular excitation rate and said arterial pulse rate.
5. The apparatus of claim 4, wherein said processing means includes means for adjusting the vagal stimulation frequency as a function of the ratio of said ventricular excitation rate to said arterial pulse rate.
6. The apparatus of claim 5, wherein said processing means includes means for increasing the vagal stimulation frequency incrementally in the presence of a high ratio of said ventricular excitation rate to said arterial pulse rate.
7. The apparatus of claim 6, wherein said processing means increases said vagal stimulation frequency at predetermined intervals until said pulse deficit is substantially eliminated.
8. The apparatus of claim 7, further comprising means for enabling generation of stimulating pulses only in the presence of atrial fibrillation.
9. The apparatus of claim 7, in which the predetermined interval is externally selectable.
10. The apparatus of claim 7, in which the predetermined interval is in the range of approximately one to ten minutes.
11- The apparatus of claim 8, further comprising means for enabling measurement of the amplitude of an arterial pulse for a predetermined time interval after a detected QRS wave, means for calculating a moving average of arterial pulse amplitudes, and means for identifying an arterial pulse as a valid pulse if its amplitude is greater than a predetermined percentage of said moving average.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU23463/97A AU2346397A (en) | 1996-03-29 | 1997-03-26 | Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/624,109 | 1996-03-29 | ||
US08/624,109 US5690681A (en) | 1996-03-29 | 1996-03-29 | Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1997036637A1 true WO1997036637A1 (en) | 1997-10-09 |
Family
ID=24500692
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/004891 WO1997036637A1 (en) | 1996-03-29 | 1997-03-26 | Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation |
Country Status (3)
Country | Link |
---|---|
US (2) | US5690681A (en) |
AU (1) | AU2346397A (en) |
WO (1) | WO1997036637A1 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19859653A1 (en) * | 1998-12-15 | 2000-06-21 | Biotronik Mess & Therapieg | Self-calibrating rate-adaptive pacemaker |
FR2790967A1 (en) * | 1999-03-17 | 2000-09-22 | Medtronic Inc | CARDIAC STIMULATION SYSTEM |
US7925352B2 (en) | 2008-03-27 | 2011-04-12 | Synecor Llc | System and method for transvascularly stimulating contents of the carotid sheath |
US8116883B2 (en) | 2003-06-04 | 2012-02-14 | Synecor Llc | Intravascular device for neuromodulation |
US8126552B2 (en) | 2008-10-21 | 2012-02-28 | Pacesetter, Inc. | Measurement of cardiac information for CRT optimziation in the presence of conduction dysfunction or atrial arrhythmia |
Families Citing this family (441)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6944501B1 (en) | 2000-04-05 | 2005-09-13 | Neurospace, Inc. | Neurostimulator involving stimulation strategies and process for using it |
US5913876A (en) | 1996-02-20 | 1999-06-22 | Cardiothoracic Systems, Inc. | Method and apparatus for using vagus nerve stimulation in surgery |
US6904318B2 (en) * | 2000-09-26 | 2005-06-07 | Medtronic, Inc. | Method and system for monitoring and controlling systemic and pulmonary circulation during a medical procedure |
US6449507B1 (en) * | 1996-04-30 | 2002-09-10 | Medtronic, Inc. | Method and system for nerve stimulation prior to and during a medical procedure |
US6735471B2 (en) * | 1996-04-30 | 2004-05-11 | Medtronic, Inc. | Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure |
US6628987B1 (en) * | 2000-09-26 | 2003-09-30 | Medtronic, Inc. | Method and system for sensing cardiac contractions during vagal stimulation-induced cardiopalegia |
US20040199209A1 (en) * | 2003-04-07 | 2004-10-07 | Hill Michael R.S. | Method and system for delivery of vasoactive drugs to the heart prior to and during a medical procedure |
USRE38705E1 (en) * | 1996-04-30 | 2005-02-22 | Medtronic, Inc. | Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers |
US8036741B2 (en) | 1996-04-30 | 2011-10-11 | Medtronic, Inc. | Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure |
US6006134A (en) * | 1998-04-30 | 1999-12-21 | Medtronic, Inc. | Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers |
US6532388B1 (en) | 1996-04-30 | 2003-03-11 | Medtronic, Inc. | Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure |
US7225019B2 (en) * | 1996-04-30 | 2007-05-29 | Medtronic, Inc. | Method and system for nerve stimulation and cardiac sensing prior to and during a medical procedure |
US7269457B2 (en) * | 1996-04-30 | 2007-09-11 | Medtronic, Inc. | Method and system for vagal nerve stimulation with multi-site cardiac pacing |
US6112117A (en) * | 1997-05-06 | 2000-08-29 | Cardiac Pacemakers, Inc. | Method and apparatus for treating cardiac arrhythmia using electrogram features |
US6479523B1 (en) * | 1997-08-26 | 2002-11-12 | Emory University | Pharmacologic drug combination in vagal-induced asystole |
US9042988B2 (en) | 1998-08-05 | 2015-05-26 | Cyberonics, Inc. | Closed-loop vagus nerve stimulation |
US9415222B2 (en) | 1998-08-05 | 2016-08-16 | Cyberonics, Inc. | Monitoring an epilepsy disease state with a supervisory module |
US7747325B2 (en) | 1998-08-05 | 2010-06-29 | Neurovista Corporation | Systems and methods for monitoring a patient's neurological disease state |
US7209787B2 (en) | 1998-08-05 | 2007-04-24 | Bioneuronics Corporation | Apparatus and method for closed-loop intracranial stimulation for optimal control of neurological disease |
US9375573B2 (en) | 1998-08-05 | 2016-06-28 | Cyberonics, Inc. | Systems and methods for monitoring a patient's neurological disease state |
US9113801B2 (en) | 1998-08-05 | 2015-08-25 | Cyberonics, Inc. | Methods and systems for continuous EEG monitoring |
US8762065B2 (en) | 1998-08-05 | 2014-06-24 | Cyberonics, Inc. | Closed-loop feedback-driven neuromodulation |
US6668191B1 (en) | 1998-10-26 | 2003-12-23 | Birinder R. Boveja | Apparatus and method for electrical stimulation adjunct (add-on) therapy of atrial fibrillation, inappropriate sinus tachycardia, and refractory hypertension with an external stimulator |
WO2000038782A1 (en) | 1998-12-28 | 2000-07-06 | Medtronic, Inc. | Regularization of ventricular rate during atrial tachyarrhythmia |
US8064997B2 (en) | 1999-05-21 | 2011-11-22 | Cardiac Pacemakers, Inc. | Method and apparatus for treating irregular ventricular contractions such as during atrial arrhythmia |
US6430438B1 (en) * | 1999-05-21 | 2002-08-06 | Cardiac Pacemakers, Inc. | Cardiac rhythm management system with atrial shock timing optimization |
EP1198271A4 (en) | 1999-06-25 | 2009-01-21 | Univ Emory | Devices and methods for vagus nerve stimulation |
US6473644B1 (en) * | 1999-10-13 | 2002-10-29 | Cyberonics, Inc. | Method to enhance cardiac capillary growth in heart failure patients |
US6377852B1 (en) * | 2000-01-20 | 2002-04-23 | Pacesetter, Inc. | Implanatable cardiac stimulation device and method for prolonging atrial refractoriness |
US6496731B1 (en) * | 2000-04-14 | 2002-12-17 | Cardiac Pacemakers, Inc. | Highly specific technique for discriminating atrial fibrillation from atrial flutter |
US7039461B1 (en) | 2000-05-13 | 2006-05-02 | Cardiac Pacemakers, Inc. | Cardiac pacing system for prevention of ventricular fibrillation and ventricular tachycardia episode |
US8914114B2 (en) | 2000-05-23 | 2014-12-16 | The Feinstein Institute For Medical Research | Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation |
US6511500B1 (en) * | 2000-06-06 | 2003-01-28 | Marc Mounir Rahme | Use of autonomic nervous system neurotransmitters inhibition and atrial parasympathetic fibers ablation for the treatment of atrial arrhythmias and to preserve drug effects |
US6487446B1 (en) | 2000-09-26 | 2002-11-26 | Medtronic, Inc. | Method and system for spinal cord stimulation prior to and during a medical procedure |
US7499742B2 (en) * | 2001-09-26 | 2009-03-03 | Cvrx, Inc. | Electrode structures and methods for their use in cardiovascular reflex control |
US7623926B2 (en) | 2000-09-27 | 2009-11-24 | Cvrx, Inc. | Stimulus regimens for cardiovascular reflex control |
US7840271B2 (en) | 2000-09-27 | 2010-11-23 | Cvrx, Inc. | Stimulus regimens for cardiovascular reflex control |
US6985774B2 (en) | 2000-09-27 | 2006-01-10 | Cvrx, Inc. | Stimulus regimens for cardiovascular reflex control |
US7158832B2 (en) * | 2000-09-27 | 2007-01-02 | Cvrx, Inc. | Electrode designs and methods of use for cardiovascular reflex control devices |
US20080167699A1 (en) * | 2000-09-27 | 2008-07-10 | Cvrx, Inc. | Method and Apparatus for Providing Complex Tissue Stimulation Parameters |
US8086314B1 (en) * | 2000-09-27 | 2011-12-27 | Cvrx, Inc. | Devices and methods for cardiovascular reflex control |
US6850801B2 (en) | 2001-09-26 | 2005-02-01 | Cvrx, Inc. | Mapping methods for cardiovascular reflex control devices |
US7616997B2 (en) | 2000-09-27 | 2009-11-10 | Kieval Robert S | Devices and methods for cardiovascular reflex control via coupled electrodes |
US6522926B1 (en) | 2000-09-27 | 2003-02-18 | Cvrx, Inc. | Devices and methods for cardiovascular reflex control |
US20080177365A1 (en) * | 2000-09-27 | 2008-07-24 | Cvrx, Inc. | Method and apparatus for electronically switching electrode configuration |
US7069070B2 (en) * | 2003-05-12 | 2006-06-27 | Cardiac Pacemakers, Inc. | Statistical method for assessing autonomic balance |
US6892098B2 (en) | 2001-04-26 | 2005-05-10 | Biocontrol Medical Ltd. | Nerve stimulation for treating spasticity, tremor, muscle weakness, and other motor disorders |
US6907295B2 (en) | 2001-08-31 | 2005-06-14 | Biocontrol Medical Ltd. | Electrode assembly for nerve control |
US8565896B2 (en) | 2010-11-22 | 2013-10-22 | Bio Control Medical (B.C.M.) Ltd. | Electrode cuff with recesses |
US8615294B2 (en) | 2008-08-13 | 2013-12-24 | Bio Control Medical (B.C.M.) Ltd. | Electrode devices for nerve stimulation and cardiac sensing |
US7778703B2 (en) | 2001-08-31 | 2010-08-17 | Bio Control Medical (B.C.M.) Ltd. | Selective nerve fiber stimulation for treating heart conditions |
US7734355B2 (en) | 2001-08-31 | 2010-06-08 | Bio Control Medical (B.C.M.) Ltd. | Treatment of disorders by unidirectional nerve stimulation |
US7974693B2 (en) | 2001-08-31 | 2011-07-05 | Bio Control Medical (B.C.M.) Ltd. | Techniques for applying, configuring, and coordinating nerve fiber stimulation |
US8571653B2 (en) | 2001-08-31 | 2013-10-29 | Bio Control Medical (B.C.M.) Ltd. | Nerve stimulation techniques |
US20090005845A1 (en) * | 2007-06-26 | 2009-01-01 | Tamir Ben David | Intra-Atrial parasympathetic stimulation |
US7904176B2 (en) | 2006-09-07 | 2011-03-08 | Bio Control Medical (B.C.M.) Ltd. | Techniques for reducing pain associated with nerve stimulation |
US7885709B2 (en) | 2001-08-31 | 2011-02-08 | Bio Control Medical (B.C.M.) Ltd. | Nerve stimulation for treating disorders |
US7778711B2 (en) * | 2001-08-31 | 2010-08-17 | Bio Control Medical (B.C.M.) Ltd. | Reduction of heart rate variability by parasympathetic stimulation |
US6934583B2 (en) | 2001-10-22 | 2005-08-23 | Pacesetter, Inc. | Implantable lead and method for stimulating the vagus nerve |
US6668195B2 (en) | 2001-10-30 | 2003-12-23 | Medtronic, Inc. | Methods and apparatus for reducing the likelihood of atrial fibrillation |
US6937896B1 (en) | 2002-02-26 | 2005-08-30 | Pacesetter, Inc. | Sympathetic nerve stimulator and/or pacemaker |
AU2003217747A1 (en) * | 2002-02-26 | 2003-09-09 | North Shore-Long Island Jewish Research Insitute | Inhibition of inflammatory cytokine production by stimulation of brain muscarinic receptors |
US20080213331A1 (en) | 2002-04-08 | 2008-09-04 | Ardian, Inc. | Methods and devices for renal nerve blocking |
US7853333B2 (en) | 2002-04-08 | 2010-12-14 | Ardian, Inc. | Methods and apparatus for multi-vessel renal neuromodulation |
US8131371B2 (en) | 2002-04-08 | 2012-03-06 | Ardian, Inc. | Methods and apparatus for monopolar renal neuromodulation |
US8774922B2 (en) | 2002-04-08 | 2014-07-08 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses having expandable balloons for renal neuromodulation and associated systems and methods |
US20140018880A1 (en) | 2002-04-08 | 2014-01-16 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for monopolar renal neuromodulation |
US20070135875A1 (en) | 2002-04-08 | 2007-06-14 | Ardian, Inc. | Methods and apparatus for thermally-induced renal neuromodulation |
US8347891B2 (en) | 2002-04-08 | 2013-01-08 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen |
US7162303B2 (en) | 2002-04-08 | 2007-01-09 | Ardian, Inc. | Renal nerve stimulation method and apparatus for treatment of patients |
US8145317B2 (en) | 2002-04-08 | 2012-03-27 | Ardian, Inc. | Methods for renal neuromodulation |
US7617005B2 (en) | 2002-04-08 | 2009-11-10 | Ardian, Inc. | Methods and apparatus for thermally-induced renal neuromodulation |
US9636174B2 (en) | 2002-04-08 | 2017-05-02 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for therapeutic renal neuromodulation |
US9308043B2 (en) | 2002-04-08 | 2016-04-12 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for monopolar renal neuromodulation |
US7620451B2 (en) | 2005-12-29 | 2009-11-17 | Ardian, Inc. | Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach |
US8175711B2 (en) | 2002-04-08 | 2012-05-08 | Ardian, Inc. | Methods for treating a condition or disease associated with cardio-renal function |
US20070129761A1 (en) | 2002-04-08 | 2007-06-07 | Ardian, Inc. | Methods for treating heart arrhythmia |
US8150519B2 (en) | 2002-04-08 | 2012-04-03 | Ardian, Inc. | Methods and apparatus for bilateral renal neuromodulation |
US7653438B2 (en) | 2002-04-08 | 2010-01-26 | Ardian, Inc. | Methods and apparatus for renal neuromodulation |
US8774913B2 (en) | 2002-04-08 | 2014-07-08 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and apparatus for intravasculary-induced neuromodulation |
US6978174B2 (en) | 2002-04-08 | 2005-12-20 | Ardian, Inc. | Methods and devices for renal nerve blocking |
US8145316B2 (en) | 2002-04-08 | 2012-03-27 | Ardian, Inc. | Methods and apparatus for renal neuromodulation |
US9308044B2 (en) | 2002-04-08 | 2016-04-12 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for therapeutic renal neuromodulation |
US7756583B2 (en) | 2002-04-08 | 2010-07-13 | Ardian, Inc. | Methods and apparatus for intravascularly-induced neuromodulation |
US7561922B2 (en) | 2004-12-22 | 2009-07-14 | Biocontrol Medical Ltd. | Construction of electrode assembly for nerve control |
WO2004110550A2 (en) | 2003-06-13 | 2004-12-23 | Biocontrol Medical Ltd. | Vagal stimulation for anti-embolic therapy |
US7844346B2 (en) | 2002-05-23 | 2010-11-30 | Biocontrol Medical Ltd. | Electrode assembly for nerve control |
US7321793B2 (en) | 2003-06-13 | 2008-01-22 | Biocontrol Medical Ltd. | Vagal stimulation for atrial fibrillation therapy |
US8204591B2 (en) | 2002-05-23 | 2012-06-19 | Bio Control Medical (B.C.M.) Ltd. | Techniques for prevention of atrial fibrillation |
US7403819B1 (en) | 2002-06-12 | 2008-07-22 | Pacesetter, Inc. | Parasympathetic nerve stimulation for control of AV conduction |
US7657482B1 (en) * | 2002-07-15 | 2010-02-02 | Paymentech, L.P. | System and apparatus for transaction fraud processing |
US7904151B2 (en) * | 2002-07-24 | 2011-03-08 | Bio Control Medical (B.C.M.) Ltd. | Parasympathetic stimulation for treating ventricular arrhythmia |
US7277757B2 (en) * | 2002-10-31 | 2007-10-02 | Medtronic, Inc. | Respiratory nerve stimulation |
US20030229380A1 (en) * | 2002-10-31 | 2003-12-11 | Adams John M. | Heart failure therapy device and method |
US7020521B1 (en) | 2002-11-08 | 2006-03-28 | Pacesetter, Inc. | Methods and apparatus for detecting and/or monitoring heart failure |
US7189204B2 (en) | 2002-12-04 | 2007-03-13 | Cardiac Pacemakers, Inc. | Sleep detection using an adjustable threshold |
US7627384B2 (en) | 2004-11-15 | 2009-12-01 | Bio Control Medical (B.C.M.) Ltd. | Techniques for nerve stimulation |
US8880192B2 (en) | 2012-04-02 | 2014-11-04 | Bio Control Medical (B.C.M.) Ltd. | Electrode cuffs |
US20060111626A1 (en) * | 2003-03-27 | 2006-05-25 | Cvrx, Inc. | Electrode structures having anti-inflammatory properties and methods of use |
US7328066B1 (en) | 2003-03-28 | 2008-02-05 | Pacesetter, Inc. | Implantable cardiac stimulation device, system and method that identifies and prevents impending arrhythmias of the atria |
US7620454B2 (en) | 2003-05-19 | 2009-11-17 | Medtronic, Inc. | Gastro-electric stimulation for reducing the acidity of gastric secretions or reducing the amounts thereof |
US7742818B2 (en) * | 2003-05-19 | 2010-06-22 | Medtronic, Inc. | Gastro-electric stimulation for increasing the acidity of gastric secretions or increasing the amounts thereof |
US8718791B2 (en) | 2003-05-23 | 2014-05-06 | Bio Control Medical (B.C.M.) Ltd. | Electrode cuffs |
US8060197B2 (en) | 2003-05-23 | 2011-11-15 | Bio Control Medical (B.C.M.) Ltd. | Parasympathetic stimulation for termination of non-sinus atrial tachycardia |
EP1648558A4 (en) * | 2003-06-13 | 2015-05-27 | Biocontrol Medical B C M Ltd | Applications of vagal stimulation |
ATE413902T1 (en) | 2003-08-18 | 2008-11-15 | Cardiac Pacemakers Inc | PATIENT MONITORING SYSTEM |
US7887493B2 (en) | 2003-09-18 | 2011-02-15 | Cardiac Pacemakers, Inc. | Implantable device employing movement sensing for detecting sleep-related disorders |
US8606356B2 (en) | 2003-09-18 | 2013-12-10 | Cardiac Pacemakers, Inc. | Autonomic arousal detection system and method |
US8002553B2 (en) | 2003-08-18 | 2011-08-23 | Cardiac Pacemakers, Inc. | Sleep quality data collection and evaluation |
DE202004021946U1 (en) | 2003-09-12 | 2013-05-29 | Vessix Vascular, Inc. | Selectable eccentric remodeling and / or ablation of atherosclerotic material |
US7392084B2 (en) | 2003-09-23 | 2008-06-24 | Cardiac Pacemakers, Inc. | Demand-based cardiac function therapy |
US7480532B2 (en) | 2003-10-22 | 2009-01-20 | Cvrx, Inc. | Baroreflex activation for pain control, sedation and sleep |
US7572226B2 (en) | 2003-10-28 | 2009-08-11 | Cardiac Pacemakers, Inc. | System and method for monitoring autonomic balance and physical activity |
US20050131467A1 (en) * | 2003-11-02 | 2005-06-16 | Boveja Birinder R. | Method and apparatus for electrical stimulation therapy for at least one of atrial fibrillation, congestive heart failure, inappropriate sinus tachycardia, and refractory hypertension |
US7657312B2 (en) * | 2003-11-03 | 2010-02-02 | Cardiac Pacemakers, Inc. | Multi-site ventricular pacing therapy with parasympathetic stimulation |
US9050469B1 (en) | 2003-11-26 | 2015-06-09 | Flint Hills Scientific, Llc | Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals |
US7783353B2 (en) | 2003-12-24 | 2010-08-24 | Cardiac Pacemakers, Inc. | Automatic neural stimulation modulation based on activity and circadian rhythm |
US7647114B2 (en) | 2003-12-24 | 2010-01-12 | Cardiac Pacemakers, Inc. | Baroreflex modulation based on monitored cardiovascular parameter |
US9020595B2 (en) | 2003-12-24 | 2015-04-28 | Cardiac Pacemakers, Inc. | Baroreflex activation therapy with conditional shut off |
US7486991B2 (en) | 2003-12-24 | 2009-02-03 | Cardiac Pacemakers, Inc. | Baroreflex modulation to gradually decrease blood pressure |
US7769450B2 (en) * | 2004-11-18 | 2010-08-03 | Cardiac Pacemakers, Inc. | Cardiac rhythm management device with neural sensor |
US7873413B2 (en) * | 2006-07-24 | 2011-01-18 | Cardiac Pacemakers, Inc. | Closed loop neural stimulation synchronized to cardiac cycles |
US7509166B2 (en) | 2003-12-24 | 2009-03-24 | Cardiac Pacemakers, Inc. | Automatic baroreflex modulation responsive to adverse event |
US7706884B2 (en) | 2003-12-24 | 2010-04-27 | Cardiac Pacemakers, Inc. | Baroreflex stimulation synchronized to circadian rhythm |
US20050149132A1 (en) | 2003-12-24 | 2005-07-07 | Imad Libbus | Automatic baroreflex modulation based on cardiac activity |
US7869881B2 (en) | 2003-12-24 | 2011-01-11 | Cardiac Pacemakers, Inc. | Baroreflex stimulator with integrated pressure sensor |
US7643875B2 (en) | 2003-12-24 | 2010-01-05 | Cardiac Pacemakers, Inc. | Baroreflex stimulation system to reduce hypertension |
US8024050B2 (en) | 2003-12-24 | 2011-09-20 | Cardiac Pacemakers, Inc. | Lead for stimulating the baroreceptors in the pulmonary artery |
US20050149129A1 (en) * | 2003-12-24 | 2005-07-07 | Imad Libbus | Baropacing and cardiac pacing to control output |
US8200331B2 (en) | 2004-11-04 | 2012-06-12 | Cardiac Pacemakers, Inc. | System and method for filtering neural stimulation |
US8396560B2 (en) | 2004-11-18 | 2013-03-12 | Cardiac Pacemakers, Inc. | System and method for closed-loop neural stimulation |
US8126559B2 (en) | 2004-11-30 | 2012-02-28 | Cardiac Pacemakers, Inc. | Neural stimulation with avoidance of inappropriate stimulation |
US8126560B2 (en) | 2003-12-24 | 2012-02-28 | Cardiac Pacemakers, Inc. | Stimulation lead for stimulating the baroreceptors in the pulmonary artery |
US7460906B2 (en) | 2003-12-24 | 2008-12-02 | Cardiac Pacemakers, Inc. | Baroreflex stimulation to treat acute myocardial infarction |
JP2007530586A (en) | 2004-03-25 | 2007-11-01 | ザ ファインスタイン インスティテュート フォー メディカル リサーチ | Nervous hemostasis |
US10912712B2 (en) | 2004-03-25 | 2021-02-09 | The Feinstein Institutes For Medical Research | Treatment of bleeding by non-invasive stimulation |
US7260431B2 (en) | 2004-05-20 | 2007-08-21 | Cardiac Pacemakers, Inc. | Combined remodeling control therapy and anti-remodeling therapy by implantable cardiac device |
US7993906B2 (en) * | 2004-05-28 | 2011-08-09 | The Board Of Trustees Of The Leland Stanford Junior University | Closed-loop electrical stimulation system for cell cultures |
CA2998199A1 (en) | 2004-06-01 | 2005-12-15 | Kwalata Trading Limited | Methods for use with stem cells involving culturing on a surface with antibodies |
US7200438B2 (en) * | 2004-06-04 | 2007-04-03 | Medtronic, Inc. | High frequency atrial burst pacing for improved ventricular rate control during atrial arrhythmias |
US7747323B2 (en) | 2004-06-08 | 2010-06-29 | Cardiac Pacemakers, Inc. | Adaptive baroreflex stimulation therapy for disordered breathing |
US20060004417A1 (en) * | 2004-06-30 | 2006-01-05 | Cvrx, Inc. | Baroreflex activation for arrhythmia treatment |
US20060025828A1 (en) * | 2004-07-28 | 2006-02-02 | Armstrong Randolph K | Impedance measurement for an implantable device |
US8396548B2 (en) | 2008-11-14 | 2013-03-12 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US8521295B2 (en) * | 2004-09-23 | 2013-08-27 | Michael D. Laufer | Location and deactivation of muscles |
US8175705B2 (en) * | 2004-10-12 | 2012-05-08 | Cardiac Pacemakers, Inc. | System and method for sustained baroreflex stimulation |
EP1809374A4 (en) * | 2004-10-12 | 2008-09-10 | Closed Loop Therapies Ltd | Methods and implantable devices for treating supraventricular arrhythmias |
US7672733B2 (en) * | 2004-10-29 | 2010-03-02 | Medtronic, Inc. | Methods and apparatus for sensing cardiac activity via neurological stimulation therapy system or medical electrical lead |
US7937143B2 (en) | 2004-11-02 | 2011-05-03 | Ardian, Inc. | Methods and apparatus for inducing controlled renal neuromodulation |
US8332047B2 (en) | 2004-11-18 | 2012-12-11 | Cardiac Pacemakers, Inc. | System and method for closed-loop neural stimulation |
US20060110374A1 (en) * | 2004-11-24 | 2006-05-25 | Dudy Czeiger | Method to accelerate stem cell recruitment and homing |
US7366571B2 (en) | 2004-12-10 | 2008-04-29 | Cyberonics, Inc. | Neurostimulator with activation based on changes in body temperature |
US7981065B2 (en) | 2004-12-20 | 2011-07-19 | Cardiac Pacemakers, Inc. | Lead electrode incorporating extracellular matrix |
US8060219B2 (en) | 2004-12-20 | 2011-11-15 | Cardiac Pacemakers, Inc. | Epicardial patch including isolated extracellular matrix with pacing electrodes |
US11207518B2 (en) | 2004-12-27 | 2021-12-28 | The Feinstein Institutes For Medical Research | Treating inflammatory disorders by stimulation of the cholinergic anti-inflammatory pathway |
EP2298410B1 (en) * | 2004-12-27 | 2013-10-09 | The Feinstein Institute for Medical Research | Treating inflammatory disorders by electrical vagus nerve stimulation |
US8609082B2 (en) | 2005-01-25 | 2013-12-17 | Bio Control Medical Ltd. | Administering bone marrow progenitor cells or myoblasts followed by application of an electrical current for cardiac repair, increasing blood supply or enhancing angiogenesis |
US8600521B2 (en) * | 2005-01-27 | 2013-12-03 | Cyberonics, Inc. | Implantable medical device having multiple electrode/sensor capability and stimulation based on sensed intrinsic activity |
US7454245B2 (en) | 2005-01-28 | 2008-11-18 | Cyberonics, Inc. | Trained and adaptive response in a neurostimulator |
US9314633B2 (en) | 2008-01-25 | 2016-04-19 | Cyberonics, Inc. | Contingent cardio-protection for epilepsy patients |
US8260426B2 (en) * | 2008-01-25 | 2012-09-04 | Cyberonics, Inc. | Method, apparatus and system for bipolar charge utilization during stimulation by an implantable medical device |
US8565867B2 (en) | 2005-01-28 | 2013-10-22 | Cyberonics, Inc. | Changeable electrode polarity stimulation by an implantable medical device |
US7561918B2 (en) | 2005-01-28 | 2009-07-14 | Cyberonics, Inc. | Autocapture in a neurostimulator |
US8700163B2 (en) | 2005-03-04 | 2014-04-15 | Cyberonics, Inc. | Cranial nerve stimulation for treatment of substance addiction |
US7769446B2 (en) * | 2005-03-11 | 2010-08-03 | Cardiac Pacemakers, Inc. | Neural stimulation system for cardiac fat pads |
US7660628B2 (en) | 2005-03-23 | 2010-02-09 | Cardiac Pacemakers, Inc. | System to provide myocardial and neural stimulation |
US8406876B2 (en) | 2005-04-05 | 2013-03-26 | Cardiac Pacemakers, Inc. | Closed loop neural stimulation synchronized to cardiac cycles |
US8473049B2 (en) | 2005-05-25 | 2013-06-25 | Cardiac Pacemakers, Inc. | Implantable neural stimulator with mode switching |
US7542800B2 (en) * | 2005-04-05 | 2009-06-02 | Cardiac Pacemakers, Inc. | Method and apparatus for synchronizing neural stimulation to cardiac cycles |
US7493161B2 (en) | 2005-05-10 | 2009-02-17 | Cardiac Pacemakers, Inc. | System and method to deliver therapy in presence of another therapy |
US7499748B2 (en) | 2005-04-11 | 2009-03-03 | Cardiac Pacemakers, Inc. | Transvascular neural stimulation device |
US7881782B2 (en) * | 2005-04-20 | 2011-02-01 | Cardiac Pacemakers, Inc. | Neural stimulation system to prevent simultaneous energy discharges |
US7676275B1 (en) | 2005-05-02 | 2010-03-09 | Pacesetter, Inc. | Endovascular lead for chronic nerve stimulation |
US7765000B2 (en) * | 2005-05-10 | 2010-07-27 | Cardiac Pacemakers, Inc. | Neural stimulation system with pulmonary artery lead |
US7734348B2 (en) * | 2005-05-10 | 2010-06-08 | Cardiac Pacemakers, Inc. | System with left/right pulmonary artery electrodes |
US7617003B2 (en) * | 2005-05-16 | 2009-11-10 | Cardiac Pacemakers, Inc. | System for selective activation of a nerve trunk using a transvascular reshaping lead |
US7551958B2 (en) * | 2005-05-24 | 2009-06-23 | Cardiac Pacemakers, Inc. | Safety control system for implantable neural stimulator |
WO2007013065A2 (en) | 2005-07-25 | 2007-02-01 | Rainbow Medical Ltd. | Electrical stimulation of blood vessels |
US7840280B2 (en) | 2005-07-27 | 2010-11-23 | Cyberonics, Inc. | Cranial nerve stimulation to treat a vocal cord disorder |
US8660647B2 (en) | 2005-07-28 | 2014-02-25 | Cyberonics, Inc. | Stimulating cranial nerve to treat pulmonary disorder |
US7706874B2 (en) | 2005-07-28 | 2010-04-27 | Cyberonics, Inc. | Stimulating cranial nerve to treat disorders associated with the thyroid gland |
US7860566B2 (en) * | 2005-10-06 | 2010-12-28 | The Cleveland Clinic Foundation | System and method for achieving regular slow ventricular rhythm in response to atrial fibrillation |
US7616990B2 (en) | 2005-10-24 | 2009-11-10 | Cardiac Pacemakers, Inc. | Implantable and rechargeable neural stimulator |
US8428731B2 (en) | 2005-10-27 | 2013-04-23 | Cyberonics, Inc. | Sequenced therapy protocols for an implantable medical device |
US7957796B2 (en) | 2005-10-28 | 2011-06-07 | Cyberonics, Inc. | Using physiological sensor data with an implantable medical device |
US8694118B2 (en) | 2005-10-28 | 2014-04-08 | Cyberonics, Inc. | Variable output ramping for an implantable medical device |
US7570999B2 (en) | 2005-12-20 | 2009-08-04 | Cardiac Pacemakers, Inc. | Implantable device for treating epilepsy and cardiac rhythm disorders |
US8868172B2 (en) | 2005-12-28 | 2014-10-21 | Cyberonics, Inc. | Methods and systems for recommending an appropriate action to a patient for managing epilepsy and other neurological disorders |
US8725243B2 (en) | 2005-12-28 | 2014-05-13 | Cyberonics, Inc. | Methods and systems for recommending an appropriate pharmacological treatment to a patient for managing epilepsy and other neurological disorders |
US9566447B2 (en) * | 2005-12-28 | 2017-02-14 | Cardiac Pacemakers, Inc. | Neural stimulation system for reducing atrial proarrhythmia |
US8109879B2 (en) | 2006-01-10 | 2012-02-07 | Cardiac Pacemakers, Inc. | Assessing autonomic activity using baroreflex analysis |
US7813805B1 (en) * | 2006-01-11 | 2010-10-12 | Pacesetter, Inc. | Subcardiac threshold vagal nerve stimulation |
US7869869B1 (en) | 2006-01-11 | 2011-01-11 | Pacesetter, Inc. | Subcardiac threshold vagal nerve stimulation |
US7996079B2 (en) * | 2006-01-24 | 2011-08-09 | Cyberonics, Inc. | Input response override for an implantable medical device |
US20070173890A1 (en) * | 2006-01-24 | 2007-07-26 | Cyberonics, Inc. | Stimulation mode adjustment for an implantable medical device |
US7974697B2 (en) * | 2006-01-26 | 2011-07-05 | Cyberonics, Inc. | Medical imaging feedback for an implantable medical device |
US7657310B2 (en) | 2006-01-26 | 2010-02-02 | Cyberonics, Inc. | Treatment of reproductive endocrine disorders by vagus nerve stimulation |
US7801601B2 (en) * | 2006-01-27 | 2010-09-21 | Cyberonics, Inc. | Controlling neuromodulation using stimulus modalities |
US20070191904A1 (en) * | 2006-02-14 | 2007-08-16 | Imad Libbus | Expandable stimulation electrode with integrated pressure sensor and methods related thereto |
TW200734462A (en) | 2006-03-08 | 2007-09-16 | In Motion Invest Ltd | Regulating stem cells |
US7713213B2 (en) * | 2006-03-13 | 2010-05-11 | Cardiac Pacemakers, Inc. | Physiological event detection systems and methods |
US8615309B2 (en) | 2006-03-29 | 2013-12-24 | Catholic Healthcare West | Microburst electrical stimulation of cranial nerves for the treatment of medical conditions |
US8180462B2 (en) | 2006-04-18 | 2012-05-15 | Cyberonics, Inc. | Heat dissipation for a lead assembly |
US7869885B2 (en) | 2006-04-28 | 2011-01-11 | Cyberonics, Inc | Threshold optimization for tissue stimulation therapy |
US7962220B2 (en) * | 2006-04-28 | 2011-06-14 | Cyberonics, Inc. | Compensation reduction in tissue stimulation therapy |
US8019435B2 (en) | 2006-05-02 | 2011-09-13 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US8005543B2 (en) * | 2006-05-08 | 2011-08-23 | Cardiac Pacemakers, Inc. | Heart failure management system |
ATE548071T1 (en) * | 2006-06-09 | 2012-03-15 | St Jude Medical | SYSTEM FOR CONTROLLING A HEART STIMULATOR |
US20080027347A1 (en) | 2006-06-23 | 2008-01-31 | Neuro Vista Corporation, A Delaware Corporation | Minimally Invasive Monitoring Methods |
US8478420B2 (en) | 2006-07-12 | 2013-07-02 | Cyberonics, Inc. | Implantable medical device charge balance assessment |
US8170668B2 (en) | 2006-07-14 | 2012-05-01 | Cardiac Pacemakers, Inc. | Baroreflex sensitivity monitoring and trending for tachyarrhythmia detection and therapy |
US20080027524A1 (en) | 2006-07-26 | 2008-01-31 | Maschino Steven E | Multi-electrode assembly for an implantable medical device |
US8457734B2 (en) | 2006-08-29 | 2013-06-04 | Cardiac Pacemakers, Inc. | System and method for neural stimulation |
JP5559539B2 (en) | 2006-10-18 | 2014-07-23 | べシックス・バスキュラー・インコーポレイテッド | System that induces desirable temperature effects on body tissue |
EP2954868A1 (en) | 2006-10-18 | 2015-12-16 | Vessix Vascular, Inc. | Tuned rf energy and electrical tissue characterization for selective treatment of target tissues |
ES2560006T3 (en) | 2006-10-18 | 2016-02-17 | Vessix Vascular, Inc. | Induction of desirable temperature effects on body tissue |
US7869867B2 (en) | 2006-10-27 | 2011-01-11 | Cyberonics, Inc. | Implantable neurostimulator with refractory stimulation |
US8295934B2 (en) | 2006-11-14 | 2012-10-23 | Neurovista Corporation | Systems and methods of reducing artifact in neurological stimulation systems |
US7826899B1 (en) | 2006-12-22 | 2010-11-02 | Pacesetter, Inc. | Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for termination of atrial tachyarrhythmias |
US7715915B1 (en) | 2006-12-22 | 2010-05-11 | Pacesetter, Inc. | Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for prevention of atrial tachyarrhythmias |
US8005545B2 (en) * | 2007-01-24 | 2011-08-23 | Bio Control Medical (B.C.M.) Ltd. | Parasympathetic stimulation for prevention and treatment of atrial fibrillation |
EP2124734A2 (en) | 2007-01-25 | 2009-12-02 | NeuroVista Corporation | Methods and systems for measuring a subject's susceptibility to a seizure |
US9898656B2 (en) | 2007-01-25 | 2018-02-20 | Cyberonics, Inc. | Systems and methods for identifying a contra-ictal condition in a subject |
US7706875B2 (en) | 2007-01-25 | 2010-04-27 | Cyberonics, Inc. | Modulation of drug effects by vagus nerve stimulation |
US7974707B2 (en) | 2007-01-26 | 2011-07-05 | Cyberonics, Inc. | Electrode assembly with fibers for a medical device |
US8406877B2 (en) * | 2007-03-19 | 2013-03-26 | Cardiac Pacemakers, Inc. | Selective nerve stimulation with optionally closed-loop capabilities |
US8249705B1 (en) | 2007-03-20 | 2012-08-21 | Cvrx, Inc. | Devices, systems, and methods for improving left ventricular structure and function using baroreflex activation therapy |
US8036736B2 (en) | 2007-03-21 | 2011-10-11 | Neuro Vista Corporation | Implantable systems and methods for identifying a contra-ictal condition in a subject |
US7904175B2 (en) * | 2007-04-26 | 2011-03-08 | Cyberonics, Inc. | Trans-esophageal vagus nerve stimulation |
US7962214B2 (en) * | 2007-04-26 | 2011-06-14 | Cyberonics, Inc. | Non-surgical device and methods for trans-esophageal vagus nerve stimulation |
US7869884B2 (en) | 2007-04-26 | 2011-01-11 | Cyberonics, Inc. | Non-surgical device and methods for trans-esophageal vagus nerve stimulation |
US7974701B2 (en) | 2007-04-27 | 2011-07-05 | Cyberonics, Inc. | Dosing limitation for an implantable medical device |
US20090132002A1 (en) * | 2007-05-11 | 2009-05-21 | Cvrx, Inc. | Baroreflex activation therapy with conditional shut off |
US20080318314A1 (en) * | 2007-06-20 | 2008-12-25 | Valentin Fulga | Production from blood of cells of neural lineage |
US8594794B2 (en) | 2007-07-24 | 2013-11-26 | Cvrx, Inc. | Baroreflex activation therapy with incrementally changing intensity |
US7818069B2 (en) * | 2007-07-27 | 2010-10-19 | Cyberonics, Inc. | Ribbon electrode |
US9788744B2 (en) | 2007-07-27 | 2017-10-17 | Cyberonics, Inc. | Systems for monitoring brain activity and patient advisory device |
US8135464B1 (en) | 2007-07-30 | 2012-03-13 | Pacesetter, Inc. | Painless ventricular rate control during supraventricular tachycardia |
WO2009029614A1 (en) | 2007-08-27 | 2009-03-05 | The Feinstein Institute For Medical Research | Devices and methods for inhibiting granulocyte activation by neural stimulation |
US8942798B2 (en) * | 2007-10-26 | 2015-01-27 | Cyberonics, Inc. | Alternative operation mode for an implantable medical device based upon lead condition |
US8868203B2 (en) * | 2007-10-26 | 2014-10-21 | Cyberonics, Inc. | Dynamic lead condition detection for an implantable medical device |
US8934971B1 (en) * | 2007-11-14 | 2015-01-13 | Pacesetter, Inc. | Implantable cardiac stimulation device and method that stabilizes ventricular rate during episodes of atrial fibrillation |
JP5189654B2 (en) | 2007-12-12 | 2013-04-24 | カーディアック ペースメイカーズ, インコーポレイテッド | A stimulation system that transmits neural stimulation from the pulmonary artery |
US9259591B2 (en) | 2007-12-28 | 2016-02-16 | Cyberonics, Inc. | Housing for an implantable medical device |
US20090171168A1 (en) | 2007-12-28 | 2009-07-02 | Leyde Kent W | Systems and Method for Recording Clinical Manifestations of a Seizure |
US20110251468A1 (en) | 2010-04-07 | 2011-10-13 | Ivan Osorio | Responsiveness testing of a patient having brain state changes |
US8382667B2 (en) | 2010-10-01 | 2013-02-26 | Flint Hills Scientific, Llc | Detecting, quantifying, and/or classifying seizures using multimodal data |
US8337404B2 (en) | 2010-10-01 | 2012-12-25 | Flint Hills Scientific, Llc | Detecting, quantifying, and/or classifying seizures using multimodal data |
US11766565B2 (en) | 2008-01-25 | 2023-09-26 | Flint Hills Scientific, L.L.C. | Contingent cardio-protection for epilepsy patients |
US9579506B2 (en) | 2008-01-25 | 2017-02-28 | Flint Hills Scientific, L.L.C. | Contingent cardio-protection for epilepsy patients |
US8571643B2 (en) | 2010-09-16 | 2013-10-29 | Flint Hills Scientific, Llc | Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex |
US9005106B2 (en) * | 2008-01-31 | 2015-04-14 | Enopace Biomedical Ltd | Intra-aortic electrical counterpulsation |
US8538535B2 (en) | 2010-08-05 | 2013-09-17 | Rainbow Medical Ltd. | Enhancing perfusion by contraction |
US9078984B2 (en) * | 2008-01-31 | 2015-07-14 | Massachusetts Institute Of Technology | Mechanical ventilator |
US9662490B2 (en) | 2008-03-31 | 2017-05-30 | The Feinstein Institute For Medical Research | Methods and systems for reducing inflammation by neuromodulation and administration of an anti-inflammatory drug |
US9211409B2 (en) | 2008-03-31 | 2015-12-15 | The Feinstein Institute For Medical Research | Methods and systems for reducing inflammation by neuromodulation of T-cell activity |
US8204603B2 (en) | 2008-04-25 | 2012-06-19 | Cyberonics, Inc. | Blocking exogenous action potentials by an implantable medical device |
US8532793B2 (en) * | 2008-04-30 | 2013-09-10 | Medtronic, Inc. | Techniques for placing medical leads for electrical stimulation of nerve tissue |
US8457747B2 (en) | 2008-10-20 | 2013-06-04 | Cyberonics, Inc. | Neurostimulation with signal duration determined by a cardiac cycle |
US8417344B2 (en) | 2008-10-24 | 2013-04-09 | Cyberonics, Inc. | Dynamic cranial nerve stimulation based on brain state determination from cardiac data |
US8005539B2 (en) * | 2008-10-31 | 2011-08-23 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8260412B2 (en) | 2008-10-31 | 2012-09-04 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8774918B2 (en) | 2008-10-31 | 2014-07-08 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
EP2367596A1 (en) * | 2008-10-31 | 2011-09-28 | Medtronic, Inc. | Shunt-current reduction housing for an implantable therapy system |
US8527045B2 (en) * | 2008-10-31 | 2013-09-03 | Medtronic, Inc. | Therapy system including cardiac rhythm therapy and neurostimulation capabilities |
US8249708B2 (en) * | 2008-10-31 | 2012-08-21 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8611996B2 (en) | 2008-10-31 | 2013-12-17 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US9597505B2 (en) * | 2008-10-31 | 2017-03-21 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8498698B2 (en) | 2008-10-31 | 2013-07-30 | Medtronic, Inc. | Isolation of sensing and stimulation circuitry |
US8560060B2 (en) | 2008-10-31 | 2013-10-15 | Medtronic, Inc. | Isolation of sensing and stimulation circuitry |
US9192769B2 (en) * | 2008-10-31 | 2015-11-24 | Medtronic, Inc. | Shunt-current reduction techniques for an implantable therapy system |
US9775987B2 (en) | 2008-10-31 | 2017-10-03 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8452394B2 (en) | 2008-10-31 | 2013-05-28 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8688210B2 (en) | 2008-10-31 | 2014-04-01 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
US8532779B2 (en) * | 2008-10-31 | 2013-09-10 | Medtronic, Inc. | Implantable medical device crosstalk evaluation and mitigation |
EP2355737B1 (en) | 2008-11-17 | 2021-08-11 | Boston Scientific Scimed, Inc. | Selective accumulation of energy without knowledge of tissue topography |
US8412338B2 (en) | 2008-11-18 | 2013-04-02 | Setpoint Medical Corporation | Devices and methods for optimizing electrode placement for anti-inflamatory stimulation |
US8849390B2 (en) | 2008-12-29 | 2014-09-30 | Cyberonics, Inc. | Processing for multi-channel signals |
US8652129B2 (en) | 2008-12-31 | 2014-02-18 | Medtronic Ardian Luxembourg S.A.R.L. | Apparatus, systems, and methods for achieving intravascular, thermally-induced renal neuromodulation |
US8588933B2 (en) | 2009-01-09 | 2013-11-19 | Cyberonics, Inc. | Medical lead termination sleeve for implantable medical devices |
US20100191304A1 (en) | 2009-01-23 | 2010-07-29 | Scott Timothy L | Implantable Medical Device for Providing Chronic Condition Therapy and Acute Condition Therapy Using Vagus Nerve Stimulation |
US8172759B2 (en) * | 2009-04-24 | 2012-05-08 | Cyberonics, Inc. | Methods and systems for detecting epileptic events using nonlinear analysis parameters |
US8827912B2 (en) | 2009-04-24 | 2014-09-09 | Cyberonics, Inc. | Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters |
US8239028B2 (en) | 2009-04-24 | 2012-08-07 | Cyberonics, Inc. | Use of cardiac parameters in methods and systems for treating a chronic medical condition |
US9211410B2 (en) | 2009-05-01 | 2015-12-15 | Setpoint Medical Corporation | Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation |
US8996116B2 (en) | 2009-10-30 | 2015-03-31 | Setpoint Medical Corporation | Modulation of the cholinergic anti-inflammatory pathway to treat pain or addiction |
US8786624B2 (en) | 2009-06-02 | 2014-07-22 | Cyberonics, Inc. | Processing for multi-channel signals |
CN102573986B (en) | 2009-06-09 | 2016-01-20 | 赛博恩特医疗器械公司 | For the nerve cuff with bag portion without wire stimulator |
US8682432B2 (en) * | 2009-10-30 | 2014-03-25 | Olympus Corporation | Cardiac-event processor and heart treatment device |
US11051744B2 (en) | 2009-11-17 | 2021-07-06 | Setpoint Medical Corporation | Closed-loop vagus nerve stimulation |
US9833621B2 (en) | 2011-09-23 | 2017-12-05 | Setpoint Medical Corporation | Modulation of sirtuins by vagus nerve stimulation |
WO2011071896A1 (en) | 2009-12-08 | 2011-06-16 | Cardiac Pacemakers, Inc. | Concurrent therapy detection in implantable medical devices |
WO2011079309A2 (en) | 2009-12-23 | 2011-06-30 | Setpoint Medical Corporation | Neural stimulation devices and systems for treatment of chronic inflammation |
US9643019B2 (en) | 2010-02-12 | 2017-05-09 | Cyberonics, Inc. | Neurological monitoring and alerts |
EP2374503B1 (en) | 2010-04-08 | 2012-07-11 | Sorin CRM SAS | Active implantable medical device for vagal stimulation with optimised ventricular filling |
JP2013523318A (en) | 2010-04-09 | 2013-06-17 | べシックス・バスキュラー・インコーポレイテッド | Power generation and control equipment for tissue treatment |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US8478428B2 (en) | 2010-04-23 | 2013-07-02 | Cyberonics, Inc. | Helical electrode for nerve stimulation |
US8562536B2 (en) | 2010-04-29 | 2013-10-22 | Flint Hills Scientific, Llc | Algorithm for detecting a seizure from cardiac data |
US8639327B2 (en) | 2010-04-29 | 2014-01-28 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
US8649871B2 (en) | 2010-04-29 | 2014-02-11 | Cyberonics, Inc. | Validity test adaptive constraint modification for cardiac data used for detection of state changes |
US8831732B2 (en) | 2010-04-29 | 2014-09-09 | Cyberonics, Inc. | Method, apparatus and system for validating and quantifying cardiac beat data quality |
US8406868B2 (en) | 2010-04-29 | 2013-03-26 | Medtronic, Inc. | Therapy using perturbation and effect of physiological systems |
EP2563210B1 (en) | 2010-04-29 | 2019-04-24 | Cyberonics, Inc. | Methods for detecting a seizure from cardiac data |
US8620425B2 (en) | 2010-04-29 | 2013-12-31 | Medtronic, Inc. | Nerve signal differentiation in cardiac therapy |
AU2011252998B2 (en) | 2010-05-12 | 2015-08-27 | Irhythm Technologies, Inc. | Device features and design elements for long-term adhesion |
US8788045B2 (en) | 2010-06-08 | 2014-07-22 | Bluewind Medical Ltd. | Tibial nerve stimulation |
US8473067B2 (en) | 2010-06-11 | 2013-06-25 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US8679009B2 (en) | 2010-06-15 | 2014-03-25 | Flint Hills Scientific, Llc | Systems approach to comorbidity assessment |
US8942819B2 (en) | 2010-06-16 | 2015-01-27 | Cardiac Pacemakers, Inc. | Automatic neural stimulation titration sweep |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US8641646B2 (en) | 2010-07-30 | 2014-02-04 | Cyberonics, Inc. | Seizure detection using coordinate data |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US8684921B2 (en) | 2010-10-01 | 2014-04-01 | Flint Hills Scientific Llc | Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis |
US8562524B2 (en) | 2011-03-04 | 2013-10-22 | Flint Hills Scientific, Llc | Detecting, assessing and managing a risk of death in epilepsy |
US8562523B2 (en) | 2011-03-04 | 2013-10-22 | Flint Hills Scientific, Llc | Detecting, assessing and managing extreme epileptic events |
TWI513451B (en) | 2010-10-25 | 2015-12-21 | Medtronic Ardian Luxembourg | Devices, systems and methods for evaluation and feedback of neuromodulation treatment |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9186504B2 (en) | 2010-11-15 | 2015-11-17 | Rainbow Medical Ltd | Sleep apnea treatment |
US9457186B2 (en) | 2010-11-15 | 2016-10-04 | Bluewind Medical Ltd. | Bilateral feedback |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US20120265198A1 (en) * | 2010-11-19 | 2012-10-18 | Crow Loren M | Renal nerve detection and ablation apparatus and method |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US20120157993A1 (en) | 2010-12-15 | 2012-06-21 | Jenson Mark L | Bipolar Off-Wall Electrode Device for Renal Nerve Ablation |
WO2012100095A1 (en) | 2011-01-19 | 2012-07-26 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
US8781582B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
US8725259B2 (en) | 2011-01-19 | 2014-05-13 | Medtronic, Inc. | Vagal stimulation |
US8706223B2 (en) | 2011-01-19 | 2014-04-22 | Medtronic, Inc. | Preventative vagal stimulation |
US8718763B2 (en) | 2011-01-19 | 2014-05-06 | Medtronic, Inc. | Vagal stimulation |
US8781583B2 (en) | 2011-01-19 | 2014-07-15 | Medtronic, Inc. | Vagal stimulation |
US9504390B2 (en) | 2011-03-04 | 2016-11-29 | Globalfoundries Inc. | Detecting, assessing and managing a risk of death in epilepsy |
US20120232606A1 (en) | 2011-03-09 | 2012-09-13 | Medtronic, Inc. | Using focal myocardial stimulation to distinguish supraventricular tachycardia from ventricular tachycardia |
US9498162B2 (en) | 2011-04-25 | 2016-11-22 | Cyberonics, Inc. | Identifying seizures using heart data from two or more windows |
US9402550B2 (en) | 2011-04-29 | 2016-08-02 | Cybertronics, Inc. | Dynamic heart rate threshold for neurological event detection |
WO2012154865A2 (en) | 2011-05-09 | 2012-11-15 | Setpoint Medical Corporation | Single-pulse activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation |
US9579030B2 (en) | 2011-07-20 | 2017-02-28 | Boston Scientific Scimed, Inc. | Percutaneous devices and methods to visualize, target and ablate nerves |
US9186209B2 (en) | 2011-07-22 | 2015-11-17 | Boston Scientific Scimed, Inc. | Nerve modulation system having helical guide |
US9526637B2 (en) | 2011-09-09 | 2016-12-27 | Enopace Biomedical Ltd. | Wireless endovascular stent-based electrodes |
WO2013055826A1 (en) | 2011-10-10 | 2013-04-18 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
WO2013055815A1 (en) | 2011-10-11 | 2013-04-18 | Boston Scientific Scimed, Inc. | Off -wall electrode device for nerve modulation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
US10206591B2 (en) | 2011-10-14 | 2019-02-19 | Flint Hills Scientific, Llc | Seizure detection methods, apparatus, and systems using an autoregression algorithm |
EP2768563B1 (en) | 2011-10-18 | 2016-11-09 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9079000B2 (en) | 2011-10-18 | 2015-07-14 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
CN108095821B (en) | 2011-11-08 | 2021-05-25 | 波士顿科学西美德公司 | Orifice renal nerve ablation |
EP2779929A1 (en) | 2011-11-15 | 2014-09-24 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
CA2859989C (en) | 2011-12-23 | 2020-03-24 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9433760B2 (en) | 2011-12-28 | 2016-09-06 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
WO2013111137A2 (en) | 2012-01-26 | 2013-08-01 | Rainbow Medical Ltd. | Wireless neurqstimulatqrs |
RU2644933C2 (en) | 2012-03-08 | 2018-02-14 | Медтроник Аф Люксембург Сарл | Biomarker samples selection as part of devices for neuromodulation and relevant systems and methods |
US9750568B2 (en) | 2012-03-08 | 2017-09-05 | Medtronic Ardian Luxembourg S.A.R.L. | Ovarian neuromodulation and associated systems and methods |
US9572983B2 (en) | 2012-03-26 | 2017-02-21 | Setpoint Medical Corporation | Devices and methods for modulation of bone erosion |
US10448839B2 (en) | 2012-04-23 | 2019-10-22 | Livanova Usa, Inc. | Methods, systems and apparatuses for detecting increased risk of sudden death |
WO2013169927A1 (en) | 2012-05-08 | 2013-11-14 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
CN103505194B (en) * | 2012-06-29 | 2015-10-21 | 北京超思电子技术股份有限公司 | Measurement device and measuring method |
WO2014032016A1 (en) | 2012-08-24 | 2014-02-27 | Boston Scientific Scimed, Inc. | Intravascular catheter with a balloon comprising separate microporous regions |
WO2014035796A1 (en) | 2012-08-31 | 2014-03-06 | Flint Hills Scientific, Llc | Contingent cardio-protection for epilepsy patients |
CN104780859B (en) | 2012-09-17 | 2017-07-25 | 波士顿科学西美德公司 | Self-positioning electrode system and method for renal regulation |
US10549127B2 (en) | 2012-09-21 | 2020-02-04 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
WO2014047411A1 (en) | 2012-09-21 | 2014-03-27 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
CN104869930B (en) | 2012-10-10 | 2020-12-25 | 波士顿科学国际有限公司 | Renal neuromodulation apparatus and methods |
US20140110296A1 (en) | 2012-10-19 | 2014-04-24 | Medtronic Ardian Luxembourg S.A.R.L. | Packaging for Catheter Treatment Devices and Associated Devices, Systems, and Methods |
WO2014087337A1 (en) | 2012-12-06 | 2014-06-12 | Bluewind Medical Ltd. | Delivery of implantable neurostimulators |
US10220211B2 (en) | 2013-01-22 | 2019-03-05 | Livanova Usa, Inc. | Methods and systems to diagnose depression |
KR102145450B1 (en) | 2013-01-24 | 2020-08-18 | 아이리듬 테크놀로지스, 아이엔씨 | Physiological monitoring device |
WO2014143571A1 (en) | 2013-03-11 | 2014-09-18 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
AU2014237950B2 (en) | 2013-03-15 | 2017-04-13 | Boston Scientific Scimed, Inc. | Control unit for use with electrode pads and a method for estimating an electrical leakage |
US9827039B2 (en) | 2013-03-15 | 2017-11-28 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9056195B2 (en) | 2013-03-15 | 2015-06-16 | Cyberonics, Inc. | Optimization of cranial nerve stimulation to treat seizure disorderse during sleep |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
US9370660B2 (en) | 2013-03-29 | 2016-06-21 | Rainbow Medical Ltd. | Independently-controlled bidirectional nerve stimulation |
JP2016524949A (en) | 2013-06-21 | 2016-08-22 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Medical device for renal nerve ablation having a rotatable shaft |
JP2016523147A (en) | 2013-06-21 | 2016-08-08 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Renal denervation balloon catheter with a riding-type electrode support |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
US9833283B2 (en) | 2013-07-01 | 2017-12-05 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
CN105377169B (en) | 2013-07-11 | 2019-04-19 | 波士顿科学国际有限公司 | Device and method for neuromodulation |
EP3019106A1 (en) | 2013-07-11 | 2016-05-18 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
US9925001B2 (en) | 2013-07-19 | 2018-03-27 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
WO2015013205A1 (en) | 2013-07-22 | 2015-01-29 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
CN105473093B (en) | 2013-08-22 | 2019-02-05 | 波士顿科学国际有限公司 | Flexible circuit with the improved adhesion strength to renal nerve modulation sacculus |
CN105555218B (en) | 2013-09-04 | 2019-01-15 | 波士顿科学国际有限公司 | With radio frequency (RF) foley's tube rinsed with cooling capacity |
EP3043733A1 (en) | 2013-09-13 | 2016-07-20 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US9241673B2 (en) | 2013-09-30 | 2016-01-26 | Cyberonics, Inc. | Systems and methods for validating monitoring device placement and locations |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
WO2015057521A1 (en) | 2013-10-14 | 2015-04-23 | Boston Scientific Scimed, Inc. | High resolution cardiac mapping electrode array catheter |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
AU2014334574B2 (en) | 2013-10-15 | 2017-07-06 | Boston Scientific Scimed, Inc. | Medical device balloon |
US10945786B2 (en) | 2013-10-18 | 2021-03-16 | Boston Scientific Scimed, Inc. | Balloon catheters with flexible conducting wires and related methods of use and manufacture |
EP3060153A1 (en) | 2013-10-25 | 2016-08-31 | Boston Scientific Scimed, Inc. | Embedded thermocouple in denervation flex circuit |
WO2015068167A2 (en) | 2013-11-06 | 2015-05-14 | Enopace Biomedical Ltd. | Wireless endovascular stent-based electrodes |
WO2015103617A1 (en) | 2014-01-06 | 2015-07-09 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
CN106572881B (en) | 2014-02-04 | 2019-07-26 | 波士顿科学国际有限公司 | Substitution of the heat sensor on bipolar electrode is placed |
US10194980B1 (en) | 2014-03-28 | 2019-02-05 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for catheter-based renal neuromodulation |
US9980766B1 (en) | 2014-03-28 | 2018-05-29 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and systems for renal neuromodulation |
US10194979B1 (en) | 2014-03-28 | 2019-02-05 | Medtronic Ardian Luxembourg S.A.R.L. | Methods for catheter-based renal neuromodulation |
US9585611B2 (en) | 2014-04-25 | 2017-03-07 | Cyberonics, Inc. | Detecting seizures based on heartbeat data |
US9302109B2 (en) | 2014-04-25 | 2016-04-05 | Cyberonics, Inc. | Cranial nerve stimulation to treat depression during sleep |
US20170209701A1 (en) * | 2014-07-25 | 2017-07-27 | Indiana University Research & Technology Corporation | Systems and methods for controlling a ventricular rate during atrial fibrillation |
US11311725B2 (en) | 2014-10-24 | 2022-04-26 | Setpoint Medical Corporation | Systems and methods for stimulating and/or monitoring loci in the brain to treat inflammation and to enhance vagus nerve stimulation |
CN107205679B (en) | 2014-10-31 | 2021-03-09 | 意锐瑟科技公司 | Wireless physiological monitoring device and system |
US9597521B2 (en) | 2015-01-21 | 2017-03-21 | Bluewind Medical Ltd. | Transmitting coils for neurostimulation |
US9764146B2 (en) | 2015-01-21 | 2017-09-19 | Bluewind Medical Ltd. | Extracorporeal implant controllers |
US10004896B2 (en) | 2015-01-21 | 2018-06-26 | Bluewind Medical Ltd. | Anchors and implant devices |
US11406833B2 (en) | 2015-02-03 | 2022-08-09 | Setpoint Medical Corporation | Apparatus and method for reminding, prompting, or alerting a patient with an implanted stimulator |
US9782589B2 (en) | 2015-06-10 | 2017-10-10 | Bluewind Medical Ltd. | Implantable electrostimulator for improving blood flow |
US10105540B2 (en) | 2015-11-09 | 2018-10-23 | Bluewind Medical Ltd. | Optimization of application of current |
US9713707B2 (en) | 2015-11-12 | 2017-07-25 | Bluewind Medical Ltd. | Inhibition of implant migration |
US10596367B2 (en) | 2016-01-13 | 2020-03-24 | Setpoint Medical Corporation | Systems and methods for establishing a nerve block |
WO2017127758A1 (en) | 2016-01-20 | 2017-07-27 | Setpoint Medical Corporation | Implantable microstimulators and inductive charging systems |
US11471681B2 (en) | 2016-01-20 | 2022-10-18 | Setpoint Medical Corporation | Batteryless implantable microstimulators |
US10695569B2 (en) | 2016-01-20 | 2020-06-30 | Setpoint Medical Corporation | Control of vagal stimulation |
US10583304B2 (en) | 2016-01-25 | 2020-03-10 | Setpoint Medical Corporation | Implantable neurostimulator having power control and thermal regulation and methods of use |
US10124178B2 (en) | 2016-11-23 | 2018-11-13 | Bluewind Medical Ltd. | Implant and delivery tool therefor |
WO2018231193A1 (en) * | 2017-06-12 | 2018-12-20 | Icahn School Of Medicine At Mount Sinai | Apparatus and method for calculating a pulse deficit value |
US20180353764A1 (en) | 2017-06-13 | 2018-12-13 | Bluewind Medical Ltd. | Antenna configuration |
US11173307B2 (en) | 2017-08-14 | 2021-11-16 | Setpoint Medical Corporation | Vagus nerve stimulation pre-screening test |
US11260229B2 (en) | 2018-09-25 | 2022-03-01 | The Feinstein Institutes For Medical Research | Methods and apparatuses for reducing bleeding via coordinated trigeminal and vagal nerve stimulation |
CA3171482C (en) | 2020-02-12 | 2024-03-26 | Irhythm Technologies, Inc | Non-invasive cardiac monitor and methods of using recorded cardiac data to infer a physiological characteristic of a patient |
JP2023526080A (en) | 2020-05-21 | 2023-06-20 | ザ・フェインステイン・インスティチュート・フォー・メディカル・リサーチ | Systems and methods for vagus nerve stimulation |
US11246523B1 (en) | 2020-08-06 | 2022-02-15 | Irhythm Technologies, Inc. | Wearable device with conductive traces and insulator |
US11350864B2 (en) | 2020-08-06 | 2022-06-07 | Irhythm Technologies, Inc. | Adhesive physiological monitoring device |
CN112675430A (en) * | 2021-02-03 | 2021-04-20 | 杭州睿笛生物科技有限公司 | Closed-loop control median nerve stimulator and use method thereof |
US11400299B1 (en) | 2021-09-14 | 2022-08-02 | Rainbow Medical Ltd. | Flexible antenna for stimulator |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5199428A (en) * | 1991-03-22 | 1993-04-06 | Medtronic, Inc. | Implantable electrical nerve stimulator/pacemaker with ischemia for decreasing cardiac workload |
US5203326A (en) * | 1991-12-18 | 1993-04-20 | Telectronics Pacing Systems, Inc. | Antiarrhythmia pacer using antiarrhythmia pacing and autonomic nerve stimulation therapy |
US5330507A (en) * | 1992-04-24 | 1994-07-19 | Medtronic, Inc. | Implantable electrical vagal stimulation for prevention or interruption of life threatening arrhythmias |
Family Cites Families (22)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
SE346468B (en) * | 1969-02-24 | 1972-07-10 | Lkb Medical Ab | |
US3796221A (en) * | 1971-07-07 | 1974-03-12 | N Hagfors | Apparatus for delivering electrical stimulation energy to body-implanted apparatus with signal-receiving means |
US3850161A (en) * | 1973-04-09 | 1974-11-26 | S Liss | Method and apparatus for monitoring and counteracting excess brain electrical energy to prevent epileptic seizures and the like |
US3918461A (en) * | 1974-01-31 | 1975-11-11 | Irving S Cooper | Method for electrically stimulating the human brain |
US4280502A (en) * | 1979-08-08 | 1981-07-28 | Intermedics, Inc. | Tachycardia arrester |
US4867164A (en) * | 1983-09-14 | 1989-09-19 | Jacob Zabara | Neurocybernetic prosthesis |
US4573481A (en) * | 1984-06-25 | 1986-03-04 | Huntington Institute Of Applied Research | Implantable electrode array |
US4890617A (en) * | 1987-11-25 | 1990-01-02 | Medtronic, Inc. | Dual chamber activity responsive pacer |
US5154172A (en) * | 1989-11-13 | 1992-10-13 | Cyberonics, Inc. | Constant current sources with programmable voltage source |
US4998974A (en) * | 1990-01-05 | 1991-03-12 | Telectronics Pacing Systems, Inc. | Apparatus and method for antitachycardia pacing in dual chamber arrhythmia control system |
US5144947A (en) * | 1990-04-03 | 1992-09-08 | Telectronics Pacing Systems, Inc. | Apparatus and method for antitachycardia pacing in a arrhythmia control systems |
US5086772A (en) * | 1990-07-30 | 1992-02-11 | Telectronics Pacing Systems, Inc. | Arrhythmia control system employing arrhythmia recognition algorithm |
US5107850A (en) * | 1990-11-02 | 1992-04-28 | Cardiac Pacemakers, Inc. | Method and apparatus for classifying and treating cardiac arrhythmias based on atrial and ventricular activity |
US5193550A (en) * | 1990-11-30 | 1993-03-16 | Medtronic, Inc. | Method and apparatus for discriminating among normal and pathological tachyarrhythmias |
US5335657A (en) * | 1991-05-03 | 1994-08-09 | Cyberonics, Inc. | Therapeutic treatment of sleep disorder by nerve stimulation |
US5222494A (en) * | 1991-07-31 | 1993-06-29 | Cyberonics, Inc. | Implantable tissue stimulator output stabilization system |
US5215089A (en) * | 1991-10-21 | 1993-06-01 | Cyberonics, Inc. | Electrode assembly for nerve stimulation |
US5243980A (en) * | 1992-06-30 | 1993-09-14 | Medtronic, Inc. | Method and apparatus for discrimination of ventricular and supraventricular tachycardia |
US5522852A (en) * | 1994-04-26 | 1996-06-04 | Incontrol, Inc. | Selective cardiac activity analysis atrial fibrillation detection system and method and atrial defibrillator utilizing same |
EP0688577A1 (en) * | 1994-06-24 | 1995-12-27 | Pacesetter AB | Device for treating atrial tachyarrhythmia |
US5480413A (en) * | 1994-11-30 | 1996-01-02 | Telectronics Pacing Systems, Inc. | Apparatus and method for stabilizing the ventricular rate of a heart during atrial fibrillation |
US5700282A (en) * | 1995-10-13 | 1997-12-23 | Zabara; Jacob | Heart rhythm stabilization using a neurocybernetic prosthesis |
-
1996
- 1996-03-29 US US08/624,109 patent/US5690681A/en not_active Expired - Lifetime
-
1997
- 1997-03-26 WO PCT/US1997/004891 patent/WO1997036637A1/en active Application Filing
- 1997-03-26 AU AU23463/97A patent/AU2346397A/en not_active Abandoned
- 1997-11-24 US US08/976,854 patent/US5916239A/en not_active Expired - Lifetime
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5199428A (en) * | 1991-03-22 | 1993-04-06 | Medtronic, Inc. | Implantable electrical nerve stimulator/pacemaker with ischemia for decreasing cardiac workload |
US5203326A (en) * | 1991-12-18 | 1993-04-20 | Telectronics Pacing Systems, Inc. | Antiarrhythmia pacer using antiarrhythmia pacing and autonomic nerve stimulation therapy |
US5330507A (en) * | 1992-04-24 | 1994-07-19 | Medtronic, Inc. | Implantable electrical vagal stimulation for prevention or interruption of life threatening arrhythmias |
Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19859653A1 (en) * | 1998-12-15 | 2000-06-21 | Biotronik Mess & Therapieg | Self-calibrating rate-adaptive pacemaker |
US6463325B1 (en) | 1998-12-15 | 2002-10-08 | Biotronki Mess-Und Therapeigerate Gmbh & Co. Ingenieurburo Berlin | Self-calibrating rate-adaptive cardiac pacemaker |
FR2790967A1 (en) * | 1999-03-17 | 2000-09-22 | Medtronic Inc | CARDIAC STIMULATION SYSTEM |
US8116883B2 (en) | 2003-06-04 | 2012-02-14 | Synecor Llc | Intravascular device for neuromodulation |
US7925352B2 (en) | 2008-03-27 | 2011-04-12 | Synecor Llc | System and method for transvascularly stimulating contents of the carotid sheath |
US8369954B2 (en) | 2008-03-27 | 2013-02-05 | Synecor Llc | System and method for transvascularly stimulating contents of the carotid sheath |
US8126552B2 (en) | 2008-10-21 | 2012-02-28 | Pacesetter, Inc. | Measurement of cardiac information for CRT optimziation in the presence of conduction dysfunction or atrial arrhythmia |
US8391977B2 (en) | 2008-10-21 | 2013-03-05 | Pacesetter, Inc. | Measurement of cardiac information for CRT optimziation in the presence of conduction dysfunction or atrial arrhythmia |
Also Published As
Publication number | Publication date |
---|---|
US5690681A (en) | 1997-11-25 |
US5916239A (en) | 1999-06-29 |
AU2346397A (en) | 1997-10-22 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US5690681A (en) | Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation | |
US11890481B2 (en) | AV nodal stimulation during atrial tachyarrhythmia to prevent inappropriate therapy delivery | |
US11129988B2 (en) | Nerve signal differentiation in cardiac therapy | |
US7826899B1 (en) | Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for termination of atrial tachyarrhythmias | |
US7715915B1 (en) | Neurostimulation and neurosensing techniques to optimize atrial anti-tachycardia pacing for prevention of atrial tachyarrhythmias | |
US6895274B2 (en) | Antitachycardial pacing | |
US6134470A (en) | Method and apparatus for treating a tachyarrhythmic patient | |
EP0647150B1 (en) | Apparatus for discrimination of ventricular and supraventricular tachycardia and apparatus for discriminating between a rapid heart rhythm of sinus origin and rapid heart rhythm of non-sinus origin | |
US7991469B2 (en) | Pacing therapy for extending atrial refractory period | |
WO1993003791A1 (en) | Discrimination of ventricular tachycardia from ventricular fibrillation | |
JP2009519808A (en) | Hemodynamically controlled anti-tachyarrhythmia pacing system | |
US8396566B2 (en) | Devices, systems and methods for pacing, resynchronization and defibrillation therapy | |
EP2032206A1 (en) | System and method for controlling a heart stimulator | |
EP1663388B1 (en) | Electrically efficient neurally-excitable stimulation | |
WO2010138450A1 (en) | System and method for rhythm identification and therapy discrimination using hemodynamic status information | |
WO2001024871A2 (en) | Modulation of intracellular calcium concentration using non-excitatory electrical signals applied to the tissue | |
US7225014B1 (en) | Anti-arrhythmia therapy based on spatial and/or temporal information | |
JP2010523202A (en) | Cardiac sympathetic nerve suppressor | |
US8135464B1 (en) | Painless ventricular rate control during supraventricular tachycardia |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AU CA JP |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): AT BE CH DE DK ES FI FR GB GR IE IT LU MC NL PT SE |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
DFPE | Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101) | ||
NENP | Non-entry into the national phase |
Ref country code: JP Ref document number: 97535388 Format of ref document f/p: F |
|
NENP | Non-entry into the national phase |
Ref country code: CA |
|
122 | Ep: pct application non-entry in european phase |