Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach

Abstract

Methods and apparatus are provided for pulsed electric field neuromodulation . via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and / or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly. The methods and apparatus of the present invention may, for example, be used to modulate one or more target neural fibers that contribute to renal function.

Description

[0001] merge by reference [0001] All publications and patent applications mentioned in this specification are herein incorporated by reference as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference. technical field [0002] The present invention relates to methods and devices for neuromodulation. More specifically, the present invention relates to methods and devices for achieving pulsed electric field neuromodulation through an inside-out approach. Background technique [0003] Congestive heart failure (CHF) is a condition that occurs when the heart is damaged and blood flow to the body's organs is reduced. If blood flow is sufficiently reduced, kidney function is impaired, leading to fluid retention, abnormal hormone secretion, and increased vasoconstriction. These results increase the heart's workload and further reduce the heart's ability to pump blood through the kidneys and circulatory sy...

AI Technical Summary

Problems solved by technology

Thus, in certain patients, desired therapeutic outcomes such as renal denervation may not be achieved with some intravascular PEF systems without concomitantly causing damage to non-target tissues

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