Vagal stimulation for cardioversion of atrial fibrillation

Abstract

Apparatus (20) for treating a subject (30) suffering from spontaneous atrial fibrillation includes an electrode device (22), adapted to be coupled to a site of the subject (30) selected from the list consisting of: a vagus nerve (24) of the subject (30), an epicardial fat pad of the subject (30), a pulmonary vein of the subject (30), a carotid artery of the subject (30), a carotid sinus of the subject (30), a vena cava vein of the subject (30), and an internal jugular vein of the subject (30), and a control unit (32), adapted to drive the electrode device (22) to apply an electrical current to the site, and to configure the current to maintain the spontaneous AF for at least about 24 hours, so as to modify blood flow within the atria and reduce risk of thromboembolic events.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS [0001] This application is a continuation of U.S. Ser. No. 10 / 560,654, filed May1, 2006, which is a §371 U.S. national stage of PCT International Application No. PCT / IL2004 / 000496, filed Jun. 10, 2004, which claims priority from and is a continuation-in-part of U.S. Ser. No. 10 / 461,696, filed Jun. 13, 2003. U.S. Ser. No. 10 / 461,696 is assigned to the assignee of the present patent application and is are incorporated herein by reference.FIELD OF THE INVENTION [0002] The present invention relates generally to treating patients by application of electrical signals to selected tissue, and specifically to methods and apparatus for stimulating tissue for treating patients suffering from atrial fibrillation and / or from increased risk of thromboembolic events. BACKGROUND OF THE INVENTION [0003] The use of nerve stimulation for treating and controlling a variety of medical, psychiatric, and neurological disorders has seen significant growth over the l...

AI Technical Summary

Benefits of technology

[0094] In some embodiments of the present invention, AF is maintained long-term, e.g., longer than about three weeks. Such AF maintenance generally reduces the frequency of recurring transitions between AF and NSR, which transitions are common in patients with AF, particularly in patients with chronic episodic AF. Such repeated transitions are generally undesirable because: (a) they often cause discomfort for the patient, (b) they may increase the risk of thromboembolic events, and (c) they often make prescribing an appropriate drug regimen difficult. Drug regimens that are beneficial for the patient when in AF are often inappropriate when the patient is in NSR, and vice versa. Knowledge that the patient will generally remain in AF typically helps a physician prescribe a more appropriate and / or lower-dosage drug regimen.

[0361] configuring the stimulation to reduce a probability of an occurrence of atrial fibrillation (AF).

Problems solved by technology

Such repeated transitions are generally undesirable because: (a) they often cause discomfort for the patient, (b) they may increase the risk of thromboembolic events, and (c) they often make prescribing an appropriate drug regimen difficult.

Drug regimens that are beneficial for the patient when in AF are often inappropriate when the patient is in NSR, and vice versa.

Cardioversion is generally not attempted during this period because of the particularly elevated risk of thromboembolic events before the anticoagulation therapy has had time to be effective.

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