36 results about "Baroreflex" patented technology

Systems and methods provide baroreflex activation to treat or reduce pain and / or to cause or enhance sedation or sleep. Methods involve activating the baroreflex system to provide pain reduction, sedation, improved sleep or some combination thereof. Systems include at least one baroreflex activation device, at least one sensor for sensing physiological activity of the patient, and a processor coupled with the baroreflex activation device(s) and the sensor(s) for processing sensed data received from the sensor and for activating the baroreflex activation device. In some embodiments, the system is fully implantable within a patient, such as in an intravascular, extravascular or intramural location.

Methods and systems for external baroreflex activation allow a physician to characterize a patient's response to baroreflex activation prior to providing baroreflex activation therapy. Methods generally include applying a baroreflex activation stimulus to a patient, measuring one or more physiological parameters of the patient, and determining the extent to which the baroreflex activation causes a baroreflex response. Multiple stimuli of different intensities and / or from different locations may be compared. Systems include one or more external baroreflex activation devices and one or more physiological parameter measuring devices. Optionally, a system may also include one or more fully or partially implantable devices for providing baroreflex activation therapy.

A method and device for delivering and monitoring baroreflex and drug therapy to manage hypertension. The method includes providing an implanted an implanted medical device configured to automatically detect drug-related effects on the autonomic nervous system including the steps of measuring a physiologic status of the autonomic nervous system at desired intervals, logging the physiologic status of the autonomic nervous system at desired intervals, monitoring the measured and logged physiologic status of the autonomic nervous system for any changes and correlating the changes to a corresponding drug administration time. The device includes an implanted baroreflex activation device capable of administering one or more hypertension treatment drugs including a controller that activates and adjusts therapy delivery, a baroreflex activation therapy delivery device, a drug therapy delivery device and a device that senses physiologic parameters.

Methods and systems for external baroreflex activation allow a physician to characterize a patient's response to baroreflex activation prior to providing baroreflex activation therapy. Methods generally include applying a baroreflex activation stimulus to a patient, measuring one or more physiological parameters of the patient, and determining the extent to which the baroreflex activation causes a baroreflex response. Multiple stimuli of different intensities and / or from different locations may be compared. Systems include one or more external baroreflex activation devices and one or more physiological parameter measuring devices. Optionally, a system may also include one or more fully or partially implantable devices for providing baroreflex activation therapy.

An approach to providing disordered breathing therapy includes delivering electrical stimulation therapy modifying a patient's baroreflex response. Disordered breathing therapy may be delivered in response to prediction or detection of disordered breathing events. Various conditions affecting the patient may be evaluated and the baroreflex therapy modified. The therapy may be modified to improve therapy efficacy, to reduce an impact to the patient and / or to mitigate therapy interactions.

An approach to providing disordered breathing therapy involves the use of a plurality of therapy devices to deliver a coordinated disordered breathing therapy regimen to the patient. The plurality of disordered breathing devices includes at least a therapy device that delivers an electrical stimulation therapy modulating a patient's baroreflex response. Other therapy devices may include a cardiac electrical stimulation device, an external respiratory therapy device, and / or other therapy devices used in the treatment of disordered breathing. A therapy controller coordinates the therapies delivered by the plurality of therapy devices.

A method of operating a baroreflex therapy system includes providing an implantable baroreflex activation device, providing a sensing arrangement, and providing a controller in operable communication with the baroreflex activation device and the sensing arrangement. The sensing arrangement is used to measure a physical parameter of a patient to generate physical parameter data. The physical parameter data is communicated to the controller, wherein the controller performs heart rate variability analysis based on the physical parameter data. An indication of results of the heart rate variability analysis are provided, upon which a determination may be made to adjust a baroreflex therapy to be delivered by the implantable baroreflex activation device.

An approach to providing disordered breathing therapy involves the use of a plurality of therapy devices to deliver a coordinated disordered breathing therapy regimen to the patient. The plurality of disordered breathing devices includes at least a therapy device that delivers an electrical stimulation therapy modulating a patient's baroreflex response. Other therapy devices may include a cardiac electrical stimulation device, an external respiratory therapy device, and / or other therapy devices used in the treatment of disordered breathing. A therapy controller coordinates the therapies delivered by the plurality of therapy devices.

A method of operating a baroreflex therapy system includes providing an implantable baroreflex activation device, providing a sensing arrangement, and providing a controller in operable communication with the baroreflex activation device and the sensing arrangement. The sensing arrangement is used to measure cardiac electrical activity of a patient to generate cardiac electrical activity data. The cardiac electrical activity data is communicated to the controller, wherein the controller performs heart rate variability analysis based on the cardiac electrical activity data. An indication of results of the heart rate variability analysis are provided, upon which a determination may be made to adjust a baroreflex therapy to be delivered by the implantable baroreflex activation device.

An exemplary embodiment of the present invention provides systems, devices, and methods for using the same for activating (stimulating) the baroreflex system of a patient using a baroreflex activation system with pacing cardiac electrical signal detection capability.

An implantable coronary perfusion monitoring device for in-vivo determination of a coronary perfusion index (CPI) indicative of the coronary perfusion of a heart has a time measurement unit to determine a blood pressure reflection wave measure t indicating the timely position in the heart cycle of the maximum of a reflected blood pressure wave and in a time period starting at a preset point of time in systole and ending at a local maximum of blood pressure following aortic valve closure and, a diastolic peak pressure measurement unit adapted to determine a diastolic peak blood pressure measure DPP related to diastolic aortic peak pressure and a systolic arterial pressure measurement unit adapted to determine a systolic arterial blood pressure measure SAP related to systolic arterial pressure, and a coronary perfusion index calculating unit adapted to determine said coronary perfusion index CPI as (t·DPP) / SAP.

Devices and methods of use identification, treatment, and / or management of heart failure and / or associated conditions. Methods may include providing a baroreflex therapy system, providing an implantable measurement device proximate a blood vessel of a patient, the implantable measurement device including a plurality of electrodes, determining an impedance of the blood vessel with the implantable measurement device over a time period of at least one cardiac cycle, generating at least one signal representative of a pressure waveform based on the impedance, activating, deactivating or otherwise modulating the baroreflex therapy system to deliver a therapy to treat heart failure based at least in part on the at least one signal representative of the pressure waveform.

Various aspects of the present subject matter provide an implantable medical device. In various embodiments, the device comprises a baroreflex stimulator and a controller. The baroreflex stimulator is adapted to generate a stimulation signal to stimulate a baroreflex. The controller is adapted to communicate with the baroreflex stimulator and implement a baroreflex stimulation protocol to vary an intensity of the baroreflex stimulation provided by the stimulation signal to abate baroreflex adaptation. According to various embodiments, the controller is adapted to implement the baroreflex stimulation protocol to periodically modulate the baroreflex stimulation to produce an effect that mimics an effect of pulsatile pressure. Other aspects are provided herein.

Methods and systems for external baroreflex activation of a baroreceptor system of a patient from a stimulator external to the patient. The method and devices, enable baroflex therapy on a temporary basis and / or assess the response of a patient to such baroreflex therapy.

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

Embodiments of the present invention generally pertain to devices and methods for use in conjunction with implanting a baroreflex therapy system which includes an implantable pulse generator and associated circuitry contained within a hermetically sealed housing, an elongate flexible electrical lead connectable to the housing, and a monopolar electrode structure coupled with the electrical lead. More specifically, the devices and methods of the present invention allow for a mapping procedure to be conducted as part of the implant procedure prior to fully implanting the baroreflex therapy system.

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

The mdx mouse is a model of Duchenne muscular dystrophy. The present invention describes that mdx mice exhibited clinically relevant cardiac phenotypes. A non-invasive method of recording electrocardiograms (ECGs) was used to a study mdx mice (n=15) and control mice (n=15). The mdx mice had significant tachycardia, consistent with observations in patients with muscular dystrophy. Heart-rate was nearly 15% faster in mdx mice than control mice (P<0.01). ECGs revealed significant shortening of the rate-corrected QT interval duration (QTc) in mdx mice compared to control mice (P<0.05). PR interval duration were shorter at baseline in mdx compared to control mice (P<0.05). The muscarinic antagonist atropine significantly increased heart-rate and decreased PR interval duration in C57 mice. Paradoxically, atropine significantly decreased heart-rate and increased PR interval duration in all mdx mice. Pharmacological autonomic blockade and baroreflex sensitivity testing demonstrated an imbalance in autonomic nervous system modulation of heart-rate, with decreased parasympathetic activity and increased sympathetic activity in mdx mice. These electrocardiographic findings in dystrophin-deficient mice provide new bases for diagnosing, understanding, and treating patients with Duchenne muscular dystrophy.

Optimizing cardiac preload based on measured pulmonary artery pressure involves varying, for each repetition of an acute burst protocol, a parameter of pacing applied to a patient's heart during the acute burst protocol. Pulmonary artery pressure is measured during the repetitions of the acute burst protocol. The length of the repetitions is chosen so that the patient's baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol. An optimum ventricular preload is determined based on the measured pulmonary artery pressure. Pacing therapy is provided using a value of the parameter that is selected based on the determination of optimum ventricular preload.

Improved methods for obtaining physiological parameters of a patient in accordance with various embodiments of the present invention can be used to monitor patient status and / or in conjunction with patient therapy. Physiological parameters can be monitored with an implantable device including a first lead and a second lead. Physiological parameters can be measured along at least three distinct vectors defined by the first lead and second lead, the first lead and an electrode located on the device body, and the second lead an the electrode. An output indicative of the physiological parameter can then be provided. Therapy, such as baroreflex therapy, can optionally be optimized based on the physiological measurements.

Disclosed are methods for regulating blood pressure in a subject which include administering a first induction stimulus effective to sensitize brainstem baroreflex neurons of a subject for a period of time in the range of about 10-15 hours thereby producing an enhanced baroreflex in the subject, wherein the enhanced baroreflex is characterized in that a threshold blood pressure for generating a depressor response is lower than prior to induction stimulus administration, the depressor response in the subject is larger than prior to induction stimulus administration or both the threshold blood pressure for generating a depressor response is lower than prior to induction stimulus administration and the depressor response in the subject is larger than prior to induction stimulus administration. An induction stimulus has diminished effectiveness to sensitize neurons in the nucleus tractus solitarius of the subject in the presence of an NMDA receptor antagonist. One or more additional induction stimuli are optionally administered to regulate blood pressure in the subject.

Embodiments of the present invention generally pertain to devices and methods for use in conjunction with implanting a baroreflex therapy system which includes an implantable pulse generator and associated circuitry contained within a hermetically sealed housing, an elongate flexible electrical lead connectable to the housing, and a monopolar electrode structure coupled with the electrical lead. More specifically, the devices and methods of the present invention allow for a mapping procedure to be conducted as part of the implant procedure prior to fully implanting the baroreflex therapy system.

The invention relates to a research on the prediction of artery pressure baroreflex sensitivity, BRS on dead brain, and the research of antihypertensive ketone selin on dead brain. Wherein, (1), BRS can be used as one independent factor to predict the occur of dead brain, that the occur time of BRS-high animal is later then the lower one; (2), ketone selin can effective improve BRS, without affected by its amount, to delay the dead brain and prolong life time.

Disclosed are methods for regulating blood pressure in a subject which include administering a first induction stimulus effective to sensitize brainstem baroreflex neurons of a subject for a period of time in the range of about 10-15 hours thereby producing an enhanced baroreflex in the subject, wherein the enhanced baroreflex is characterized in that a threshold blood pressure for generating a depressor response is lower than prior to induction stimulus administration, the depressor response in the subject is larger than prior to induction stimulus administration or both the threshold blood pressure for generating a depressor response is lower than prior to induction stimulus administration and the depressor response in the subject is larger than prior to induction stimulus administration. An induction stimulus has diminished effectiveness to sensitize neurons in the nucleus tractus solitarius of the subject in the presence of an NMDA receptor antagonist. One or more additional induction stimuli are optionally administered to regulate blood pressure in the subject.