Contingent Vagus Nerve Stimulation for Epilepsy Cardiac Protection
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Solution Overview
Problem
Current treatments for epilepsy and its associated cardiac co-morbidities, such as cardiac alterations and sudden unexpected death in epilepsy (SUDEP), lack effective management strategies, particularly in addressing cardiac impairments and sympatho-vagal imbalances.
Innovation Solution
A method and system for vagus nerve stimulation (VNS) that involves analyzing body data streams to detect epileptic seizures and applying specific electrical signals to the vagus nerve, including pulsed signals to block action potential conduction, aimed at managing cardiac changes and restoring sympathetic-parasympathetic tone.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If vagus nerve stimulation is applied to treat epilepsy, then seizure management improves, but cardiac conduction may be blocked causing bradycardia or asystole
Solution Approach 1:
The vagus nerve is segmented into multiple stimulation sites: a first stimulation site for delivering therapeutic signals to treat epilepsy, and a second stimulation site (cardiac branch) for delivering signals to modulate heart rate. This segmentation allows independent control of brain and cardiac effects, enabling seizure management while preventing harmful cardiac conduction blocking.
Solution Approach 2:
Different stimulation parameters and approaches are applied to different locations along the vagus nerve. The first stimulation site receives signals optimized for epilepsy treatment, while the second stimulation site receives signals specifically tuned for cardiac rate modulation. This local differentiation allows the system to achieve therapeutic benefits while minimizing adverse effects at each specific location.
2Reliability
If electrical signals are applied to modulate heart rate during seizures, then cardiac protection improves, but device complexity increases
Solution Approach 1:
The vagus nerve stimulation system serves multiple functions: it treats epilepsy through brain-targeted stimulation and simultaneously provides cardiac protection through heart rate modulation. By utilizing the same implantable device and lead system to deliver both therapeutic and protective signals through different stimulation sites, the invention achieves multi-functionality without requiring separate devices, thereby limiting the increase in device complexity.
Solution Approach 2:
The invention combines seizure treatment and cardiac protection into a single integrated vagus nerve stimulation system. The implantable device delivers both anti-seizure therapy and cardio-protective signals through the same lead and generator, merging two therapeutic functions into one unified system. This integration reduces overall system complexity compared to using separate devices for each function.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The approach effectively treats epilepsy and its cardiac co-morbidities by modulating heart rate and reducing the risk of SUDEP through targeted VNS, enhancing cardiac vagal tone and providing cardio-protective benefits.
Implementation Method 1
applying a first electrical signal to a vagus nerve of the patient based on a determination that the patient is not having and/or has not had an epileptic seizure characterized by a decrease in the patient's heart rate, wherein the first electrical signal is not a vagus nerve conduction blocking electrical signal, and applying a second electrical signal to a vagus nerve of the patient based on a determination that the patient is having and/or has had an epileptic seizure characterized by a decrease in the patient's heart rate, wherein the second electrical signal is a pulsed electrical signal that blocks action potential conduction in the vagus nerve
Data Source
AI summary
Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase.