Vagus Nerve Stimulation Using High Frequency Blocking
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Solution Overview
Problem
Vagal nerve stimulation for cardiac therapy often causes undesired side effects due to activation of non-cardiac vagus nerve branches, such as shortness of breath, voice alteration, and neck pain, resulting from the stimulation of nerve fibers innervating the pharynx and larynx.
Innovation Solution
An implantable medical device system that delivers low frequency therapeutic stimulation to activate cardiac vagus nerve branches while simultaneously applying high frequency blocking stimulation to prevent activation of non-targeted nerve fibers, using a nerve cuff with distinct electrode pairs for therapeutic and blocking stimulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If vagal nerve stimulation is applied to activate cardiac branches for therapeutic effect, then cardiac therapy benefit is improved, but undesired activation of non-cardiac branches causes side effects
Solution Approach 1:
The patent divides the vagus nerve stimulation into two distinct functional segments: cardiac-targeted stimulation and non-cardiac blocking stimulation. By using separate electrode pairs on the nerve cuff, the system can independently control which nerve fibers are activated versus blocked, thereby achieving selective cardiac therapy while preventing unwanted activation of pharyngeal, laryngeal, and neck nerve branches.
Solution Approach 2:
The patent applies different stimulation qualities to different regions of the vagus nerve. The cardiac-targeted electrodes deliver low-frequency pulsed stimulation optimized for cardiac branch activation, while the blocking electrodes deliver high-frequency continuous stimulation optimized for preventing non-cardiac activation. This local differentiation of stimulation parameters allows simultaneous therapeutic benefit and side effect prevention.
2Object-affected harmful factors
If high frequency blocking stimulation is applied to prevent non-cardiac activation, then side effects are reduced, but device complexity increases due to multiple electrode pairs and stimulation modes
Solution Approach 1:
The patent designs a single nerve cuff electrode assembly that performs multiple functions: it can deliver both cardiac-targeted low-frequency stimulation and non-cardiac blocking high-frequency stimulation through different electrode pairs. This multi-functional design consolidates what could be multiple separate devices into one implantable system, managing complexity while achieving dual therapeutic and protective functions.
Solution Approach 2:
The patent combines the therapeutic stimulation and blocking stimulation capabilities within a single nerve cuff device. By integrating both low-frequency cardiac activation electrodes and high-frequency blocking electrodes on the same implantable platform, the system merges two distinct therapeutic approaches into one unified device, reducing overall system complexity compared to using separate implants.
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
Effectively reduces the likelihood of activating non-targeted nerve fibers, minimizing side effects like laryngeal activation, and maintaining the therapeutic cardiac effect by ensuring only cardiac branches are activated, thereby improving the safety and efficacy of vagal nerve stimulation.
Implementation Method 1
relatively higher frequency stimulation is delivered to the vagus nerve during the low frequency therapeutic stimulation to reduce the likelihood of activating non-targeted excitable tissue
Data Source
AI summary
An implantable medical device and associated method deliver a therapy to an autonomic nerve. The therapy delivery includes delivering therapeutic low frequency (LF) electrical stimulation pulses to the autonomic nerve and delivering a high frequency electrical signal to the autonomic nerve during the LF frequency stimulation pulse delivery. The high frequency stimulation signal blocks activation of autonomic nerve fibers innervating a non-targeted tissue during the therapeutic LF stimulation pulse delivery.