Baroreflex Modulation Based On Monitored Cardiovascular Parameter

Abstract

The present invention is a system for providing baroreceptor stimulation comprising, a sensor to sense a physiologic parameter and provide a signal indicative of the physiologic parameter, a baroreceptor activation device, which includes, a pulse generator to intermittently generate a stimulation signal to provide baroreceptor stimulation for a baroreflex therapy, and a control system to adjust the stimulation signal based on the signal indicative of the physiologic parameter such that the stimulation signal provides a desired baroreceptor stimulation corresponding to a desired physiologic parameter.

1 . A system for providing baroreflex stimulation, comprising: 
 a heart rate monitor to sense a heart rate and provide a signal indicative of the heart rate; and a baroreflex stimulator, including: a pulse generator to intermittently generate a stimulation signal to provide baroreflex stimulation for a baroreflex therapy; and    a modulator to adjust the stimulation signal based on the signal indicative of the heart rate such that the stimulation signal provides a desired baroreflex stimulation corresponding to a desired heart rate.    
   
   
       2 . The system of  claim 1 , wherein the desired heart rate includes a programmable value.  
   
   
       3 . The system of  claim 1 , wherein the desired heart rate includes a percent change based on a heart rate during a time without baroreflex stimulation and a heart rate during a time with baroreflex stimulation.  
   
   
       4 . The system of  claim 1 , wherein the desired heart rate includes a change in a number of heart beats for a heart rate during a time without baroreflex stimulation and a heart rate during a time with baroreflex stimulation.  
   
   
       5 . The system of  claim 1 , wherein the modulator is adapted to adjust signal characteristic of the stimulation signal, wherein the signal characteristic is selected from a group consisting of: an amplitude, a frequency, a burst frequency, a pulse width, and a duty cycle.  
   
   
       6 . The system of  claim 1 , wherein the modulator is adapted to adjust any combination of at least two stimulation signal attributes from a group of stimulation signal attributes consisting of: an amplitude, a frequency, a burst frequency, a pulse width, and a duty cycle.  
   
   
       7 . A system for providing baroreflex stimulation, comprising: 
 a baroreflex stimulator, including: a pulse generator to generate a stimulation signal to provide intermittent baroreflex stimulation for a baroreflex therapy; and    a modulator to adjust the stimulation signal;    a cardiovascular parameter monitor to monitor at least one cardiovascular parameter and provide a first signal indicative of the cardiovascular parameter during the baroreflex stimulation and a second signal indicative of the cardiovascular parameter without the baroreflex stimulation; and    a comparator to provide a detected change for the cardiovascular parameter based on the first and second signals, and to provide a therapy control signal based on a desired change for the cardiovascular parameter and the detected change.    
   
   
       8 . The system of  claim 7 , wherein the modulator is adapted to adjust at least one stimulation signal attribute from a group of stimulation signal attributes consisting of: an amplitude, a frequency, a burst frequency, a pulse width, and a duty cycle.  
   
   
       9 . The system of  claim 7 , wherein the cardiovascular parameter monitor is adapted to monitor a parameter selected from the group consisting of: heart rate, blood pressure, respiration rate, a surrogate parameter for heart rate that increases and decreases with the heart rate, a percent change for the cardiovascular parameter when influenced by the baroreflex stimulation and a quantitative change associated with the cardiovascular parameter when influenced by the baroreflex stimulation.  
   
   
       10 . The system of  claim 7 , wherein the desired change for the cardiovascular parameter includes a percent change for the cardiovascular parameter when influenced by the baroreflex stimulation.  
   
   
       11 . The system of  claim 7 , wherein the desired change for the cardiovascular parameter includes a quantitative change associated with the cardiovascular parameter when influenced by the baroreflex stimulation.  
   
   
       12 . A baroreflex stimulator, comprising: 
 means for intermittently providing baroreflex stimulation for a baroreflex therapy over a period of time;    means for comparing values for at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied to provide a detected feedback change;    means for comparing the detected feedback change to a desired feedback change to provide a comparison result; and    means for adjusting the baroreflex stimulation based on the comparison result to control the baroreflex therapy over the period of time.    
   
   
       13 . The baroreflex stimulator of  claim 12 , wherein the means for comparing values for at least one cardiovascular feedback parameter includes means for comparing heart rate when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.  
   
   
       14 . The baroreflex stimulator of  claim 12 , further comprising means for programming the desired feedback change.  
   
   
       15 . A method, comprising: 
 intermittently providing baroreflex stimulation for a baroreflex therapy over a period of time;    comparing values for at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied to provide a detected feedback change;    comparing the detected feedback change to a desired feedback change to provide a comparison result; and    adjusting the baroreflex stimulation based on the comparison result to control the baroreflex therapy over the period of time.    
   
   
       16 . The method of  claim 15 , further comprising programming the desired feedback change for use in comparing the detected feedback change to the desired feedback change.  
   
   
       17 . The method of  claim 16 , wherein programming the desired feedback change includes programming a percent change for the at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.  
   
   
       18 . The method of  claim 16 , wherein programming the desired feedback change includes programming a quantitative value change for the at least one cardiovascular feedback parameter when the baroreflex stimulation is applied and when then baroreflex stimulation is not applied.  
   
   
       19 . The method of  claim 15 , wherein the at least one cardiovascular feedback parameter is selected from the group consisting of, heart rate, blood pressure and respiration.  
   
   
       20 . The method of  claim 15 , wherein adjusting the baroreflex stimulation includes adjusting a signal characteristic of a baroreflex signal used to provide the baroreflex stimulation wherein the signal characteristic is selected from the group consisting of: 
 amplitude, frequency, burst frequency, pulse width and a duty cycle.    
   
   
       21 . A system for providing baroreceptor stimulation comprising: 
 a sensor to sense a physiologic parameter and provide a signal indicative of the physiologic parameter; and    a baroreceptor activation device, including a pulse generator to intermittently generate a stimulation signal to provide baroreceptor stimulation for a baroreflex therapy; and    a control system to adjust the stimulation signal based on the signal indicative of the physiologic parameter such that the stimulation signal provides a desired baroreceptor stimulation corresponding to a desired physiologic parameter.    
   
   
       22 . A system for providing baroreceptor stimulation, comprising: 
 a baroreceptor activation device including:    a pulse generator to generate a stimulation signal to provide intermittent baroreceptor stimulation for a baroreflex therapy; and    a sensor to monitor at least one physiologic parameter and provide a first a signal indicative of the physiologic parameter during the baroreceptor stimulation and a second signal indicative of a threshold value of a physiologic parameter;    a comparator to provide a detected change for the physiologic parameter based on the first and second signals, and to provide a therapy control signal based on the desired change for the physiologic parameter and the desired change.    
   
   
       23 . A baroreceptor stimulator, comprising 
 means for intermittently providing baroreceptor stimulation for a baroreflex for a baroreflex therapy over a period of time;    means for comparing values for at least one physiologic parameter when the baroreceptor stimulation is applied and values indicative of a threshold value to provide a detected change in the physiologic parameter;    means for comparing the detected physiologic parameter change to a desired physiologic parameter change to provide a comparison result; and    means for adjusting the baroreceptor stimulation based on the comparison result to control the baroreflex therapy over a period of time.    
   
   
       24 . A method, comprising: 
 intermittently providing baroreceptor stimulation for a baroreflex therapy over a period of time;    comparing values for at least one physiologic parameter when the baroreceptor stimulation is applied and values indicative of a threshold parameter to provide a detected physiologic parameter change;    comparing the detected physiologic parameter change to a desired physiologic parameter change to provide a comparison result; and    adjusting the baroreceptor stimulation based on the comparison result to control the baroreflex therapy over a period of time.