Implantable system to transvascularly stimulate nerve

Abstract

This document discusses, among other things, apparatus, systems, and methods for transvascularly stimulation of a nerve or nerve trunk. In an example, an apparatus is configured to transvascularly stimulate a nerve trunk through a blood vessel. The apparatus includes an expandable electrode that is chronically implantable in a blood vessel proximate a nerve trunk. The expandable electrode is configured to abut a predetermined surface area of the vessel wall along a predetermined length of the vessel. An electrical lead is coupled to the expandable electrode. An implantable pulse generator is coupled to the lead and configured to deliver an electrical stimulation signal to the electrode through the lead. in an example method, an electrical signal is delivered from an implanted medical device to an electrode chronically implanted in a blood vessel proximate a nerve trunk to transvascularly deliver neural stimulation from the electrode to the nerve trunk.

1 . (canceled) 
     
     
         2 . An implantable system, comprising:
 an implantable device; and   an implantable satellite unit configured to communicate with the implantable device, the satellite unit being implantable separately from the implantable device, the satellite unit including an electrode chronically implantable in a blood vessel and configured to abut an intravascular surface of the blood vessel, wherein the satellite unit is configured to use the electrode in the blood vessel to transvascularly deliver electrical stimulation from the electrode through a wall of the blood vessel to a targeted nerve on or near an extravascular surface of the blood vessel.   
     
     
         3 . The system of  claim 2 , wherein the satellite unit is configured to communicate with the implantable device using a wireless link. 
     
     
         4 . The system of  claim 2 , wherein the system is configured to be implanted in a body, and the satellite unit is configured to communicate with the implantable device using conduction through the body. 
     
     
         5 . The system of  claim 2 , wherein the nerve is a vagus nerve or a branch of the vagus nerve, and the satellite unit is configured to use the electrode in the blood vessel to transvascularly stimulate the vagus nerve or the branch of the vagus nerve. 
     
     
         6 . The system of  claim 2 , wherein the blood vessel is a pulmonary artery, and the satellite unit is configured to use the electrode in the pulmonary artery to transvascularly stimulate the vagus nerve or the branch of the vagus nerve. 
     
     
         7 . The system of  claim 2 , wherein the blood vessel is an internal jugular vein, and the satellite unit is configured to use the electrode in the internal jugular vein to transvascularly stimulate the vagus nerve. 
     
     
         8 . The system of  claim 2 , wherein the blood vessel is an aortic arch, and the satellite unit is configured to use the electrode in the aortic arch to transvascularly stimulate the vagus nerve. 
     
     
         9 . The system of  claim 2 , wherein the blood vessel is an azygos vein, and the satellite unit is configured to use the electrode in the azygos vein to transvascularly stimulate the vagus nerve. 
     
     
         10 . The system of  claim 2 , wherein the blood vessel is a subclavian artery and the nerve is a cardiac nerve, and the satellite unit is configured to use the electrode in the subclavian artery to transvascularly stimulate the cardiac nerve. 
     
     
         11 . The system of  claim 2 , wherein the nerve is a parasympathetic nerve. 
     
     
         12 . The system of  claim 2 , the nerve is a carotid sinus nerve, and the satellite unit is configured to use the electrode in the blood vessel to transvascularly stimulate the carotid sinus nerve. 
     
     
         13 . The system of  claim 2 , wherein the expandable electrode includes a drug-eluting component. 
     
     
         14 . system of  claim 13 , wherein the drug-eluting component is configured to elute a drug to reduce inflammation or is configured to elute a drug to prevent occlusion. 
     
     
         15 . The system of  claim 2 , wherein the expendable electrode includes a stent. 
     
     
         16 . The system of  claim 2 , wherein the expandable electrode includes a mesh, and at least part of the mesh is conductive. 
     
     
         17 . The system of  claim 2 , wherein the blood vessel is a carotid artery and the nerve is the carotid sinus nerve, and the satellite unit is configured to use the electrode in the carotid artery to transvascularly stimulate the cardiac sinus nerve. 
     
     
         18 . The system of  claim 2 , wherein the blood vessel is a blood vessel proximate to a nerve that innervates a kidney, wherein the satellite unit is configured to use the electrode in the blood vessel to transvascularly stimulate the nerve that innervates the kidney. 
     
     
         19 . The system of  claim 2 , wherein the blood vessel is a blood vessel proximate to a nerve that innervates a lung, wherein the satellite unit is configured to use the electrode in the blood vessel to transvascularly stimulate the nerve that innervates the lung 
     
     
         20 . The system of  claim 2 , wherein the implantable device includes an implantable cardiac device configured to pace cardiac tissue. 
     
     
         21 . An implantable system for implantation in a body, comprising:
 an implantable cardiac device configured to pace cardiac tissue; and   an implantable satellite unit configured to communicate with the cardiac device using a wireless link or using conduction through the body, the satellite unit being implantable separately from the implantable cardiac device, the satellite unit including an electrode chronically implantable in a blood vessel and configured to abut an intravascular surface of the blood vessel, wherein the satellite unit is configured to use the electrode in the blood vessel to transvascularly deliver electrical stimulation from the electrode through a wall of the blood vessel to a targeted nerve on or near an extravascular surface of the blood vessel.