System and method for sustained baroreflex stimulation

Abstract

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.

1 . (canceled) 
     
     
         2 . A method for operating a neurostimulator having a neurostimulation generator, a controller, a memory, and a programmed therapy application with a programmed stimulation protocol stored in the memory, the method comprising:
 using the controller to execute the therapy application to deliver a chronic neurostimulation therapy with an intensity to produce a therapeutic effect, including control the neurostimulation generator to generate a neurostimulation waveform,   wherein the programmed stimulation protocol is configured to provide a programmed variation in the intensity of the neurostimulation therapy to sustain the therapeutic effect of the chronic neurostimulation therapy.   
     
     
         3 . The method of  claim 2 , wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to mimic naturally-occurring neural activity. 
     
     
         4 . The method of  claim 3 , wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the neurostimulation waveform to mimic noise. 
     
     
         5 . The method of  claim 4 , wherein the neurostimulation waveform has an amplitude, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the amplitude of the neurostimulation waveform. 
     
     
         6 . The method of  claim 2 , wherein the neurostimulation waveform has a frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the frequency of the neurostimulation waveform. 
     
     
         7 . The method of  claim 2 , wherein the neurostimulation waveform includes a burst frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity modulate the burst frequency of the neurostimulation waveform. 
     
     
         8 . The method of  claim 2 , further comprising changing a morphology of the neurostimulation waveform. 
     
     
         9 . The method of  claim 2 , wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to periodically vary the neurostimulation waveform. 
     
     
         10 . The method of  claim 9 , further comprising detecting a physiologic parameter, wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to use the detected physiologic parameter to periodically vary the neurostimulation waveform. 
     
     
         11 . A non-transitory machine-readable medium including instructions, which when executed by a machine, cause the machine to:
 delivering a chronic neurostimulation therapy with an intensity to produce a therapeutic effect, including executing a programmed therapy application with a programmed stimulation protocol to control delivery of the neurostimulation therapy, including generating a neurostimulation waveform, wherein the programmed stimulation protocol is configured to provide a programmed variation in the intensity of the neurostimulation therapy to sustain the therapeutic effect of the chronic neurostimulation therapy.   
     
     
         12 . The non-transitory machine-readable medium of  claim 11 , wherein the neurostimulation waveform has an amplitude, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the amplitude of the neurostimulation waveform. 
     
     
         13 . The non-transitory machine-readable medium of  claim 11 , wherein the neurostimulation waveform has a frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the frequency of the neurostimulation waveform. 
     
     
         14 . The non-transitory machine-readable medium of  claim 11 , wherein the neurostimulation waveform includes a burst frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the burst frequency of the neurostimulation waveform. 
     
     
         15 . A system for use with neurostimulation electrodes, comprising:
 a neurostimulation generator configured to generate a neurostimulation waveform and deliver the neurostimulation waveform through the neurostimulation electrodes;   a controller operably connected to the neurostimulation generator to control the generation of the neurostimulation waveform, the controller including a memory with a programmed therapy application with a programmed stimulation protocol stored in the memory,   wherein the controller is configured to execute the programmed therapy application to deliver a chronic neurostimulation therapy with an intensity to produce a therapeutic effect, including control the neurostimulation generator to generate a neurostimulation waveform,   wherein the programmed stimulation protocol is configured to provide a programmed variation in the intensity of the neurostimulation therapy to sustain the therapeutic effect of the chronic neurostimulation therapy.   
     
     
         16 . The system of  claim 15 , wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to mimic naturally-occurring neural activity. 
     
     
         17 . The system of  claim 15 , wherein the neurostimulation waveform has an amplitude, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the amplitude of the neurostimulation waveform. 
     
     
         18 . The system of  claim 15 , wherein the neurostimulation waveform has a frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the frequency of the neurostimulation waveform. 
     
     
         19 . The system of  claim 15 , wherein the neurostimulation waveform includes a burst frequency, and the programmed stimulation protocol is configured to provide the programmed variation in the intensity to modulate the burst frequency of the neurostimulation waveform. 
     
     
         20 . The system of  claim 15 , further comprising changing a morphology of the neurostimulation waveform. 
     
     
         21 . The system of  claim 15 , wherein the programmed stimulation protocol is configured to provide the programmed variation in the intensity to periodically vary the neurostimulation waveform.