NEUROSTIMULATION AND RECORDING OF PHYSIOLOGICAL RESPONSE FOR THE TREATMENT OF CHRONIC CARDIAC DYSFUNCTION

摘要

Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A neural fulcrum zone is identified and ongoing neurostimulation therapy is delivered within the neural fulcrum zone. The implanted stimulation device includes a physiological sensor for recording the patient's response to the neurostimulation therapy on an ambulatory basis over extended periods of time.

主权项

1. An implantable medical device (IMD), comprising:
an electrode assembly; a neurostimulator coupled to the electrode assembly, said neurostimulator adapted to deliver a stimulation signal to a patient in a neural fulcrum zone of the patient, said stimulation signal comprising an ON time and an OFF time; a heart rate sensor configured to acquire a heart rate signal from the patient; and a control system coupled to the neurostimulator, and the heart rate sensor and configured to:
monitor a baseline signal acquired by the heart rate sensor, wherein the baseline signal comprises a baseline heart rate during the OFF time of the stimulation signal;monitor a response signal acquired by the heart rate sensor, wherein the response signal comprises a heart rate response during the ON time of the stimulation signal; anddetect whether the stimulation signal is within the neural fulcrum zone corresponding to a stimulation intensity during which a transition heart rate response is detected, the transition heart rate response being between tachycardia and bradycardia and comprising a heart rate change between the baseline signal and the response signal that is less than a predefined threshold.