Active implantable medical device for heart failure therapy with stochastic stimulation of the vagus nerve

摘要

A method for heart treatment includes analyzing the cardiac rhythm. The method further includes utilizing a generator to produce discharges (Si) of N pulses (I) of VNS stimulation in succession. The discharge may be synchronized to a detected R ventricular depolarization wave of each cardiac cycle. The method further includes controlling a stochastic modulation of the discharges control of the delivery of each VNS pulse of each discharge by selective inhibition or not of the generation of these VNS pulses. The number of pulses of each discharge thus randomly varies, and thus varies the VNS stimulation energy of this discharge, which is artificially induced, cycle-to-cycle variability in the RR interval. This stochastic therapy is applied if the spontaneous heart rate variability falls below a minimum level.

主权项

1. An active implantable medical device for the treatment of heart failure with vagus nerve stimulation (VNS), synchronous with cardiac activity, including:
a circuit configured to analyze the cardiac rhythm by collecting an intracardiac electrogram EGM signal and detecting a ventricular depolarization R-wave in each cardiac cycle; a generator, adapted to produce discharges, each discharge comprising N pulses of VNS stimulation generable in succession, with N≧0, the generator configured to initiate the production of each possible discharge VNS with an R-wave synchronization of the moment of delivery of the first VNS pulse of this discharge; and a lead coupled to the generator, wherein the lead is used by the generator to deliver each discharge and perform sensing, wherein the generator comprises a stochastic modulation module configured to separately controlling the delivery of each of the N possible VNS pulses of each discharge according to the result of a randomization; wherein the circuit for analyzing the cardiac rhythm is further configured to evaluate a spontaneous heart rate variability parameter (VSS) and wherein the stochastic modulation is activated in response to the spontaneous heart rate variability parameter falling below a threshold.