Controlled titration of neurostimulation therapy

摘要

Described herein are methods and devices that utilize electrical neural stimulation to treat heart failure by modulating a patient's autonomic balance in a manner that inhibits sympathetic activity and/or augments parasympathetic activity. Because other therapies for treating heart failure may also affect a patient's autonomic balance, a device for delivering neural stimulation is configured to appropriately titrate such therapy in either an open-loop or closed-loop fashion.

主权项

1. An implantable device for delivering neurostimulation to a patient, comprising:
a pulse generator for outputting neurostimulation pulses and for connecting to one or more stimulation electrodes to deliver electrical stimulation to one or more selected neural sites the produce parasympathetic stimulation and/or sympathetic inhibition; a controller connected to the pulse generator for controlling the output of neurostimulation pulses in accordance with a defined schedule that specifies the times of day the neurostimulation pulses are to be delivered and in accordance with one or more stimulation parameters; a sensor interfaced to the controller for sensing a physiological variable reflective of a patient's autonomic balance; a telemetry unit interfaced to the controller, wherein the controller is programmed to receive medication dosage information via telemetry that includes the time or times of day that a medication affecting the patient's autonomic balance is to be taken; and, wherein the controller is programmed to adjust the schedule for delivering neurostimulation in accordance with received medication dosage information after confirming that the medication has had its expected effect on the patient's autonomic balance as reflected by the sensed physiological variable.