DYNAMIC STIMULATION ADJUSTMENT FOR IDENTIFICATION OF A NEURAL FULCRUM

摘要

Systems and methods are provided for delivering neurostimulation therapies to patients for treating chronic heart failure. A computer-implemented control system is operated to automatically identify a neural fulcrum zone based on a monitored patient physiological response. Ongoing neurostimulation therapy is delivered within the neural fulcrum zone.

主权项

1. A neurostimulation system, comprising:
an implantable medical device (IMD) comprising neurostimulator coupled to an electrode assembly, said neurostimulator adapted to deliver a stimulation signal to a patient, said stimulation signal comprising an ON time and an OFF time; and a control system programmed to:
monitor a heart rate of a patient implanted with the IMD during delivery to the patient a plurality of stimulation signals at a first frequency, each stimulation signal having at least one parameter setting different than the parameter settings of the other stimulation signals in the plurality of stimulation signals, wherein said monitoring the heart rate comprises monitoring a baseline heart rate during the OFF time periods of the stimulation signal and monitoring a heart rate response during the ON time periods of the stimulation signal;identify a first subset of the plurality of stimulation signals during which tachycardia is detected during the ON time periods of the stimulation signal;identify a second subset of the plurality of stimulation signals during which bradycardia is detected during the ON time periods of the stimulation signal; andidentify a neural fulcrum zone corresponding to a third subset of the plurality of stimulation signals during which a transition heart rate response is detected during the ON time periods of the stimulation signal, said transition heart rate response between tachycardia and bradycardia.