Electrically efficient neurally-excitable stimulation

A - Human Necessities – 61 – N

Patent

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A61N 1/362 (2006.01) A61N 1/365 (2006.01)

Patent

CA 2535553

A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.

L'invention concerne un dispositif médical, par exemple, un dispositif médical implantable, conçu pour envoyer une ou plusieurs impulsions de stimulation par excitation neuronale à un tissu myocardique pendant un laps de temps durant lequel le tissu est réfractaire. La durée des impulsions est inférieure ou égale à environ une demie milliseconde. Dans certains modes de réalisation, l'intensité courante des impulsions est inférieure ou égale à environ 20 milliampères. Dans des modes de réalisations exemplaires, le dispositif médical envoie un train d'impulsions de six impulsions ou moins séparé les unes des autres par un intervalle qui est supérieur ou égal à environ 10 millisecondes. Dans certains modes de réalisation, le dispositif médical envoie des impulsions d'après un programme stocké dans une mémoire, ou en fonction d'un paramètre physiologique contrôlé d'un patient, tel que, par exemple, une pression intracardiaque. Dans certains modes de réalisation, le dispositif médical suspend ou diffère l'envoi d'impulsions de stimulation en fonction de la détection d'une ischémie cardiaque.

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