ECG input to implantable pulse generator using carotid sinus leads

Abstract

A monitoring device is provided to monitor a patient. The monitoring device includes at least one lead having an electrode. The lead is positioned proximate a location within the patient's body, and the lead is adapted to sense cardiac electrical activity. The monitoring device also includes a control system coupled to the at least one lead to receive a signal representative of the cardiac electrical activity.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS [0001] This application is a continuation of U.S. patent application Ser. No. 10 / 402,911 (Attorney Docket No. 021433-000410US), filed on Mar. 27, 2003, which is: (i) a continuation-in-part of U.S. patent application Ser. No. 09 / 963,777 (Attorney Docket No. 021433-000120US), filed on Sep. 26, 2001; and (ii) claims the benefit of U.S. Provisional Patent Application No. 60 / 368,222 (Attorney Docket No. 021433-000400US), filed on Mar. 27, 2002, the disclosures of each of the above being hereby incorporated by reference in their entirety. The parent application for this application has incorporated by reference the disclosures of the following U.S. Patent Applications: U.S. patent application Ser. No. 09 / 964,079 (Attorney Docket No. 021433-000110US), filed on Sep. 26, 2001, now issued as U.S. Pat. No. 6,985,774, and U.S. patent application Ser. No. 09 / 963,991 (Attorney Docket No. 021433-000130US), filed on Sep. 26, 2001, now issued as U.S. Pat. No....

AI Technical Summary

Benefits of technology

The present invention provides a system, method, and device for regulating blood pressure, heart rate, and neurohormonal activity by activating baroreceptors. By selectively and controllably activating baroreceptors, the invention reduces excessive blood pressure, reduces heart rate, and minimizes the deleterious effects on the heart, vasculature, and other organs and tissues. The invention utilizes electrodes placed on the carotid sinus, aortic arch, or other blood vessels to induce a baroreceptor signal and effect a change in the baroreflex system. The invention also includes an elastic base and a stretchable electrode for conformable attachment to blood vessels. The technical effects of the invention include reducing blood pressure and heart rate, minimizing the impact on the heart and other organs, and improving the efficacy of treating hypertension and heart failure.

Problems solved by technology

Cardiovascular disease is a major contributor to patient illness and mortality.

Hypertension is a leading cause of heart failure and stroke.

It is the primary cause of death in over 42,000 patients per year and is listed as a primary or contributing cause of death in over 200,000 patients per year in the U.S. Accordingly, hypertension is a serious health problem demanding significant research and development for the treatment thereof.

Hypertension occurs when the body's smaller blood vessels (arterioles) constrict, causing an increase in blood pressure.

Because the blood vessels constrict, the heart must work harder to maintain blood flow at the higher pressures.

Although the body may tolerate short periods of increased blood pressure, sustained hypertension may eventually result in damage to multiple body organs, including the kidneys, brain, eyes and other tissues, causing a variety of maladies associated therewith.

The elevated blood pressure may also damage the lining of the blood vessels, accelerating the process of atherosclerosis and increasing the likelihood that a blood clot may develop.

This could lead to a heart attack and / or stroke.

Sustained high blood pressure may eventually result in an enlarged and damaged heart (hypertrophy), which may lead to heart failure.

It is characterized by an inability of the heart to pump enough blood to meet the body's needs and results in fatigue, reduced exercise capacity and poor survival.

It has been reported that the cost of treating heart failure in the United States exceeds $20 billion annually.

Accordingly, heart failure is also a serious health problem demanding significant research and development for the treatment and / or management thereof.

Heart failure results in the activation of a number of body systems to compensate for the heart's inability to pump sufficient blood.

The cardiac, renal and vascular responses increase the workload of the heart, further accelerating myocardial damage and exacerbating the heart failure state.

Although each of these alternative approaches is beneficial in some ways, each of the therapies has its own disadvantages.

For example, drug therapy is often incompletely effective.

Some patients may be unresponsive (refractory) to medical therapy.

Drugs often have unwanted side effects and may need to be given in complex regimens.

These and other factors contribute to poor patient compliance with medical therapy.

Drug therapy may also be expensive, adding to the health care costs associated with these disorders.

Likewise, surgical approaches are very costly, may be associated with significant patient morbidity and mortality and may not alter the natural history of the disease.

Baropacing also has not gained acceptance.

These include the invasiveness of the surgical procedure to implant the nerve electrodes, and postoperative pain in the jaw, throat, face and head during stimulation.

In addition, it has been noted that high voltages sometimes required for nerve stimulation may damage the carotid sinus nerves.

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