Intermedics Inc.

Cyberonics, Inc.

Robert A Adkins

Ross G Baker, Jr

Reese S Terry, Jr

Eckhard U Alt

Richard V Calfee

Burke T Barrett

Cormac A O'Donovan

A device for treating patients suffering from congestive heart failure includes an implantable neurostimulator for stimulating the patient's vagus nerve at or above the cardiac branch with an electrical pulse waveform at a stimulating rate sufficient to maintain the patient's heart beat at a rate well below the patient's normal resting heart rate, thereby allowing rest and recovery of the heart muscle, to increase in coronary blood flow, and/or growth of coronary capillaries. A metabolic need sensor detects the patient's current physical state and concomitantly supplies a control signal to the neurostimulator to vary the stimulating rate. If the detection indicates a state of rest, the neurostimulator rate reduces the patient's heart rate below the patient's normal resting rate. If the detection indicates physical exertion, the neurostimulator rate increases the patient's heart rate above the normal resting rate.

Treatment of congestive heart failure and autonomic cardiovascular drive disorders

A device and method of controlling seizures in an epileptic patient, in which the device is implanted in the patient for selective activation to generate an electrical waveform constituting a pre-programmed therapy regimen for application to the patient's vagus nerve to modulate the electrical activity thereof in a manner to inhibit, abort, or reduce the severity and duration of the seizure. The device is activated to generate the waveform upon detecting a time rate of change in the patient's heart rate relative to a predetermined threshold time rate of change which is sufficiently abrupt and of sufficient magnitude to be inconsistent with normal physical activity, as being indicative of an imminent epileptic seizure. Sustained cardiac activity at the highest heart rate detected in the change in heart rate is used as a confirmation of imminent seizure. The electrical waveform is generated a burst of pulses, with a minimum time interval between consecutive pulse bursts selected to avoid overstimulation of the nerve. Cardiac activity of the patient is detected using electrodes which include the conductive housing for the device and a stimulating electrode to be mounted on the nerve for large signal detection, or which are integral with the device housing itself so that no electrical leads are required to be implanted for such detection and the electrodes are arranged to detect the cardiac activity with a sensitivity that is substantially independent of orientation of the device as implanted in the patient.

Automatic activation of a neurostimulator device using a detection

A body function assistance device, capable of analyzing changing but cyclic physiologic needs of a patient and generating a response based on the analysis. A microprocessor in the body function assistance device controls the response of the device to various external events and internal timer events. The microprocessor recognizes variations in patterns of recurrent events and adjusts the output of the body function assistasnce device in response to the detected variations. In a particular embodiment, an implantable cardiac pacer is responsive to a circadian wake-sleep cycle.

Implantable device with circadian rhythm adjustment

A body function assistance device, capable of analyzing changing but cyclic physiologic needs of a patient and generating a response based on the analysis. A microprocessor in the body function assistance device controls the response of the device to various external events and internal timer events. The microprocessor recognized variations in patterns of recurrent events and adjusts the output of the body function assistance device in response to the detected variations. In a particular embodiment, an implantable cardiac pacer is responsive to a circadian wake-sleep cycle.

A controller for variably controlling the pacing rate of a cardiac pacer responsive to temperature which includes a logic and control unit, a parameter communication unit, an analog to digital converter and a temperature sensor. The temperature sensor in the right ventricle or atrium communicates a value related to blood temperature through the analog to digital converter to the logic and control unit. The logic and control unit operates under control of the rate algorithm to calculate a pacing rate value related to variations in the blood temperature. The pacing rate value is calculated as the sum of a reference rate, a natural rate response term, and a dynamic rate response term which contributes rate only in response to physical activity. A step rate response is also added to the calculated pacing rate when predetermined criteria related to the blood temperature and calculated pacing rate indicate the onset of physical activity. Under the control of the rate algorithm, the controller also maintains the level and rate of change of the calculated pacing rate within predetermined limits, and prevents the pacing rate from remaining at the maximum rate limit after physical activity has ceased.

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Angleton, TX, United States of America

Robert A Adkins