APPARATUSES FOR MONOPOLAR RENAL NEUROMODULATION
Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally.
1 . An apparatus for performing renal neuromodulation of a patient, the apparatus comprising:
an electric field generator;
a device configured for percutaneous placement proximate a renal vasculature of the patient, the device comprising a monopolar electrode electrically coupled to the electric field generator; and
a ground electrode configured for electrical coupling to an exterior of the patient,
wherein the apparatus is configured for delivery of an electric field between the monopolar electrode and the ground electrode to modulate a neural fiber that contributes to renal function while the device is located proximate the renal vasculature.
2 . The apparatus of claim 1 wherein the monopolar electrode is configured for placement at a position chosen from the group consisting of within the renal vasculature, adjacent to the renal vasculature, external to the renal vasculature, external to the renal vasculature via a laparoscopic approach, external to the renal vasculature via an intra-to-extravascular approach and combinations thereof.
3 . The apparatus of claim 1 wherein the device is configured for intravascular placement, the device further comprising an expandable element configured for expansion from a collapsed delivery configuration to an expanded deployed configuration within the renal vasculature of the patient.
4 . The apparatus of claim 3 wherein the expandable element is configured to center the monopolar electrode within the renal vasculature of the patient.
5 . The apparatus of claim 3 wherein the expandable element is configured to position the monopolar electrode in contact with a wall of the renal vasculature of the patient.
6 . The apparatus of claim 3 wherein the expandable element is configured to position the monopolar electrode external to the renal vasculature of the patient via an intra-to-extravascular approach.
7 . The apparatus of claim 3 wherein the expandable element is configured to alter impedance between the monopolar electrode and the ground electrode when positioned within the renal vasculature of the patient.
8 . The apparatus of claim 3 wherein the expandable element comprises an inflatable balloon.
9 . The apparatus of claim 8 wherein the inflatable balloon comprises the monopolar electrode.
10 . The apparatus of claim 9 wherein the inflatable balloon is fabricated from a conductive polymer.
11 . The apparatus of claim 1 wherein the ground electrode further comprises a ground pad configured for attachment to skin of the patient.
12 . The apparatus of claim 1 wherein the apparatus is configured to deliver a thermal electric field to the neural fiber.
13 . The apparatus of claim 12 wherein the thermal electric field is configured to at least partially ablate the neural fiber.
14 . The apparatus of claim 1 wherein the monopolar electrode further comprises a thermocouple.
15 . The apparatus of claim 1 wherein the monopolar electrode is configured to monitor tissue impedance.
16 . The apparatus of claim 1 wherein the apparatus is configured to deliver a pulsed electric field.