Catheter system for acute neuromodulation
A neuromodulation system includes a first therapy element adapted for positioning within a superior vena cava, and a second therapy element adapted for positioning within a pulmonary artery. The first therapy element is carried on a first elongate flexible shaft, and the second therapy element is carried on a second elongate flexible shaft. One of the first and second shafts is slidably received within a lumen of the other of the first and second shafts—so that the second therapy element may be advanced within the body relative to the first therapy element. A stimulator is configured to energize the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the superior vena cava and to energize the second therapy element within the pulmonary artery to deliver sympathetic therapy to a second nerve fiber disposed external to the pulmonary artery. For treatment of heart failure, the first nerve fiber may be a vagus nerve and the second nerve fiber may be a sympathetic nerve fiber.
1. A neuromodulation system for treating a patient, comprising:
a first therapy element adapted for positioning within a first blood vessel, the first therapy element carried on a first elongate shaft, wherein the elongate shaft of the first therapy element includes
an outer sheath having a distal portion, and an expandable anchoring element on the distal portion, the expandable anchoring element radially expandable from the distal portion of the outer sheath from a streamlined to an expanded position in response to relative movement of a proximal portion of the outer sheath towards the distal portion, wherein the therapy element comprises electrodes on the expandable anchoring element, and
an inner sheath slidably disposed within the outer sheath, the inner and outer sheath having distal portions fixed to one another, such that relative longitudinal movement of proximal portions of the inner and outer sheaths in opposite directions while the distal portions remain fixed to one another moves the proximal portion of the inner sheath towards the fixed distal portions to move the expandable anchoring element between streamlined and expanded positions;
a second therapy element adapted for positioning with a second blood vessel different from the first blood vessel, the second therapy element carried on a second shaft, wherein one of the first and second shafts is slidably received within a lumen of the other of the first and second shafts; and
a stimulator configured to (a) energize the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the first blood vessel and (b) energize the second therapy element within the second blood vessel to deliver sympathetic therapy to a second nerve fiber disposed external to the first blood vessel.
2. The system of claim 1 , further including control means for receiving input corresponding to sensed heart rate and/or blood pressure of the patient and controlling the stimulation in response to said sensed heart rate and/or blood.
3. The system of claim 1 , wherein each of the first and second therapy elements is at least partially expandable to position the first and second therapy elements in contact with surrounding walls of the first and second blood vessels.
4. The system of claim 1 , wherein the second therapy element is adapted for positioning within a pulmonary artery.
5. The system of claim 4 , further including an expandable balloon coupled to the second therapy element, the balloon positioned such that when the first therapy element is retained in the first blood vessel, expansion of the balloon causes the second therapy element to be carried by blood flow from the heart to the pulmonary artery.
6. The system of claim 4 , wherein the first therapy element is adapted for positioning within a superior vena cava.