Coordinating emergency treatment of cardiac dysfunction and non-cardiac neural dysfunction
Herein is described a device and methods-of-use to treat multiple possible causes of sudden neurological dysfunction related to cardiac, cerebrovascular, or brain electrical abnormalities. The device can be employed so as to treat cardiac dysfunction such as arrhythmia and subsequently related dysfunction of the central nervous system such as stroke and seizure. Alternatively, the device can be employed so as to treat cardiac dysfunction simultaneous with treatment of dysfunction of the central nervous system. Finally, the device can be employed so as to augment the effectiveness of treating cardiac dysfunction, namely the restoration of cardiac output and blood flow to the brain, by dilating the arteries of the brain.
1. A method for treating a subject exhibiting neurological dysfunction with a stimulation control system comprising a stimulation control device, a cardiac stimulation end device, and a neural stimulation end device, the stimulation control system capable of controlling delivery of stimulation to both the heart and one or more neural structures, the method comprising:
receiving, at the stimulation control device, data regarding a determination of a state of consciousness of the subject;
based on the state of consciousness, receiving, by the stimulation control device, data identifying one or more symptoms or signs exhibited by the subject indicative of a global neurological dysfunction condition or a focal neurological dysfunction condition; and
based on the identified symptoms or signs:
determining, by the stimulation control device, whether to deliver stimulation to the subject by one or both of the cardiac stimulation end device and the neural stimulation end device,
determining, by the stimulation control device, one or more parameters of stimulation energy to be provided to the applied end device, the determination in accordance with the identified symptoms or signs, and
delivering, by one or both of the cardiac stimulation end device and neural stimulation end device, one or more types of stimulation energy to the subject based on the one or more parameters.
2. The method of claim 1 , wherein receiving data regarding the determination of the state of consciousness of the subject comprises receiving an indication-that the subject is unconscious and wherein the identified one or more symptoms or signs exhibited by the subject are indicative of the global neurological dysfunction condition, the method further comprising identifying a treatable cardiac arrhythmia arising in the heart, wherein the stimulation control device controls a serial or substantially simultaneous delivery of cardiac stimulation via the cardiac stimulation end device and delivery of neural stimulation via the neural stimulation end device.
3. The method of claim 2 , further comprising:
receiving, by the stimulation control device, data indicating restoration of normal cardiac rhythm due to the delivered cardiac stimulation;
ceasing, by the stimulation control device, delivery of the cardiac stimulation via the cardiac stimulation end device,
determining, by the stimulation control device, whether the subject exhibits additional symptoms or signs indicative of the focal neurological dysfunction condition, and
responsive to the determination, controlling, by the stimulation control device, delivery of neural stimulation via the neural device.
4. The method of claim 1 , wherein receiving data regarding the determination of the state of consciousness of the subject comprises receiving an indication that the subject is conscious and wherein the identified one or more symptoms or signs exhibited by the subject are indicative of the focal neurological dysfunction condition, the method further comprising identifying a stroke or seizure condition arising in the neural structures in the subject, wherein the stimulation control device controls the delivery of neural stimulation to a cranial or peripheral nerve of the subject with the neural stimulation end device.
5. The method of claim 1 , wherein the stimulation control device controls a substantially simultaneous delivery of both cardiac and neural stimulation with both end devices, and wherein the delivery of the neural stimulation is initiated prior to initiation of the delivery of the cardiac stimulation.
6. The method of claim 1 , wherein the stimulation control device controls a substantially simultaneous delivery of both cardiac and neural stimulation with both end devices, and wherein the delivery of cardiac stimulation is ceased prior to cessation of the delivery of the neural stimulation.
7. The method of claim 1 , wherein the delivery of neural stimulation energy via the neural stimulation end device comprises delivering neural stimulation energy to a neural structure.
8. The method of claim 1 , wherein the data identifying one or more symptoms or signs is received by the stimulation control device from one of the cardiac stimulation end device or the neural stimulation end device.
9. The method of claim 1 , the method further comprising:
subsequent to delivering neural stimulation energy with the neural stimulation end device without delivering cardiac stimulation energy with the cardiac stimulation end device, receiving, by the stimulation control device, data indicating persistence of cardiac arrhythmia arising in the heart; and
responsive to receiving the data, controlling, by the stimulation control device, delivery of both cardiac and neural stimulation energy via the cardiac stimulation end device and neural stimulation end device, respectively.