System and methods for electrical stimulation of biological systems
Systems and methods for the treatment of gastroesophageal reflux disease (GERD) include at least one electrically stimulating electrode coupled to a pulse generator. Individuals with GERD are treated by implanting a stimulation device within and/or proximate the patient's lower esophageal sphincter, gastric fundus, or other nearby gastrointestinal structures and applying electrical stimulation to the patient's lower esophageal sphincter and/or fundus, in accordance with certain predefined protocols. Electrical stimulation provided by the disclosed systems results in an increase in the length of the high pressure zone of the LES and/or modulation of the receptive relaxation response of the fundus to decrease gastric pressure, creating a longer barrier to the reflux of gastric contents or increasing functional lower esophageal pressure respectively, thereby treating GERD.
1. A system for increasing a length of a high pressure zone of a lower esophageal sphincter (LES) of a patient, the high pressure zone having a maximum pressure, said system comprising:
at least one electrically stimulating electrode configured to be implanted proximate said LES;
a waveform generator coupled to said at least one electrode; and,
a controller configured to electrically stimulate an area proximate said LES, wherein said controller controls the waveform generator to repeatedly generate and apply an electrical pulse train through the at least one electrically stimulating electrode and wherein said electrical pulse train comprises a pulse width having a range of 30 μsec to 5 msec and a pulse amplitude having a range of 2 to 15 mAmp, wherein values for each of said pulse width and pulse amplitude are selected such that the length of said high pressure zone is increased above a threshold level which reduces at least one of a frequency of occurrence or an intensity of gastroesophageal reflux symptoms in said patient and said maximum pressure is not increased.
2. The system of claim 1 , wherein said at least one electrode is configured to be positioned within said LES.
3. The system of claim 1 , wherein said at least one electrode is configured to be positioned within a gastric cardia of said patient.
4. The system of claim 1 , wherein said at least one electrode is configured to be positioned in an area within 3 cm of said LES.
5. The system of claim 1 , comprising at least two electrodes wherein at least one first electrode is configured to be positioned within said LES and at least one second electrode is configured to be positioned within a gastric cardia of said patient.
6. The system of claim 1 , comprising at least two electrodes wherein at least one first electrode is configured to be positioned within said LES and at least one second electrode is configured to be positioned in an area within 3 cm of said LES.
7. The system of claim 1 , comprising at least two electrodes wherein at least one first electrode is configured to be positioned within a gastric cardia of said patient and at least one second electrode is configured to be positioned in an area within 3 cm of said LES.
8. The system of claim 1 , comprising at least three electrodes wherein at least one first electrode is configured to be positioned within said LES, at least one second electrode is configured to be positioned within a gastric cardia of said patient, and at least one third electrode is configured to be positioned in an area within 3 cm of said LES.
9. The system of claim 1 , wherein said high pressure zone has a baseline length prior to stimulation and said threshold level defines a length of said high pressure zone which is at least 10% greater than said baseline length.
10. A system for increasing a length of a high pressure zone of a lower esophageal sphincter (LES) of a patient, the high pressure zone having a maximum pressure, said system comprising:
at least one electrically stimulating electrode configured to be positioned proximate said LES;
a waveform generator coupled to said at least one electrode;
a controller configured to electrically stimulate an area proximate said LES to increase the length of said high pressure zone above a threshold level which reduces at least one of a frequency of occurrence or an intensity of gastroesophageal reflux symptoms in said patient, wherein said controller controls the waveform generator to repeatedly generate and apply an electrical pulse train through the at least one electrically stimulating electrode, wherein said electrical pulse train comprises a pulse width having a range of 30 μsec to 5 msec and a pulse amplitude having a range of 2 to 15 mAmp, and wherein values for each of said pulse width and pulse amplitude are selected such that prior to stimulation, an average pressure within said high pressure zone is greater than a first pressure, the maximum pressure is equal to a second pressure, and a baseline length is equal to a first length and, after stimulation, an average pressure within said high pressure zone is greater than the first pressure, the maximum pressure is equal the second pressure, and a length of the high pressure zone is at least 10% greater than said baseline length.
11. The system of claim 10 , wherein said at least one electrode is configured to be positioned within said LES.
12. The system of claim 10 , wherein said at least one electrode is configured to be positioned within a gastric cardia of said patient or within 3 cm of said LES.
13. The system of claim 10 , further comprising at least one sensor for sensing at least one physiological parameter of said patient.
14. The system of claim 13 , wherein said at least one sensor is configured to measure any one or combination of LES high pressure zone length, LES pressure, esophageal pH, inclinometer data, temperature, or accelerometer data.
15. The system of claim 14 , wherein said controller is configured to electrically stimulate said area proximate said LES based on data sensed by said at least one sensor.
16. The system of claim 10 wherein the average pressure is 5 mm Hg and the maximum pressure is 10 mm Hg.