Systems and methods for hypertension control
Systems and methods for hypertension control via energy delivery to one or more nerves affecting blood pressure are provided. Systems may include implantable devices configured for non-contacting neuromodulation. Implantable devices may be configured for intravascular implantation. Systems may also include external devices configured to communicated with implantable neuromodulation devices, Additional systems may include non-implantable devices for delivering modulation energy and ablation energy to one or more nerves affecting blood pressure.
1. A hypertension therapy device, comprising:
a carrier configured for deployment in vasculature of a subject;
an antenna located on the carrier;
at least one electrode arranged for deployment with the carrier, the at least one electrode being arranged so as to create an electric field when the electrode is energized;
at least a portion of a circuit arranged for intravascular deployment with the carrier within a blood vessel, the circuit portion being electrically connected to the at least one electrode, the circuit portion further being configured to:
generate a physiological signal indicating a change in a subject's blood pressure; and
receive a control signal configured to, when the change in the subject's blood pressure exceeds a predetermined threshold, cause an electrical signal providing an initial amount of nerve inhibition to be delivered to the at least one electrode and cause an amplitude and a pulse duration of the electrical signal to be iteratively increased by a predetermined amount at a predetermined rate until a desired amount of nerve inhibition occurs; and
wherein the at least one electrode is configured to emit from within an interior of the blood vessel an electrical field sufficient to modulate signals of at least one nerve located outside of the interior of the blood vessel the vasculature, and
wherein the at least one electrode includes a plurality of electrode contacts arranged in subsets, the electrode contacts within each subset being electrically connected to each other.
2. The device of claim 1 , wherein the at least one electrode serves as one of a cathode or an anode, and wherein tissue of a patient serves as another of the anode and the cathode.
3. The device of claim 1 , wherein the at least one electrode includes a conductive loop.
4. The device of claim 1 , wherein the carrier includes a stent and the at least one pair of electrodes and the circuit portion are deployed on the stent.
5. The device of claim 1 , wherein the at least one electrode is configured to emit a unidirectional electrical field.
6. The device of claim 1 , wherein the field sufficient to modulate is a field configured to block nerve transmission.
7. The device of claim 1 , wherein the field sufficient to modulate is a field configured to augment a nerve transmission.
8. The device of claim 1 , wherein the at least one electrode and the circuit portion are configured so that when the carrier is implanted in a carotid artery adjacent a baroreceptor the unidirectional electrical field is shaped to modulate the subject's baroreflex via augmenting a nerve transmission.
9. The device of claim 1 , wherein the carrier is configured for substantially permanent implantation in the vasculature.
10. The device of claim 1 , wherein the carrier is configured for temporary location in the vasculature and for removal following a period of modulation.
11. The device of claim 1 , wherein the at least one electrode and the circuit portion are configured so that when the carrier is implanted in a carotid artery adjacent a glossopharyngeal nerve, the electrical field is shaped to modulate the glossopharyngeal nerve.
12. The device of claim 1 , wherein the at least one electrode and the circuit portion are configured so that when the carrier is implanted in a jugular vein in a vicinity of a glossopharyngeal nerve, the electrical field is shaped to modulate the glossopharyngeal nerve.
13. The device of claim 1 , wherein the at least one electrode and the circuit portion are configured so that when the carrier is implanted in a renal artery in a vicinity of a renal nerve, the electrical field is shaped to modulate the renal nerve.
14. The device of claim 1 , wherein the at least one electrodes and the circuit portion are configured so that when the carrier is implanted in a renal artery in a vicinity of a sympathetic renal nerve, the electrical field is shaped to modulate the sympathetic renal nerve.
15. The device of claim 1 , wherein the circuit portion is configured to receive power wirelessly from a source external to the subject.
16. An intravascular device for hypertension therapy, comprising:
a carrier configured for deployment in a blood vessel via an intravascular deployment mechanism; and
a plurality of electrode contacts arranged circumferentially about the carrier;
wherein the electrode contacts are configured to receive energy from a source and to radiate energy via the plurality of electrical contacts to a plurality of locations on a wall of the blood vessel,
wherein the electrode contacts are arranged in subsets, the electrode contacts within each subset being electrically connected to each other, and
a circuit electrically connected to the electrode contacts and configured to:
generate a physiological signal indicating a change in a subject's blood pressure; and
receive a control signal configured to, when the change in the subject's blood pressure exceeds a predetermined threshold, cause an electrical signal providing an initial amount of nerve inhibition to be delivered to the electrode contacts and cause an amplitude and a pulse duration of the electrical signal to be iteratively increased by a predetermined amount at a predetermined rate until a desired amount of nerve inhibition occurs.
17. The device of claim 16 , wherein at least a portion of the electrode contacts are configured to radiate energy substantially simultaneously to a plurality of locations on a wall of the blood vessel.
18. The device of claim 16 , wherein at least a portion of the electrode contacts are configured to radiate energy to at least one nerve outside the interior of the blood vessel via the blood vessel wall.
19. The device of claim 16 , wherein the carrier is expandable to a position that enables the plurality of electrode contacts to make contact with the vessel wall.
20. The device of claim 16 , wherein the carrier is a balloon.
21. The device of claim 16 , wherein the electrode contacts are arranged on the balloon.
22. The device of claim 16 , wherein the carrier is an expandable mesh.
23. The device of claim 16 , wherein the electrode contacts are configured to radiate ablative energy.
24. The device of claim 16 , wherein the carrier includes an insulator and the contacts protrude through openings in the insulator.
25. The device of claim 16 , wherein each subset of electrode contacts is part of a single elongated electrode and wherein a plurality of first portions of the single electrode are insulated to prevent the plurality of first portions from contacting the vessel wall, and wherein a plurality of second portions of the electrode are exposed to permit the plurality of second portions to contact the vessel wall.
26. The device of claim 16 , further comprising a balloon, and
wherein the carrier is flexible and designed to expand in response to inflation of the balloon.
27. The device of claim 16 , further comprising a mesh of flexible electrodes.