TREATMENT OF CONGESTIVE HEART FAILURE WITH ELECTRICAL STIMULATION, AND ASSOCIATED SYSTEMS AND METHODS
Systems and methods for treating congestive heart failure with high frequency stimulation are disclosed. A representative method for treating a patient includes applying an electrical signal having a frequency of from about 1 kHz to about 100 kHz to the patient via a treatment system that includes a signal delivery element in electrical communication with the patient's vagus nerve at a portion of the vagus nerve located at or proximate to the anterior interventricular junction of the patient's heart. The method can further include automatically detecting at least one physiological parameter of the patient, automatically determining at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction based on the detected parameter, and automatically adjusting the applied signal based on the determined ejection fraction.
1 . A method for treating congestive heart failure in a patient, comprising:
applying an electrical signal to the patient via a treatment system that includes a signal delivery element in electrical communication with the patient's vagus nerve at a portion of the vagus nerve located at or proximate to the anterior interventricular junction of the patient's heart, the electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz;
automatically detecting at least one physiological parameter of the patient;
based on the detected parameter, automatically determining an ejection fraction indicator that is at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
automatically adjusting the applied signal based on the determined ejection fraction indicator.
2 . The method of claim 1 wherein automatically adjusting the applied signal includes stopping the application of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.
3 . The method of claim 2 wherein applying the electrical signal occurs at a first time, and wherein automatically adjusting the applied signal includes applying the electrical signal at a second time in response to detecting an ejection fraction indicator less than the target ejection fraction threshold.
4 . The method of claim 1 wherein automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator less than a target ejection fraction threshold.
5 . The method of claim 1 wherein automatically adjusting the applied signal includes decreasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.
6 . The method of claim 1 wherein:
automatically detecting a physiological parameter includes automatically detecting the patient's heart rate; and
automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to the increase in the patient's heart rate.
7 . The method of claim 1 wherein applying the electrical signal includes applying the signal to the patient via a lead positioned at or proximate to the atrial-ventricular fat pads of the patient's heart.
8 . The method of claim 1 wherein applying the electrical signal includes applying the signal with a pulse width less than or equal to 1/(2×the frequency of the signal).
9 . The method of claim 1 wherein the treatment system includes an implantable treatment system.
10 . The method of claim 1 wherein the at least one detected physiological parameter includes at least one of the patient's heart rate, the patient's blood pressure, and the patient's blood flow rate.
11 . A method for treating congestive heart failure in a patient, comprising:
applying an electrical signal to an epicardial fat pad of the patient's heart, the applied signal having a frequency of from about 1 kHz to about 100 kHz;
automatically monitoring an ejection fraction of the patient;
automatically comparing the monitored ejection fraction value to a predetermined threshold; and
based on the comparison, automatically adjusting the applied signal.
12 . The method of claim 11 wherein automatically adjusting the applied signal includes stopping the application of the applied signal in response to detecting an ejection fraction greater than or equal to a target ejection fraction threshold.
13 . The method of claim 12 wherein applying the electrical signal occurs at a first time, and wherein automatically adjusting the applied signal includes applying the electrical signal at a second time in response to detecting an ejection fraction less than the target ejection fraction threshold.
14 . The method of claim 11 wherein automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction less than a target ejection fraction threshold.
15 . The method of claim 11 wherein automatically adjusting the applied signal includes decreasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction greater than or equal to a target ejection fraction threshold.
16 . A system for treating congestive heart failure in a patient, comprising:
an electrical signal generator having a computer readable storage medium;
an implantable signal delivery element coupled to the signal generator, wherein the signal delivery element is configured to be positioned proximate an epicardial fat pad of the patient and apply an electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz to neural tissue proximate and/or within the epicardial fat pad; and
wherein the computer-readable storage medium has instructions that when executed:
determine in real-time at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
adjust the signal applied by the signal delivery element in response to the determined ejection fraction.
17 . The system of claim 16 , further comprising a sensor in communication with the computer-readable storage medium, wherein the sensor is configured to detect a physiological parameter of the patient, and wherein the instructions, when executed, calculate the ejection fraction based on the physiological parameter.
18 . The system of claim 16 wherein the signal generator is an implantable signal generator.
19 . The system of claim 16 wherein the instructions, when executed, and in response to a determined ejection fraction greater than or equal to a predetermined target threshold, cease to apply the electrical signal.
20 . The system of claim 16 wherein the instructions, when executed, and in response to a determined ejection fraction less than or equal to a predetermined target threshold, start application of the electrical signal.
21 . The system of claim 16 wherein the instructions, when executed, and in response to a determined ejection fraction less than or equal to a predetermined target threshold, increase at least one of an amplitude or a pulse width of the electrical signal.
22 . The system of claim 16 wherein the signal delivery element is configured to be positioned within a coronary blood vessel of the patient.
23 . A method for treating congestive heart failure in a patient, comprising:
applying an electrical signal to the patient via a treatment system that includes a signal delivery element positioned at an epicardial fat pad of the patient's heart, the electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz;
automatically detecting at least one physiological parameter of the patient via one or more sensing elements;
based on the detected parameter, automatically determining an ejection fraction indicator that is at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
automatically adjusting the applied signal based on the determined ejection fraction indicator.
24 . The method of claim 23 wherein automatically adjusting the applied signal includes stopping the application of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.
25 . The method of claim 23 wherein applying the electrical signal occurs at a first time, and wherein automatically adjusting the applied signal includes applying the electrical signal at a second time in response to detecting an ejection fraction indicator less than the target ejection fraction threshold.
26 . The method of claim 23 wherein automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator less than a target ejection fraction threshold.
27 . The method of claim 23 wherein automatically adjusting the applied signal includes decreasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.
28 . The method of claim 23 wherein:
automatically detecting a physiological parameter includes automatically detecting the patient's heart rate; and
automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to the increase in the patient's heart rate.
29 . The method of claim 23 wherein applying the electrical signal includes applying the signal to the patient via a lead positioned at or proximate to the atrial-ventricular fat pads of the patient's heart.
30 . The method of claim 23 wherein applying the electrical signal includes applying the signal with a pulse width less than or equal to 1/(2×the frequency of the signal).
31 . The method of claim 23 wherein the treatment system includes an implantable treatment system.
32 . The method of claim 23 wherein the at least one detected physiological parameter includes at least one of the patient's heart rate, the patient's blood pressure, and the patient's blood flow rate.
33 . A system for treating congestive heart failure in a patient, comprising:
an implantable electrical signal generator having a computer readable storage medium;
an implantable signal delivery element coupled to the signal generator, wherein the signal delivery element is configured to be positioned at or proximate the patient's vagus nerve at a portion of the vagus nerve located at or proximate to the interventricular junction of the patient's heart, and wherein the signal delivery element is configured to apply an electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz to neural tissue proximate the portion of the vagus nerve; and
wherein the computer-readable storage medium has instructions that when executed:
determine an ejection fraction indicator that is at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
adjust the signal applied by the signal delivery element in response to the determined ejection fraction indicator.
34 . The system of claim 33 , further comprising a sensor in communication with the computer-readable storage medium, wherein the sensor is configured to detect a physiological parameter of the patient, and wherein the instructions, when executed, calculate the ejection fraction indicator based on the physiological parameter.
35 . The system of claim 33 wherein the instructions, when executed, and in response to a determined ejection fraction indicator greater than or equal to a predetermined target threshold, cease to apply the electrical signal.
36 . The system of claim 33 wherein the instructions, when executed, and in response to a determined ejection fraction indicator less than or equal to a predetermined target threshold, start application of the electrical signal.
37 . The system of claim 33 wherein the instructions, when executed, and in response to a determined ejection fraction indicator less than or equal to a predetermined target threshold, increase at least one of an amplitude or a pulse width of the electrical signal.
38 . The system of claim 33 wherein the signal delivery element is configured to be positioned within a coronary blood vessel of the patient.
39 . A system for treating congestive heart failure in a patient, comprising:
an implantable electrical signal generator having a computer readable storage medium;
an implantable signal delivery element coupled to the signal generator, wherein the signal delivery element is configured to be positioned at least partially within the coronary sinus of the patient's heart, and wherein the signal delivery element is configured to apply an electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz to neural tissue proximate the coronary sinus; and
wherein the computer-readable storage medium has instructions that when executed:
determine an ejection fraction indicator that is at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
adjust the signal applied by the signal delivery element in response to the determined ejection fraction indicator.
40 . The system of claim 39 , further comprising a sensor in communication with the computer-readable storage medium, wherein the sensor is configured to detect a physiological parameter of the patient, and wherein the instructions, when executed, calculate the ejection fraction indicator based on the physiological parameter.
41 . The system of claim 39 wherein the instructions, when executed, and in response to a determined ejection fraction indicator greater than or equal to a predetermined target threshold, cease to apply the electrical signal.
42 . The system of claim 39 wherein the instructions, when executed, and in response to a determined ejection fraction indicator less than or equal to a predetermined target threshold, start application of the electrical signal.
43 . The system of claim 39 wherein the instructions, when executed, and in response to a determined ejection fraction indicator less than or equal to a predetermined target threshold, increase at least one of an amplitude or a pulse width of the electrical signal.
44 . A method for treating congestive heart failure in a patient, comprising:
applying an electrical signal to the patient via a treatment system that includes a signal delivery element positioned at least partially within the coronary sinus of the patient's heart, the electrical signal having a frequency in a range of from about 1 kHz to about 100 kHz;
automatically detecting at least one physiological parameter of the patient via one or more sensing elements;
based on the detected parameter, automatically determining an ejection fraction indicator that is at least one of an ejection fraction of the patient's heart and a correlate of the ejection fraction; and
automatically adjusting the applied signal based on the determined ejection fraction indicator.
45 . The method of claim 44 wherein automatically adjusting the applied signal includes stopping the application of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.
46 . The method of claim 45 wherein applying the electrical signal occurs at a first time, and wherein automatically adjusting the applied signal includes applying the electrical signal at a second time in response to detecting an ejection fraction indicator less than the target ejection fraction threshold.
47 . The method of claim 44 wherein automatically adjusting the applied signal includes increasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator less than a target ejection fraction threshold.
48 . The method of claim 44 wherein automatically adjusting the applied signal includes decreasing at least one of an amplitude of the applied signal and a pulse width of the applied signal in response to detecting an ejection fraction indicator greater than or equal to a target ejection fraction threshold.