Vagus nerve and carotid baroreceptor stimulation system

1. A method of operating an implantable neurostimulation system, comprising:

delivering a vagus nerve stimulation (VNS) therapy to a vagus nerve of a patient for the treatment of chronic heart failure, according to a first set of parameters, with a VNS subsystem comprising VNS stimulation circuitry of a pulse generator;

delivering a carotid baroreceptor stimulation (CBS) therapy to carotid baroreceptors of the patient for the treatment of hypertension, according to a second set of parameters different from the first set of parameters, with a CBS subsystem comprising CBS stimulation circuitry of the pulse generator, wherein at least a portion of the CBS therapy is provided using the CBS subsystem during a same time during which at least a portion of the VNS therapy is provided using the VNS subsystem;

determining an activity level of the patient; and

temporarily suspending delivery of the CBS therapy during a period of increased activity level of the patient.

2. The method according to claim 1 , further comprising:

detecting subcutaneous electrocardiographic (ECG) signals; and

determining, based on the ECG signals, a change in a heart rate in response to at least one of the VNS therapy or the CBS therapy.

3. The method according to claim 1 , further comprising:

estimating when the patient is in a sleep state; and

modifying at least one of the first set of parameters of the VNS therapy or the second set of parameters of the CBS therapy when the patient is estimated to be in a sleep state.

4. The method according to claim 1 , wherein:

delivering the VNS therapy comprises delivering the VNS therapy via a VNS electrode assembly coupled to the vagus nerve; and

delivering the CBS therapy comprises delivering the CBS therapy via a CBS electrode assembly electrically coupled to the carotid baroreceptors.

5. The method according to claim 4 , wherein the VNS electrode assembly and the CBS electrode assembly are provided on a cuff portion of a lead assembly, the cuff portion configured to wrap around both the vagus nerve and a carotid artery.

6. The method according to claim 4 , wherein the VNS electrode assembly is provided at a distal end of a first lead assembly and the CBS electrode assembly is provided at a distal end of a second lead assembly.

7. The method according to claim 1 , wherein:

delivering the VNS therapy comprises delivering electrical stimulation via a first VNS electrode assembly coupled to a first vagus nerve and delivering electrical stimulation via a second VNS electrode assembly coupled to a second vagus nerve.

8. The method according to claim 1 , wherein:

delivering the CBS therapy comprises delivering electrical stimulation via a first CBS electrode assembly electrically coupled to a first carotid baroreceptor region and delivering electrical stimulation via a second CBS electrode assembly electrically coupled to a second baroreceptor region.

9. The method according to claim 1 , wherein:

delivering the VNS therapy comprises delivering the VNS therapy via a VNS electrode assembly coupled to the vagus nerve and provided at a distal end of a first lead assembly; and

delivering the CBS therapy comprises:

delivering electrical stimulation via a first CBS electrode assembly electrically coupled to a first carotid baroreceptor region and provided at a distal end of a first CBS lead portion; and

delivering electrical stimulation via a second CBS electrode assembly electrically coupled to a second carotid baroreceptor region and provided at a distal end of a second CBS lead portion, the first and second CBS lead portions coupled to a bifurcated portion of a second lead assembly.

10. The method according to claim 1 , wherein:

delivering the VNS therapy comprises:

delivering electrical stimulation via a first VNS electrode assembly coupled to a first vagus nerve and provided at a distal end of a first VNS lead portion, the first VNS lead portion coupled to a bifurcated portion of a first lead assembly; and

delivering electrical stimulation via a second VNS electrode assembly coupled to a second vagus nerve and provided at a distal end of a second VNS lead portion, the second VNS lead portion coupled to a bifurcated portion of a second lead assembly; and

delivering the CBS therapy comprises

delivering electrical stimulation via a first CBS electrode assembly electrically coupled to a first carotid baroreceptor region and provided at a distal end of a first CBS lead portion, the first CBS lead portion coupled to the bifurcated portion of the first lead assembly; and

delivering electrical stimulation via a second VNS electrode assembly electrically coupled to a second carotid baroreceptor region and provided at a distal end of a second CBS lead portion, the second CBS lead portion coupled to the bifurcated portion of the second lead assembly.

11. A non-transitory computer-readable medium having instructions stored thereon that are executable by a processor of an implantable neurostimulation system to cause the processor to perform operations comprising:

delivering a vagus nerve stimulation (VNS) therapy to a vagus nerve of a patient, according to a first set of parameters, with a VNS subsystem comprising VNS stimulation circuitry of a pulse generator of the implantable neurostimulation system;

delivering a carotid baroreceptor stimulation (CBS) therapy to carotid baroreceptors of the patient, according to a second set of parameters different from the first set of parameters, with a CBS subsystem comprising CBS stimulation circuitry of the pulse generator, wherein at least a portion of the CBS therapy is provided using the CBS subsystem during a same time during which at least a portion of the VNS therapy is provided using the VNS subsystem;

determining an activity level of the patient and

temporarily suspending delivery of the CBS therapy during a period of increased activity level of the patient.

12. The non-transitory computer-readable medium of claim 11 , wherein the operations further comprise:

detecting subcutaneous electrocardiographic (ECG) signals; and

determining, based on the ECG signals, a change in a heart rate in response to at least one of the VNS therapy or the CBS therapy.

13. The non-transitory computer-readable medium of claim 11 , wherein the operations further comprise:

estimating when the patient is in a sleep state; and

modifying at least one of the first set of parameters of the VNS therapy or the second set of parameters of the CBS therapy when the patient is estimated to be in a sleep state.

14. The non-transitory computer-readable medium of claim 11 , wherein the operations further comprise:

determining an activity level of the patient; and

modifying at least one of the first set of parameters of the VNS therapy or the second set of parameters of the CBS therapy based on the determined activity level.

15. The non-transitory computer-readable medium of claim 11 , wherein the operations further comprise:

delivering the VNS therapy comprises delivering bilateral VNS therapy to a first vagus nerve and a second vagus nerve.

16. The non-transitory computer-readable medium of claim 11 , wherein the operations further comprise:

delivering the CBS therapy comprises delivering bilateral CBS therapy to a first baroreceptor region and a second baroreceptor region.