Devices, systems, and methods for delivering therapy to intestinal muscle
Systems for delivering therapy to an intestinal muscle in a patient may comprise a cardiac sensor, an intestinal sensor, an implantable pulse generator and a signal delivery device. The signal delivery device may be configured to deliver a stimulation signal to the muscle. The implantable pulse generator may comprise a microcontroller configured to receive cardiac data from the cardiac sensor and calculate a heart rate parameter therefrom, receive intestinal activity data from the intestinal sensor and calculate an intestinal activity parameter therefrom, determine a physiological state of a patient based on the parameters, adjust a stimulation parameter of the stimulation signal based on the determined state, and instruct the signal delivery device to deliver an adjusted stimulation signal.
1. A method for delivering a stimulation signal to an intestinal muscle of a patient comprising:
receiving electrocardiographic of a heart from a cardiac sensor;
receiving myoelectrical intestinal activity data from an intestinal sensor, wherein the myoelectrical intestinal activity data is data from a duodenum, a jejunum, or an ileum of the patient;
determining a physiological state of the patient based on the electrocardiographic data;
calculating an intestinal activity parameter from the myoelectrical intestinal activity data;
adjusting a stimulation signal based on the determined physiological state and the intestinal activity parameter, wherein one or more of an amplitude, a frequency, a pulse width, a burst interval, a duty cycle, and a stimulation duration of the stimulation signal is adjusted based on the intestinal activity parameter; and
applying the adjusted stimulation signal to the intestinal muscle of the patient.
2. The method of claim 1 further comprising calculating a heart rate parameter from the electrocardiographic data.
3. The method of claim 2 , wherein the heart rate parameter comprises a time-domain heart rate parameter or a frequency-domain heart rate parameter.
4. The method of claim 3 , wherein the heart rate parameter comprises average heart rate.
5. The method of claim 3 , wherein the heart rate parameter comprises power of a low frequency band, power of a high frequency band, or a low frequency to high frequency power ratio.
6. The method of claim 3 , wherein the heart rate parameter comprises a time-domain heart rate parameter and a frequency-domain heart rate parameter.
7. The method of claim 1 , wherein the intestinal activity parameter comprises an intestinal slow wave activity parameter or an intestinal bursting activity parameter.
8. The method of claim 7 , wherein the intestinal slow wave activity parameter comprises an intestinal slow wave frequency or intestinal slow wave power.
9. The method of claim 7 , wherein the intestinal bursting activity parameter comprises intestinal bursting duration, intestinal bursting spike number, or intestinal bursting spike frequency.
10. The method of claim 7 , wherein the intestinal activity parameter comprises intestinal slow wave activity parameter and an intestinal bursting activity parameter.
11. The method of claim 1 , wherein the frequency of the stimulation signal is adjusted based on the intestinal activity parameter.
12. The method of claim 1 , wherein the pulse width and the duty cycle of the stimulation signal are adjusted and the adjusted stimulation signal comprises pulse width between about 1 milliseconds and about 10 milliseconds and a duty cycle between about 0.1% and about 10%.
13. The method of claim 1 , wherein the intestinal muscle is intestinal muscle of a duodenum, a jejunum, or an ileum.
14. The method of claim 1 further comprising receiving intestinal temperature data from an intestinal thermal probe, wherein the intestinal activity parameter is calculated from the myoelectrical intestinal activity data and the intestinal temperature data.
15. The method of claim 1 , wherein the adjusted stimulation signal is applied to the intestinal muscle of the patient using a signal delivery device and the method further comprises surgically implanting the signal delivery device or non-surgically positioning the signal delivery device.
16. The method of claim 15 wherein the method comprises non-surgically positioning the signal delivery device using a trans-nasal or a trans-oral catheter.
17. The method of claim 1 , wherein the intestinal sensor is placed in a duodenum, a jejunum, or an ileum of the patient.
18. A method for delivering a stimulation signal to an intestinal muscle of a patient comprising:
receiving electrocardiographic data of a heart from a cardiac sensor;
receiving intestinal activity data from an intestinal sensor, wherein the intestinal activity data is data from a duodenum, a jejunum, or an ileum of the patient;
determining a physiological state of the patient based on the electrocardiographic data;
calculating an intestinal activity parameter from the intestinal activity data;
adjusting stimulation signal based on the determined physiological state and the intestinal activity parameter, wherein one or more of an amplitude, a frequency, a pulse width, a burst interval, a duty cycle, and a stimulation duration of the stimulation signal is adjusted based on the intestinal activity parameter; and
applying the adjusted stimulation signal to the intestinal muscle of the patient.
19. The method of claim 18 , wherein the intestinal muscle is intestinal muscle of a duodenum, a jejunum, or an ileum.
20. The method of claim 18 , wherein the intestinal sensor is placed in a duodenum, a jejunum, or an ileum of the patient.
21. A system for delivering an electrical stimulus to a muscle of a small intestine of a patient comprising:
a cardiac sensor;
an intestinal sensor;
an implantable signal delivery device configured to deliver a stimulation signal to the muscle;
an implantable pulse generator comprising a microcontroller configured to:
receive cardiac data from the cardiac sensor and calculate a heart rate parameter from the cardiac data;
receive intestinal activity data from the intestinal sensor and calculate an intestinal activity parameter from the intestinal activity data;
determine a physiological state of the patient based on the heart rate parameter;
adjust a stimulation signal based on the determined physiological state and the intestinal activity parameter, wherein one or more of an amplitude, a frequency, a pulse width, a burst interval, a duty cycle, and a stimulation duration of the stimulation signal is adjusted based on the intestinal activity parameter; and
instruct the implantable signal delivery device to deliver the adjusted stimulation signal.
22. The system of claim 21 , wherein the muscle of the small intestine is intestinal muscle of a duodenum, a jejunum, or an ileum.
23. The system of claim 21 , wherein the intestinal activity data is data from a duodenum, a jejunum, or an ileum of the patient.
24. The system of claim 21 , wherein the intestinal sensor is placed in a duodenum, a jejunum, or an ileum of the patient.
25. An implantable pulse generator comprising:
a non-transitory computer readable memory comprising instructions to:
calculate a heart rate parameter from cardiac data received from a cardiac sensor;
calculate an intestinal activity parameter from intestinal activity data received from an intestinal sensor;
determine a physiological state of a patient based on the heart rate parameter; and
adjust a stimulation signal based on the determined physiological state and the intestinal activity parameter, wherein one or more of an amplitude, a frequency, a pulse width, a burst interval, a duty cycle, and a stimulation duration of the stimulation signal is adjusted based on the intestinal activity parameter; and
a microcontroller configured to execute the instructions.
26. The implantable pulse generator of claim 25 , wherein the intestinal activity data is data from a duodenum, a jejunum, or an ileum of the patient.
27. The implantable pulse generator of claim 25 , wherein the intestinal sensor is placed in a duodenum, a jejunum, or an ileum of the patient.