Method and system for the prediction of cardiac arrhythmias

Abstract

Methods and systems are provided for determining an increased likelihood of the occurrence of a cardiac arrhythmia in a patient. The methods and systems comprise monitoring the sympathetic neural discharges of a patient from the left stellate ganglion, the thoracic ganglia, or both, and detecting increases in the sympathetic neural discharges. The methods and systems may further comprise delivering anti-arrhythmic therapy to the patient in response to a detected increase in the sympathetic neural discharge, such as delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, cardioversion or defibrillation shocks. Pharmacologic agents which may be used in connection with the delivery of anti-arrhythmic therapy include those which are known to exert anti-arrhythmic effect and anti-convulsant agents, such as phenyloin, carbamazepine, valproate, and phenobarbitone.

1 . A method for determining an increased likelihood of the occurrence of a cardiac arrhythmia in a patient, the method comprising: 
 monitoring the sympathetic neural discharges of the patient from the left stellate ganglion or the thoracic ganglia; and    detecting an increase in the sympathetic neural discharges.    
   
   
       2 . The method of  claim 1  wherein the step of monitoring the sympathetic neural discharges comprises implanting an electrode on the left stellate ganglion in the patient, wherein the electrode senses the electrical activity of the left stellate ganglion.  
   
   
       3 . The method of  claim 2  wherein the increase in the sympathetic neural discharges is determined by an increase in the amplitude or frequency of the sensed electrical activity beyond defined values.  
   
   
       4 . The method of  claim 2  wherein the increase in the sympathetic neural discharges is determined by comparing the sensed electrical activity and the normal electrical activity of the patient.  
   
   
       5 . The method of  claim 1  further comprising producing an output signal in response to a detected increase in the sympathetic neural discharges.  
   
   
       6 . The method of  claim 5  wherein the output signal is an audible sound.  
   
   
       7 . The method of  claim 5  wherein the output signal is a command signal.  
   
   
       8 . The method of  claim 7  further comprising the step of delivering anti-arrhythmic therapy in response to the command signal, the anti-arrhythmic therapy selected from any one or more of the group consisting of: delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, cardioversion or defibrillation shocks.  
   
   
       9 . The method of  claim 8  wherein the one or more pharmacological agents is an anti-convulsant agent.  
   
   
       10 . The method of  claim 9  wherein the anti-convulsant agent is selected from the group consisting of: phenyloin, carbamazepine, valproate, and phenobarbitone.  
   
   
       11 . A system for determining an increased likelihood of the occurrence of a cardiac arrhythmia in a patient, the system comprising: 
 a sensor for acquiring data relating to the sympathetic neural discharges of a patient from the left stellate ganglion or the thoracic ganglia;    a processor for receiving the data acquired from the sensor, wherein the processor analyzes the data and determines if there is an increase in the sympathetic neural discharge; and    an output unit for generating an output signal in response to a determined increase in the sympathetic neural discharge.    
   
   
       12 . The system of  claim 11  wherein the sensor is an electrode that is implanted on the left stellate ganglion of the patient and wherein the electrode senses the electrical activity of the left stellate ganglion.  
   
   
       13 . The system of  claim 12  wherein the processor determines that an increase in the sympathetic neural discharge has occurred by an increase in the amplitude or frequency of the sensed electrical activity beyond defined values.  
   
   
       14 . The system of  claim 12  wherein the processor determines that an increase in the sympathetic neural discharge has occurred by comparing the sensed electrical activity and the normal electrical activity of the left stellate ganglion.  
   
   
       15 . The system of  claim 11  wherein the output signal is an audible sound.  
   
   
       16 . The system of  claim 11  wherein the output signal is a command signal.  
   
   
       17 . The system of  claim 16  further comprising an anti-arrhythmia delivery module for delivering anti-arrhythmic therapy in response to the command signal, the anti-arrhythmic therapy selected from any one or more of the group consisting of: delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, and cardioversion or defibrillation shocks.  
   
   
       18 . The system of  claim 17  wherein the one or more pharmacological agents is an anti-convulsant agent.  
   
   
       19 . The system of  claim 18  wherein the anti-convulsant agent is selected from the group consisting of: phenyloin, carbamazepine, valproate, and phenobarbitone.  
   
   
       20 . A cardiac arrhythmia prediction system comprising: 
 means for monitoring the sympathetic neural discharges of a patient from the left stellate ganglion or the thoracic ganglia;    means for determining an increase in the sympathetic neural discharge; and    means for producing an output signal in response to a determined increase in the sympathetic neural discharge.    
   
   
       21 . The system of  claim 20  wherein the means for monitoring sympathetic neural discharges comprises sensing the electrical activity of the left stellate ganglion.  
   
   
       22 . The system of  claim 21  wherein the means for determining an increase in the sympathetic neural discharges comprises comparing the sensed electrical activity of the left stellate ganglion and the normal electrical activity of the left stellate ganglion.  
   
   
       23 . The system of  claim 21  wherein the increase in the sympathetic neural discharge is determined by detecting an increase in the amplitude or frequency of the sensed electrical activity beyond defined values.  
   
   
       24 . The system of  claim 20  wherein the output signal is an audible sound.  
   
   
       25 . The system of  claim 20  wherein the output signal is a command signal.  
   
   
       26 . The system of  claim 25  further comprising means for delivering anti-arrhythmic therapy in response to the command signal, the anti-arrhythmic therapy selected from any one or more of the group consisting of: delivering one or more pharmacological agents; stimulating myocardial hyperinnervation in the sinus node and right ventricle of the heart of the patient; and applying cardiac pacing, cardioversion or defibrillation shocks.  
   
   
       27 . The system of  claim 26  wherein the one or more pharmacological agents is an anti-convulsant agent.  
   
   
       28 . The system of  claim 27  wherein the anti-convulsant agent is selected from the group consisting of: phenyloin, carbamazepine, valproate, and phenobarbitone.