Renal nerve stimulation methods for treatment of patients

Abstract

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

1 - 43 . (canceled) 
   
   
       44 . A method of treating a patient, the method comprising:
 providing instructions to a practitioner for treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, wherein the instructions include informing a practitioner to—
 position an energy delivery element proximate to a renal nerve of the patient; and 
 deliver an energy field via the energy delivery element to modulate neural function of the renal nerve. 
   
   
   
       45 . A method of treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, the method comprising:
 providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber that innervates a kidney of the patient; and   providing instructions to the treatment provider to deliver energy to the neural fiber via the modulation instrument in order to modulate a function of the neural fiber and reduce sympathetic neural activity in the patient.   
   
   
       46 . The method of  claim 45  wherein providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber further comprises providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber. 
   
   
       47 . The method of  claim 46  wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to introduce the modulation instrument into the patient via the patient's femoral artery. 
   
   
       48 . The method of  claim 46  wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to introduce a catheter into the patient. 
   
   
       49 . The method of  claim 46  wherein providing instructions to the treatment provider to intravascularly position the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument within a renal blood vessel of the patient. 
   
   
       50 . The method of  claim 49  wherein providing instructions to the treatment provider to position the modulation instrument within a renal blood vessel of the patient further comprises providing instructions to the treatment provider to position the modulation instrument within a renal artery of the patient. 
   
   
       51 . The method of  claim 50  wherein providing instructions to the treatment provider to position the modulation instrument within a renal artery of the patient further comprises providing instructions to the treatment provider to position the modulation instrument in contact with a wall of the renal artery. 
   
   
       52 . The method of  claim 51  wherein providing instructions to the treatment provider to position the modulation instrument in contact with a wall of the renal artery further comprises providing instructions to the treatment provider to position an electrode in contact with a wall of the renal artery. 
   
   
       53 . The method of  claim 45  wherein providing instructions to the treatment provider to deliver energy further comprises providing instructions to the treatment provider to deliver energy to the neural fiber via the modulation instrument to ablate the neural fiber and reduce sympathetic neural activity in the patient. 
   
   
       54 . The method of  claim 45  wherein providing instructions to a treatment provider to position a modulation instrument proximate a post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument proximate the post-ganglionic neural fiber at an extravascular site. 
   
   
       55 . The method of  claim 45  wherein:
 providing instructions to a treatment provider to position a modulation instrument further comprises providing instructions to a treatment provider to position the modulation instrument proximate to a first post-ganglionic neural fiber that innervates a first kidney of the patient and proximate to a second post-ganglionic neural fiber that innervates a second kidney of the patient; and   providing instructions to the treatment provider to deliver energy further comprises providing instructions to the treatment provider to deliver energy to the first neural fiber and the second neural fiber via the modulation instrument to modulate the functions of the first neural fiber and second neural fiber, respectively, and reduce sympathetic neural activity in the patient.   
   
   
       56 . A method of treating a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure, the method comprising:
 providing instructions to a treatment provider to position a modulation instrument proximate to a post-ganglionic neural fiber that innervates a kidney of the patient; and   providing instructions to the treatment provider to modulate a function of the neural fiber via the modulation instrument and reduce sympathetic neural activity in the patient.   
   
   
       57 . The method of  claim 56  wherein providing instructions to a treatment provider to position a modulation instrument further comprises providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber. 
   
   
       58 . The method of  claim 57  wherein providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to implant an electrode proximate to the post-ganglionic neural fiber. 
   
   
       59 . The method of  claim 57  wherein providing instructions to the treatment provider to implant the modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to implant a drug delivery device proximate the post-ganglionic neural fiber. 
   
   
       60 . The method of  claim 56  wherein providing instructions to a treatment provider to position a modulation instrument proximate the post-ganglionic neural fiber further comprises providing instructions to the treatment provider to position the modulation instrument proximate the post-ganglionic neural fiber at an extravascular site. 
   
   
       61 . A method of treating a patient, the method comprising:
 providing instructions to a medical care provider for positioning an electrode proximate to post-ganglionic neural fibers that innervate a kidney of a patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, renal disease, or chronic renal failure; and   providing instructions to the medical care provider for generating an electric field via the electrode such that at least a portion of the neural fibers are in the electric field, wherein the electric field alters neural function of the neural fibers.