Devices and methods for cardiovascular reflex control via coupled electrodes

Abstract

Devices, systems and methods are disclosed by which the blood pressure, nervous system activity, and neurohormonal activity may be selectively and controllably reduced by activating baroreceptors. A baroreceptor activation device is positioned near a baroreceptor, preferably a baroreceptor located in the carotid sinus. A control system may be used to modulate the baroreceptor activation device. The control system may utilize an algorithm defining a stimulus regimen which promotes long term efficacy and reduces power requirements/consumption. The baroreceptor activation device may utilize RF-coupled or other electrodes to activate the baroreceptors. The electrodes may be adapted for connection to the carotid arteries at or near the carotid sinus, and may be designed to minimize extraneous tissue stimulation.

1 . A system for effecting a change in the baroreflex system in a patient, the system comprising:
 an activation device comprising both (a) an electrode structure and (b) a receiving coil separate from the electrode structure, wherein the activation device is positionable proximate a baroreceptor and the receiving coil is configured to receive a control signal to generate an activation current in the electrode structure to induce a baroreflex; and   a control system having a transmitter comprising a transmitting coil implantable in a vein proximate the baroreceptor which wirelessly couples to the receiving coil of the activation device, the control system including a processor and a memory, wherein the memory includes software defining a stimulus regimen which causes the control system to generate the control signal which is transmitted by the transmitting coil and received by the receiving coil to produce current in the electrode to induce the baroreflex.   
   
   
       2 . A system as in  claim 1 , wherein the control system comprises a driver which generated the control signal which is coupled to the transmitter. 
   
   
       3 . A system as in  claim 1 , wherein the control system is implantable. 
   
   
       4 . A system as in  claim 3 , further comprising a cable connecting the control system to the transmitter. 
   
   
       5 . A system as in  claim 3 , wherein the transmitter is incorporated into the implantable control system. 
   
   
       6 . A system as in  claim 4 , wherein the control system is implantable at a location remote from the transmitter and the cable is adapted to be placed in a lumen of the vein between the control system and the transmitter. 
   
   
       7 . A system for activating vascular excitable tissue, comprising:
 a transmitter comprising a transmitting coil implantable in a vein; and   an electrode structure comprising a receiving coil implantable in a vascular lumen, said electrode structure adapted to receive a signal transmitted from the transmitting coil of the transmitter and to produce electrical current which activates the vascular excitable tissue, wherein the transmitting coil and receiving coil are adapted for wireless transmission therebetween.   
   
   
       8 . The system of  claim 7 , wherein the electrode structure comprises a stent like structure which may be intravascularly delivered in a collapsed state and expanded to be implanted in a blood vessel near a target receptor. 
   
   
       9 . The system of  claim 7 , wherein the electrode structure comprises a conductive metal which can be energized by EM transmission from the transmitter. 
   
   
       10 . The system of  claim 9 , wherein the conductive metal is insulated. 
   
   
       11 . The system of  claim 7 , wherein the electrode structure comprises a receiving coil. 
   
   
       12 . The system of  claim 11 , wherein the electrode structure comprises electrode pads connected to the receiving coil. 
   
   
       13 . A system for activating a baroreflex, said system comprising;
 an activation device comprising both (a) an electrode structure and (b) a receiving coil separate from the electrode structure, wherein said electrode structure is configured to be implantable proximate excitable tissue in the carotid artery; and   a transmitter comprising a transmitting coil separate from the activation device and configured to be implantable in a jugular vein proximate the carotid artery, wherein the transmitting coil and the receiving coil are adapted for wireless transmission therebetween.   
   
   
       14 . A system as in  claim 13 , further comprising a control system which produces an electromagnetic control signal and leads, wherein the control system is implantable and the leads are adapted to connect the transmitter to the control system through the vein via a remote entry site.