Renal nerve stimulation method 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 . A method for treating a human patient comprising:
 a. positioning a nerve stimulation device adjacent to a renal nerve of at least one kidney of the patient, and   b. at least partially blocking the renal nerve of the kidney.   
     
     
         2 . A method as in  claim 1  wherein the nerve stimulation device is an electrode, and the electrode is positioned surgically in the patient. 
     
     
         3 . A method as in  claim 1  wherein the nerve stimulation device is a drug delivery device, and the device is positioned surgically in the patient. 
     
     
         4 . A method as in  claim 1  where the nerve stimulation device is placed in a renal vein of the kidney. 
     
     
         5 . A method as in  claim 1  where the nerve stimulation device is placed in a renal artery of the kidney. 
     
     
         6 . The method of  claim 1  wherein the nerve stimulation device is a cuff placed around a renal artery of the kidney. 
     
     
         7 . The method of  claim 1  wherein the nerve stimulation device is implanted in the patient. 
     
     
         8 . The method as in  claim 1  wherein afferent fibers of the renal nerve are blocked and efferent fibers are not blocked. 
     
     
         9 . The method as in  claim 1  wherein efferent fibers of the renal nerve are blocked and afferent fibers are not blocked. 
     
     
         10 . A method as in  claim 1  wherein the step of blocking the renal nerve is accomplished by a block selected from a group consisting of an anodal block, a cathodal block and a collision block. 
     
     
         11 . A method as in  claim 1  wherein the step of blocking the renal nerve is accomplished by overpacing the nerve. 
     
     
         12 . A method as in  claim 1  wherein the step of blocking is accomplished by continuous infusion of an anesthetic drug to the nerve. 
     
     
         13 . A method as in  claim 1  further comprising monitoring blood pressure of the patient, and adjusting a level of blocking in response to said blood pressure. 
     
     
         14 . A method as in  claim 1  wherein the nerve stimulation device is a catheter. 
     
     
         15 . A method as in  claim 1  wherein the nerve stimulation device is a lead with multiple electrode. 
     
     
         16 . A method as in  claim 1  wherein the step of blocking is accomplished by the injection of a neurotoxin. 
     
     
         17 . A method as in  claim 1  wherein the step of blocking is accomplished by ablation of the renal nerve. 
     
     
         18 . A method as in  claim 1  wherein the step of blocking is accomplished by cooling of the renal nerve. 
     
     
         19 . A method as in  claim 1  applied to a patient suffering from at least one of heart failure, chronic renal failure and hypertension. 
     
     
         20 . A method to stimulate a renal nerve in a mammalian patient comprising:
 a. positioning a nerve stimulation device proximate a renal nerve of a kidney of the patient;   b. applying a stimulation signal with the device to the renal nerve, and   c. at least partially blocking the renal nerve by application of the stimulation signal.   
     
     
         21 . A method as in  claim 20  wherein the nerve stimulation device is an electrode, and the stimulation signal is an electrical current applied by the electrode to the renal nerve. 
     
     
         22 . A method as in  claim 20  wherein the nerve stimulation device is a drug delivery device and the stimulation signal is a nerve blocking drug applied to the renal nerve. 
     
     
         23 . A method as in  claim 20  wherein the nerve stimulation device is coupled to a renal blood vessel proximate the renal nerve. 
     
     
         24 . A method as in  claims 20  wherein the nerve stimulation device is a cuff applied to a renal blood vessel proximate the renal nerve, and the cuff applies a stimulation signal to the renal nerve. 
     
     
         25 . A method for reducing abnormally elevated sympathetic renal nerve signals comprising:
 a. positioning at least one electrode proximate to a renal nerve of a mammalian patient;   b. applying an electrical current to the electrode with an electric controller to stimulate the renal nerve to at least reduce signal traffic in sympathetic efferent renal nerve fibers, and   c. said controller regulating the current applied to the electrode based on at least one condition of the patient being monitored by a sensor.   
     
     
         26 . A method as in  claim 25  wherein the controller monitors blood pressure in the patient and the sensor is a blood pressure sensor. 
     
     
         27 . A method as in  claim 25  wherein the controller monitors blood oxygen in the patient and the sensor is a blood oxygen sensor. 
     
     
         28 . An apparatus for reducing abnormally elevated sympathetic comprising:
 a nerve stimulation device to be placed proximate to a renal nerve of the patient and said device adapted to stimulate the renal nerve, and   a nerve stimulator activating the stimulation device to stimulate the renal nerve.   
     
     
         29 . An apparatus as in  claim 28  wherein the stimulation device is an electrode and said stimulator is a controller that applies an electrical current to the electrode. 
     
     
         30 . An apparatus as in  claim 28  wherein the stimulation device is a drug delivery catheter insertable into a renal blood vessel, and said stimulator is a drug dispenser coupled to said catheter. 
     
     
         31 . An apparatus as in  claim 28  further comprising a patient sensor connectable to said stimulator, wherein said stimulator receives a signal from the sensor indicative of a condition of the patient and controls the activation of the stimulation device based on said signal. 
     
     
         32 . An apparatus as in  claim 31  wherein said sensor is a blood pressure sensor and said condition is a blood pressure level of the patient. 
     
     
         33 . An apparatus as in  claim 31  wherein said sensor is a blood oxygen sensor and said condition is a blood oxygen level of the patient. 
     
     
         34 . An apparatus as in  claim 28  wherein the said stimulator dispenses drug an anesthetic drug periodically into the said catheter. 
     
     
         35 . An apparatus for reducing abnormally elevated sympathetic comprising:
 a nerve stimulation device positionable proximate to a renal blood vessel of the patient and said device adapted to stimulate a renal nerve adjacent the vessel, and   a nerve stimulator activating the stimulation device to stimulate the renal nerve.   
     
     
         36 . A nerve stimulation device implantable in a mammalian patient comprising:
 an implantable stimulator,   an implantable lead connected to said stimulator,   an implanted nerve stimulation cuff connectable to said lead and adapted to receive signals generated by the stimulator, wherein said cuff at least partially envelopes an artery.   
     
     
         37 . A nerve stimulation device as in  claim 36  wherein said cuff is at least partially attached to an external surface of an artery 
     
     
         38 . A nerve stimulation device comprising:
 a stimulator implantable into a mammalian patient,   a nerve stimulation cuff in communication with said stimulator to receive a nerve stimulation signal for the stimulator, and said cuff adapted to be implanted into the patient and positioned proximate to an outer surface of an artery of the patient, wherein said cuff stimulates a nerve adjacent the artery when activated by the nerve stimulation signal.   
     
     
         39 . A nerve stimulation device as in  claim 38  wherein said cuff is adapted to at least partially envelopes the said artery. 
     
     
         40 . A nerve stimulation device as in  claim 38  wherein said cuff dispenses a drug to the artery and the stimulator is a drug dispensing device. 
     
     
         41 . A nerve stimulation device as in  claim 38  wherein said stimulator is an electrostimulator. 
     
     
         42 . A nerve stimulation device as in  claim 38  wherein said cuff includes electrodes. 
     
     
         43 . A nerve stimulation device as in  claim 38  further comprising a catheter lead extending from the stimulator to the cuff.