Devices, systems, and methods for improving left ventricular structure and function using baroreflex activation therapy

Abstract

Described here are devices, systems, and methods for improving left ventricular function in a patient with systolic heart failure with left ventricular dysfunction using baroreflex activation therapy. In general the systems have at least one electrode and a control system in communication with the electrode, the control system including a processor and memory, wherein the memory includes software defining a stimulus regime configured to effect improvement in left ventricular function. The methods for improving left ventricular function in a subject typically include identifying a patient in need of left ventricular function improvement and stimulating a baroreceptor with a baroreceptor activation device to improve left ventricular function.

1 - 18 . (canceled) 
     
     
         19 . A system for improving left ventricular function comprising:
 a baroreceptor activation device for stimulating a baroreceptor; and   a control system in communication with the baroreceptor activation device, the control system including a processor and memory, wherein the memory includes software defining a baroreceptor stimulus regime configured to effect improvement in left ventricular function.   
     
     
         20 . The system of  claim 19 , wherein the baroreceptor activation device comprises an electrode, a mechanical mechanism, a chemical mechanism, a biological mechanism, or a combination thereof, to stimulate the baroreceptor. 
     
     
         21 . The system of  claim 20 , wherein the baroreceptor activation device comprises an electrode. 
     
     
         22 . The system of  claim 19 , wherein the baroreceptor stimulus regime comprises a continuous control signal. 
     
     
         23 . The system of  claim 22 , wherein the continuous control signal comprises an electrical pulse or a train of electrical pulses. 
     
     
         24 . The system of  claim 23 , wherein the continuous control signal comprises a train of electrical pulses having a pulse width of between about 400 microseconds to about 500 microseconds. 
     
     
         25 . The system of  claim 19 , wherein the baroreceptor stimulus regime comprises a periodic control signal. 
     
     
         26 . The system of  claim 25 , wherein the periodic control signal comprises a designated start time and a designated duration. 
     
     
         27 . The system of  claim 19 , wherein the baroreceptor stimulus regime comprises an episodic control signal. 
     
     
         28 . The system of  claim 27 , wherein the episodic control signal is activated by a physician. 
     
     
         29 . The system of  claim 27 , wherein the episodic control signal is triggered by an increase in blood pressure over a predetermined threshold. 
     
     
         30 . The system of  claim 19 , further comprising a sensor for monitoring a parameter of left ventricular function. 
     
     
         31 . The system of  claim 30 , wherein the parameter is ejection fraction, cardiac output, end diastolic volume, or a combination thereof. 
     
     
         32 . The system of  claim 19 , wherein the system comprises a battery power source. 
     
     
         33 . The system of  claim 19 , wherein the baroreceptor activation device is disposed intravascularly, extravascularly, or within a vascular wall. 
     
     
         34 . The system of  claim 19 , wherein the baroreceptor is located in a vein. 
     
     
         35 . The system of  claim 34 , wherein the vein is selected from the group consisting of the inferior vena cava, the superior vena cava, the portal vein, the jugular vein, the subclavian vein, the iliac vein, the azygous vein, the pulmonary vein, and the femoral vein. 
     
     
         36 . The system of  claim 19 , wherein the baroreceptor is located in a carotid sinus, the aortic arch, the heart, the common carotid artery, the subclavian artery, the pulmonary artery, the femoral artery, or the brachiocephalic artery.