Catheter system for acute neuromodulation

Abstract

A neuromodulation system includes a first therapy element adapted for positioning within a superior vena cava, and a second therapy element adapted for positioning within a pulmonary artery. Each therapy element is carried on a corresponding elongate flexible shaft. One of the shafts is slidably received within a lumen of the other so that the second therapy element may be advanced within the body relative to the first. A stimulator energizes the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the superior vena cava and to energize the second therapy element within the pulmonary artery to deliver sympathetic therapy to a second nerve fiber disposed external to the pulmonary artery. For treatment of heart failure, the first nerve fiber may be a vagus nerve and the second nerve fiber may be a sympathetic nerve fiber.

We claim: 
     
         1 . A method of treating a patient, comprising:
 (a) stimulating at least one parasympathetic nerve fiber using a first therapeutic element disposed in a superior vena cava of the patient; and   (b) stimulating at least one sympathetic nerve fiber using a second therapeutic element disposed in a pulmonary artery of the patient.   
     
     
         2 . The method of  claim 1 , further including:
 introducing a therapy system into the vasculature, the therapy system including the first therapeutic element and the second therapeutic element coupled to the first therapeutic element,   advancing the therapy device within the vasculature to position the first therapeutic element within the superior vena cava; and   advancing the second therapeutic element relative to the first therapeutic element to position the second therapeutic element within the pulmonary artery.   
     
     
         3 . The method of  claim 1 , wherein the first therapeutic element is provided on a first elongate shaft, the second therapeutic element is provided on a second elongate shaft, and wherein advancing the second therapeutic element relative to the first therapeutic element includes sliding a first one of the first and second shafts within a lumen of a second one of the first and second shafts. 
     
     
         4 . The method of  claim 3 , wherein advancing the second therapeutic element includes, with the second therapeutic element disposed in the heart, inflating a balloon carried by the second therapeutic element such that the balloon and second therapeutic element are carried by blood flow into the pulmonary artery. 
     
     
         5 . The method of  claim 1 , wherein the first therapeutic element comprises electrodes, and wherein step (a) includes energizing the electrodes. 
     
     
         6 . The method of  claim 5 , further including anchoring the first therapeutic element within the superior vena cava to bias the electrodes into contact with a wall of the superior vena cava. 
     
     
         7 . The method of  claim 1 , wherein the second therapeutic element comprises electrodes, and wherein step (b) includes energizing the electrodes. 
     
     
         8 . The method of  claim 7 , further including anchoring the second therapeutic element within the pulmonary artery to bias the electrodes into contact with a wall of the pulmonary artery. 
     
     
         9 . The method of  claim 1 , further including sensing at least one parameter within the body using the therapy device. 
     
     
         10 . The method of  claim 9 , wherein the sensed parameter comprises pressure. 
     
     
         11 . A neuromodulation system for treating a patient, comprising:
 a first therapy element adapted for positioning within a first blood vessel, the first therapy element carried on a first elongate shaft;   a second therapy element adapted for positioning with a second blood vessel different from the first blood vessel, the second therapy element carried on a second shaft, wherein one of the first and second shafts is slidably received within a lumen of the other of the first and second shafts; and   a stimulator configured to (a) energize the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the first blood vessel and (b) energize the second therapy element within the second blood vessel to deliver sympathetic therapy to a second nerve fiber disposed external to the first blood vessel.   
     
     
         12 . The system of  claim 11 , further including control means for controlling the stimulation in response to sensed heart rate and/or blood pressure of the patient. 
     
     
         13 . The system of  claim 11 , wherein each of the first and second therapy elements is at least partially expandable to position the first and second therapy elements in contact with surrounding walls of the first and second blood vessels. 
     
     
         14 . The system of  claim 11 , wherein the second therapy element is adapted for positioning within a pulmonary artery. 
     
     
         15 . The system of  claim 14 , further including an expandable balloon coupled to the second therapy element, the balloon positioned such that when the first therapy element is retained in the first blood vessel, expansion of the balloon causes the second therapy element to be carried by blood flow from the heart to the pulmonary artery. 
     
     
         16 . The system of  claim 14 , wherein the first therapy element is adapted for positioning within a superior vena cava.