Systems and methods for interrupting nerve activity to treat a medical condition

Abstract

Provided are devices, systems, and methods for treating or preventing heart failure or a symptom of heart failure through coordinated nerve activity interruption for one or more target nerves. Devices disclosed herein may comprise a vascular catheter comprising a telescopic needle assembly configured to puncture vascular tissue in contact with the catheter, wherein the needle assembly comprises one or more electrodes configured to deliver electrical energy to a tissue in contact with the one or more electrodes. Methods may include treating or preventing heart failure or a symptom of heart failure by inserting a catheter into a vascular tissue of the subject; guiding the catheter towards the greater splanchnic nerve; piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve; and ablating the target nerve by delivering a stimulation energy to the target nerve with one or more electrodes.

1 . A method of treating or preventing heart failure or a symptom of heart failure in a subject in need thereof comprising:
 a. inserting a catheter into a vascular lumen defined by a vascular tissue of the subject;   b. guiding the catheter towards a location proximal to a target nerve, wherein the target nerve comprises the greater splanchnic nerve;   c. piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve, wherein the telescopic needle assembly comprises an electrode assembly, wherein the telescopic needle assembly comprises a first section surrounding a second section, wherein the second section extends outwards from the first section; and   d. delivering a stimulation energy to the target nerve with the electrode assembly, thereby fully or partially ablating the target nerve and treating or preventing heart failure or a symptom of heart failure in the subject.   
     
     
         2 .- 73 . (canceled) 
     
     
         74 . A vascular catheter comprising:
 a. a longitudinal axis for adjusting the orientation of the device body within the subject;   b. a needle assembly lumen comprising a telescopic needle assembly configurable from a first position to a second position, wherein the telescopic needle assembly is within the catheter in the first position, wherein the telescopic needle assembly extends through the exit port and punctures vascular tissue in contact with the catheter in the second position, the needle assembly comprising:
 (i) one or more electrodes configured to deliver electrical energy to a tissue; 
 (ii) a first section and the second section, the first section surrounding the second section, wherein the second section extends outwards from the first section when the needle assembly is in the second position, wherein the needle assembly is configured to puncture vascular tissue in contact with the catheter in a unilateral vector when transitioned to the second position, wherein the catheter comprises a single needle assembly. 
   
     
     
         75 . The vascular catheter of  claim 74 , further comprising a base electrode on an outer surface of the catheter. 
     
     
         76 . The vascular catheter of  claim 75 , wherein the base electrode is positioned within 0-degrees radially of a location on the outer surface of the vascular catheter relative to the longitudinal axis of the vascular catheter on an outer surface thereof. 
     
     
         77 . The vascular catheter of  claim 74 , further comprising a first electrical circuit electrically coupled to the one or more electrodes, further comprising a second electrical circuit electrically coupled to a base electrode, wherein the catheter is configured to provide electrical energy of differing frequencies to the first electrical circuit and the second electrical circuit. 
     
     
         78 . The vascular catheter of  claim 74 , wherein the needle assembly comprises:
 a. a distal point on the second section;   b. a first electrode;   c. a second electrode;   d. a wire connecting the first electrode and the second electrode to a power source;   e. an insulating material insulating the first electrode, the second electrode, and the wire from the vascular catheter.   
     
     
         79 . The vascular catheter of  claim 78 , wherein the wire comprises an enamel coated wire or a multi-strain braid. 
     
     
         80 . The vascular catheter of  claim 74 , wherein the first section comprises a first tubular body, wherein the second section comprises a second tubular body, wherein the first tubular body extends outward from the second tubular body, and wherein the first tubular body nests within the second tubular body such that the tubular body is fully or partially contained within the first tubular body. 
     
     
         81 . The vascular catheter of  claim 80 , wherein the needle assembly further comprises a third section comprising a sharp distal point, wherein the second section surrounds the third section, wherein the third section extends outward from the second section. 
     
     
         82 . The vascular catheter of  claim 80 , wherein the first electrode is positioned on the first tubular body, and wherein the second electrode is positioned on the second tubular body. 
     
     
         83 . The vascular catheter of  claim 80 , wherein the first electrode and the second electrode are positioned on the first tubular body, or the second tubular body. 
     
     
         84 . The vascular catheter of  claim 80 , wherein the needle assembly further comprises an electrically insulating material within the needle assembly, wherein the electrically insulating material comprises a dielectric insulator between the first and second tubular bodies. 
     
     
         85 . The vascular catheter of  claim 74 , wherein the one or more electrodes comprises three electrodes, wherein the three electrodes are arranged such that the second electrode is between the first and third electrodes, and wherein the second electrode is a negative electrode and the first and third electrodes are positive electrodes, or wherein adjacent electrodes have opposite polarity. 
     
     
         86 . The vascular catheter of  claim 85 , wherein the catheter is configured to permit ablation between the first and second electrode, or the second and third electrode. 
     
     
         87 . The vascular catheter of  claim 74 , further comprising an electrically insulating material in contact with the wire, wherein the electrically insulating material comprises a dielectric, a dielectric washer, or a polyimide liner. 
     
     
         88 . The vascular catheter of  claim 74 , wherein when the needle assembly extends a prescribed distance from the exit port and is in proximity to a target nerve when in the second position, and is configured to ablate a length of a target nerve that is at least as long as the deployed distance between the first and second tubular bodies. 
     
     
         89 . The vascular catheter of  claim 74 , wherein the needle assembly is configured to deliver an electric charge in a bipolar manner. 
     
     
         90 . The vascular catheter of  claim 74 , wherein the one or more electrodes comprises a silk-screened electrode. 
     
     
         91 . The vascular catheter of  claim 74 , further comprising a rotary electrical connector configured to rotate the needle assembly. 
     
     
         92 . Use of a vascular catheter for treating or preventing heart failure or a symptom of heart failure in a subject in need thereof comprising:
 a. providing the vascular catheter device, the device comprising:
 a. a longitudinal axis for adjusting the orientation of the device body within the subject; 
 b. a needle assembly lumen comprising a telescopic needle assembly configurable from a first position to a second position, wherein the telescopic needle assembly is within the catheter in the first position, wherein the telescopic needle assembly extends through the exit port and punctures vascular tissue in contact with the catheter in the second position, 
   b. guiding the catheter towards a location proximal to a target nerve, wherein the target nerve comprises the greater splanchnic nerve;   c. piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve, wherein the telescopic needle assembly comprises an electrode assembly, wherein the second section extends outwards from the first section; and   d. delivering a stimulation energy to the target nerve with the electrode assembly, thereby fully or partially ablating the target nerve and treating or preventing heart failure or a symptom of heart failure in the subject.