Contingent cardio-protection for epilepsy patients

Patent metadata

Field	Value
Publication number	US-12478314-B2
Application number	US-202217582695-A
Country	US
Kind code	B2
Filing date	Jan 24, 2022
Priority date	Jan 25, 2008
Publication date	Nov 25, 2025
Grant date	Nov 25, 2025

Abstract

Disclosed are methods and systems for treating epilepsy by stimulating a main trunk of a vagus nerve, or a left vagus nerve, when the patient has had no seizure or a seizure that is not characterized by cardiac changes such as an increase in heart rate, and stimulating a cardiac branch of a vagus nerve, or a right vagus nerve, when the patient has had a seizure characterized by cardiac changes such as a heart rate increase.

First claim

What is claimed:

1 . A method of treating a medical condition in a patient using an implantable medical device, the implantable medical device including a first electrode coupled to a cardiac branch of a vagus nerve and a second electrode coupled to a main trunk of a cervical vagus nerve, the method comprising:
applying a first open-loop electrical signal having a programmed on-time and off-time to the main trunk of the cervical vagus nerve; sensing at least one body signal of the patient; determining via one or more processors an indication of a seizure status for the patient based on the at least one body signal; determining via one or more processors a status of the patient where the status is at least one of: a heart rate status; a heart rate variability status, a heart beat morphology status, a heart sound status, or a thoracic chest wall deflection caused by a heart's apex status; applying a closed-loop electrical signal to the main trunk of the cervical vagus nerve based on a first status; and applying a second closed-loop electrical signal to the cardiac branch of the vagus nerve based on a second status.

2 . The method of claim 1 , further comprising classifying an occurrence of the seizure based on the at least one body signal.

3 . The method of claim 2 , the method further comprising at least one of: logging an occurrence of the onset of the seizure; logging a time of the occurrence of the onset of the seizure; logging a date of the occurrence of the onset of the seizure; logging a result of the classification of the seizure; providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider; providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the seizure; assessing at least one of an awareness or responsiveness of the patient during the seizure; assessing a severity of the seizure; determining an end of the seizure; determining a beginning of a post-ictal period; determining an end of the post-ictal period; and assessing a patient's post-ictal impairment or recovery from the seizure where the further action is logged into a memory.

4 . The method of claim 1 , the method further comprising at least one of: logging an occurrence of the onset of the seizure; logging a time of the occurrence of the onset of the seizure; logging a date of the occurrence of the onset of the seizure; providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider; providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the seizure; assessing at least one of an awareness or responsiveness of the patient during the seizure; assessing a severity of the seizure; determining an end of the seizure; determining a beginning of a post-ictal period; determining an end of the post-ictal period; and assessing a patient's post-ictal impairment or recovery from the seizure where the further action is logged into a memory.

5 . The method of claim 1 , wherein the at least one body signal is a patient's cardiac activity which is one of the heart rate, the heart rate variability, the heart beat morphology, the heart sound, or the thoracic chest wall deflection caused by the heart's apex.

6 . The method of claim 1 , wherein the signal of the patient's cardiac activity is provided by at least one of a force transducer, an electrocardiogram (EKG) signal, a phonocardiogram (PKG) signal, an apexcardiography signal, a blood pressure signal, and an echocardiography signal.

7 . The method of claim 1 , wherein the at least one body signal is provided by at least one of an accelerometer, an inclinometer, an actigraph, an imaging system, a dynamometer, a gyroscope, or an electromyogram (EMG).

8 . The method of claim 1 , wherein the at least one body signal is provided by at least one of a skin resistance sensor, a skin temperature sensor, a skin blood flow sensor, or a skin sweat gland activity sensor.

9 . The method of claim 1 , further comprising classifying an epileptic event based upon at least one of the patient's cardiac activity, a body movement or movement force data, or the patient's dermal activity.

10 . An implantable medical device, the implantable medical device including a first electrode coupled to a cardiac branch of a vagus nerve and a second electrode coupled to a main trunk of a cervical vagus nerve and one or more processors, the one or more processors configured to perform a the method comprising:
applying a first open-loop electrical signal having a programmed on-time and off-time to the main trunk of the cervical vagus nerve; sensing at least one body signal of the patient; determining an indication of a seizure status for the patient based on the at least one body signal; determining a status of the patient where the status is at least one of: a heart rate status; a heart rate variability status, a heart beat morphology status, a heart sound status, or a thoracic chest wall deflection caused by a heart's apex status; applying a closed-loop electrical signal to the main trunk of the cervical vagus nerve based on a first status; and applying a second closed-loop electrical signal to the cardiac branch of the vagus nerve based on a second status.

11 . The method of claim 10 , further comprising at least one of:
logging an occurrence of the onset of the seizure; logging a time of the occurrence of the onset of the seizure; logging a date of the occurrence of the onset of the seizure; logging a result of the classification of the seizure; providing at least one of a warning, an alarm or an alert to the patient, a caregiver or a health care provider; providing a therapy to prevent, abort, reduce a severity, or reduce a duration of the seizure; assessing at least one of an awareness or responsiveness of the patient during the seizure; assessing a severity of the seizure; determining an end of the seizure; determining a beginning of a post-ictal period; determining an end of the post-ictal period; and assessing a patient's post-ictal impairment or recovery from the seizure.

12 . The implantable medical device of claim 10 , where the one or more processors are further configured to perform at least one of:
logging an occurrence of the classified seizure; logging a time of the occurrence of the classified seizure; logging a date of the occurrence of the classified seizure; logging a time for the warning, the alarm or the alert to the patient, the caregiver or the health care provider; logging the provided therapy for the classified seizure; logging the assessment of the awareness or responsiveness of the patient during the classified seizure; logging the assessment of the severity of the classified seizure; logging the end of the classified seizure; logging the beginning of a post-ictal period; logging the end of the post-ictal period; and logging the assessment of the patient's post-ictal impairment or recovery from the classified seizure.

13 . The implantable medical device of claim 10 , wherein the at least one body signal is a patient's cardiac activity which is one of the heart rate, the heart rate variability, the heart beat morphology, the heart sound, or the thoracic chest wall deflection caused by the heart's apex.

14 . The implantable medical device of claim 13 , wherein the signal indicative of the patient's cardiac activity is provided by at least one of an electrocardiogram (EKG) signal, a phonocardiogram (PKG) signal, an apexcardiography signal, a blood pressure signal, and an echocardiography signal.

15 . The implantable medical device of claim 10 ,

Assignees

• Osorio Ivan
• Flint Hills Scient Llc

Inventors

• Osorio Ivan

Classifications

• A61B5/33

  specially adapted for cooperation with other devices · CPC title

• A61B5/7264

  Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems · CPC title

• A61B2562/0219

  Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches · CPC title

• A61B8/0883

  for diagnosis of the heart · CPC title

• A61B7/04

  Electric stethoscopes · CPC title