Therapy using perturbation and effect of physiological systems

(1)

FI

G.

1

14 24 18 8 10 28 34 26 22 20 2 16 6 30 36 12 32 LV RV 4

(2)

FIG. 2

THERAPY DELIVERY 50 ₆₈ TIMING AND CONTROL

MICRO-PROCESSOR INTERFACESENSOR

TELEMETRY SIGNAL PROC. MEMORY SWITCH MATRIX 55 52 54 56 58 60 62 64 70 51 65 10 PULSE GEN.

(3)

Perturb Physiological System 102 Monitor Physiological Parameters 104 Provide a Response Index 106 Assess Status of a Selected Organ Using the Response

Index 108 Deliver Therapy Based on Assessed Status 110

FIG. 3

100

(4)

212 Brain

FIG. 4

220 Heart 214 224 202 240 204 244 230 232 242 222 210 210

(5)

Deliver Electrical Stimulation to the

Vagus Nerve

302

Monitor Electrical Activity of the Vagus

Nerve

304

Provide a Response

Index 306

Assess Status of the Heart Using the

Response Index 308 Deliver Therapy Based on Assessed Status 310

FIG. 5

300

(6)

FIG. 6

0 5 10 -40 -20 0 20 40 60 80

time from stimulus (ms)

amplitude ( µV) 1 2 3 4 0.05mA stimulation 1mA stimulation 5mA stimulation peak-to-peak amplitude

(7)

FI

G.

7

70 0 70 2 No Pe rt ur b th e Va gu s N er ve No 70 4 La te nc y is di ff er en t f ro m ba se lin e No 70 6 La te nc y is x gr ea te r t ha n lat en cy d ur in g sle ep Ye s Ye s La te nc y is x sm all er th an lat en cy d ur in g ac tiv ity Ye s 70 8 Ye s 71 0 71 2 St im ula te he ar t De ac tiv at e h ea rt b y t itr at ion of Va ga l s tim ula tio n u sin g c uf f i n n ec k pa cin g o f t he h ea rt En do ca rd ial va ga lst im ula tio n o f A V or sin us no de ep ica rd ial va ga lst im ula tio n o f A V or sin us m od e SC S

(8)

FIG. 8A

RR I (n or -20 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

FIG. 8B

LV C (n or -20 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

FIG. 8C

PLV (n or ma liz ed ) -20 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

FIG. 8D

PQ I (n or ma liz ed ) -20 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

FIG. 8E

Di sp er sio n (n or ma liz ed ) -20 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

FIG. 8F

La te nc y (n or ma liz ed ) -20 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 -0.2 ₀ ₂₀ ₄₀ ₆₀ ₈₀ ₁₀₀ time(s)

(9)

1 0.5 0 -.05 -1 -1.5 R 2

latency dispersion RRI LVC Plv PQI

(10)

0

τ d

0 10 20 30 40

FIG. 10a

τRRI(s)

0 0 10 20 30 40

FIG. 10b

τRRI(s) 40 30 20 10 0 τ disp er sio n (s ) 0 10 20 30 40

FIG. 10c

τLVC(s) 40 30 20 10 0 τ late nc y (s ) 0 10 20 30 40

FIG. 10d

τLVC(s) 40 30 20 10 0 τ disp er sio n (s ) 0 10 20 30 40

FIG. 10e

τPLV(s) 40 30 20 10 0 τ late nc y (s ) 0 10 20 30 40

FIG. 10f

τPLV(s) 40 30 20 10 0 τ disp er sio n (s ) 0 10 20 30 40

FIG. 10g

τPQ(s) 40 30 20 10 0 τ late nc y (s ) 0 10 20 30 40

FIG. 10h

τPQ(s)

(11)

Transceiver 11 15 80

FIG. 11

10 82 84 33 33 15a 15b