Connect public, paid and private patent data with Google Patents Public Datasets

Enteric rhythm management

Download PDF

Info

Publication number
US20040176812A1
US20040176812A1 US10675818 US67581803A US2004176812A1 US 20040176812 A1 US20040176812 A1 US 20040176812A1 US 10675818 US10675818 US 10675818 US 67581803 A US67581803 A US 67581803A US 2004176812 A1 US2004176812 A1 US 2004176812A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
nerve
vagal
stimulation
vagus
blocking
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10675818
Inventor
Mark Knudson
Richard Wilson
Katherine Tweden
Timothy Conrad
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
EnteroMedics Inc
Original Assignee
Beta Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36007Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/0551Spinal or peripheral nerve electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/321Electromedical belts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/36053Implantable neurostimulators for stimulating central or peripheral nerve system adapted for vagal stimulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36071Pain

Abstract

At least one of a plurality of gastrointestinal disorders is treated by stimulating an enteric nervous system of a patient to enhance a functional tone of the enteric nervous system. A treatment includes electrically stimulating a vagus nerve of the patient at a stimulation site proximal to at least one site of vagal innervation of a gastrointestinal organ. The electrical stimulation includes applying a stimulation signal at the stimulation site. An optional proximal electrical blocking signal is applied to the vagus nerve at a proximal blocking site proximal to the stimulation site. The proximal blocking signal is selected to at least partially block nerve impulses at the proximal blocking site.

Description

    I. CROSS-REFERENCE TO RELATED APPLICATION
  • [0001]
    The present application is a continuation-in-part application of U.S. patent application Ser. No. 10/358,093 filed Feb. 3, 2003 and entitled “Method and Apparatus for Treatment of Gastroesophageal Disease (GERD)”. The present application discloses and claims subject matter disclosed in the following commonly assigned and copending U.S. patent applications filed on the same date as the present application and in the name of the same inventors: U.S. patent application Ser. No. ______, not yet assigned, entitled “Nerve Stimulation And Conduction Block Therapy”, having Attorney Docket No. 14283.1USI3 and U.S. patent application Ser. No. ______, not yet assigned, entitled “Nerve Conduction Block Treatment”, having Attorney Docket No. 14283.1USI1.
  • II. BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of the Invention
  • [0003]
    This invention pertains to treatments of disorders associated, at least in part, with neural activity. These may include, without limitation, gastrointestinal, pancreo-biliary, cardio-respiratory and central nervous system disorders (including neurological and psychiatric, psychological and panic disorders). More particularly, this invention pertains to treatment of such disorders through management of neural impulse stimulation and blocking.
  • [0004]
    2. Description of the Prior Art
  • [0005]
    A. Functional Gastrointestinal Disorders (FGIDs)
  • [0006]
    Functional Gastrointestinal Disorders (FGIDs) are a diagnostic grouping having diagnostic criteria based on symptomatology, because the pathophysiology of these diseases is multifactorial with some pathophysiologic mechanisms in common. FGIDs are thought to be due to altered autonomic nervous system balance and to be pathophysiological combinations of: (1) abnormal GI motility; (2) visceral hypersensitivity; and, (3) brain-gut interactions. Tougas, “The Autonomic Nervous System in Functional Bowel Disorders”, Gut, Vol. 47 (Suppl IV), pp. iv78-iv80 (2000) and Drossman, “Rome II: A Multinational Consensus Document on Gastrointestinal Disorders—The Functional Gastrointestinal Disorders and the Rome II Process”, Gut, Vol. 45 (Suppl II):II1-II5 (1999). The FGIDs of interest to the present invention are functional dyspepsia (dysmotility-like) and irritable bowel syndrome (IBS).
  • [0007]
    1. Functional Dyspepsia (Dysmotility-Like)
  • [0008]
    Functional dyspepsia (dysmotility-like), is diagnosed when a patient's symptoms, in the absence of other organic disease likely to explain the symptoms, include persistent or recurrent pain or discomfort centered in the upper abdomen that may be accompanied by upper abdominal fullness, early satiety, bloating or nausea. Talley et al., “Rome II: A Multinational Consensus Document on Gastrointestinal Disorders—Functional Gastroduodenal Disorders” Gut, Vol. 45 (Suppl II), pp. I37-II42 (1999).
  • [0009]
    A spectrum of dysmotilities has been documented in patients with functional dyspepsia. These include delayed gastric emptying of solids and liquids, reduced vagal tone, gastric dysrhythmias and impaired gastric accommodation. Furthermore, some studies have found good correlation between symptoms and indices of dysmotility, while others have not. Stanghellini V, et al., “Delayed Gastric Emptying of Solids in Patients with Functional Dyspepsia”, Gastroenterol, (1996) 110:1036-1042. Undeland K A, et al., “Wide Gastric Antrum and Low Vagal Tone in Patients with Diabetes Mellitus Type 1 Compared to Patients with Functional Dyspepsia and Healthy Individuals”, Dig Dis Sci, (1996) 41:9-16. Tack J, et al., “Role of Impaired Gastric Accommodation to a Meal in Functional Dyspepsia”, Gastroenterol, (1998) 115:1346-1352. Wilmer A, et al., “Ambulatory Gastrojejunal Manometry in Severe Motility-like Dyspepsia: Lack of Correlation between Dysmotility, Symptoms and Gastric Emptying”, Gut, (1998) 42:235-242. Tack J, et al., “Symptom Pattern and Gastric Emptying Rate Assessed by the Octanoic Acid Breath Test in Functional Dyspepsia” [abstract]. Gastroenterol, (1998) 114:A301. Cuomo R, et al., “Functional Dyspepsia Symptoms, Gastric Emptying and Satiety Provocation Test: Analysis of Relationships”, Scand J Gastroenterol, (2001) 36:1030-1036. Sarnelli G, et al., “Symptoms Associated with Impaired Gastric Emptying of Solids and Liquids in Functional Dyspepsia”, Am J Gastroenterol, (2003) 98:783-788.
  • [0010]
    2. Irritable Bowel Syndrome (IBS)
  • [0011]
    The second FGID of interest, IBS, is diagnosed when a patient's symptoms include persistent abdominal pain or discomfort, in the absence of other explanatory organic disease, along with at least two of the following: relief of pain with defecation, onset of symptoms associated with a change in frequency of stools and/or onset of symptoms associated with a change in appearance/form of stools. Thompson WG, et al., “Rome II: A Multinational Consensus Document on Gastrointestinal Disorders—Functional Bowel Disorders and Functional Abdominal Pain”, Gut, (1999);45(Suppl II):II43-II47.
  • [0012]
    In addition to colonic dysmotility, a number of other GI motility abnormalities have been identified, including delayed gastric emptying, gastroparesis, and small intestine motility abnormalities. Vassallo M J, et al., “Colonic Tone and Motility in Patients with Irritable Bowel Syndrome”, Mayo Clin Proc, (1992);67:725-731. Van Wijk H J, et al., “Gastric Emptying and Dyspeptic Symptoms in the Irritable Bowel Syndrome”, Scand J Gastroenterol, (1992);27:99-102. Evans P R, et al., “Gastroparesis and Small Bowel Dysmotility in Irritable Bowel Syndrome”, Dig Dis Sci (1997);42:2087-2093. Cann P A, et al. “Irritable Bowel Syndrome: Relationship of Disorders in the Transit of a Single Solid Meal to Symptoms Patterns”, Gut, (1983);24:405-411. Kellow J E, et al., “Dysmotility of the Small Intestine in Irritable Bowel Syndrome”, Gut, (1988);29:1236-1243. Evans PR, et al., “Jejunal Sensorimotor Dysfunction in Irritable Bowel Syndrome: Clinical and Psychosocial Features”, Gastroenterol, (1996);110:393-404. Schmidt T, et al., “Ambulatory 24-Hour Jejunal Motility in Diarrhea-Predominant Irritable Bowel Syndrome”, J Gastroenterol, (1996);31:581-589. Simren M, et al., “Abnormal Propagation Pattern of Duodenal Pressure Waves in the Irritable Bowel Syndrome (IBS)”, Dig Dis Sci, (2000);45:2151-2161.
  • [0013]
    A related finding is that patients with constipation-predominant IBS have evidence of decreased vagal tone, while diarrhea-predominant IBS is associated with evidence of increased sympathetic activity. Aggarwal A, et al., “Predominant Symptoms in Irritable Bowel Syndrome Correlate with Specific Autonomic Nervous system Abnormalities”, Gastroenterol, (1994); 106:945-950.
  • [0014]
    There is no cure for IBS. Treatments include supportive palliative care (antidiarrheals, dietary modification and counseling).
  • [0015]
    A recently approved drug to treat selected patients with FGIDs is tegaserod maleate sold under the tradename “Zelnorm®” by Novartis Pharmaceuticals Corp., East Hanover, N.J., USA. The product literature on Zelnorm recognizes the enteric nervous system is a key element in treating IBS. The literature suggests Zelnorm® acts to enhance basal motor activity and to normalize impaired motility. Novartis product description, Zelnorm®, July 2002 (T2002-19). Zelnorm's approved use is limited to females with constipation-related IBS. It is for short-term use only.
  • [0016]
    B. Gastroparesis
  • [0017]
    The third disease indication discussed here, gastroparesis (or delayed gastric emptying) is associated with upper GI symptoms such as nausea, vomiting fullness, bloating and early satiety. Gastroparesis can be caused by many underlying conditions. The most important, because of chronicity and prevalence, are diabetes, idiopathic and post-surgical. Hombuckle K, et al. “The Diagnosis and Work-Up of the Patient with Gastroparesis”, J Clin Gastroenterol, (2000);30: 117-124. GI dysmotility in the form of delayed gastric emptying is, by definition, present in these patients.
  • [0018]
    In patients with Type 1 diabetes mellitus and delayed gastric emptying, there appears to be a relationship between delayed gastric emptying and low vagal tone. Merio R, et al., “Slow Gastric Emptying in Type 1 Diabetes: Relation to Autonomic and Peripheral Neuropathy, Blood Glucose, and Glycemic Control”, Diabetes Care, (1997);20:419-423. A related finding is that patients with Type 1 diabetes have low vagal tone in association with increased gastric antral size, possibly contributing to the dysmotility-associated symptoms seen in these patients. Undeland K A, et al., “Wide Gastric Antrum and Low Vagal Tone in Patients with Diabetes Mellitus Type 1 Compared to Patients with Functional Dyspepsia and Healthy Individuals”, Dig Dis Sci, (1996);41:9-16.
  • [0019]
    The current treatments for gastroparesis are far from satisfactory. They include supportive care, such as dietary modification, prokinetic drugs, and; when required, interventions such as intravenous fluids and placement of a nasogastric tube may be needed.
  • [0020]
    C. Gastroesophageal Reflux Disease (GERD)
  • [0021]
    The fourth indication, GERD, can be associated with a wide spectrum of symptoms, including dyspepsia, reflux of gastric contents into the mouth, dysphagia, persistent cough, refractory hyperreactive airway disease and even chronic serous otitis media. Sontag SJ, et al., “Asthmatics with Gastroesophageal Reflux: Long Term Results of a Randomized Trial of Medical and Surgical Antireflux Therapies”, Am J Gastroenterol, (2003);98:987-999. Poelmans J, et al., “Prospective Study on the Incidence of Chronic Ear Complaints Related to Gastroesophageal Reflux and on the Outcome of Antireflux Therapy”, Ann Otol Rhinol Laryngol, (2002);111:933-938.
  • [0022]
    GERD is considered to be a chronic condition for which long-term medical therapy and/or surgical therapy is often deemed necessary, in significant part because esophageal adenocarcinoma is sometimes a consequence of GERD. DeVault KR, et al., “Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease”, Am J Gastroenterol, (1999);94:1434-1442. Lagergren J, et al., “Symptomatic Gastroesophageal Reflux as a Risk Factor for Esophageal Adenocarcinoma”, New Engl J Med, (1999);340:825-831.
  • [0023]
    The underlying pathophysiological mechanisms in GERD are considered to be transient lower esophageal relaxations (TLESRs) in the presence of either an inadequate pressure gradient between the stomach and the esophagus across the lower esophageal sphincter and/or low amplitude esophageal activity at times when gastric contents do reflux into the esophagus. In addition, gastric distention is thought to be associated with an increase in TLESRs. Mittal RK, et al., “Mechanism of Disease: The Esophagogastric Junction”, New Engl J Med, (1997);336:924-932. Scheffer RC, et al., “Elicitation of Transient Lower Oesophageal Sphincter Relaxations in Response to Gastric Distension”, Neurogastroenterol Motil, (2002);14:647-655.
  • [0024]
    GERD is generally considered to be the result of a motility disorder which permits the abnormal and prolonged exposure of the esophageal lumen to acidic gastric contents. Hunt, “The Relationship Between The Control Of pH And Healing And Symptom Relief In Gastro-Oesophageal Reflux Disease”, Ailment Pharmacol Ther., 9 (Suppl. 1) pp. 3-7 (1995). Many factors are believed to contribute to the onset of GERD. These include transient lower esophageal sphincter relaxations (as previously described), decreased LES resting tone, delayed stomach emptying and an ineffective esophageal clearance.
  • [0025]
    Certain drugs have had some effectiveness at controlling GERD but fail to treat underlying causes of the disease. Examples of such drugs are H2-receptor antagonists (which control gastric acid secretion in the basal state) and proton pump inhibitors (which control meal-stimulated acid secretion). Hunt, id. Both classes of drugs can raise intragastric pH to or about 4 for varying durations. Hunt, supra.
  • [0026]
    Surgery treatments are also employed for the treatment of GERD and include techniques for bulking the lower esophageal sphincter such as fundoplication and techniques described in U.S. Pat. No. 6,098,629 Johnson et al, Aug. 8, 2000. Other surgical techniques include placement of pacemakers for stimulating muscle contractions in the esophageal sphincter, the stomach muscles or in the pyloric valve. U.S. Pat. No. 6,104,955 to Bourgeois, U.S. Pat. No. 5,861,014 to Familoni.
  • [0027]
    A summary of GERD treatments can be found in DeVault, et al., “Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease”, Amer. J. of Gastroenterology, Vol. 94, No. 6, pp. 1434-1442 (1999).
  • [0028]
    Notwithstanding multiple attempts at various types of treatment, GERD continues to be a serious disease proving to be difficult to treat by any of the foregoing prior art techniques. In view of the foregoing and notwithstanding various efforts exemplified in the prior art, there remains a need for an effective treatment for GERD. It is an object of the present invention to provide a novel treatment and novel apparatus for the treatment of GERD.
  • [0029]
    D. Electrical Stimulation to Treat GI Disorders
  • [0030]
    Treatment of gastrointestinal diseases through nerve stimulation have been suggested. For example, U.S. Past. No. 6,238,423 to Bardy dated May 29, 2001 describes a constipation treatment involving electrical stimulation of the muscles or related nerves of the gut. U.S. Pat. No. 6,571,127 to Ben-Haim et al. dated May 27, 2003 describes increasing motility by applying an electrical field to the GI tract. U.S. Pat. No. 5,540,730 to Terry, Jr. et al., dated Jul. 30, 1996 describes a motility treatment involving vagal stimulation to alter GI contractions in response to a sense condition indicative of need for treatment. The '730 patent also uses a definition of dysmotility more restrictive than in the present application. In the '730 patent, dysmotility is described as hyper- or hypo-contractility. In the present application, dysmotility is a broader concept to refer to all abnormalities of gastric emptying or bowel transfer regardless of cause. U.S. Pat. No. 6,610,713 to Tracey dated Aug. 26, 2003 describes inhibiting release of a proinflammatory cytokine by treating a cell with a cholinergic agonist by stimulating efferent vagus nerve activity to inhibit the inflammatory cytokine cascade.
  • [0031]
    A substantial body of literature is developed on nerve stimulation. For example, in Dapoigny et al., “Vagal influence on colonic motor activity in conscious nonhuman primates”, Am. J. Physiol., 262: G231-G236 (1992), vagal influence on colonic motor activity was investigated in conscious monkeys. To block antidromic interference, the vagus was blocked via vagal cooling and a vagal stimulation electrode was implanted distal to the vagal block. It was noted that vagal efferent stimulation increased contractile frequency and that the vagus has either a direct or indirect influence on fasting and fed colonic motor activity throughout the colon, and that a non-adrenergic, noncholinergic inhibitory pathway is under vagal control.
  • [0032]
    Colonic and gastric stimulation are also described in a number of articles associated with M. P. Mintchev. These include: Mintchev, et al., “Electrogastrographic impact of multi-site functional gastric electrical stimulation”, J. of Medical Eng. & Tech., Vol. 23, No. 1 pp. 5-9 (1999); Rashev, et al., “Three-dimensional static parametric modeling of phasic colonic contractions for the purpose of microprocessor-controlled functional stimulation”, J. of Medical Eng. & Tech., Vol. 25, No. 3 pp. 85-96 (2001); Lin et al., “Hardware—software co-design of portable functional gastrointestinal stimulator system”, J. of Medical Eng. & Tech., Vol. 27, No. 4 pp. 164-177 (2003); Amaris et al., “Microprocessor controlled movement of solid colonic content using sequential neural electrical stimulation”, Gut, 50: pp 475-479 (2002) and Rashev et al., “Microprocessor-Controlled Colonic Peristalsis”, Digestive Diseases and Sciences, Vol. 47, No. 5, pp. 1034-1048 (2002).
  • [0033]
    The foregoing references describe nerve stimulation to stimulate muscular contraction in the GI tract. As will be more fully discussed, the present invention utilizes vagal stimulation to improve vagal tone (similar in concept to improving cardiac electrical tone through cardiac pacing) and/or to treat GI disorders by altering the nature of duodenum contents by stimulation pancreatic and biliary output. The invention is also applicable to treating other diseases such as neuropsychiatric disorders.
  • [0034]
    Vagal tone has been shown to be associated with dyspepsia. Hjelland, et al., “Vagal tone and meal-induced abdominal symptoms in healthy subjects”, Digestion, 65: 172-176 (2002). Also, Hausken, et al., “Low Vagal Tone and Antral Dysmotility in Patients with Functional Dyspepsia”, Psychosomatic Medicine, 55: 12-22 (1993). Also, decreased vagal tone has been associated with irritable bowel syndrome. Heitkemper, et al., “Evidence for Automatic Nervous System Imbalance in Women with Irritable Bowel Syndrome”, Digestive Diseases and Sciences, Vol. 43, No. 9, pp. 2093-2098 (1998).
  • [0035]
    Also, as will be discussed, the present invention includes, in several embodiments, a blocking of a nerve (such as the vagal nerve) to avoid antidromic influences during stimulation. Cryogenic nerve blocking of the vagus is described in Dapoigny et al., “Vagal influence on colonic motor activity in conscious nonhuman primates”, Am. J. Physiol., 262: G231-G236 (1992). Electrically induced nerve blocking is described in Van Den Honert, et al., “Generation of Unidirectionally Propagated Action Potentials in a Peripheral Nerve by Brief Stimuli”, Science, Vol. 206, pp. 1311-1312. An electrical nerve block is described in Solomonow, et al., “Control of Muscle Contractile Force through Indirect High-Frequency Stimulation”, Am. J. of Physical Medicine, Vol. 62, No. 2, pp. 71-82 (1983) and Petrofsky, et al., “Impact of Recruitment Order on Electrode Design for Neural Prosthetics of Skeletal Muscle”, Am. J. of Physical Medicine, Vol. 60, No.5, pp. 243-253 (1981). A neural prosthesis with an electrical nerve block is also described in U.S. Patent Application Publication No. US 2002/0055779 A1 to Andrews published May 9, 2002. A cryogenic vagal block and resulting effect on gastric emptying are described in Paterson C A, et al., “Determinants of Occurrence and Volume of Transpyloric Flow During Gastric Emptying of Liquids in Dogs: Importance of Vagal Input”, Dig Dis Sci, (2000);45:1509-1516.
  • III. SUMMARY OF THE INVENTION
  • [0036]
    According to a preferred embodiment of the present invention, a method and apparatus are disclosed for treating at least one of a plurality of gastrointestinal disorders of a patient characterized at least in part by an altered autonomic balance or altered motility. The method includes electrically stimulating an enteric nervous system of the patient to enhance a functional tone of the enteric nervous system.
  • [0037]
    Enteric rhythm management (ERM) treats GI diseases in which dysmotility is thought to play a major role. This therapy is based on the physiological actions of pancreatic exocrine secretion and bile on the composition (osmolality and pH) and the digestion (enzymatic activity and, in the case of fats, emulsification) of intra-duodenal chyme, thereby presenting a novel approach to regulating the motility of the GI tract and, in particular, gastric emptying and the digestion and propulsion of chyme through the duodenum and into the jejunum and ileum.
  • [0038]
    ERM as a therapy for GI diseases involving dysmotility is based on the following: (1) pacing the delivery of pancreatic exocrine secretion and bile can be used to either up- or down-regulate at least two aspects of GI motility—gastric emptying and small bowel transit—by modulating the osmolality, the pH and the digestion, including emulsification as needed, of intra-duodenal chyme; (2) pacing the efferent activity of the intra-abdominal vagus nerve as needed while blocking afferent activity of that same nerve as needed can be used to treat GI dysmotility in patients with either increased or decreased vagal tone as a component of their disease; and, (3) treating GI dysmotility disorders can and often does require flexibility in adjusting treatment algorithms based on symptomatic response because of inter-patient differences with a diagnostic group and because of intra-patient variability over time.
  • [0039]
    The goals of enteric rhythm management in gastroparesis are: 1) to regulate the composition and digestion of duodenal chyme and, by so doing, to facilitate gastric emptying through the modulatory effect of duodenal chemo- and mechanoreceptors on the pylorus and 2) to up-regulate or down-regulate vagal tone to optimize gastricintestinal motility and symptom relief.
  • [0040]
    In patient with GERD, ERM utilizing a physiologic enteric pacing device will, as described earlier, allow pacing of the delivery of pancreatic exocrine secretion and bile, thereby initiating pyloric relaxation, gastric emptying and consequent reduction in gastric distention, leading to a decrease in the underlying mechanism of GERD, that is, TLESRs.
  • [0041]
    Kellow J E, et al., “Rome II: A Multinational Consensus Document on Gastrointestinal Disorders—Principles of Applied Neurogastroenterology: Physiology/Motility-Sensation”, Gut, (1999);45(Suppl II):II17-II24. Paterson C A, et al., “Determinants of Occurrence and Volume of Transpyloric Flow During Gastric Emptying of Liquids in Dogs: Importance of Vagal Input”, Dig Dis Sci, (2000);45:1509-1516. Tougas G, “The Autonomic Nervous System in Functional Bowel Disorders”, Gut, (2000);47(Suppl IV):iv78-iv80. Guyton A C, et al., “Propulsion and Mixing of Food in the Alimentary Tract”, Textbook of Medical Physiology, 10th ed. Philadelphia: W. B. Saunders and Company, 200:728-737. Guyton A C, et al., “Secretory Functions of the Alimentary Tract”, Textbook of Medical Physiology, 10th ed. Philadelphia: W. B. Saunders and Company, 200:738-753. Schwartz M P, et al., “Human Duodenal Motor Activity in Response to Acid and Different Nutrients”, Dig Dis Sci, (2001);46:1472-1481. Schwartz MP, et al., “Chemospecific Alterations in Duodenal Perception and Motor Response in Functional Dyspepsia”, Am J Gastroenterol, (2001);96:2596-2602.
  • [0042]
    ERM involves pacing and thereby regulating the timing and the volume of pancreatic exocrine secretion and bile delivered to the intraluminal contents of the duodenum. In one embodiment, this is accomplished with a small, laparoscopically implantable and programmable medical device called a physiologic enteric pacing device. Three leads are positioned intra-abdominally and then connected to a subcutaneous, programmable pulse generator. A pacing lead may be placed on the anterior vagal trunk and another pacing lead may be placed on the posterior vagal trunk. One or more intra-abdominal electrode, i.e. blocking electrodes, may be placed on the vagus nerve proximal to the pacing leads.
  • [0043]
    An additional embodiment of the present invention pertains to treating at least one of a plurality of gastrointestinal disorders of a patient by electrically stimulating a vagus nerve of the patient at a stimulation site proximal to at least one site of vagal innervation of a gastrointestinal organ. The electrical stimulation includes applying a stimulation signal at the stimulation site. A proximal electrical blocking signal is applied to the vagus nerve at a proximal blocking site proximal to the stimulation site. The proximal blocking signal is selected to at least partially block nerve impulses proximal to the proximal blocking site.
  • [0044]
    The invention further includes a treatment apparatus having a stimulation electrode adapted for placement on a nerve of a patient at a stimulation site and a stimulation signal generator for generating a stimulation signal at the stimulation electrode and selected to electrically stimulate a nerve to induce bi-directional propagation of nervous impulses in a stimulated nerve. The apparatus includes a blocking member for placement on the nerve at a blocking site and creating localized conditions at the blocking site that at least partially diminish transmission of nerve impulses past the blocking site.
  • [0045]
    A still further embodiment of the present invention includes a method for treating at least one of a plurality of disorders of a patient where the disorders are associated with a gastrointestinal tract of a patient where the disorders are characterized at least in part by hyper-tonal vagal activity innervating at least one of a plurality of alimentary tract organs of the patient at an innervation site. The method includes applying a neural conduction block to a vagus nerve of the patient at a blocking site proximal to the innervation site. The neural conduction block is selected to at least partially block nerve impulses on the vagus nerve distal to the blocking site.
  • [0046]
    A yet further embodiment pertains to a treatment apparatus having an electrically controllable neural conduction electrode adapted to be placed on a vagus nerve of a patient at a blocking site proximal to an innervation site. A blocking signal generator generates a blocking signal selected to at least partially block nerve impulses on the vagus nerve distal to the blocking site.
  • [0047]
    A still additional embodiment of the present invention includes a method for treating at least one of a plurality of disorders of a patient by electrically stimulating a vagus nerve at a stimulation site with a stimulation signal selected to have a therapeutic effect on a target organ. An electrical blocking signal is applied to the vagus nerve at a blocking site on a side of said stimulation site opposite the target organ. The blocking signal is selected to at least partially block nerve impulses to a second organ on a side of said blocking site opposite the stimulation site. In specific examples, the target organ may be gastrointestinal or central nervous with the other organ being cardio-respiratory.
  • IV. BRIEF DESCRIPTION OF THE DRAWINGS
  • [0048]
    [0048]FIG. 1 is a schematic representation of a gastric-emptying feedback loop with a patient-controlled stimulator for stimulating an organ of the loop;
  • [0049]
    [0049]FIG. 2 is a view similar to FIG. 1 with an automatic controller replacing the patient-controller of FIG. 1 and with feedback circuits to the automatic controller schematically represented;
  • [0050]
    [0050]FIG. 3 is a schematic illustration of an alimentary tract (GI tract plus non-GI organs such as the pancreas and liver) and its relation to vagal and enteric innervation;
  • [0051]
    [0051]FIG. 4 is the view of FIG. 3 showing the application of a pacing electrode according to an embodiment of the present invention;
  • [0052]
    [0052]FIG. 5 is a schematic representation of pacing system;
  • [0053]
    [0053]FIG. 6 is the view of FIG. 4 showing the application of a nerve conduction block electrode proximal to the pacing electrode;
  • [0054]
    [0054]FIG. 7 is the view of FIG. 6 showing the application of a nerve conduction block electrode distal to the pacing electrode; and
  • [0055]
    [0055]FIG. 8 is the view of FIG. 3 showing the application of a nerve conduction block electrode according to an embodiment of the present invention.
  • V. DESCRIPTION OF THE PREFERRED EMBODIMENT
  • [0056]
    With reference now to the various drawing figures in which identical elements are numbered identically throughout, a description of the preferred embodiment of the present invention will now be described.
  • [0057]
    A. Invention of Parent Application
  • [0058]
    [0058]FIGS. 1 and 2 and the description which follow are from the aforementioned U.S. patent application Ser. No. 10/358,093 filed Feb. 3, 2003 filed Feb. 3, 2003 and entitled “Method and Apparatus for Treatment of Gastroesophageal Disease (GERD)”.
  • [0059]
    With initial reference to FIG. 1, a gastric emptying feedback loop is shown schematically for ease of illustration. The feedback loop illustrates a patient's stomach S which is provided with food from the esophagus E. A lower esophageal sphincter LES is shown positioned between the esophagus E and the stomach S. The lower esophageal sphincter normally provides control of reflux of stomach contents into the esophagus E.
  • [0060]
    On a proximal or lower end of the stomach S the stomach discharges into the superior duodenum D which is an upper portion of the intestines. The superior duodenum D and the stomach S are separated by a pyloric valve PV which opens to permit gastric emptying from the stomach into the duodenum D.
  • [0061]
    Also schematically illustrated in FIG. 1 are nerve paths N providing signal flow paths from both the superior duodenum D and the stomach S to the brain B. An efferent Vagal nerve VN connects the brain B to the pancreas P of the patient. A conduit (pancreatic duct PD) extends from the pancreas P and discharges into the superior duodenum D.
  • [0062]
    The presence of food contents within the duodenum D (such contents being referred to as “chyme”) may prevent passage of gastric content of the stomach S past the pyloric valve PV into the duodenum D. As long as such gastric contents cannot be passed into the duodenum D, such contents can be forced retrograde past the lower esophageal sphincter LES and into the esophagus E creating the symptoms and discomfort of GERD. The contents discharging from the stomach S into the duodenum D are acidic (and high osmolality) and reside in the duodenum D until pH is elevated (close to a neutral pH of 6-7) and osmolality is normalized.
  • [0063]
    The elevation of pH and reduction of osmolality of chyme in the duodenum D results from exocrine secretion being administered from the pancreas P and from bile from the liver into the duodenum D. This raises the pH and lowers the osmolality of the duodenum D content permitting discharge from the duodenum D and thereby permitting gastric emptying across the pyloric valve PV.
  • [0064]
    According to the present invention gastroesophageal reflux disease (GERD) results from a derangement of the feedback loops involved in upper GI digestion and motility control. This problem encompasses receptors and reflexes that regulate the propulsive contractions of the stomach, upper duodenum and biliary tree and the secretions of the exocrine pancreas. The interaction of these receptors and reflexes control gastric emptying (by coordinating gastric propulsive contractions and sphincter [primarily pyloric] tone) and regulate the pH and osmolality of the chyme in the duodenum. This chemo-regulation is mediated through control of bile delivery and stimulation of secretion by the exocrine pancreas of fluid delivered to the superior duodenum. Chey et al., “Neural Hormonal Regulation of Exocrine Pancreatic Secretion”, Pancreatology, pp. 320-335 (2001).
  • [0065]
    Normally, ingestate delivered to the stomach is mixed by low intensity gastric mixing contractions with the enzymatic, ionic, including hydrogen ion (H+), and water secretions of the glands of the stomach. When the material is adequately reduced in size and is a smooth consistency, the fluid, now called chyme, is delivered to the ampulla of the small intestine by the much stronger propulsive, or emptying, contractions of the stomach coupled with transitory relaxation of the pyloric sphincter. This material is at a very low pH (about 2) and high osmolality, which activates receptors, including those for H+ and osmotic pressure, which are abundant in the wall of the ampulla. This receptor activation initiates the series of reflexes that cause pancreatic exocrine secretion to be delivered into the superior duodenum and ampulla. This fluid contains digestive enzymes, water and buffering compounds to raise the pH, and reduce the osmolality, of the chyme.
  • [0066]
    Once a neutral pH and physiological osmolality are achieved, then propulsive contractions in the superior duodenum move the chyme out of the superior portion into the length of the duodenum; At which point the stretch and baro-receptors in the ampulla allow the pyloric sphincter to relax and another bolus of gastric contents is delivered into the ampulla by the peristaltic gastric emptying contractions. This material, at a very low pH (less than 2), activates hydrogen ion (H+) on receptors of the ampulla (upper most portion of the duodenum) causing the pancreatic fluids to be delivered to the material in the ampulla restarting the cycle as described above. Chapter 3, “The Stomach”, Gastrointestinal System, 2nd Ed., M. S. Long editor, Mosby Publisher, London (2002).
  • [0067]
    If the control system is down regulated by, for example, by increased pH of gastric contents entering the ampulla, feedback may thereby be reduced from the H+ receptors in the duodenum that stimulate pancreatic exocrine secretion and bile delivery to the duodenum, then movement of chyme from the superior duodenum is delayed, causing delay of gastric emptying. Mabayo, et al., “Inhibition of Food Passage by Osmeprazole in the Chicken”, European J. of Pharmacology, pp. 161-165 (1995).
  • [0068]
    In GERD, this reflex is inhibited in such a way that the stomach empties more slowly so that the gastric emptying contractions force gastric contents to flow retrograde into the esophagus. This is a result of the situation in which the gastric emptying contractions are vigorous but must operate against a contracted pyloric sphincter. These vigorous peristaltic contractions eventually begin to force gastric contents to flow retrograde into the esophagus because of the inherent imbalance between a very strong pyloric sphincter and a much weaker gastroesophageal sphincter. The delay in gastric emptying is directly related to a slow down in the transport of chyme out of the ampulla and superior duodenum. The drugs used to treat this disease raise pH further dampening the hydrogen-receptor-pancreatic secretion loop, further delaying gastric emptying. Benini, “Gastric Emptying and Dyspeptic Symptoms in Patients with Gastroesophageal Reflux”, Amer. J. of Gastroenterology, pp. 1351-1354 (1996).
  • [0069]
    The present invention is directed towards reestablishing the link between gastric emptying and pancreatic secretion delivery, thereby addressing the main pathology of this disease by shortening chyme residence time in the superior duodenum so that intestinal contents move into the distal digestive tract in a more normal manner. According to a first embodiment, this is done by stimulating the H+ ion receptors or by stimulation of the pancreas directly or via its para-sympathetic innervation (pre-ganglionic Vagal nerves). Stimulation of pancreatic exocrine secretion has been shown by direct stimulation of the thoracic vagus nerves in dogs. Kaminski et al., “The Effect of Electrical Vagal Stimulation on Canine Pancreatic Exocrine Function”, Surgery, pp. 545-552 (1975). This results in a more rapid (normal) neutralization of chyme in the ampulla, allowing it move down the duodenum more quickly so that gastric emptying is returned to a more normal pace.
  • [0070]
    Acidity (pH) can be assessed by measuring bicarbonate. It will be understood that references to —H includes such indirect measurements. Also, effects of the therapy described herein can be assessed and/or controlled by measuring an indication of pancreatic exocrine secretion or bile (e.g., HCO3 ).
  • [0071]
    An alternative embodiment uses gastrocopic delivery of a paralyzing agent (e.g. botulism toxin) to the pyloric valve along with use of H2 antagonists or PPI's to manage the acidity of the chyme reaching the duodenum.
  • [0072]
    As an additional alternative to pancreatic stimulation, the gall bladder can be stimulated to encourage bile movement into the duodenum. Shown schematically in the figures, the gall bladder GB resides below the liver L. The gall bladder is connected to the small intestine (specifically the duodenum D) via a bile duct BD. The bile duct BD can discharge directly into the duodenum D or via the pancreatic duct PD as shown. The bile can normalize the chyme to accelerate duodenal emptying. Bile consists of bile acids (detergents that emulsify lipids), cholesterol, phospholipids, electrolytes such as (Na+, K+, Ca+2, Cl, HCO3 ) and H2O. Chapter 4, “The Liver and Biliary Tract”, Gastrointestinal System, 2nd Ed., M. S. Long editor, Mosby Publisher, London (2002). The gall bladder GB or bile duct can be stimulated indirectly via stimulation of the vagal nerve VN or directly stimulated by an electrode 11 (shown in phantom lines).
  • [0073]
    As illustrated in the figures, an electrical stimulator 10, 20 which may be implanted is provided which alternatively may be directly connected to the Vagal nerve VN or the pancreas P to stimulate the pancreas directly or indirectly to excrete exocrine into the duodenum D (or more distally into the small intestine—e.g., into the jejunum) and increase the pH of chyme in the duodenum D as described. Alternatively, the same can be done to promote bile release. The frequency may be varied to maximize the response and selectively stimulate exocrine instead of endocrine secretions. Rosch et al., “Frequency-Dependent Secretion of Pancreatic Amylase, Lipase, Trypsin, and Chymotrypsin During Vagal Stimulation in Rats”, Pancreas, pp. 499-506 (1990). See, also, Berthoud et al., “Characteristics of Gastric and Pancreatic Reponses to Vagal Stimulation with Varied Frequencies: Evidence for Different Fiber Calibers?”, J. Auto. Nervous Sys., pp. 77-84 (1987) (showed frequency-response relationship with insulin, i.e., significantly less insulin was released at lower frequencies −2 Hz v. 8 Hz—also, frequency-response curves evidenced distinctly different profiles for gastric, pancreatic and cardiovascular responses.) Slight insulin release can maximize pancreatic exocrine secretion. Chey et al., “Neural Hormonal Regulation of Exocrine Pancreatic Secretion”, Pancreatology, pp. 320-335 (2001).
  • [0074]
    With a patient control stimulation as shown in FIG. 1, the patient may activate the stimulator 10 by remote transmitter to stimulate an electrical charge either after eating (e.g., about 60 to 90 minutes after eating) or on onset of GERD symptoms. It will be appreciated that there are a wide variety of nerve stimulators and organ stimulators available for implantation and are commercially available and which include connectors for connecting directly to nerves.
  • [0075]
    [0075]FIG. 2 illustrates an additional embodiment where the patient activated loop is replaced with an automatic loop having a programmable stimulator 20 which receives as an input signals from sensors in the duodenum to measure pH, osmolality or strain (e.g., from baro-sensors) on the duodenum indicating filling or may measure acidity in the esophagus or strain on the lower esophageal sphincter LES or stomach S all of which may be provided to the implantable controller 20 which can be provided with desirable software to process the incoming signals and generate a stimulating signal to either the vagal nerve, the pancreas P or the duodenum D (or jejunum) directly in response to such received signals. It will be appreciated that stimulators and controllers are well within the skill of the art. U.S. Pat. No. 5,540,730 teaches a neurostimulator to stimulate a vagus nerve to treat a motility disorder. U.S. Pat. No. 5,292,344 teaches gastrointestinal sensors, including pH sensors.
  • [0076]
    B. Application of Parent Application to Treatments Other than GERD
  • [0077]
    In addition to treatment of GERD, the foregoing invention is applicable to treatment of a plurality of GI diseases associated with delayed gastric emptying or altered autonomic activity. These include functional gastrointestinal disorders and gastroparesis. Furthermore, applicants have determined that duodenal content impacts a plurality of motility disorders throughout the bowels and can diseases associated with dysmotility (e.g., irritable bowel syndrome). Accordingly it is an object of the present invention to use the teachings of the aforementioned parent application to treat GI disorders associated with delayed gastric emptying and abnormal intestinal transport.
  • [0078]
    C. Additional Disclosure of the Present Application
  • [0079]
    1. Enteric Innervation
  • [0080]
    [0080]FIG. 3 is a schematic illustration of an alimentary tract (GI tract plus non-GI organs such as the pancreas and ball bladder, collectively labeled PG) and its relation to vagal and enteric innervation. The lower esophageal sphincter (LES) acts as a gate to pass food into the stomach S and, assuming adequate function of all components, prevent reflux. The pylorus PV controls passage of chyme from the stomach S into the intestines I (collectively shown in the figures and including the large intestine or colon and the small intestine including the duodenum, jejunum and ileum).
  • [0081]
    The biochemistry of the contents of the intestines I is influenced by the pancreas P and gall bladder PG which discharge into the duodenum. This discharge is illustrated by dotted arrow A.
  • [0082]
    The vagus nerve VN transmits signals to the stomach S, pylorus PV, pancreas and gall bladder PG directly. Originating in the brain, there is a common vagus nerve VN in the region of the diaphragm (not shown). In the region of the diaphragm, the vagus VN separates into anterior and posterior components with both acting to innervate the GI tract. In FIGS. 3, 5-8, the anterior and posterior vagus nerves are not shown separately. Instead, the vagus nerve VN is shown schematically to include both anterior and posterior nerves.
  • [0083]
    The vagus nerve VN contains both afferent and efferent components sending signals away from and to, respectively, its innervated organs.
  • [0084]
    In addition to influence from the vagus nerve VN, the GI and alimentary tracts are greatly influenced by the enteric nervous system ENS. The enteric nervous system ENS is an interconnected network of nerves, receptors and actuators throughout the GI tract. There are many millions of nerve endings of the enteric nervous system ENS in the tissues of the GI organs. For ease of illustration, the enteric nervous system ENS is illustrated as a line enveloping the organs innervated by the enteric nervous system ENS
  • [0085]
    The vagus nerve VN innervates, at least in part, the enteric nervous system ENS (schematically illustrated by vagal trunk VN3 which represents many vagus-ENS innervation throughout the cut). Also, receptors in the intestines I connect to the enteric nervous system ENS. Arrow B in the figures illustrates the influence of duodenal contents on the enteric nervous system ENS as a feedback to the secretion function of the pancreas, liver and gall bladder. Specifically, receptors in the intestine I respond the biochemistry of the intestine contents (which are chemically modulated by the pancreao-biliary output of Arrow A). This biochemistry includes pH and osmolality.
  • [0086]
    In the figures, vagal trunks VN1, VN2, VN4 and VN6 illustrate schematically the direct vagal innervation of the GI organs of the LES, stomach S, pylorus PV and intestines I. Trunk VN3 illustrates direct communication between the vagus VN and the ENS. Trunk VN5 illustrates direct vagal innervation of the pancreas and gall bladder. Enteric nerves ENS1-ENS4 represent the multitude of enteric nerves in the stomach S, pylorus PV, pancreas and gall bladder PG and intestines I.
  • [0087]
    While communicating with the vagus nerve VN, the enteric nervous system ENS can act independently of the vagus and the central nervous system. For example, in patients with a severed vagus nerve (vagotomy—an historical procedure for treating ulcers), the enteric nervous system can operate the gut. Most enteric nerve cells are not directly innervated by the vagus. Gershon, “The Second Brain”, Harper Collins Publishers, Inc, New York, N.Y. p. 19 (1998)
  • [0088]
    In FIG. 3, the vagus VN and its trunks (illustrated as VN1-VN6) and the enteric nervous system ENS are shown in phantom lines to illustrate reduced vagal and enteric nerve tone (i.e., sub-optimal nerve transmission levels). Reduced vagal and enteric tone contribute directly to the ineffectiveness of the GI organs as well as indirectly (through reduced pancreatic/biliary output). The reduced pancreatic/biliary output is illustrated by the dotted presentation of arrow A. As previously discussed, the vagus can be stimulated to stimulate pancreatic or biliary output. Therefore, the reduced output of arrow A results in a reduced feedback illustrated by the dotted presentation of arrow B.
  • [0089]
    2. Enteric Rhythm Management (ERM)
  • [0090]
    The benefits of the present invention are illustrated in FIG. 4 where a stimulating or pacing electrode PE is applied to the vagus VN. While only one electrode is shown in FIG. 4, separate electrodes could be applied to both the anterior and posterior vagus nerves (or to the common vagus or vagal branches). In a preferred embodiment, the electrode PE is placed a few centimeters below the diaphragm and proximal to stomach and pancreo/biliary innervation. While this placement is presently preferred for ease of surgical access, other placement locations may be used.
  • [0091]
    By pacing the vagus through the pacing electrode, vagal tone is optimized by either up- or down-regulation. With reference to the parasympathetic and enteric nervous systems, “tone” refers to basal activity of a nerve or nervous system facilitating appropriate physiologic response to a patient's internal environment. For example, low vagal tone implies a reduction in vagus nerve activity resulting in decreased response of the alimentary tract to ingested food. As used in the present application, “pacing” is not limited to mean timed events coordinated with specifically timed physiologic events. Instead, pacing means any electrical stimulation of a nerve trunk to induce bi-directional propagation of nervous impulses in the stimulated nerve.
  • [0092]
    The operating effectiveness of the vagus is enhanced so that local physiological signals generated in the enteric nervous system (or sent to the brain from the organs) are more appropriately responded to within the alimentary tract. Due to its innervation of the enteric nervous system, pacing of the vagus enhances the functional tone of the enteric nervous system. By enhancing the functional tone it will be noted that the stimulation pacing is elevating the degree of functionality of the vagus and enteric nerves. In this context, “pacing” is not meant to mean timed pulsed coordinated with muscular contractions or synchronized with other invents. Pacing means elevating the activity level of the nerves.
  • [0093]
    Tonal enhancement of the vagus and enteric nerves is illustrated by the solid lines for the nerves VN, ENS in FIG. 4. Vagal trunk VN5 is in solid line to illustrate enhanced tone of the many vagal nerve components communicating with the enteric nervous system ENS. Direct vagal innervation of the LES, stomach S, pylorus PV and intestines I remains shown as low tone indicated by phantom lines VN1, VN2, VN4, VN6. The tonal pacing described herein is not intended to trigger or drive the muscular contractility of these organs. The stimulation is not intended to be timed to trigger contractility and is not provided with an energy level sufficient to drive peristaltic contractions. Instead, these functions remain controlled by the central and enteric nerves systems. The enhanced nerve tone provided by the present invention permits these functions to occur.
  • [0094]
    Pacing to enhance vagal tone is not initiated in response to any senses event (or in anticipation of an immediate need to GI activity). Instead, the pacing can be done intermittently over the day to provide an enhanced level of operating functionality to the vagus. By way of non-limiting example, the stimulation pacing can be done during awake hours. For example, every ten minutes, pacing signals can be sent to the pacing electrodes. The pacing signals have a duration of 30 seconds with a current of 4 mA, a frequency of 12 Hz and an impulse duration of 2 msec. These parameters are representative only. A wide range of signal parameters may be used to stimulate the vagus nerve. Examples of these are recited in the afore-referenced literature
  • [0095]
    As will be further discussed, the present invention permits ERM to be uniquely designed and modified by an attending physician to meet the specific needs of individual patients. For example, pacing can be limited to discrete intervals in the morning, afternoon and evening with the patient free to coordinate meals around these events.
  • [0096]
    In addition to enhancing vagal and enteric tone directly, the pacing also enhances the pancreatic and biliary output for the reasons discussed above. Namely, while ERM does not drive muscular events over nerve trunks VN1, VN2, VN4, VN6, the enhanced tone stimulates pancreo-biliary output over trunk VN5 (illustrated by the solid line of VN5 in FIG. 4). This enhanced output is illustrated as solid arrow A′ in FIG. 4. As a consequence there is a greater feedback to the intestinal receptors as illustrated by solid arrow B′ in FIG. 4. This enhanced biochemistry feedback further enhances the tone of the enteric nervous system ENS.
  • [0097]
    3. Implantable Pacing Circuit
  • [0098]
    A representative pacing circuit 100 is schematically shown in FIG. 5. Similar to cardiac pacing devices, an implantable controller 102 contains an induction coil 104 for inductive electrical coupling to a coil 106 of an external controller 108. The implantable controller 102 includes anterior and posterior pulse generators 110, 112 electrically connected through conductors 114, 116 to anterior and posterior pacing electrodes 118, 120 for attachment to anterior and posterior trunks, respectively, of the vagus nerve VN. The implantable controller 102 also includes a battery 122 and a CPU 124 which includes program storage and memory. The timing and parameters of the pulse at the electrodes 118, 120 can be adjusted by inductively coupling the external controller 108 to the implantable controller 102 and inputting pacing parameters (e.g., pulse width, frequency and amplitude).
  • [0099]
    While a fully implantable controller 102 is desirable, it is not necessary. For example, the electrodes 118, 120 can be implanted connected to a receiving antenna placed near the body surface. The control circuits (i.e., the elements 124, 110, 112 and 108) can be housed in an external pack worn by the patient with a transmitting antenna held in place on the skin over the area of the implanted receiving antenna. Such a design is forward-compatible in that the implanted electrodes can be later substituted with the implantable controller 102 at a later surgery if desired.
  • [0100]
    Although not shown in FIG. 5, the controller 102 can also include circuits generating nerve conduction block signals (as will be described) which connect to electrodes which may be positioned on a nerve proximally, distally (or both) of the electrodes 118, 120.
  • [0101]
    4. Nerve Conduction Block
  • [0102]
    [0102]FIG. 6 shows an alternative embodiment using a nerve conduction blocking electrode PBE proximal to the pacing electrode for providing a conduction block. A nerve block is, functionally speaking, a reversible vagotomy. Namely, application of the block at least partially prevents nerve transmission across the site of the block. Removal of the block restores normal nerve activity at the site. A block is any localized imposition of conditions that at least partially diminish transmission of impulses.
  • [0103]
    The vagal block may be desirable in some patients since unblocked pacing may result in afferent vagal and antidromic efferent signals having undesired effect on organs innervated by the vagus proximal to the GI tract (e.g., undesirable cardiac response). Further, the afferent signals of the pacing electrode PE can result in a central nervous system response that tends to offset the benefits of the pacing electrode on the ENS and pancreo/biliary function, thereby reducing the GI and enteric rhythm management effectiveness of vagal pacing.
  • [0104]
    The block may be intermittent and applied only when the vagus is paced by the pacing electrode PE. The preferred nerve conduction block is an electronic block created by a signal at the vagus by an electrode PBE controlled by the implantable controller (such as controller 102 or an external controller). The nerve conduction block can be any reversible block. For example, cryogenics (either chemically or electronically induced) or drug blocks can be used. An electronic cryogenic block may be a Peltier solid-state device which cools in response to a current and may be electrically controlled to regulate cooling. Drug blocks may include a pump-controlled subcutaneous drug delivery.
  • [0105]
    With such an electrode conduction block, the block parameters (signal type and timing) can be altered by a controller and can be coordinated with the pacing signals to block only during pacing. A representative blocking signal is a 500 Hz signal with other parameters (e.g., timing and current) matched to be the same as the pacing signal). While an alternating current blocking signal is described, a direct current (e.g., −70 mV DC) could be used. The foregoing specific examples of blocking signals are representative only. Other examples and ranges of blocking signals are described in the aforementioned literature (all incorporated herein by reference). As will be more fully described, the present invention gives a physician great latitude in selected pacing and blocking parameters for individual patients.
  • [0106]
    Similar to FIG. 4, the vagus VN and enteric nervous system ENS in FIG. 6 distal to the block PBE are shown in solid lines to illustrate enhanced tone (except for the direct innervation VN1, VN2, VN4, VN6 to the GI tract organs). Similarly, arrows A′, B′ are shown in solid lines to illustrate the enhanced pancreo-biliary output and resultant enhanced feedback stimulation to the enteric nervous system ENS. The proximal vagus nerve segment VNP proximal to the block PBE is shown in phantom lines to illustrate it is not stimulated by the pacing electrode PE while the blocking electrode PBE is activated.
  • [0107]
    5. Proximal and Distal Blocking
  • [0108]
    [0108]FIG. 7 illustrates the addition over FIG. 6 of a nerve conductive block DBE distal to the pacing electrode PE. The proximal block PBE prevents adverse events resulting from afferent signals and heightens the GI effectiveness by blocking antidromic interference as discussed with reference to FIG. 6.
  • [0109]
    In FIG. 7, the distal block DBE is provided in the event there is a desire to isolate the pacing effect of electrode PE. For example, a physician may which to enhance the vagus and enteric activity in the region proximal to the duodenum but may wish to avoid stimulating pancreo-biliary output. For example, a patient may have a GI problem without apparent colon dysfunction (e.g., gastroparesis functional dyspepsia without bowel symptoms). Placing the distal block DBE on a branch of the vagus between the pacing electrode PE and the pancreas and gall bladder PG prevents increased pancreo-biliary output and resultant feedback (illustrated by dotted arrows A and B in FIG. 7 and dotted distal vagal nerve segment VND and vagal trunk VN5).
  • [0110]
    6. Blocking as an Independent Therapy
  • [0111]
    [0111]FIG. 8 illustrates an alternative embodiment of the invention.
  • [0112]
    In certain patients, the vagus nerve may be hyperactive contributing to diarrhea-dominant IBS. Use of a blocking electrode alone in the vagus permits down-regulating the vagus nerve VN, the enteric nervous system ENS and pancreo-biliary output. The block down-regulates efferent signal transmission. In FIG. 8, the hyperactive vagus is illustrated by the solid line of the proximal vagus nerve segment VNP. The remainder of the vagus and enteric nervous system are shown in reduced thickness to illustrate down-regulation of tone. The pancreo-biliary output (and resulting feedback) is also reduced. In FIG. 8, the blocking electrode BE is shown high on the vagus relative to the GI tract innervation (e.g., just below the diaphragm), the sole blocking electrode could be placed lower (e.g., just proximal to pancreo/biliary innervation VN5).
  • [0113]
    7. Application to Obesity
  • [0114]
    The foregoing discussion has been described in a preferred embodiment of treating FGIDs, gastroparesis and GERD. Obesity is also treatable with the present invention.
  • [0115]
    Recent literature describes potential obesity treatments relative to gut hormone fragment peptide YY3-36. See, e.g., Batterham, et al., “Inhibition of Food Intake in Obese Subjects by Peptide YY3-36”, New England J. Med., pp. 941-948 (Sep. 4, 2003) and Komer et al., “To Eat or Not to Eat—How the Gut Talks to the Brain”, New England J. Med., pp. 926-928 (Sep. 4, 2003). The peptide YY3-36 (PPY) has the effect of inhibiting gut motility through the phenomena of the ileal brake. Vagal afferents create a sensation of satiety.
  • [0116]
    The present invention can electrically simulate the effects of PPY by using the vagal block to down-regulate afferent vagal activity to create a desired sensation of satiety. Since the down-regulation does not require continuous blocking signals, the beneficial efferent signals are permitted.
  • [0117]
    8. Application to Other Therapies
  • [0118]
    There are numerous suggestions for vagal pacing or stimulation to treat a wide variety of diseases. For example, U.S. Pat. No. 5,188,104 dated Feb. 23, 1993 describes vagal stimulation to treat eating disorders. U.S. Pat. No. 5,231,988 dated Aug. 3, 1993 describes vagal stimulation to treat endocrine disorders. U.S. Pat. No. 5,215,086 dated Jun. 1, 1993 describes vagal stimulation to treat migraines. U.S. Pat. No. 5,269,303 dated Dec. 14, 1993 describes vagal stimulation to treat dementia. U.S. Pat. No. 5,330,515 dated Jul. 19, 1994 describes vagal stimulation to treat pain. U.S. Pat. No. 5,299,569 dated Apr. 5, 1994 describes vagal stimulation to treat neuropsychiatric disorders. U.S. Pat. No. 5,335,657 dated Aug. 9, 1994 describes vagal stimulation to treat sleep disorders. U.S. Pat. No. 5,707,400 dated Jan. 13, 1998 describes vagal stimulation to treat refractory hypertension. U.S. Pat. No. 6,473,644 dated Oct. 29, 2002 describes vagal stimulation to treat heart failure. U.S. Pat. No. 5,571,150 dated Nov. 5, 1996 describes vagal stimulation to treat patients in comas. As previously described, U.S. Pat. No. 5,540,730 dated Jul. 30, 1996 describes vagal stimulation to treat motility disorders and U.S. Pat. No. 6,610,713 dated Aug. 26, 2003 describes vagal stimulation to inhibit inflammatory cytokine production. All of the foregoing U.S. patents listed in this paragraph are incorporated herein by reference.
  • [0119]
    All of the foregoing suffer from undesired effects of vagal pacing on cardiovascular, gastrointestinal or other organs. Nerve conduction blocking permits longer pulse durations which would otherwise have adverse effects on other organs such as those of the cardiovascular or gastrointestinal systems. In accordance with the present invention, all of the foregoing disclosures can be modified by applying a blocking electrode and blocking signal as disclosed herein to prevent adverse side effects. By way of specific example, pacing a vagus nerve in the thoracic cavity or neck combined with a blocking electrode on the vagus nerve distal to the pacing electrode can be used to treat neuropsychiatric disorders (such as depression and schizophrenia) and Parkinson's and epilepsy and dementia. In such treatments, the blocking electrode is placed distal to the stimulating electrode 25 shown in FIGS. 4 and 2, respectively, of each of U.S. Pat. Nos. 5,269,303 and 5,299,569. The present invention thereby enables the teachings of the afore-referenced patents listed in foregoing two paragraphs.
  • [0120]
    As described, the parameters of the stimulating and blocking electrodes can be inputted via a controller and, thereby, modified by a physician. Also, FIG. 2 illustrates a feedback for controlling a stimulating electrode. Feedbacks for stimulating electrodes are also described in the patents incorporated by reference. The blocking electrode can also be controlled by an implanted controller and feedback system. For example, physiologic parameters (e.g., heart rate, blood pressure, etc.) can be monitored. The blocking signal can be regulated by the controller to maintain measured parameters in a desired range. For example, blocking can be increased to maintain heart rate within a desired rate range during stimulation pacing.
  • [0121]
    9. Opportunity for Physician to Alter Treatment for Specific Patient
  • [0122]
    Gastrointestinal disorders are complex. For many, the precise mechanism is of the disorder is unknown. Diagnosis and treatment are often iterative processes. The present invention is particularly desirable for treating such disorders.
  • [0123]
    Use of proximal and distal blocking electrodes in combination with one or more pacing electrode permits a physician to alter an operating permutation of the electrodes. This permits regional and local up- or down-regulation of the nervous system and organs. Further, pacing parameters (duty cycle, current, frequency, pulse length) can all be adjusted. Therefore, the treating physician has numerous options to alter a treatment to meet the needs of a specific patient.
  • [0124]
    In addition, a physician can combine the present invention with other therapies (such as drug therapies like prokinetic agents).
  • [0125]
    With the foregoing detailed description of the present invention, it has been shown how the objects of the invention have been attained in a preferred manner. Modifications and equivalents of disclosed concepts such as those which might readily occur to one skilled in the art, are intended to be included in the scope of the claims which are appended hereto.

Claims (14)

We claim:
1. A method for treating at least one of a plurality of gastrointestinal disorders of a patient where said disorders are characterized at least in part by abnormal gastrointestinal system activity attributable at least in part to altered autonomic balance, said method comprising:
electrically stimulating an enteric nervous system of said patient to enhance a functional tone of said enteric nervous system, and
applying said stimulation with frequency of occurrence selected to elevate nerve activity sufficient to relieve symptoms.
2. A method according to claim 1 further comprising:
electrically stimulating pancreo-biliary organs of said alimentary tract to stimulate discharge of secretions of said pancreo-biliary organs into a duodenum of said patient by an amount sufficient to enhance a transport of contents through a gastrointestinal organ of said alimentary tract.
3. A method according to claim 1 further comprising:
electrically stimulating pancreo-biliary organs of said alimentary tract to induce discharge of secretions of said pancreo-biliary organs into a duodenum of said patient by an amount sufficient for receptors in a gastrointestinal organ of said patient to respond to said secretions to contribute to an enhancement of said functional tone of said enteric nervous system.
4. A method according to each of claims 1 or 2 wherein:
said electrical stimulation is created by placing an electrode on a vagus nerve of said patient and applying an electrical stimulating current to said electrode and create a stimulation signal in said vagus nerve.
5. A method according to claim 4 further comprising:
applying a proximal nerve conduction block on said vagus intermediate a site of said electrical stimulation and a central nervous system of said patient with said nerve block selected to block passage of said stimulation signal to said central nervous system.
6. A method according to claim 5 wherein said nerve conduction block is a cryogenic block.
7. A method according to claim 5 wherein said proximal nerve conduction block is a pharmocologic block.
8. A method according to claim 5 wherein said proximal nerve conduction block is an electrical conduction block.
9. A method according to claim 8 wherein:
said electrical conduction block is selected to function during periods of application of said electrical stimulating current to said electrode.
10. A method according to claim 5 further comprising:
applying a distal nerve conduction block on said vagus with said site of said electrical stimulation disposed between said proximal and distal nerve blocks.
11. A method for treating at least one of a plurality of gastrointestinal disorders of a patient, said method comprising:
electrically stimulating a vagus nerve of said patient at a stimulation site proximal to at least one site of vagal innervation of a gastrointestinal organ of said patient, said electrical stimulation including applying a stimulation signal at said site;
applying a proximal electrical blocking signal to said vagus nerve at a proximal blocking site proximal to said stimulation site with said proximal blocking signal selected to at least partially block nerve impulses proximal to said proximal blocking site.
12. A method according to claim 11 further comprising:
applying a distal electrical blocking signal to said vagus nerve at a distal blocking site distal to said stimulation site with said distal blocking signal selected to at least partially block efferent transmission of said stimulation signal distal to said distal blocking site.
13. A method according to claim 11 wherein said proximal blocking signal is variable by a controller to regulate transmission of afferent proximal to said proximal blocking site.
14. A method according to claim 12 wherein said distal blocking signal is variable by a controller to regulate transmission of efferent proximal to said distal blocking site.
US10675818 2003-02-03 2003-09-29 Enteric rhythm management Abandoned US20040176812A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US10358093 US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10675818 US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management

Applications Claiming Priority (27)

Application Number Priority Date Filing Date Title
US10675818 US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10752944 US7167750B2 (en) 2003-02-03 2004-01-06 Obesity treatment with electrically induced vagal down regulation
US10752940 US7444183B2 (en) 2003-02-03 2004-01-06 Intraluminal electrode apparatus and method
US10756176 US20050070974A1 (en) 2003-09-29 2004-01-12 Obesity and eating disorder stimulation treatment with neural block
US10756166 US20050070970A1 (en) 2003-09-29 2004-01-12 Movement disorder stimulation with neural block
EP20040707122 EP1601414B1 (en) 2003-02-03 2004-01-30 Apparatus for neural stimulation
DK04707122T DK1601414T3 (en) 2003-02-03 2004-01-30 neural stimulation
PCT/US2004/002847 WO2004069331B1 (en) 2003-02-03 2004-01-30 Neural stimulation
US10881045 US7844338B2 (en) 2003-02-03 2004-06-30 High frequency obesity treatment
US11040767 US7613515B2 (en) 2003-02-03 2005-01-21 High frequency vagal blockage therapy
US11656113 US7693577B2 (en) 2003-02-03 2007-01-22 Irritable bowel syndrome treatment
US11656121 US7986995B2 (en) 2003-02-03 2007-01-22 Bulimia treatment
US11656132 US7720540B2 (en) 2003-02-03 2007-01-22 Pancreatitis treatment
US11656122 US7630769B2 (en) 2003-02-03 2007-01-22 GI inflammatory disease treatment
US11656123 US20070135846A1 (en) 2003-02-03 2007-01-22 Vagal obesity treatment
US11891770 US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US12721603 US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US12908375 US8046085B2 (en) 2003-02-03 2010-10-20 Controlled vagal blockage therapy
US13178221 US8369952B2 (en) 2003-02-03 2011-07-07 Bulimia treatment
US13188293 US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US13276638 US8538533B2 (en) 2003-02-03 2011-10-19 Controlled vagal blockage therapy
US13758223 US8862233B2 (en) 2003-02-03 2013-02-04 Electrode band system and methods of using the system to treat obesity
US14019126 US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14028030 US9162062B2 (en) 2003-02-03 2013-09-16 Controlled vagal blockage therapy
US14480242 US9586046B2 (en) 2003-02-03 2014-09-08 Electrode band system and methods of using the system to treat obesity
US14930233 US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15625755 US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

Related Parent Applications (3)

Application Number Title Priority Date Filing Date
US10358093 Continuation-In-Part US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10674324 Continuation-In-Part US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US10752940 Continuation-In-Part US7444183B2 (en) 2003-02-03 2004-01-06 Intraluminal electrode apparatus and method

Related Child Applications (5)

Application Number Title Priority Date Filing Date
US10674330 Continuation-In-Part US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US10752940 Continuation-In-Part US7444183B2 (en) 2003-02-03 2004-01-06 Intraluminal electrode apparatus and method
US10752944 Continuation-In-Part US7167750B2 (en) 2003-02-03 2004-01-06 Obesity treatment with electrically induced vagal down regulation
US10881045 Continuation-In-Part US7844338B2 (en) 2003-02-03 2004-06-30 High frequency obesity treatment
US11891770 Continuation US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders

Publications (1)

Publication Number Publication Date
US20040176812A1 true true US20040176812A1 (en) 2004-09-09

Family

ID=32907599

Family Applications (11)

Application Number Title Priority Date Filing Date
US10358093 Abandoned US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10674324 Abandoned US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy
US10675818 Abandoned US20040176812A1 (en) 2003-02-03 2003-09-29 Enteric rhythm management
US10674330 Active 2023-11-29 US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US11450202 Abandoned US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US11891770 Active 2023-10-27 US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US12721603 Active US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US13188293 Active US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14019126 Active US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14930233 Active US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15625755 Pending US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

Family Applications Before (2)

Application Number Title Priority Date Filing Date
US10358093 Abandoned US20040172084A1 (en) 2003-02-03 2003-02-03 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US10674324 Abandoned US20040172085A1 (en) 2003-02-03 2003-09-29 Nerve stimulation and conduction block therapy

Family Applications After (8)

Application Number Title Priority Date Filing Date
US10674330 Active 2023-11-29 US7489969B2 (en) 2003-02-03 2003-09-29 Vagal down-regulation obesity treatment
US11450202 Abandoned US20060229685A1 (en) 2003-02-03 2006-06-09 Method and apparatus for treatment of gastro-esophageal reflux disease (GERD)
US11891770 Active 2023-10-27 US7729771B2 (en) 2003-02-03 2007-08-13 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US12721603 Active US8010204B2 (en) 2003-02-03 2010-03-11 Nerve blocking for treatment of gastrointestinal disorders
US13188293 Active US8538542B2 (en) 2003-02-03 2011-07-21 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14019126 Active US9174040B2 (en) 2003-02-03 2013-09-05 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US14930233 Active US9682233B2 (en) 2003-02-03 2015-11-02 Nerve stimulation and blocking for treatment of gastrointestinal disorders
US15625755 Pending US20170304615A1 (en) 2003-02-03 2017-06-16 Nerve stimulation and blocking for treatment of gastrointestinal disorders

Country Status (3)

Country Link
US (11) US20040172084A1 (en)
DK (1) DK1601414T3 (en)
EP (1) EP2366425A1 (en)

Cited By (104)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040024428A1 (en) * 1999-07-01 2004-02-05 Burke Barrett Treatment of obesity by bilateral vagus nerve stimulation
US20040039427A1 (en) * 2001-01-02 2004-02-26 Cyberonics, Inc. Treatment of obesity by sub-diaphragmatic nerve stimulation
US20040167583A1 (en) * 2003-02-03 2004-08-26 Enteromedics, Inc. Electrode band apparatus and method
US20040172085A1 (en) * 2003-02-03 2004-09-02 Beta Medical, Inc. Nerve stimulation and conduction block therapy
US20050065571A1 (en) * 2001-05-01 2005-03-24 Imran Mir A. Responsive gastric stimulator
US20050070970A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Movement disorder stimulation with neural block
US20050090873A1 (en) * 2003-10-22 2005-04-28 Imran Mir A. Gastrointestinal stimulation device
US20050222226A1 (en) * 2000-06-30 2005-10-06 Sumitomo Pharmaceuticals Company, Limited Five-membered cyclic compounds
US20050273060A1 (en) * 2004-06-03 2005-12-08 Mayo Foundation For Medical Education And Research Obesity treatment and device
US20060020298A1 (en) * 2004-07-20 2006-01-26 Camilleri Michael L Systems and methods for curbing appetite
US20060020277A1 (en) * 2004-07-20 2006-01-26 Gostout Christopher J Gastric reshaping devices and methods
US20060070334A1 (en) * 2004-09-27 2006-04-06 Blue Hen, Llc Sidewall plank for constructing a trailer and associated trailer sidewall construction
US20060106332A1 (en) * 2004-11-12 2006-05-18 Enteromedics Inc. Pancreatic exocrine secretion diversion apparatus and method
US20060200208A1 (en) * 2005-03-04 2006-09-07 Cyberonics, Inc. Cranial nerve stimulation for treatment of substance addiction
US20060247719A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Weight loss method and advice
US20060247722A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Noninvasively adjustable gastric band
US20060247721A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Identification of electrodes for nerve stimulation in the treatment of eating disorders
US20070016262A1 (en) * 2005-07-13 2007-01-18 Betastim, Ltd. Gi and pancreatic device for treating obesity and diabetes
US20070027484A1 (en) * 2005-07-28 2007-02-01 Cyberonics, Inc. Autonomic nerve stimulation to treat a pancreatic disorder
US20070027504A1 (en) * 2005-07-27 2007-02-01 Cyberonics, Inc. Cranial nerve stimulation to treat a hearing disorder
US20070027492A1 (en) * 2005-07-28 2007-02-01 Cyberonics, Inc. Autonomic nerve stimulation to treat a gastrointestinal disorder
US20070043400A1 (en) * 2005-08-17 2007-02-22 Donders Adrianus P Neural electrode treatment
US20070213771A1 (en) * 2006-03-07 2007-09-13 Spinner Robert J Regional anesthetic
US20080183237A1 (en) * 2006-04-18 2008-07-31 Electrocore, Inc. Methods And Apparatus For Treating Ileus Condition Using Electrical Signals
US20090149926A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware System for thermal modulation of neural activity
US20090149798A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Implant system for chemical modulation of neural activity
US20090149914A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Method for reversible chemical modulation of neural activity
US20090149799A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Method for chemical modulation of neural activity
US20090149797A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware System for reversible chemical modulation of neural activity
US20090210019A1 (en) * 2008-02-14 2009-08-20 Dennis Dong-Won Kim Treatment of excess weight by neural downregulation in combination with compositions
US20090254143A1 (en) * 2008-04-04 2009-10-08 Tweden Katherine S Methods and systems for glucose regulation
US20090270943A1 (en) * 2008-04-25 2009-10-29 Maschino Steven E Blocking Exogenous Action Potentials by an Implantable Medical Device
US7657310B2 (en) 2006-01-26 2010-02-02 Cyberonics, Inc. Treatment of reproductive endocrine disorders by vagus nerve stimulation
US7689284B2 (en) 2001-05-01 2010-03-30 Intrapace, Inc. Pseudounipolar lead for stimulating a digestive organ
US7706875B2 (en) 2007-01-25 2010-04-27 Cyberonics, Inc. Modulation of drug effects by vagus nerve stimulation
US7705016B2 (en) 2003-02-13 2010-04-27 Albert Einstein College Of Medicine Of Yeshiva University Regulation of food intake by modulation of long-chain fatty acyl-CoA levels in the hypothalamus
US7706874B2 (en) 2005-07-28 2010-04-27 Cyberonics, Inc. Stimulating cranial nerve to treat disorders associated with the thyroid gland
US7747322B2 (en) 2001-05-01 2010-06-29 Intrapace, Inc. Digestive organ retention device
US7756582B2 (en) 2001-05-01 2010-07-13 Intrapace, Inc. Gastric stimulation anchor and method
US20100204741A1 (en) * 2008-08-08 2010-08-12 Tweden Katherine S Systems for regulation of blood pressure and heart rate
US7801601B2 (en) 2006-01-27 2010-09-21 Cyberonics, Inc. Controlling neuromodulation using stimulus modalities
US7822486B2 (en) 2005-08-17 2010-10-26 Enteromedics Inc. Custom sized neural electrodes
US7840280B2 (en) 2005-07-27 2010-11-23 Cyberonics, Inc. Cranial nerve stimulation to treat a vocal cord disorder
US7837719B2 (en) 2002-05-09 2010-11-23 Daemen College Electrical stimulation unit and waterbath system
US7844338B2 (en) 2003-02-03 2010-11-30 Enteromedics Inc. High frequency obesity treatment
US7869885B2 (en) 2006-04-28 2011-01-11 Cyberonics, Inc Threshold optimization for tissue stimulation therapy
US7869884B2 (en) 2007-04-26 2011-01-11 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7869867B2 (en) 2006-10-27 2011-01-11 Cyberonics, Inc. Implantable neurostimulator with refractory stimulation
US7904175B2 (en) 2007-04-26 2011-03-08 Cyberonics, Inc. Trans-esophageal vagus nerve stimulation
US20110087337A1 (en) * 2007-10-11 2011-04-14 Peter Forsell Apparatus for controlling flow in a bodily organ
US7957796B2 (en) 2005-10-28 2011-06-07 Cyberonics, Inc. Using physiological sensor data with an implantable medical device
US7962214B2 (en) 2007-04-26 2011-06-14 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7974701B2 (en) 2007-04-27 2011-07-05 Cyberonics, Inc. Dosing limitation for an implantable medical device
US7979127B2 (en) 2001-05-01 2011-07-12 Intrapace, Inc. Digestive organ retention device
US8032223B2 (en) 2005-09-01 2011-10-04 Intrapace, Inc. Randomized stimulation of a gastrointestinal organ
US8150508B2 (en) 2006-03-29 2012-04-03 Catholic Healthcare West Vagus nerve stimulation method
US8165669B2 (en) 2007-12-05 2012-04-24 The Invention Science Fund I, Llc System for magnetic modulation of neural conduction
US8165668B2 (en) 2007-12-05 2012-04-24 The Invention Science Fund I, Llc Method for magnetic modulation of neural conduction
US8170658B2 (en) 2007-12-05 2012-05-01 The Invention Science Fund I, Llc System for electrical modulation of neural conduction
US8180446B2 (en) 2007-12-05 2012-05-15 The Invention Science Fund I, Llc Method and system for cyclical neural modulation based on activity state
US8195287B2 (en) 2007-12-05 2012-06-05 The Invention Science Fund I, Llc Method for electrical modulation of neural conduction
US8239028B2 (en) 2009-04-24 2012-08-07 Cyberonics, Inc. Use of cardiac parameters in methods and systems for treating a chronic medical condition
US8255057B2 (en) 2009-01-29 2012-08-28 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8337404B2 (en) 2010-10-01 2012-12-25 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8382667B2 (en) 2010-10-01 2013-02-26 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8391970B2 (en) 2007-08-27 2013-03-05 The Feinstein Institute For Medical Research Devices and methods for inhibiting granulocyte activation by neural stimulation
US8412338B2 (en) 2008-11-18 2013-04-02 Setpoint Medical Corporation Devices and methods for optimizing electrode placement for anti-inflamatory stimulation
US8414559B2 (en) 2009-05-07 2013-04-09 Rainbow Medical Ltd. Gastroretentive duodenal pill
US8417344B2 (en) 2008-10-24 2013-04-09 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
US8452387B2 (en) 2010-09-16 2013-05-28 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8457747B2 (en) 2008-10-20 2013-06-04 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
US8565867B2 (en) 2005-01-28 2013-10-22 Cyberonics, Inc. Changeable electrode polarity stimulation by an implantable medical device
US8562536B2 (en) 2010-04-29 2013-10-22 Flint Hills Scientific, Llc Algorithm for detecting a seizure from cardiac data
US8612002B2 (en) 2009-12-23 2013-12-17 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8641646B2 (en) 2010-07-30 2014-02-04 Cyberonics, Inc. Seizure detection using coordinate data
US8649871B2 (en) 2010-04-29 2014-02-11 Cyberonics, Inc. Validity test adaptive constraint modification for cardiac data used for detection of state changes
US8660647B2 (en) 2005-07-28 2014-02-25 Cyberonics, Inc. Stimulating cranial nerve to treat pulmonary disorder
US8679009B2 (en) 2010-06-15 2014-03-25 Flint Hills Scientific, Llc Systems approach to comorbidity assessment
US8684921B2 (en) 2010-10-01 2014-04-01 Flint Hills Scientific Llc Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
US8696543B2 (en) 2007-10-11 2014-04-15 Kirk Promotion Ltd. Method for controlling flow of intestinal contents in a patient's intestines
US8715181B2 (en) 2009-04-03 2014-05-06 Intrapace, Inc. Feedback systems and methods for communicating diagnostic and/or treatment signals to enhance obesity treatments
US8725239B2 (en) 2011-04-25 2014-05-13 Cyberonics, Inc. Identifying seizures using heart rate decrease
US8729129B2 (en) 2004-03-25 2014-05-20 The Feinstein Institute For Medical Research Neural tourniquet
US8788034B2 (en) 2011-05-09 2014-07-22 Setpoint Medical Corporation Single-pulse activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
EP2756866A1 (en) 2007-03-09 2014-07-23 Enteromedics Inc. Remote monitoring and control of implantable devices
US8798754B2 (en) 2005-09-26 2014-08-05 Venturi Group, Llc Neural blocking therapy
US8825164B2 (en) 2010-06-11 2014-09-02 Enteromedics Inc. Neural modulation devices and methods
US8827912B2 (en) 2009-04-24 2014-09-09 Cyberonics, Inc. Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters
US8831732B2 (en) 2010-04-29 2014-09-09 Cyberonics, Inc. Method, apparatus and system for validating and quantifying cardiac beat data quality
US8886339B2 (en) 2009-06-09 2014-11-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8914114B2 (en) 2000-05-23 2014-12-16 The Feinstein Institute For Medical Research Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US8934976B2 (en) 2004-09-23 2015-01-13 Intrapace, Inc. Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors
US8996116B2 (en) 2009-10-30 2015-03-31 Setpoint Medical Corporation Modulation of the cholinergic anti-inflammatory pathway to treat pain or addiction
US9050469B1 (en) 2003-11-26 2015-06-09 Flint Hills Scientific, Llc Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals
US9211409B2 (en) 2008-03-31 2015-12-15 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation of T-cell activity
US9211410B2 (en) 2009-05-01 2015-12-15 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9289610B2 (en) 2008-05-15 2016-03-22 Boston Scientific Neuromodulation Corporation Fractionalized stimulation pulses in an implantable stimulator device
US9314633B2 (en) 2008-01-25 2016-04-19 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US9402550B2 (en) 2011-04-29 2016-08-02 Cybertronics, Inc. Dynamic heart rate threshold for neurological event detection
US9409020B2 (en) 2014-05-20 2016-08-09 Nevro Corporation Implanted pulse generators with reduced power consumption via signal strength/duration characteristics, and associated systems and methods
US9504390B2 (en) 2011-03-04 2016-11-29 Globalfoundries Inc. Detecting, assessing and managing a risk of death in epilepsy
US9572983B2 (en) 2012-03-26 2017-02-21 Setpoint Medical Corporation Devices and methods for modulation of bone erosion
US9662490B2 (en) 2008-03-31 2017-05-30 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation and administration of an anti-inflammatory drug
US9833621B2 (en) 2011-09-23 2017-12-05 Setpoint Medical Corporation Modulation of sirtuins by vagus nerve stimulation

Families Citing this family (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070203531A9 (en) * 1999-12-03 2007-08-30 Medtronic, Inc. Heart rate variability control of gastric electrical stimulator
US20060085046A1 (en) * 2000-01-20 2006-04-20 Ali Rezai Methods of treating medical conditions by transvascular neuromodulation of the autonomic nervous system
US20080077192A1 (en) * 2002-05-03 2008-03-27 Afferent Corporation System and method for neuro-stimulation
US7076307B2 (en) * 2002-05-09 2006-07-11 Boveja Birinder R Method and system for modulating the vagus nerve (10th cranial nerve) with electrical pulses using implanted and external components, to provide therapy neurological and neuropsychiatric disorders
US20050070974A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Obesity and eating disorder stimulation treatment with neural block
US7684865B2 (en) * 2003-03-14 2010-03-23 Endovx, Inc. Methods and apparatus for treatment of obesity
US20040226556A1 (en) 2003-05-13 2004-11-18 Deem Mark E. Apparatus for treating asthma using neurotoxin
EP1750799A2 (en) * 2004-05-04 2007-02-14 The Cleveland Clinic Foundation Methods of treating medical conditions by neuromodulation of the sympathetic nervous system
US7664551B2 (en) 2004-07-07 2010-02-16 Medtronic Transneuronix, Inc. Treatment of the autonomic nervous system
US8452407B2 (en) * 2004-08-16 2013-05-28 Boston Scientific Neuromodulation Corporation Methods for treating gastrointestinal disorders
US8600521B2 (en) 2005-01-27 2013-12-03 Cyberonics, Inc. Implantable medical device having multiple electrode/sensor capability and stimulation based on sensed intrinsic activity
US7454245B2 (en) * 2005-01-28 2008-11-18 Cyberonics, Inc. Trained and adaptive response in a neurostimulator
US7561918B2 (en) * 2005-01-28 2009-07-14 Cyberonics, Inc. Autocapture in a neurostimulator
US8371307B2 (en) 2005-02-08 2013-02-12 Koninklijke Philips Electronics N.V. Methods and devices for the treatment of airway obstruction, sleep apnea and snoring
US8096303B2 (en) 2005-02-08 2012-01-17 Koninklijke Philips Electronics N.V Airway implants and methods and devices for insertion and retrieval
US8676330B2 (en) 2009-03-20 2014-03-18 ElectroCore, LLC Electrical and magnetic stimulators used to treat migraine/sinus headache and comorbid disorders
US8983629B2 (en) 2009-03-20 2015-03-17 ElectroCore, LLC Non-invasive vagal nerve stimulation to treat disorders
US9248286B2 (en) 2009-03-20 2016-02-02 ElectroCore, LLC Medical self-treatment using non-invasive vagus nerve stimulation
US8812112B2 (en) 2005-11-10 2014-08-19 ElectroCore, LLC Electrical treatment of bronchial constriction
CN101674862A (en) 2005-11-10 2010-03-17 电子核心公司 Electrical stimulation treatment of bronchial constriction
US8874227B2 (en) 2009-03-20 2014-10-28 ElectroCore, LLC Devices and methods for non-invasive capacitive electrical stimulation and their use for vagus nerve stimulation on the neck of a patient
US8918178B2 (en) 2009-03-20 2014-12-23 ElectroCore, LLC Non-invasive vagal nerve stimulation to treat disorders
US9333347B2 (en) 2010-08-19 2016-05-10 ElectroCore, LLC Devices and methods for non-invasive electrical stimulation and their use for vagal nerve stimulation on the neck of a patient
US9037247B2 (en) 2005-11-10 2015-05-19 ElectroCore, LLC Non-invasive treatment of bronchial constriction
US9254383B2 (en) 2009-03-20 2016-02-09 ElectroCore, LLC Devices and methods for monitoring non-invasive vagus nerve stimulation
US9358381B2 (en) 2011-03-10 2016-06-07 ElectroCore, LLC Non-invasive vagal nerve stimulation to treat disorders
US9403001B2 (en) 2009-03-20 2016-08-02 ElectroCore, LLC Non-invasive magnetic or electrical nerve stimulation to treat gastroparesis, functional dyspepsia, and other functional gastrointestinal disorders
US8983628B2 (en) 2009-03-20 2015-03-17 ElectroCore, LLC Non-invasive vagal nerve stimulation to treat disorders
US8676324B2 (en) 2005-11-10 2014-03-18 ElectroCore, LLC Electrical and magnetic stimulators used to treat migraine/sinus headache, rhinitis, sinusitis, rhinosinusitis, and comorbid disorders
US9126050B2 (en) 2009-03-20 2015-09-08 ElectroCore, LLC Non-invasive vagus nerve stimulation devices and methods to treat or avert atrial fibrillation
US20100174340A1 (en) * 2006-04-18 2010-07-08 Electrocore, Inc. Methods and Apparatus for Applying Energy to Patients
US20110125203A1 (en) 2009-03-20 2011-05-26 ElectroCore, LLC. Magnetic Stimulation Devices and Methods of Therapy
CN101400403A (en) 2006-02-10 2009-04-01 电子核心公司 Methods and apparatus for treating anaphylaxis using electrical modulation
JP2009525806A (en) 2006-02-10 2009-07-16 エレクトロコア、インコーポレイテッド Low blood pressure electrical stimulation therapy
US8041428B2 (en) 2006-02-10 2011-10-18 Electrocore Llc Electrical stimulation treatment of hypotension
US9020597B2 (en) 2008-11-12 2015-04-28 Endostim, Inc. Device and implantation system for electrical stimulation of biological systems
US8160709B2 (en) 2006-05-18 2012-04-17 Endostim, Inc. Use of electrical stimulation of the lower esophageal sphincter to modulate lower esophageal sphincter pressure
US7761168B2 (en) * 2006-07-13 2010-07-20 Yossi Gross Peltier unidirectional and selective nerve stimulation
US8135478B2 (en) * 2006-07-13 2012-03-13 Rainbow Medical Ltd Peltier unidirectional and selective nerve stimulation
US20080071173A1 (en) * 2006-09-18 2008-03-20 Aldrich William N Visualizing Formation of Ablation Lesions
US20150224310A1 (en) * 2006-10-09 2015-08-13 Endostim, Inc. Device and Implantation System for Electrical Stimulation of Biological Systems
US9345879B2 (en) * 2006-10-09 2016-05-24 Endostim, Inc. Device and implantation system for electrical stimulation of biological systems
US7738961B2 (en) * 2006-10-09 2010-06-15 Endostim, Inc. Method and apparatus for treatment of the gastrointestinal tract
US9724510B2 (en) * 2006-10-09 2017-08-08 Endostim, Inc. System and methods for electrical stimulation of biological systems
EP2081638A4 (en) * 2006-11-03 2013-06-12 Gep Technology Inc Apparatus and methods for minimally invasive obesity treatment
US20100217347A1 (en) * 2006-12-16 2010-08-26 Greatbatch, Inc. Neurostimulation for the treatment of pulmonary disorders
WO2008100974A3 (en) * 2007-02-13 2009-12-30 Sharma Virender K Method and apparatus for electrical stimulation of the pancreatico-biliary system
US8224436B2 (en) 2007-04-02 2012-07-17 Cardiac Research, Inc. Unidirectional neural stimulation systems, devices and methods
US20080281365A1 (en) * 2007-05-09 2008-11-13 Tweden Katherine S Neural signal duty cycle
US20100216754A1 (en) * 2007-11-13 2010-08-26 Meritage Pharma, Inc. Compositions for the treatment of inflammation of the gastrointestinal tract
WO2009094609A1 (en) 2008-01-25 2009-07-30 Sharma Virender K Device and implantation system for electrical stimulation of biological systems
US9005106B2 (en) 2008-01-31 2015-04-14 Enopace Biomedical Ltd Intra-aortic electrical counterpulsation
US8483831B1 (en) 2008-02-15 2013-07-09 Holaira, Inc. System and method for bronchial dilation
WO2009114008A1 (en) * 2008-03-11 2009-09-17 Sharma Virender K Method and apparatus for treatment of the gastrointestinal tract
US8473062B2 (en) 2008-05-01 2013-06-25 Autonomic Technologies, Inc. Method and device for the treatment of headache
ES2398052T3 (en) 2008-05-09 2013-03-13 Innovative Pulmonary Solutions, Inc. Systems for treating bronchial tree
EP2318089A4 (en) 2008-07-11 2011-08-10 Gep Technology Inc Apparatus and methods for minimally invasive obesity treatment
US9717557B2 (en) 2008-11-11 2017-08-01 Apama Medical, Inc. Cardiac ablation catheters and methods of use thereof
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
US8295902B2 (en) * 2008-11-11 2012-10-23 Shifamed Holdings, Llc Low profile electrode assembly
US9333031B2 (en) 2013-04-08 2016-05-10 Apama Medical, Inc. Visualization inside an expandable medical device
US9795442B2 (en) 2008-11-11 2017-10-24 Shifamed Holdings, Llc Ablation catheters
US8412336B2 (en) 2008-12-29 2013-04-02 Autonomic Technologies, Inc. Integrated delivery and visualization tool for a neuromodulation system
US9320908B2 (en) 2009-01-15 2016-04-26 Autonomic Technologies, Inc. Approval per use implanted neurostimulator
US9370654B2 (en) * 2009-01-27 2016-06-21 Medtronic, Inc. High frequency stimulation to block laryngeal stimulation during vagal nerve stimulation
US9427581B2 (en) 2013-04-28 2016-08-30 ElectroCore, LLC Devices and methods for treating medical disorders with evoked potentials and vagus nerve stimulation
US9566426B2 (en) 2011-08-31 2017-02-14 ElectroCore, LLC Systems and methods for vagal nerve stimulation
US9399134B2 (en) 2011-03-10 2016-07-26 ElectroCore, LLC Non-invasive vagal nerve stimulation to treat disorders
US9375571B2 (en) 2013-01-15 2016-06-28 ElectroCore, LLC Mobile phone using non-invasive nerve stimulation
US8494641B2 (en) 2009-04-22 2013-07-23 Autonomic Technologies, Inc. Implantable neurostimulator with integral hermetic electronic enclosure, circuit substrate, monolithic feed-through, lead assembly and anchoring mechanism
WO2010151698A3 (en) * 2009-06-24 2011-03-24 Shifamed, Llc Steerable medical delivery devices and methods of use
CA2779135A1 (en) 2009-10-27 2011-05-12 Innovative Pulmonary Solutions, Inc. Delivery devices with coolable energy emitting assemblies
US8911439B2 (en) 2009-11-11 2014-12-16 Holaira, Inc. Non-invasive and minimally invasive denervation methods and systems for performing the same
CN106618731A (en) 2009-11-11 2017-05-10 赫莱拉公司 Systems, apparatuses, and methods for treating tissue and controlling stenosis
DE212011100038U1 (en) 2010-03-05 2012-07-17 Endostim, Inc. Device and implantation system for electrical stimulation of biological systems
US8840601B2 (en) 2010-03-24 2014-09-23 Shifamed Holdings, Llc Intravascular tissue disruption
CN103118620B (en) 2010-05-12 2015-09-23 施菲姆德控股有限责任公司 Low profile electrode assembly
US8538535B2 (en) 2010-08-05 2013-09-17 Rainbow Medical Ltd. Enhancing perfusion by contraction
US8805519B2 (en) 2010-09-30 2014-08-12 Nevro Corporation Systems and methods for detecting intrathecal penetration
WO2012142539A1 (en) 2011-04-14 2012-10-18 Endostim, Inc. Systems and methods for treating gastroesophageal reflux disease
CA2833387A1 (en) 2011-05-03 2012-11-08 Shifamed Holdings, Llc Steerable delivery sheaths
US9037245B2 (en) 2011-09-02 2015-05-19 Endostim, Inc. Endoscopic lead implantation method
US9526637B2 (en) 2011-09-09 2016-12-27 Enopace Biomedical Ltd. Wireless endovascular stent-based electrodes
US9782583B2 (en) 2012-02-21 2017-10-10 Virender K. Sharma System and method for electrical stimulation of anorectal structures to treat urinary dysfunction
US8961550B2 (en) 2012-04-17 2015-02-24 Indian Wells Medical, Inc. Steerable endoluminal punch
US9623238B2 (en) 2012-08-23 2017-04-18 Endostim, Inc. Device and implantation system for electrical stimulation of biological systems
EP2934540A4 (en) 2012-12-24 2016-10-12 Neurogastrx Inc Methods for treating gi tract disorders
US9398933B2 (en) 2012-12-27 2016-07-26 Holaira, Inc. Methods for improving drug efficacy including a combination of drug administration and nerve modulation
US9174049B2 (en) 2013-01-27 2015-11-03 ElectroCore, LLC Systems and methods for electrical stimulation of sphenopalatine ganglion and other branches of cranial nerves
US9498619B2 (en) 2013-02-26 2016-11-22 Endostim, Inc. Implantable electrical stimulation leads
US9456916B2 (en) 2013-03-12 2016-10-04 Medibotics Llc Device for selectively reducing absorption of unhealthy food
US9067070B2 (en) 2013-03-12 2015-06-30 Medibotics Llc Dysgeusia-inducing neurostimulation for modifying consumption of a selected nutrient type
US9011365B2 (en) 2013-03-12 2015-04-21 Medibotics Llc Adjustable gastrointestinal bifurcation (AGB) for reduced absorption of unhealthy food
US9370660B2 (en) 2013-03-29 2016-06-21 Rainbow Medical Ltd. Independently-controlled bidirectional nerve stimulation
EP3021776A1 (en) 2013-07-17 2016-05-25 Cook Medical Technologies LLC Ablation mesh
US9827425B2 (en) 2013-09-03 2017-11-28 Endostim, Inc. Methods and systems of electrode polarity switching in electrical stimulation therapy
US9205258B2 (en) 2013-11-04 2015-12-08 ElectroCore, LLC Nerve stimulator system
US9844554B2 (en) 2014-06-24 2017-12-19 Neurogastrx, Inc. Prodrugs of metopimazine
US9682234B2 (en) 2014-11-17 2017-06-20 Endostim, Inc. Implantable electro-medical device programmable for improved operational life

Citations (68)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5188104A (en) * 1991-02-01 1993-02-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5199430A (en) * 1991-03-11 1993-04-06 Case Western Reserve University Micturitional assist device
US5215086A (en) * 1991-05-03 1993-06-01 Cyberonics, Inc. Therapeutic treatment of migraine symptoms by stimulation
US5231988A (en) * 1991-08-09 1993-08-03 Cyberonics, Inc. Treatment of endocrine disorders by nerve stimulation
US5263480A (en) * 1991-02-01 1993-11-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5269303A (en) * 1991-02-22 1993-12-14 Cyberonics, Inc. Treatment of dementia by nerve stimulation
US5292344A (en) * 1992-07-10 1994-03-08 Douglas Donald D Percutaneously placed electrical gastrointestinal pacemaker stimulatory system, sensing system, and pH monitoring system, with optional delivery port
US5299569A (en) * 1991-05-03 1994-04-05 Cyberonics, Inc. Treatment of neuropsychiatric disorders by nerve stimulation
US5330515A (en) * 1992-06-17 1994-07-19 Cyberonics, Inc. Treatment of pain by vagal afferent stimulation
US5335657A (en) * 1991-05-03 1994-08-09 Cyberonics, Inc. Therapeutic treatment of sleep disorder by nerve stimulation
US5423872A (en) * 1992-05-29 1995-06-13 Cigaina; Valerio Process and device for treating obesity and syndromes related to motor disorders of the stomach of a patient
US5514175A (en) * 1994-11-09 1996-05-07 Cerebral Stimulation, Inc. Auricular electrical stimulator
US5540730A (en) * 1995-06-06 1996-07-30 Cyberonics, Inc. Treatment of motility disorders by nerve stimulation
US5571150A (en) * 1994-12-19 1996-11-05 Cyberonics, Inc. Treatment of patients in coma by nerve stimulation
US5690691A (en) * 1996-05-08 1997-11-25 The Center For Innovative Technology Gastro-intestinal pacemaker having phased multi-point stimulation
US5707400A (en) * 1995-09-19 1998-01-13 Cyberonics, Inc. Treating refractory hypertension by nerve stimulation
US5716385A (en) * 1996-11-12 1998-02-10 University Of Virginia Crural diaphragm pacemaker and method for treating esophageal reflux disease
US5747060A (en) * 1996-03-26 1998-05-05 Euro-Celtique, S.A. Prolonged local anesthesia with colchicine
US5836994A (en) * 1997-04-30 1998-11-17 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US5861014A (en) * 1997-04-30 1999-01-19 Medtronic, Inc. Method and apparatus for sensing a stimulating gastrointestinal tract on-demand
US5919216A (en) * 1997-06-16 1999-07-06 Medtronic, Inc. System and method for enhancement of glucose production by stimulation of pancreatic beta cells
US6091992A (en) * 1997-12-15 2000-07-18 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6093167A (en) * 1997-06-16 2000-07-25 Medtronic, Inc. System for pancreatic stimulation and glucose measurement
US6097984A (en) * 1998-11-25 2000-08-01 Medtronic, Inc. System and method of stimulation for treating gastro-esophageal reflux disease
US6098629A (en) * 1999-04-07 2000-08-08 Endonetics, Inc. Submucosal esophageal bulking device
US6104955A (en) * 1997-12-15 2000-08-15 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6216039B1 (en) * 1997-05-02 2001-04-10 Medtronic Inc. Method and apparatus for treating irregular gastric rhythms
US6238423B1 (en) * 1997-01-13 2001-05-29 Medtronic, Inc. Apparatus and method for treating chronic constipation
US6243607B1 (en) * 1996-09-05 2001-06-05 University Technologies International Inc. Gastro-intestinal electrical pacemaker
US6261280B1 (en) * 1999-03-22 2001-07-17 Medtronic, Inc Method of obtaining a measure of blood glucose
US6341236B1 (en) * 1999-04-30 2002-01-22 Ivan Osorio Vagal nerve stimulation techniques for treatment of epileptic seizures
US6364899B1 (en) * 1998-01-23 2002-04-02 Innercool Therapies, Inc. Heat pipe nerve cooler
US6369079B1 (en) * 1998-06-15 2002-04-09 Sepracor, Inc. Methods for treating irritable bowel syndrome using optically pure (+) norcisapride
US20020055779A1 (en) * 1996-03-05 2002-05-09 Brian J. Andrews Neural prosthesis
US6405732B1 (en) * 1994-06-24 2002-06-18 Curon Medical, Inc. Method to treat gastric reflux via the detection and ablation of gastro-esophageal nerves and receptors
US6473644B1 (en) * 1999-10-13 2002-10-29 Cyberonics, Inc. Method to enhance cardiac capillary growth in heart failure patients
US20020161360A1 (en) * 2001-04-26 2002-10-31 Carroll Ronald J. Method and device for neurocryo analgesia and anesthesia
US20030018367A1 (en) * 2001-07-23 2003-01-23 Dilorenzo Daniel John Method and apparatus for neuromodulation and phsyiologic modulation for the treatment of metabolic and neuropsychiatric disease
US20030045909A1 (en) * 2001-08-31 2003-03-06 Biocontrol Medical Ltd. Selective nerve fiber stimulation for treating heart conditions
US6558708B1 (en) * 1995-05-17 2003-05-06 Cedars-Sinai Medical Center Methods for manipulating upper gastrointestinal transit, blood flow, and satiety, and for treating visceral hyperalgesia
US6571127B1 (en) * 1997-07-16 2003-05-27 Impulse Dynamics N.V. Method of increasing the motility of a GI tract
US6610713B2 (en) * 2000-05-23 2003-08-26 North Shore - Long Island Jewish Research Institute Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US20030181958A1 (en) * 2002-03-22 2003-09-25 Dobak John D. Electric modulation of sympathetic nervous system
US20030181959A1 (en) * 2002-03-22 2003-09-25 Dobak John D. Wireless electric modulation of sympathetic nervous system
US20030212440A1 (en) * 2002-05-09 2003-11-13 Boveja Birinder R. Method and system for modulating the vagus nerve (10th cranial nerve) using modulated electrical pulses with an inductively coupled stimulation system
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation
US20040039425A1 (en) * 2002-05-29 2004-02-26 Beverley Greenwood-Van Meerveld Spinal cord stimulation as treatment for functional bowel disorders
US6746474B2 (en) * 2002-05-31 2004-06-08 Vahid Saadat Apparatus and methods for cooling a region within the body
US20040127953A1 (en) * 2001-02-20 2004-07-01 Kilgore Kevin L. Systems and methods for reversibly blocking nerve activity
US20040167583A1 (en) * 2003-02-03 2004-08-26 Enteromedics, Inc. Electrode band apparatus and method
US20040172085A1 (en) * 2003-02-03 2004-09-02 Beta Medical, Inc. Nerve stimulation and conduction block therapy
US20040236381A1 (en) * 2003-05-19 2004-11-25 Medtronic, Inc. Gastro-electric stimulation for reducing the acidity of gastric secretions or reducing the amounts thereof
US20040236382A1 (en) * 2003-05-19 2004-11-25 Medtronic, Inc. Gastro-electric stimulation for increasing the acidity of gastric secretions or increasing the amounts thereof
US6826428B1 (en) * 2000-04-11 2004-11-30 The Board Of Regents Of The University Of Texas System Gastrointestinal electrical stimulation
US20040249416A1 (en) * 2003-06-09 2004-12-09 Yun Anthony Joonkyoo Treatment of conditions through electrical modulation of the autonomic nervous system
US6853862B1 (en) * 1999-12-03 2005-02-08 Medtronic, Inc. Gastroelectric stimulation for influencing pancreatic secretions
US20050038484A1 (en) * 2003-02-03 2005-02-17 Enteromedics, Inc. Controlled vagal blockage therapy
US20050049655A1 (en) * 2003-08-27 2005-03-03 Boveja Birinder R. System and method for providing electrical pulses to the vagus nerve(s) to provide therapy for obesity, eating disorders, neurological and neuropsychiatric disorders with a stimulator, comprising bi-directional communication and network capabilities
US20050070970A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Movement disorder stimulation with neural block
US20050070974A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Obesity and eating disorder stimulation treatment with neural block
US6895278B1 (en) * 1999-04-14 2005-05-17 Transneuronix, Inc. Gastric stimulator apparatus and method for use
US20050137644A1 (en) * 1998-10-26 2005-06-23 Boveja Birinder R. Method and system for vagal blocking and/or vagal stimulation to provide therapy for obesity and other gastrointestinal disorders
US20050143787A1 (en) * 2002-05-09 2005-06-30 Boveja Birinder R. Method and system for providing electrical pulses for neuromodulation of vagus nerve(s), using rechargeable implanted pulse generator
US20050143378A1 (en) * 2003-12-29 2005-06-30 Yun Anthony J. Treatment of conditions through pharmacological modulation of the autonomic nervous system
US20050149141A1 (en) * 2004-01-07 2005-07-07 Starkebaum Warren L. Gastric stimulation for altered perception to treat obesity
US20050149148A1 (en) * 2001-05-17 2005-07-07 Medtronic, Inc. Apparatus and method for blocking activation of tissue or conduction of action potentials while other tissue is being therapeutically activated
US6993391B2 (en) * 2000-12-11 2006-01-31 Metacure N.V. Acute and chronic electrical signal therapy for obesity
US20060036293A1 (en) * 2004-08-16 2006-02-16 Whitehurst Todd K Methods for treating gastrointestinal disorders

Family Cites Families (129)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3128760A (en) 1961-08-21 1964-04-14 Winston Electronics Ltd Vagotomy test apparatus
US3411507A (en) 1964-04-01 1968-11-19 Medtronic Inc Method of gastrointestinal stimulation with electrical pulses
US4114625A (en) 1976-12-02 1978-09-19 Onat Mustafa V Anti-vomiting, anti-aspirating oral-nasal gastric tube
US4198963A (en) 1978-10-19 1980-04-22 Michigan Instruments, Inc. Cardiopulmonary resuscitator, defibrillator and monitor
US4441210A (en) 1981-09-18 1984-04-03 Hochmair Erwin S Transcutaneous signal transmission system and methods
CA1215128A (en) 1982-12-08 1986-12-09 Pedro Molina-Negro Electric nerve stimulator device
US4702254A (en) * 1983-09-14 1987-10-27 Jacob Zabara Neurocybernetic prosthesis
US4867164A (en) * 1983-09-14 1989-09-19 Jacob Zabara Neurocybernetic prosthesis
US5025807A (en) * 1983-09-14 1991-06-25 Jacob Zabara Neurocybernetic prosthesis
DK165547C (en) 1985-10-04 1993-04-26 Basem Nashef A probe for the treatment of hollow bodies with electric current;
US5236480A (en) * 1989-01-05 1993-08-17 Camfil Ab Air filter for workstations and methods of making and using such air filter
US5226426A (en) * 1990-12-18 1993-07-13 Inbae Yoon Safety penetrating instrument
US5226429A (en) 1991-06-20 1993-07-13 Inamed Development Co. Laparoscopic gastric band and method
US5370675A (en) 1992-08-12 1994-12-06 Vidamed, Inc. Medical probe device and method
US5344438A (en) 1993-04-16 1994-09-06 Medtronic, Inc. Cuff electrode
US5601604A (en) 1993-05-27 1997-02-11 Inamed Development Co. Universal gastric band
US5620955A (en) 1993-06-18 1997-04-15 Peptide Technologies Corporation Bombesin receptor antagonists and uses thereof
US5437291A (en) * 1993-08-26 1995-08-01 Univ Johns Hopkins Method for treating gastrointestinal muscle disorders and other smooth muscle dysfunction
US6974578B1 (en) * 1993-12-28 2005-12-13 Allergan, Inc. Method for treating secretions and glands using botulinum toxin
US7468060B2 (en) * 1998-02-19 2008-12-23 Respiratory Diagnostic, Inc. Systems and methods for treating obesity and other gastrointestinal conditions
US5591217A (en) * 1995-01-04 1997-01-07 Plexus, Inc. Implantable stimulator with replenishable, high value capacitive power source and method therefor
US6735471B2 (en) 1996-04-30 2004-05-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
US6532388B1 (en) * 1996-04-30 2003-03-11 Medtronic, Inc. Method and system for endotracheal/esophageal stimulation prior to and during a medical procedure
JP3246374B2 (en) 1997-01-13 2002-01-15 株式会社日立製作所 The magnetic recording apparatus using the magnetoresistive element
US5749907A (en) 1997-02-18 1998-05-12 Pacesetter, Inc. System and method for identifying and displaying medical data which violate programmable alarm conditions
WO1998037926A1 (en) 1997-02-26 1998-09-03 Alfred E. Mann Foundation For Scientific Research Battery-powered patient implantable device
US5830434A (en) 1997-02-26 1998-11-03 Medical University Of South Carolina Foundation For Research Development Methods of treating non-insulin dependent diabetes mellitus with pancreatic polypeptide
US5938596A (en) 1997-03-17 1999-08-17 Medtronic, Inc. Medical electrical lead
US6400987B1 (en) 1997-08-13 2002-06-04 Sorin Biomedica Cardio S.P.A. Active implantable device
US6479523B1 (en) 1997-08-26 2002-11-12 Emory University Pharmacologic drug combination in vagal-induced asystole
US5967977A (en) 1997-10-03 1999-10-19 Medtronic, Inc. Transesophageal medical lead
US6148222A (en) 1998-07-10 2000-11-14 Cardiocommand, Inc. Esophageal catheters and method of use
US20060116736A1 (en) 2001-07-23 2006-06-01 Dilorenzo Daniel J Method, apparatus, and surgical technique for autonomic neuromodulation for the treatment of obesity
WO2000013791A1 (en) * 1998-09-07 2000-03-16 Anglo American Research Laboratories (Proprietary) Limited Gold catalyst for fuel cell
DE19847446B4 (en) 1998-10-08 2010-04-22 Biotronik Gmbh & Co. Kg Nerve electrode assembly
US6615081B1 (en) 1998-10-26 2003-09-02 Birinder R. Boveja Apparatus and method for adjunct (add-on) treatment of diabetes by neuromodulation with an external stimulator
US6564102B1 (en) 1998-10-26 2003-05-13 Birinder R. Boveja Apparatus and method for adjunct (add-on) treatment of coma and traumatic brain injury with neuromodulation using an external stimulator
US6366814B1 (en) 1998-10-26 2002-04-02 Birinder R. Boveja External stimulator for adjunct (add-on) treatment for neurological, neuropsychiatric, and urological disorders
US6505074B2 (en) 1998-10-26 2003-01-07 Birinder R. Boveja Method and apparatus for electrical stimulation adjunct (add-on) treatment of urinary incontinence and urological disorders using an external stimulator
US6208902B1 (en) 1998-10-26 2001-03-27 Birinder Bob Boveja Apparatus and method for adjunct (add-on) therapy for pain syndromes utilizing an implantable lead and an external stimulator
US6611715B1 (en) 1998-10-26 2003-08-26 Birinder R. Boveja Apparatus and method for neuromodulation therapy for obesity and compulsive eating disorders using an implantable lead-receiver and an external stimulator
US6678560B1 (en) 1999-01-21 2004-01-13 Cardiac Pacemakers, Inc. Cardiac rhythm management system with electrosurgery mode
US6624150B2 (en) 1999-02-26 2003-09-23 Inspire Pharmaceuticals, Inc. Method of treating gastrointestinal tract disease with purinergic receptor agonists
EP1198271A4 (en) 1999-06-25 2009-01-21 Univ Emory Devices and methods for vagus nerve stimulation
US6587719B1 (en) * 1999-07-01 2003-07-01 Cyberonics, Inc. Treatment of obesity by bilateral vagus nerve stimulation
US7149773B2 (en) 1999-07-07 2006-12-12 Medtronic, Inc. System and method of automated invoicing for communications between an implantable medical device and a remote computer system or health care provider
US6308105B1 (en) 1999-07-15 2001-10-23 Medtronic Inc. Medical electrical stimulation system using an electrode assembly having opposing semi-circular arms
US6381496B1 (en) 1999-10-01 2002-04-30 Advanced Bionics Corporation Parameter context switching for an implanted device
US6113915A (en) 1999-10-12 2000-09-05 Allergan Sales, Inc. Methods for treating pain
JP2003526410A (en) * 1999-12-07 2003-09-09 トランスニューロニックス インコーポレイテッド Band of removable stomach
US6418346B1 (en) 1999-12-14 2002-07-09 Medtronic, Inc. Apparatus and method for remote therapy and diagnosis in medical devices via interface systems
DE60033054T2 (en) 1999-12-16 2007-06-06 St. Jude Medical Ab Programming system for medical devices
US6261572B1 (en) 2000-01-11 2001-07-17 Allergan Sales, Inc. Method for treating a pancreatic disorder with a neurotoxin
US6612983B1 (en) 2000-03-28 2003-09-02 Medtronic, Inc. Pancreatic secretion response to stimulation test protocol
US6306423B1 (en) * 2000-06-02 2001-10-23 Allergan Sales, Inc. Neurotoxin implant
JP2001356159A (en) * 2000-06-15 2001-12-26 Seiko Epson Corp Gps reception system
US6505077B1 (en) 2000-06-19 2003-01-07 Medtronic, Inc. Implantable medical device with external recharging coil electrical connection
US20020072780A1 (en) 2000-09-26 2002-06-13 Transneuronix, Inc. Method and apparatus for intentional impairment of gastric motility and /or efficiency by triggered electrical stimulation of the gastrointestinal tract with respect to the intrinsic gastric electrical activity
US7623926B2 (en) 2000-09-27 2009-11-24 Cvrx, Inc. Stimulus regimens for cardiovascular reflex control
US6591137B1 (en) 2000-11-09 2003-07-08 Neuropace, Inc. Implantable neuromuscular stimulator for the treatment of gastrointestinal disorders
US6832114B1 (en) 2000-11-21 2004-12-14 Advanced Bionics Corporation Systems and methods for modulation of pancreatic endocrine secretion and treatment of diabetes
US20020094962A1 (en) * 2000-12-01 2002-07-18 Gary Ashley Motilide compounds
US6609025B2 (en) * 2001-01-02 2003-08-19 Cyberonics, Inc. Treatment of obesity by bilateral sub-diaphragmatic nerve stimulation
US6754536B2 (en) 2001-01-31 2004-06-22 Medtronic, Inc Implantable medical device affixed internally within the gastrointestinal tract
US7702394B2 (en) 2001-05-01 2010-04-20 Intrapace, Inc. Responsive gastric stimulator
WO2002087685A3 (en) 2001-05-01 2003-07-31 Second Sight Llc High-density array of micro-machined electrodes for neural stimulation
US6901295B2 (en) 2001-07-14 2005-05-31 Virender K. Sharma Method and apparatus for electrical stimulation of the lower esophageal sphincter
US6622038B2 (en) * 2001-07-28 2003-09-16 Cyberonics, Inc. Treatment of movement disorders by near-diaphragmatic nerve stimulation
US20040036377A1 (en) 2001-08-15 2004-02-26 Steven Mezinis High voltage lc electric and magnetic field motivator
US6600956B2 (en) 2001-08-21 2003-07-29 Cyberonics, Inc. Circumneural electrode assembly
US6760626B1 (en) 2001-08-29 2004-07-06 Birinder R. Boveja Apparatus and method for treatment of neurological and neuropsychiatric disorders using programmerless implantable pulse generator system
US7734355B2 (en) * 2001-08-31 2010-06-08 Bio Control Medical (B.C.M.) Ltd. Treatment of disorders by unidirectional nerve stimulation
US7974693B2 (en) * 2001-08-31 2011-07-05 Bio Control Medical (B.C.M.) Ltd. Techniques for applying, configuring, and coordinating nerve fiber stimulation
US7187978B2 (en) 2001-11-01 2007-03-06 Medtronic, Inc. Method and apparatus for programming an implantable medical device
US7050856B2 (en) 2002-01-11 2006-05-23 Medtronic, Inc. Variation of neural-stimulation parameters
US6721603B2 (en) * 2002-01-25 2004-04-13 Cyberonics, Inc. Nerve stimulation as a treatment for pain
US6985773B2 (en) * 2002-02-07 2006-01-10 Cardiac Pacemakers, Inc. Methods and apparatuses for implantable medical device telemetry power management
US7689277B2 (en) 2002-03-22 2010-03-30 Leptos Biomedical, Inc. Neural stimulation for treatment of metabolic syndrome and type 2 diabetes
US7689276B2 (en) 2002-09-13 2010-03-30 Leptos Biomedical, Inc. Dynamic nerve stimulation for treatment of disorders
US8145316B2 (en) * 2002-04-08 2012-03-27 Ardian, Inc. Methods and apparatus for renal neuromodulation
US20040193229A1 (en) 2002-05-17 2004-09-30 Medtronic, Inc. Gastric electrical stimulation for treatment of gastro-esophageal reflux disease
US7292890B2 (en) * 2002-06-20 2007-11-06 Advanced Bionics Corporation Vagus nerve stimulation via unidirectional propagation of action potentials
WO2004036377A3 (en) 2002-10-15 2004-07-29 Naresh C Bhavaraju Configuring and testing treatment therapy parameters for a medical device system
US7238357B2 (en) * 2002-11-05 2007-07-03 Allergan, Inc. Methods for treating ulcers and gastroesophageal reflux disease
US6736722B1 (en) 2002-12-04 2004-05-18 Deere & Company Unloader tube cleaning system for harvesting apparatus
US8064994B2 (en) 2003-01-14 2011-11-22 The United States Of America As Represented By The Department Of Veterans Affairs Cervical vagal stimulation induced weight loss
US7613515B2 (en) * 2003-02-03 2009-11-03 Enteromedics Inc. High frequency vagal blockage therapy
US20060015151A1 (en) * 2003-03-14 2006-01-19 Aldrich William N Method of using endoscopic truncal vagoscopy with gastric bypass, gastric banding and other procedures
US7684865B2 (en) 2003-03-14 2010-03-23 Endovx, Inc. Methods and apparatus for treatment of obesity
US7783358B2 (en) * 2003-03-14 2010-08-24 Endovx, Inc. Methods and apparatus for treatment of obesity with an ultrasound device movable in two or three axes
US7430449B2 (en) 2003-03-14 2008-09-30 Endovx, Inc. Methods and apparatus for testing disruption of a vagal nerve
DE10318071A1 (en) 2003-04-17 2004-11-25 Forschungszentrum Jülich GmbH Device for desynchronization of neuronal brain activity
US7444184B2 (en) * 2003-05-11 2008-10-28 Neuro And Cardial Technologies, Llc Method and system for providing therapy for bulimia/eating disorders by providing electrical pulses to vagus nerve(s)
US7191012B2 (en) 2003-05-11 2007-03-13 Boveja Birinder R Method and system for providing pulsed electrical stimulation to a craniel nerve of a patient to provide therapy for neurological and neuropsychiatric disorders
US8265770B2 (en) * 2003-10-02 2012-09-11 Medtronic, Inc. Driver circuitry switchable between energy transfer and telemetry for an implantable medical device
US7991479B2 (en) * 2003-10-02 2011-08-02 Medtronic, Inc. Neurostimulator programmer with clothing attachable antenna
US7054690B2 (en) 2003-10-22 2006-05-30 Intrapace, Inc. Gastrointestinal stimulation device
CN1917918A (en) * 2004-02-10 2007-02-21 皇家飞利浦电子股份有限公司 External defibrillator with training mode and method of use
WO2006017634A3 (en) 2004-08-04 2006-11-23 James Coburn Devices, systems, and methods employing a molded nerve cuff electrode
US7486993B2 (en) * 2004-08-05 2009-02-03 Neurotone Systems, Inc. Brain stimulation method and device
US8214047B2 (en) 2004-09-27 2012-07-03 Advanced Neuromodulation Systems, Inc. Method of using spinal cord stimulation to treat gastrointestinal and/or eating disorders or conditions
US7734340B2 (en) 2004-10-21 2010-06-08 Advanced Neuromodulation Systems, Inc. Stimulation design for neuromodulation
EP1880298B1 (en) 2005-02-17 2016-07-13 Metacure Limited Charger with data transfer capabilities
US7774069B2 (en) * 2005-04-29 2010-08-10 Medtronic, Inc. Alignment indication for transcutaneous energy transfer
US7561923B2 (en) 2005-05-09 2009-07-14 Cardiac Pacemakers, Inc. Method and apparatus for controlling autonomic balance using neural stimulation
US20070016262A1 (en) 2005-07-13 2007-01-18 Betastim, Ltd. Gi and pancreatic device for treating obesity and diabetes
CN101283553A (en) * 2005-07-27 2008-10-08 高通股份有限公司 System and method for forward link only messages
US20070027484A1 (en) 2005-07-28 2007-02-01 Cyberonics, Inc. Autonomic nerve stimulation to treat a pancreatic disorder
US7672727B2 (en) 2005-08-17 2010-03-02 Enteromedics Inc. Neural electrode treatment
US7822486B2 (en) 2005-08-17 2010-10-26 Enteromedics Inc. Custom sized neural electrodes
US7551960B2 (en) * 2005-09-08 2009-06-23 Medtronic, Inc. External presentation of electrical stimulation parameters
US7620455B2 (en) 2005-10-25 2009-11-17 Cyberonics, Inc. Cranial nerve stimulation to treat eating disorders
EP1981584B1 (en) 2006-02-03 2015-05-13 Interventional Autonomics Corporation Intravascular device for neuromodulation
CN101400403A (en) 2006-02-10 2009-04-01 电子核心公司 Methods and apparatus for treating anaphylaxis using electrical modulation
US8041428B2 (en) 2006-02-10 2011-10-18 Electrocore Llc Electrical stimulation treatment of hypotension
US20070191912A1 (en) * 2006-02-10 2007-08-16 Vision Quest Industries, Inc. Interactive electrical stimulator device and server-based support system
CA2641821C (en) * 2006-02-16 2017-10-10 Imthera Medical, Inc. An rfid-based apparatus, system, and method for therapeutic treatment of a patient
US8187297B2 (en) 2006-04-19 2012-05-29 Vibsynt, Inc. Devices and methods for treatment of obesity
US8160709B2 (en) 2006-05-18 2012-04-17 Endostim, Inc. Use of electrical stimulation of the lower esophageal sphincter to modulate lower esophageal sphincter pressure
US8068918B2 (en) 2007-03-09 2011-11-29 Enteromedics Inc. Remote monitoring and control of implantable devices
US20080300657A1 (en) 2007-05-31 2008-12-04 Mark Raymond Stultz Therapy system
WO2009064408A1 (en) 2007-11-12 2009-05-22 Dilorenzo Daniel J Method and apparatus for programming of autonomic neuromodulation for the treatment of obesity
US8260426B2 (en) 2008-01-25 2012-09-04 Cyberonics, Inc. Method, apparatus and system for bipolar charge utilization during stimulation by an implantable medical device
DE202010017584U1 (en) 2009-05-08 2012-02-29 Université Libre de Bruxelles gastrointestinal device
EP2575958B1 (en) 2010-05-27 2017-10-18 Ndi Medical, LLC Waveform shapes for treating neurological disorders optimized for energy efficiency
WO2012012432A1 (en) 2010-07-19 2012-01-26 Cardiac Pacemakers, Inc. Minimally invasive lead system for vagus nerve stimulation
US20130184775A1 (en) 2010-10-01 2013-07-18 Indiana University Research & Technology Corporation Long term vagal nerve stimulation for therapeutic and diagnostic treatment
WO2012060874A3 (en) 2010-11-01 2012-07-19 Udaya Sankar Devanaboyina Methods for diagnosis and treatment of disorders of the gastrointestinal tract. and apparatus for use therewith
US9014813B2 (en) 2010-11-03 2015-04-21 Cleveland Clinic Foundation Apparatus for energy efficient stimulation

Patent Citations (76)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5188104A (en) * 1991-02-01 1993-02-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5263480A (en) * 1991-02-01 1993-11-23 Cyberonics, Inc. Treatment of eating disorders by nerve stimulation
US5269303A (en) * 1991-02-22 1993-12-14 Cyberonics, Inc. Treatment of dementia by nerve stimulation
US5199430A (en) * 1991-03-11 1993-04-06 Case Western Reserve University Micturitional assist device
US5215086A (en) * 1991-05-03 1993-06-01 Cyberonics, Inc. Therapeutic treatment of migraine symptoms by stimulation
US5335657A (en) * 1991-05-03 1994-08-09 Cyberonics, Inc. Therapeutic treatment of sleep disorder by nerve stimulation
US5299569A (en) * 1991-05-03 1994-04-05 Cyberonics, Inc. Treatment of neuropsychiatric disorders by nerve stimulation
US5231988A (en) * 1991-08-09 1993-08-03 Cyberonics, Inc. Treatment of endocrine disorders by nerve stimulation
US5423872A (en) * 1992-05-29 1995-06-13 Cigaina; Valerio Process and device for treating obesity and syndromes related to motor disorders of the stomach of a patient
US5330515A (en) * 1992-06-17 1994-07-19 Cyberonics, Inc. Treatment of pain by vagal afferent stimulation
US5292344A (en) * 1992-07-10 1994-03-08 Douglas Donald D Percutaneously placed electrical gastrointestinal pacemaker stimulatory system, sensing system, and pH monitoring system, with optional delivery port
US6405732B1 (en) * 1994-06-24 2002-06-18 Curon Medical, Inc. Method to treat gastric reflux via the detection and ablation of gastro-esophageal nerves and receptors
US5514175A (en) * 1994-11-09 1996-05-07 Cerebral Stimulation, Inc. Auricular electrical stimulator
US5571150A (en) * 1994-12-19 1996-11-05 Cyberonics, Inc. Treatment of patients in coma by nerve stimulation
US6558708B1 (en) * 1995-05-17 2003-05-06 Cedars-Sinai Medical Center Methods for manipulating upper gastrointestinal transit, blood flow, and satiety, and for treating visceral hyperalgesia
US5540730A (en) * 1995-06-06 1996-07-30 Cyberonics, Inc. Treatment of motility disorders by nerve stimulation
US5707400A (en) * 1995-09-19 1998-01-13 Cyberonics, Inc. Treating refractory hypertension by nerve stimulation
US20020055779A1 (en) * 1996-03-05 2002-05-09 Brian J. Andrews Neural prosthesis
US5747060A (en) * 1996-03-26 1998-05-05 Euro-Celtique, S.A. Prolonged local anesthesia with colchicine
US5690691A (en) * 1996-05-08 1997-11-25 The Center For Innovative Technology Gastro-intestinal pacemaker having phased multi-point stimulation
US6243607B1 (en) * 1996-09-05 2001-06-05 University Technologies International Inc. Gastro-intestinal electrical pacemaker
US6449511B1 (en) * 1996-09-05 2002-09-10 University Technologies International Inc. Gastrointestinal electrical stimulator having a variable electrical stimulus
US5716385A (en) * 1996-11-12 1998-02-10 University Of Virginia Crural diaphragm pacemaker and method for treating esophageal reflux disease
US6238423B1 (en) * 1997-01-13 2001-05-29 Medtronic, Inc. Apparatus and method for treating chronic constipation
US6083249A (en) * 1997-04-30 2000-07-04 Medtronic, Inc. Apparatus for sensing and stimulating gastrointestinal tract on-demand
US5995872A (en) * 1997-04-30 1999-11-30 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US5861014A (en) * 1997-04-30 1999-01-19 Medtronic, Inc. Method and apparatus for sensing a stimulating gastrointestinal tract on-demand
US5836994A (en) * 1997-04-30 1998-11-17 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6216039B1 (en) * 1997-05-02 2001-04-10 Medtronic Inc. Method and apparatus for treating irregular gastric rhythms
US6135978A (en) * 1997-06-16 2000-10-24 Medtronic, Inc. System for pancreatic stimulation and glucose measurement
US6093167A (en) * 1997-06-16 2000-07-25 Medtronic, Inc. System for pancreatic stimulation and glucose measurement
US5919216A (en) * 1997-06-16 1999-07-06 Medtronic, Inc. System and method for enhancement of glucose production by stimulation of pancreatic beta cells
US6571127B1 (en) * 1997-07-16 2003-05-27 Impulse Dynamics N.V. Method of increasing the motility of a GI tract
US6104955A (en) * 1997-12-15 2000-08-15 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6091992A (en) * 1997-12-15 2000-07-18 Medtronic, Inc. Method and apparatus for electrical stimulation of the gastrointestinal tract
US6364899B1 (en) * 1998-01-23 2002-04-02 Innercool Therapies, Inc. Heat pipe nerve cooler
US6369079B1 (en) * 1998-06-15 2002-04-09 Sepracor, Inc. Methods for treating irritable bowel syndrome using optically pure (+) norcisapride
US20050137644A1 (en) * 1998-10-26 2005-06-23 Boveja Birinder R. Method and system for vagal blocking and/or vagal stimulation to provide therapy for obesity and other gastrointestinal disorders
US6097984A (en) * 1998-11-25 2000-08-01 Medtronic, Inc. System and method of stimulation for treating gastro-esophageal reflux disease
US6261280B1 (en) * 1999-03-22 2001-07-17 Medtronic, Inc Method of obtaining a measure of blood glucose
US6098629A (en) * 1999-04-07 2000-08-08 Endonetics, Inc. Submucosal esophageal bulking device
US6895278B1 (en) * 1999-04-14 2005-05-17 Transneuronix, Inc. Gastric stimulator apparatus and method for use
US6341236B1 (en) * 1999-04-30 2002-01-22 Ivan Osorio Vagal nerve stimulation techniques for treatment of epileptic seizures
US6473644B1 (en) * 1999-10-13 2002-10-29 Cyberonics, Inc. Method to enhance cardiac capillary growth in heart failure patients
US6853862B1 (en) * 1999-12-03 2005-02-08 Medtronic, Inc. Gastroelectric stimulation for influencing pancreatic secretions
US6826428B1 (en) * 2000-04-11 2004-11-30 The Board Of Regents Of The University Of Texas System Gastrointestinal electrical stimulation
US6610713B2 (en) * 2000-05-23 2003-08-26 North Shore - Long Island Jewish Research Institute Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US6993391B2 (en) * 2000-12-11 2006-01-31 Metacure N.V. Acute and chronic electrical signal therapy for obesity
US20040127953A1 (en) * 2001-02-20 2004-07-01 Kilgore Kevin L. Systems and methods for reversibly blocking nerve activity
US20020161360A1 (en) * 2001-04-26 2002-10-31 Carroll Ronald J. Method and device for neurocryo analgesia and anesthesia
US6928320B2 (en) * 2001-05-17 2005-08-09 Medtronic, Inc. Apparatus for blocking activation of tissue or conduction of action potentials while other tissue is being therapeutically activated
US20050149148A1 (en) * 2001-05-17 2005-07-07 Medtronic, Inc. Apparatus and method for blocking activation of tissue or conduction of action potentials while other tissue is being therapeutically activated
US20030018367A1 (en) * 2001-07-23 2003-01-23 Dilorenzo Daniel John Method and apparatus for neuromodulation and phsyiologic modulation for the treatment of metabolic and neuropsychiatric disease
US6684105B2 (en) * 2001-08-31 2004-01-27 Biocontrol Medical, Ltd. Treatment of disorders by unidirectional nerve stimulation
US20030045909A1 (en) * 2001-08-31 2003-03-06 Biocontrol Medical Ltd. Selective nerve fiber stimulation for treating heart conditions
US20030181958A1 (en) * 2002-03-22 2003-09-25 Dobak John D. Electric modulation of sympathetic nervous system
US20030181959A1 (en) * 2002-03-22 2003-09-25 Dobak John D. Wireless electric modulation of sympathetic nervous system
US20050143787A1 (en) * 2002-05-09 2005-06-30 Boveja Birinder R. Method and system for providing electrical pulses for neuromodulation of vagus nerve(s), using rechargeable implanted pulse generator
US7076307B2 (en) * 2002-05-09 2006-07-11 Boveja Birinder R Method and system for modulating the vagus nerve (10th cranial nerve) with electrical pulses using implanted and external components, to provide therapy neurological and neuropsychiatric disorders
US20050149146A1 (en) * 2002-05-09 2005-07-07 Boveja Birinder R. Method and system to provide therapy for obesity and other medical disorders, by providing electrical pules to symapthetic nerves or vagal nerve(s) with rechargeable implanted pulse generator
US20030212440A1 (en) * 2002-05-09 2003-11-13 Boveja Birinder R. Method and system for modulating the vagus nerve (10th cranial nerve) using modulated electrical pulses with an inductively coupled stimulation system
US20040039425A1 (en) * 2002-05-29 2004-02-26 Beverley Greenwood-Van Meerveld Spinal cord stimulation as treatment for functional bowel disorders
US6746474B2 (en) * 2002-05-31 2004-06-08 Vahid Saadat Apparatus and methods for cooling a region within the body
US20040172085A1 (en) * 2003-02-03 2004-09-02 Beta Medical, Inc. Nerve stimulation and conduction block therapy
US20040167583A1 (en) * 2003-02-03 2004-08-26 Enteromedics, Inc. Electrode band apparatus and method
US20050038484A1 (en) * 2003-02-03 2005-02-17 Enteromedics, Inc. Controlled vagal blockage therapy
US7167750B2 (en) * 2003-02-03 2007-01-23 Enteromedics, Inc. Obesity treatment with electrically induced vagal down regulation
US20040236382A1 (en) * 2003-05-19 2004-11-25 Medtronic, Inc. Gastro-electric stimulation for increasing the acidity of gastric secretions or increasing the amounts thereof
US20040236381A1 (en) * 2003-05-19 2004-11-25 Medtronic, Inc. Gastro-electric stimulation for reducing the acidity of gastric secretions or reducing the amounts thereof
US20040249416A1 (en) * 2003-06-09 2004-12-09 Yun Anthony Joonkyoo Treatment of conditions through electrical modulation of the autonomic nervous system
US20050049655A1 (en) * 2003-08-27 2005-03-03 Boveja Birinder R. System and method for providing electrical pulses to the vagus nerve(s) to provide therapy for obesity, eating disorders, neurological and neuropsychiatric disorders with a stimulator, comprising bi-directional communication and network capabilities
US20050070974A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Obesity and eating disorder stimulation treatment with neural block
US20050070970A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Movement disorder stimulation with neural block
US20050143378A1 (en) * 2003-12-29 2005-06-30 Yun Anthony J. Treatment of conditions through pharmacological modulation of the autonomic nervous system
US20050149141A1 (en) * 2004-01-07 2005-07-07 Starkebaum Warren L. Gastric stimulation for altered perception to treat obesity
US20060036293A1 (en) * 2004-08-16 2006-02-16 Whitehurst Todd K Methods for treating gastrointestinal disorders

Cited By (207)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040024428A1 (en) * 1999-07-01 2004-02-05 Burke Barrett Treatment of obesity by bilateral vagus nerve stimulation
US7299091B2 (en) 1999-07-01 2007-11-20 Cyberonics, Inc. Treatment of obesity by bilateral vagus nerve stimulation
US8914114B2 (en) 2000-05-23 2014-12-16 The Feinstein Institute For Medical Research Inhibition of inflammatory cytokine production by cholinergic agonists and vagus nerve stimulation
US20050222226A1 (en) * 2000-06-30 2005-10-06 Sumitomo Pharmaceuticals Company, Limited Five-membered cyclic compounds
US20040039427A1 (en) * 2001-01-02 2004-02-26 Cyberonics, Inc. Treatment of obesity by sub-diaphragmatic nerve stimulation
US7340306B2 (en) 2001-01-02 2008-03-04 Cyberonics, Inc. Treatment of obesity by sub-diaphragmatic nerve stimulation
US7756582B2 (en) 2001-05-01 2010-07-13 Intrapace, Inc. Gastric stimulation anchor and method
US20050065571A1 (en) * 2001-05-01 2005-03-24 Imran Mir A. Responsive gastric stimulator
US7702394B2 (en) 2001-05-01 2010-04-20 Intrapace, Inc. Responsive gastric stimulator
US7689284B2 (en) 2001-05-01 2010-03-30 Intrapace, Inc. Pseudounipolar lead for stimulating a digestive organ
US8239027B2 (en) 2001-05-01 2012-08-07 Intrapace, Inc. Responsive gastric stimulator
US8364269B2 (en) 2001-05-01 2013-01-29 Intrapace, Inc. Responsive gastric stimulator
US7979127B2 (en) 2001-05-01 2011-07-12 Intrapace, Inc. Digestive organ retention device
US7747322B2 (en) 2001-05-01 2010-06-29 Intrapace, Inc. Digestive organ retention device
US9517152B2 (en) 2001-05-01 2016-12-13 Intrapace, Inc. Responsive gastric stimulator
US7837719B2 (en) 2002-05-09 2010-11-23 Daemen College Electrical stimulation unit and waterbath system
US7844338B2 (en) 2003-02-03 2010-11-30 Enteromedics Inc. High frequency obesity treatment
US8538542B2 (en) 2003-02-03 2013-09-17 Enteromedics Inc. Nerve stimulation and blocking for treatment of gastrointestinal disorders
US8538533B2 (en) 2003-02-03 2013-09-17 Enteromedics Inc. Controlled vagal blockage therapy
US8369952B2 (en) 2003-02-03 2013-02-05 Enteromedics, Inc. Bulimia treatment
US7729771B2 (en) 2003-02-03 2010-06-01 Enteromedics Inc. Nerve stimulation and blocking for treatment of gastrointestinal disorders
US7167750B2 (en) 2003-02-03 2007-01-23 Enteromedics, Inc. Obesity treatment with electrically induced vagal down regulation
US7720540B2 (en) 2003-02-03 2010-05-18 Enteromedics, Inc. Pancreatitis treatment
US8046085B2 (en) 2003-02-03 2011-10-25 Enteromedics Inc. Controlled vagal blockage therapy
US7693577B2 (en) 2003-02-03 2010-04-06 Enteromedics Inc. Irritable bowel syndrome treatment
US8010204B2 (en) 2003-02-03 2011-08-30 Enteromedics Inc. Nerve blocking for treatment of gastrointestinal disorders
US9682233B2 (en) 2003-02-03 2017-06-20 Enteromedics Inc. Nerve stimulation and blocking for treatment of gastrointestinal disorders
US20040172086A1 (en) * 2003-02-03 2004-09-02 Beta Medical, Inc. Nerve conduction block treatment
US20040172085A1 (en) * 2003-02-03 2004-09-02 Beta Medical, Inc. Nerve stimulation and conduction block therapy
US8862233B2 (en) 2003-02-03 2014-10-14 Enteromedics Inc. Electrode band system and methods of using the system to treat obesity
US20040172088A1 (en) * 2003-02-03 2004-09-02 Enteromedics, Inc. Intraluminal electrode apparatus and method
US9586046B2 (en) 2003-02-03 2017-03-07 Enteromedics, Inc. Electrode band system and methods of using the system to treat obesity
US20040167583A1 (en) * 2003-02-03 2004-08-26 Enteromedics, Inc. Electrode band apparatus and method
US7444183B2 (en) 2003-02-03 2008-10-28 Enteromedics, Inc. Intraluminal electrode apparatus and method
US9162062B2 (en) 2003-02-03 2015-10-20 Enteromedics Inc. Controlled vagal blockage therapy
US9174040B2 (en) 2003-02-03 2015-11-03 Enteromedics Inc. Nerve stimulation and blocking for treatment of gastrointestinal disorders
US7986995B2 (en) 2003-02-03 2011-07-26 Enteromedics Inc. Bulimia treatment
US7705016B2 (en) 2003-02-13 2010-04-27 Albert Einstein College Of Medicine Of Yeshiva University Regulation of food intake by modulation of long-chain fatty acyl-CoA levels in the hypothalamus
US20050070970A1 (en) * 2003-09-29 2005-03-31 Knudson Mark B. Movement disorder stimulation with neural block
US20100286745A1 (en) * 2003-10-22 2010-11-11 Intrapace, Inc. Radially Expandable Gastrointestinal Stimulation Device
US7054690B2 (en) 2003-10-22 2006-05-30 Intrapace, Inc. Gastrointestinal stimulation device
US7676270B2 (en) 2003-10-22 2010-03-09 Intrapace, Inc. Radially expandable gastrointestinal stimulation device
US7430450B2 (en) 2003-10-22 2008-09-30 Intrapace, Inc. Device and method for treating obesity
US20050090873A1 (en) * 2003-10-22 2005-04-28 Imran Mir A. Gastrointestinal stimulation device
US9050469B1 (en) 2003-11-26 2015-06-09 Flint Hills Scientific, Llc Method and system for logging quantitative seizure information and assessing efficacy of therapy using cardiac signals
US8729129B2 (en) 2004-03-25 2014-05-20 The Feinstein Institute For Medical Research Neural tourniquet
US8911393B2 (en) 2004-06-03 2014-12-16 Mayo Foundation For Medical Education And Research Obesity treatment and device
US20050273060A1 (en) * 2004-06-03 2005-12-08 Mayo Foundation For Medical Education And Research Obesity treatment and device
US20110009980A1 (en) * 2004-06-03 2011-01-13 Mayo Foundation For Medical Education And Research Obesity treatment and device
US8372158B2 (en) 2004-06-03 2013-02-12 Enteromedics, Inc. Obesity treatment and device
US7803195B2 (en) 2004-06-03 2010-09-28 Mayo Foundation For Medical Education And Research Obesity treatment and device
US20060020277A1 (en) * 2004-07-20 2006-01-26 Gostout Christopher J Gastric reshaping devices and methods
US20060020298A1 (en) * 2004-07-20 2006-01-26 Camilleri Michael L Systems and methods for curbing appetite
US9662240B2 (en) 2004-09-23 2017-05-30 Intrapace, Inc. Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors
US8934976B2 (en) 2004-09-23 2015-01-13 Intrapace, Inc. Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors
US9259342B2 (en) 2004-09-23 2016-02-16 Intrapace, Inc. Feedback systems and methods to enhance obstructive and other obesity treatments, optionally using multiple sensors
US20060070334A1 (en) * 2004-09-27 2006-04-06 Blue Hen, Llc Sidewall plank for constructing a trailer and associated trailer sidewall construction
US20110021968A1 (en) * 2004-11-12 2011-01-27 Enteromedics Inc. Pancreatic exocrine secretion diversion apparatus and method
US8617095B2 (en) 2004-11-12 2013-12-31 Enteromedics Inc. Pancreatic exocrine secretion diversion apparatus and method
US7833279B2 (en) 2004-11-12 2010-11-16 Enteromedics Inc. Pancreatic exocrine secretion diversion apparatus and method
US20060106332A1 (en) * 2004-11-12 2006-05-18 Enteromedics Inc. Pancreatic exocrine secretion diversion apparatus and method
US8565867B2 (en) 2005-01-28 2013-10-22 Cyberonics, Inc. Changeable electrode polarity stimulation by an implantable medical device
US9586047B2 (en) 2005-01-28 2017-03-07 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US20060200208A1 (en) * 2005-03-04 2006-09-07 Cyberonics, Inc. Cranial nerve stimulation for treatment of substance addiction
US8700163B2 (en) 2005-03-04 2014-04-15 Cyberonics, Inc. Cranial nerve stimulation for treatment of substance addiction
US7310557B2 (en) 2005-04-29 2007-12-18 Maschino Steven E Identification of electrodes for nerve stimulation in the treatment of eating disorders
US7835796B2 (en) 2005-04-29 2010-11-16 Cyberonics, Inc. Weight loss method and device
US7899540B2 (en) 2005-04-29 2011-03-01 Cyberonics, Inc. Noninvasively adjustable gastric band
US20060247722A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Noninvasively adjustable gastric band
US20060247719A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Weight loss method and advice
US20060247721A1 (en) * 2005-04-29 2006-11-02 Cyberonics, Inc. Identification of electrodes for nerve stimulation in the treatment of eating disorders
US20070016262A1 (en) * 2005-07-13 2007-01-18 Betastim, Ltd. Gi and pancreatic device for treating obesity and diabetes
US8095218B2 (en) 2005-07-13 2012-01-10 Betastim, Ltd. GI and pancreatic device for treating obesity and diabetes
US7840280B2 (en) 2005-07-27 2010-11-23 Cyberonics, Inc. Cranial nerve stimulation to treat a vocal cord disorder
US20070027504A1 (en) * 2005-07-27 2007-02-01 Cyberonics, Inc. Cranial nerve stimulation to treat a hearing disorder
US20070027492A1 (en) * 2005-07-28 2007-02-01 Cyberonics, Inc. Autonomic nerve stimulation to treat a gastrointestinal disorder
US7856273B2 (en) 2005-07-28 2010-12-21 Cyberonics, Inc. Autonomic nerve stimulation to treat a gastrointestinal disorder
US20070027484A1 (en) * 2005-07-28 2007-02-01 Cyberonics, Inc. Autonomic nerve stimulation to treat a pancreatic disorder
US8660647B2 (en) 2005-07-28 2014-02-25 Cyberonics, Inc. Stimulating cranial nerve to treat pulmonary disorder
US7706874B2 (en) 2005-07-28 2010-04-27 Cyberonics, Inc. Stimulating cranial nerve to treat disorders associated with the thyroid gland
US8103349B2 (en) 2005-08-17 2012-01-24 Enteromedics Inc. Neural electrode treatment
US7822486B2 (en) 2005-08-17 2010-10-26 Enteromedics Inc. Custom sized neural electrodes
US7672727B2 (en) 2005-08-17 2010-03-02 Enteromedics Inc. Neural electrode treatment
US20070043400A1 (en) * 2005-08-17 2007-02-22 Donders Adrianus P Neural electrode treatment
WO2007021534A1 (en) 2005-08-17 2007-02-22 Enteromedics Inc. Neural electrode treatment
EP2275171A2 (en) 2005-08-17 2011-01-19 Enteromedics Inc. Apparatus for neural electrode treatment
US8032223B2 (en) 2005-09-01 2011-10-04 Intrapace, Inc. Randomized stimulation of a gastrointestinal organ
US8798754B2 (en) 2005-09-26 2014-08-05 Venturi Group, Llc Neural blocking therapy
US7957796B2 (en) 2005-10-28 2011-06-07 Cyberonics, Inc. Using physiological sensor data with an implantable medical device
US8972013B2 (en) 2005-10-28 2015-03-03 Cyberonics, Inc. Using physiological sensor data with an implantable medical device
US7657310B2 (en) 2006-01-26 2010-02-02 Cyberonics, Inc. Treatment of reproductive endocrine disorders by vagus nerve stimulation
US7801601B2 (en) 2006-01-27 2010-09-21 Cyberonics, Inc. Controlling neuromodulation using stimulus modalities
US8027718B2 (en) 2006-03-07 2011-09-27 Mayo Foundation For Medical Education And Research Regional anesthetic
US20070213771A1 (en) * 2006-03-07 2007-09-13 Spinner Robert J Regional anesthetic
US9108041B2 (en) 2006-03-29 2015-08-18 Dignity Health Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8660666B2 (en) 2006-03-29 2014-02-25 Catholic Healthcare West Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US9289599B2 (en) 2006-03-29 2016-03-22 Dignity Health Vagus nerve stimulation method
US8219188B2 (en) 2006-03-29 2012-07-10 Catholic Healthcare West Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
US8738126B2 (en) 2006-03-29 2014-05-27 Catholic Healthcare West Synchronization of vagus nerve stimulation with the cardiac cycle of a patient
US8615309B2 (en) 2006-03-29 2013-12-24 Catholic Healthcare West Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US8150508B2 (en) 2006-03-29 2012-04-03 Catholic Healthcare West Vagus nerve stimulation method
US8280505B2 (en) 2006-03-29 2012-10-02 Catholic Healthcare West Vagus nerve stimulation method
US9533151B2 (en) 2006-03-29 2017-01-03 Dignity Health Microburst electrical stimulation of cranial nerves for the treatment of medical conditions
US20080183237A1 (en) * 2006-04-18 2008-07-31 Electrocore, Inc. Methods And Apparatus For Treating Ileus Condition Using Electrical Signals
US7869885B2 (en) 2006-04-28 2011-01-11 Cyberonics, Inc Threshold optimization for tissue stimulation therapy
US7869867B2 (en) 2006-10-27 2011-01-11 Cyberonics, Inc. Implantable neurostimulator with refractory stimulation
US7706875B2 (en) 2007-01-25 2010-04-27 Cyberonics, Inc. Modulation of drug effects by vagus nerve stimulation
EP2756866A1 (en) 2007-03-09 2014-07-23 Enteromedics Inc. Remote monitoring and control of implantable devices
US7962214B2 (en) 2007-04-26 2011-06-14 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7904175B2 (en) 2007-04-26 2011-03-08 Cyberonics, Inc. Trans-esophageal vagus nerve stimulation
US7869884B2 (en) 2007-04-26 2011-01-11 Cyberonics, Inc. Non-surgical device and methods for trans-esophageal vagus nerve stimulation
US7974701B2 (en) 2007-04-27 2011-07-05 Cyberonics, Inc. Dosing limitation for an implantable medical device
US8306627B2 (en) 2007-04-27 2012-11-06 Cyberonics, Inc. Dosing limitation for an implantable medical device
US8391970B2 (en) 2007-08-27 2013-03-05 The Feinstein Institute For Medical Research Devices and methods for inhibiting granulocyte activation by neural stimulation
US20110087337A1 (en) * 2007-10-11 2011-04-14 Peter Forsell Apparatus for controlling flow in a bodily organ
US9662117B2 (en) * 2007-10-11 2017-05-30 Peter Forsell Apparatus for controlling flow in a bodily organ
US8696543B2 (en) 2007-10-11 2014-04-15 Kirk Promotion Ltd. Method for controlling flow of intestinal contents in a patient's intestines
US8165668B2 (en) 2007-12-05 2012-04-24 The Invention Science Fund I, Llc Method for magnetic modulation of neural conduction
US9789315B2 (en) 2007-12-05 2017-10-17 Gearbox, Llc Method and system for modulating neural activity
US8233976B2 (en) 2007-12-05 2012-07-31 The Invention Science Fund I, Llc System for transdermal chemical modulation of neural activity
US8989858B2 (en) 2007-12-05 2015-03-24 The Invention Science Fund I, Llc Implant system for chemical modulation of neural activity
US9358374B2 (en) 2007-12-05 2016-06-07 Gearbox, Llc Method and system for blocking nerve conduction
US8170658B2 (en) 2007-12-05 2012-05-01 The Invention Science Fund I, Llc System for electrical modulation of neural conduction
US9014802B2 (en) 2007-12-05 2015-04-21 The Invention Science Fund I, Llc Method and system for modulating neural activity in a limb
US20090149914A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Method for reversible chemical modulation of neural activity
US8630706B2 (en) 2007-12-05 2014-01-14 The Invention Science Fund I, Llc Method and system for reversible chemical modulation of neural activity
US9020591B2 (en) 2007-12-05 2015-04-28 The Invention Science Fund I, Llc Method and system for ultrasonic neural modulation in a limb
US8195287B2 (en) 2007-12-05 2012-06-05 The Invention Science Fund I, Llc Method for electrical modulation of neural conduction
US20090149798A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Implant system for chemical modulation of neural activity
US8160695B2 (en) 2007-12-05 2012-04-17 The Invention Science Fund I, Llc System for chemical modulation of neural activity
US20090149799A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware Method for chemical modulation of neural activity
US8165669B2 (en) 2007-12-05 2012-04-24 The Invention Science Fund I, Llc System for magnetic modulation of neural conduction
US20090149926A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware System for thermal modulation of neural activity
US8180446B2 (en) 2007-12-05 2012-05-15 The Invention Science Fund I, Llc Method and system for cyclical neural modulation based on activity state
US9020592B2 (en) 2007-12-05 2015-04-28 The Invention Science Fund I, Llc Method and system for blocking nerve conduction
US20090149797A1 (en) * 2007-12-05 2009-06-11 Searete Llc, A Limited Liability Corporation Of The State Of Delaware System for reversible chemical modulation of neural activity
US8180447B2 (en) 2007-12-05 2012-05-15 The Invention Science Fund I, Llc Method for reversible chemical modulation of neural activity
US8170660B2 (en) 2007-12-05 2012-05-01 The Invention Science Fund I, Llc System for thermal modulation of neural activity
US8170659B2 (en) 2007-12-05 2012-05-01 The Invention Science Fund I, Llc Method for thermal modulation of neural activity
US9314633B2 (en) 2008-01-25 2016-04-19 Cyberonics, Inc. Contingent cardio-protection for epilepsy patients
US20090210019A1 (en) * 2008-02-14 2009-08-20 Dennis Dong-Won Kim Treatment of excess weight by neural downregulation in combination with compositions
US9186502B2 (en) * 2008-02-14 2015-11-17 Enteromedics Inc. Treatment of excess weight by neural downregulation in combination with compositions
US20160045730A1 (en) * 2008-02-14 2016-02-18 Enteromedics Inc. Treatment of excess weight by neural downregulation in combination with compositions
US9211409B2 (en) 2008-03-31 2015-12-15 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation of T-cell activity
US9662490B2 (en) 2008-03-31 2017-05-30 The Feinstein Institute For Medical Research Methods and systems for reducing inflammation by neuromodulation and administration of an anti-inflammatory drug
US8483830B2 (en) 2008-04-04 2013-07-09 Enteromedics Inc. Methods and systems for glucose regulation
US20090254143A1 (en) * 2008-04-04 2009-10-08 Tweden Katherine S Methods and systems for glucose regulation
US8204603B2 (en) 2008-04-25 2012-06-19 Cyberonics, Inc. Blocking exogenous action potentials by an implantable medical device
US20090270943A1 (en) * 2008-04-25 2009-10-29 Maschino Steven E Blocking Exogenous Action Potentials by an Implantable Medical Device
US9393423B2 (en) 2008-05-15 2016-07-19 Boston Scientific Neuromodulation Corporation Fractionalized stimulation pulses in an implantable stimulator device
US9782593B2 (en) 2008-05-15 2017-10-10 Boston Scientific Neuromodulation Corporation Fractionalized stimulation pulses in an implantable stimulator device
US9289610B2 (en) 2008-05-15 2016-03-22 Boston Scientific Neuromodulation Corporation Fractionalized stimulation pulses in an implantable stimulator device
US9095711B2 (en) 2008-08-08 2015-08-04 Enteromedics Inc. Systems for regulation of blood pressure and heart rate
US20100204741A1 (en) * 2008-08-08 2010-08-12 Tweden Katherine S Systems for regulation of blood pressure and heart rate
US9616231B2 (en) 2008-08-08 2017-04-11 Enteromedics Inc. Systems for regulation of blood pressure and heart rate
US8768469B2 (en) 2008-08-08 2014-07-01 Enteromedics Inc. Systems for regulation of blood pressure and heart rate
US8457747B2 (en) 2008-10-20 2013-06-04 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
US8874218B2 (en) 2008-10-20 2014-10-28 Cyberonics, Inc. Neurostimulation with signal duration determined by a cardiac cycle
US8768471B2 (en) 2008-10-24 2014-07-01 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
US8849409B2 (en) 2008-10-24 2014-09-30 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
US8417344B2 (en) 2008-10-24 2013-04-09 Cyberonics, Inc. Dynamic cranial nerve stimulation based on brain state determination from cardiac data
US8412338B2 (en) 2008-11-18 2013-04-02 Setpoint Medical Corporation Devices and methods for optimizing electrode placement for anti-inflamatory stimulation
US9403013B2 (en) 2009-01-29 2016-08-02 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8849410B2 (en) 2009-01-29 2014-09-30 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8509906B2 (en) 2009-01-29 2013-08-13 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8255057B2 (en) 2009-01-29 2012-08-28 Nevro Corporation Systems and methods for producing asynchronous neural responses to treat pain and/or other patient conditions
US8715181B2 (en) 2009-04-03 2014-05-06 Intrapace, Inc. Feedback systems and methods for communicating diagnostic and/or treatment signals to enhance obesity treatments
US8827912B2 (en) 2009-04-24 2014-09-09 Cyberonics, Inc. Methods and systems for detecting epileptic events using NNXX, optionally with nonlinear analysis parameters
US8239028B2 (en) 2009-04-24 2012-08-07 Cyberonics, Inc. Use of cardiac parameters in methods and systems for treating a chronic medical condition
US9849286B2 (en) 2009-05-01 2017-12-26 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9211410B2 (en) 2009-05-01 2015-12-15 Setpoint Medical Corporation Extremely low duty-cycle activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US8414559B2 (en) 2009-05-07 2013-04-09 Rainbow Medical Ltd. Gastroretentive duodenal pill
US9700716B2 (en) 2009-06-09 2017-07-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US9174041B2 (en) 2009-06-09 2015-11-03 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8886339B2 (en) 2009-06-09 2014-11-11 Setpoint Medical Corporation Nerve cuff with pocket for leadless stimulator
US8996116B2 (en) 2009-10-30 2015-03-31 Setpoint Medical Corporation Modulation of the cholinergic anti-inflammatory pathway to treat pain or addiction
US8612002B2 (en) 2009-12-23 2013-12-17 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US9162064B2 (en) 2009-12-23 2015-10-20 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8855767B2 (en) 2009-12-23 2014-10-07 Setpoint Medical Corporation Neural stimulation devices and systems for treatment of chronic inflammation
US8649871B2 (en) 2010-04-29 2014-02-11 Cyberonics, Inc. Validity test adaptive constraint modification for cardiac data used for detection of state changes
US9241647B2 (en) 2010-04-29 2016-01-26 Cyberonics, Inc. Algorithm for detecting a seizure from cardiac data
US9700256B2 (en) 2010-04-29 2017-07-11 Cyberonics, Inc. Algorithm for detecting a seizure from cardiac data
US8562536B2 (en) 2010-04-29 2013-10-22 Flint Hills Scientific, Llc Algorithm for detecting a seizure from cardiac data
US8831732B2 (en) 2010-04-29 2014-09-09 Cyberonics, Inc. Method, apparatus and system for validating and quantifying cardiac beat data quality
US9358395B2 (en) 2010-06-11 2016-06-07 Enteromedics Inc. Neural modulation devices and methods
US8825164B2 (en) 2010-06-11 2014-09-02 Enteromedics Inc. Neural modulation devices and methods
US8679009B2 (en) 2010-06-15 2014-03-25 Flint Hills Scientific, Llc Systems approach to comorbidity assessment
US9220910B2 (en) 2010-07-30 2015-12-29 Cyberonics, Inc. Seizure detection using coordinate data
US8641646B2 (en) 2010-07-30 2014-02-04 Cyberonics, Inc. Seizure detection using coordinate data
US8948855B2 (en) 2010-09-16 2015-02-03 Flint Hills Scientific, Llc Detecting and validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US9020582B2 (en) 2010-09-16 2015-04-28 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8571643B2 (en) 2010-09-16 2013-10-29 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8452387B2 (en) 2010-09-16 2013-05-28 Flint Hills Scientific, Llc Detecting or validating a detection of a state change from a template of heart rate derivative shape or heart beat wave complex
US8852100B2 (en) 2010-10-01 2014-10-07 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8337404B2 (en) 2010-10-01 2012-12-25 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8888702B2 (en) 2010-10-01 2014-11-18 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8945006B2 (en) 2010-10-01 2015-02-03 Flunt Hills Scientific, LLC Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
US8382667B2 (en) 2010-10-01 2013-02-26 Flint Hills Scientific, Llc Detecting, quantifying, and/or classifying seizures using multimodal data
US8684921B2 (en) 2010-10-01 2014-04-01 Flint Hills Scientific Llc Detecting, assessing and managing epilepsy using a multi-variate, metric-based classification analysis
US9504390B2 (en) 2011-03-04 2016-11-29 Globalfoundries Inc. Detecting, assessing and managing a risk of death in epilepsy
US8725239B2 (en) 2011-04-25 2014-05-13 Cyberonics, Inc. Identifying seizures using heart rate decrease
US9498162B2 (en) 2011-04-25 2016-11-22 Cyberonics, Inc. Identifying seizures using heart data from two or more windows
US9402550B2 (en) 2011-04-29 2016-08-02 Cybertronics, Inc. Dynamic heart rate threshold for neurological event detection
US8788034B2 (en) 2011-05-09 2014-07-22 Setpoint Medical Corporation Single-pulse activation of the cholinergic anti-inflammatory pathway to treat chronic inflammation
US9833621B2 (en) 2011-09-23 2017-12-05 Setpoint Medical Corporation Modulation of sirtuins by vagus nerve stimulation
US9572983B2 (en) 2012-03-26 2017-02-21 Setpoint Medical Corporation Devices and methods for modulation of bone erosion
US9409020B2 (en) 2014-05-20 2016-08-09 Nevro Corporation Implanted pulse generators with reduced power consumption via signal strength/duration characteristics, and associated systems and methods

Also Published As

Publication number Publication date Type
US8010204B2 (en) 2011-08-30 grant
US20040172084A1 (en) 2004-09-02 application
US20140172052A1 (en) 2014-06-19 application
US7729771B2 (en) 2010-06-01 grant
US8538542B2 (en) 2013-09-17 grant
US7489969B2 (en) 2009-02-10 grant
US9682233B2 (en) 2017-06-20 grant
US20110282411A1 (en) 2011-11-17 application
EP2366425A1 (en) 2011-09-21 application
US20040172086A1 (en) 2004-09-02 application
US20100168815A1 (en) 2010-07-01 application
US20170304615A1 (en) 2017-10-26 application
US9174040B2 (en) 2015-11-03 grant
US20080021512A1 (en) 2008-01-24 application
US20060229685A1 (en) 2006-10-12 application
US20160193465A1 (en) 2016-07-07 application
US20040172085A1 (en) 2004-09-02 application
DK1601414T3 (en) 2012-05-29 grant

Similar Documents

Publication Publication Date Title
US6885895B1 (en) Methods and systems for electrical and/or drug stimulation as a therapy for erectile dysfunction
US8401640B2 (en) Systems and methods for delivering vagal nerve stimulation
US6941171B2 (en) Implantable stimulator methods for treatment of incontinence and pain
US6832114B1 (en) Systems and methods for modulation of pancreatic endocrine secretion and treatment of diabetes
US7778704B2 (en) Electrical stimulation of the sympathetic nerve chain
US7660628B2 (en) System to provide myocardial and neural stimulation
US20070179559A1 (en) Electrical stimulation to alleviate chronic pelvic pain
US7328068B2 (en) Method, system and device for treating disorders of the pelvic floor by means of electrical stimulation of the pudendal and associated nerves, and the optional delivery of drugs in association therewith
US7155284B1 (en) Treatment of hypertension
US7584004B2 (en) Vascularly stabilized peripheral nerve cuff assembly
US7616990B2 (en) Implantable and rechargeable neural stimulator
US20050240229A1 (en) Methods and systems for stimulation as a therapy for erectile dysfunction
US20060259077A1 (en) Cervical wagal stimulation induced weight loss
US20070162085A1 (en) Method, apparatus, surgical technique, and stimulation parameters for autonomic neuromodulation for the treatment of obesity
US7433734B2 (en) Apparatus and method for blocking activation of tissue or conduction of action potentials while other tissue is being therapeutically activated
US20090062881A1 (en) Gi and pancreatic device for treating obesity and diabetes
US20060173493A1 (en) Multi-phasic signal for stimulation by an implantable device
US20080243196A1 (en) Unidirectional neural stimulation systems, devices and methods
US20080086179A1 (en) Method and apparatus for treatment of the gastrointestinal tract
US8010198B2 (en) Systems and methods for avoiding neural stimulation habituation
US7200443B2 (en) Transcutaneous electrical nerve stimulator for appetite control
US7369894B2 (en) Method, system and device for treating disorders of the pelvic floor by electrical stimulation of the sacral and/or pudendal nerves
US20070038264A1 (en) Methods and systems for treating autism
US20090187230A1 (en) Method and apparatus for programming of autonomic neuromodulation for the treatment of obesity
US6650943B1 (en) Fully implantable neurostimulator for cavernous nerve stimulation as a therapy for erectile dysfunction and other sexual dysfunction

Legal Events

Date Code Title Description
AS Assignment

Owner name: BETA MEDICAL, INC., MINNESOTA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:KNUDSON, MARK B.;WILSON, RICHARD R.;TWEDEN, KATHERINE S.;AND OTHERS;REEL/FRAME:014576/0913

Effective date: 20030929

AS Assignment

Owner name: ENTEROMEDICS INC., MINNESOTA

Free format text: CHANGE OF NAME;ASSIGNOR:BETA MEDICAL, INC.;REEL/FRAME:014970/0774

Effective date: 20031114