Implantable Digital Device For Tissue Stimulation

10264 words - 41 pages

1. An implantable digital stimulation system for atrial fibrillation treatment by electrical stimulation of a vagal nerve in a patient, the implantable digital stimulation system comprising: a plurality of electrodes at one or more intravascular locations in proximity to a vagal nerve inside the patient; and an implantable stimulator comprising: (a) a control unit for controlling the electrical stimulation by programmable selection of at least some of the plurality of electrodes and by programmable selection of one of a plurality of stimulation waveforms, and (b) a stimulation signal generator connected to the control unit and producing stimulation signals that have segmented waveforms that are programmably selectable by the control unit; (c) an implantable sensing unit with internal reference to monitor a heart rate of the patient during the stimulation treatment.2. The implantable digital stimulation system as recited in claim 1 wherein at least one of the plurality of electrodes is in close proximity to a site being stimulated and at least another one of the plurality of electrode is remote from the site being simulated.3. The implantable digital stimulation system as recited in claim 1 further comprising a low impedance power generator with an internal reference.4. The implantable digital stimulation system as recited in claim 3 wherein a distal electrode is related to a container of the power generator.5. The implantable digital stimulation system as recited in claim 3 wherein a distal electrode is mounted on a container of the power generator.6. The implantable digital stimulation system as recited in claim 1 wherein at least one of the plurality of electrodes is located at a distal coronary sinus, proximal coronary sinus, jugular vein, superior vena cava and inferior vena cava.7. The implantable digital stimulation system as recited in claim 6 wherein during the stimulation treatment the implantable stimulator operates to: pace the heart of the patient at a rate lower than the vagal stimulation rate, but faster than an intrinsic heart rate; sense electrograms from one or more intravascular locations before and during producing stimulation signals; compares morphology of the electrograms from the one or more intravascular locations before and during pacing the heart; determining in response to morphology changes of the electrograms before and during pacing the heart, whether producing stimulation signals is stimulating a ventricle; and continuing or stopping the stimulation treatment based on the morphology.8. The implantable digital stimulation system as recited in claim 6 wherein the stimulation treatment comprises a high voltage vagal stimulation from the at least one intravascular location of the patient to slow ventricular rate to permit cardiac resynchronization therapy and prolong atrial-ventricular interval to allow greater filling time.9. The vas recited in claim 6 wherein the stimulation treatment comprises a high voltage vagal...

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