Abstract: Neuromodulation is used to enhance left ventricular relaxation. An exemplary neuromodulation system includes a therapy element positionable in proximity to at least one nerve fiber, and a stimulator configured to energize the therapy element to delivery therapy to the at least one nerve fiber such that left ventricular relaxation and left ventricular contractility are contemporaneously enhanced.

Abstract: A method for positioning an electrode array of a neuromodulation catheter at a target circumferential position along a posterior wall of a superior vena cava includes advancing the catheter to a target longitudinal position within the superior vena cava, and orienting a marker on the extracorporeal portion of the catheter in a circumferential orientation known to position the array at the target circumferential position along the posterior wall. A method of positioning the array at a target longitudinal position includes advancing the catheter into the superior vena cava and using features of the catheter to detect the location of right atrial tissue, such as by sensing for a P-wave using an electrogram captured using an electrode carried at a distal end of the catheter, or by using such electrodes to capture the atrium using atrial pacing pulses. Once the location of the right atria is determined, the electrode array may be deployed in a position known to be proximal to the atrium.

Abstract: Electrode systems for transvascular stimulation of target nerves include electrode arrays, elements promoting blood flow between electrode surfaces and surrounding vascular walls, electrodes shaped to promote more even current density than electrodes having angular edges, features for retaining the electrode systems with blood vessels, and features for using electrode-carrying elements to asymmetrically distend blood vessel walls towards target nerve structures.

Abstract: A neuromodulation catheter is positionable in a blood vessel having a wall for use in delivering therapeutic energy to targets external to the blood vessel. An electrically insulative substrate such as an elongate finger is carried at a distal end of the catheter body. The substrate has a first face carrying a plurality of electrodes, and a second face on an opposite side of the substrate from the first face. The finger is biased such that when expanded within the blood vessel, it forms a spiral configuration with the first face facing outwardly to bias the electrodes in contact with the blood vessel wall.

Abstract: A method for positioning an electrode array of a neuromodulation catheter at a target circumferential position along a posterior wall of a blood vessel. The method includes advancing the catheter to a target longitudinal position within the blood vessel and positioning the array within the blood vessel so as to minimize interference by CRM leads or coils in the blood vessel during therapeutic delivery of energy using the array.

Abstract: Neuromodulation is used to enhance left ventricular relaxation. An exemplary neuromodulation system includes a therapy element positionable in proximity to at least one nerve fiber, and a stimulator configured to energize the therapy element to delivery therapy to the at least one nerve fiber such that left ventricular relaxation and left ventricular contractility are contemporaneously enhanced.

Abstract: Neuromodulation is used to enhance left ventricular relaxation. An exemplary neuromodulation system includes a therapy element positionable in proximity to at least one nerve fiber, and a stimulator configured to energize the therapy element to delivery therapy to the at least one nerve fiber such that left ventricular relaxation and left ventricular contractility are contemporaneously enhanced.

Abstract: Neuromodulation is used to enhance left ventricular relaxation. An exemplary neuromodulation system includes a therapy element positionable in proximity to at least one nerve fiber, and a stimulator configured to energize the therapy element to delivery therapy to the at least one nerve fiber such that left ventricular relaxation and left ventricular contractility are contemporaneously enhanced.

Abstract: Electrode systems for transvascular stimulation of target nerves include electrode arrays, elements promoting blood flow between electrode surfaces and surrounding vascular walls, electrodes shaped to promote more even current density than electrodes having angular edges, features for retaining the electrode systems with blood vessels, and features for using electrode-carrying elements to asymmetrically distend blood vessel walls towards target nerve structures.

Abstract: A neuromodulation system includes a first therapy element adapted for positioning within a superior vena cava, and a second therapy element adapted for positioning within a pulmonary artery. The first therapy element is carried on a first elongate flexible shaft, and the second therapy element is carried on a second elongate flexible shaft. One of the first and second shafts is slidably received within a lumen of the other of the first and second shafts—so that the second therapy element may be advanced within the body relative to the first therapy element. A stimulator is configured to energize the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the superior vena cava and to energize the second therapy element within the pulmonary artery to deliver sympathetic therapy to a second nerve fiber disposed external to the pulmonary artery.

Abstract: A method for positioning an electrode array of a neuromodulation catheter at a target circumferential position along a posterior wall of a superior vena cava includes advancing the catheter to a target longitudinal position within the superior vena cava, and orienting a marker on the extracorporeal portion of the catheter in a circumferential orientation known to position the array at the target circumferential position along the posterior wall. A method of positioning the array at a target longitudinal position includes advancing the catheter into the superior vena cava and using features of the catheter to detect the location of right atrial tissue, such as by sensing for a P-wave using an electrogram captured using an electrode carried at a distal end of the catheter, or by using such electrodes to capture the atrium using atrial pacing pulses. Once the location of the right atria is determined, the electrode array may be deployed in a position known to be proximal to the atrium.

Abstract: A neuromodulation system includes a first therapy element adapted for positioning within a superior vena cava, and a second therapy element adapted for positioning within a pulmonary artery. The first therapy element is carried on a first elongate flexible shaft, and the second therapy element is carried on a second elongate flexible shaft. One of the first and second shafts is slidably received within a lumen of the other of the first and second shafts—so that the second therapy element may be advanced within the body relative to the first therapy element. A stimulator is configured to energize the first therapy element within the first blood vessel to deliver therapy to a first nerve fiber disposed external to the superior vena cava and to energize the second therapy element within the pulmonary artery to deliver sympathetic therapy to a second nerve fiber disposed external to the pulmonary artery.

Abstract: A method for positioning an electrode array of a neuromodulation catheter at a target circumferential position along a posterior wall of a superior vena cava includes advancing the catheter to a target longitudinal position within the superior vena cava, and orienting a marker on the extracorporeal portion of the catheter in a circumferential orientation known to position the array at the target circumferential position along the posterior wall. A method of positioning the array at a target longitudinal position includes advancing the catheter into the superior vena cava and using features of the catheter to detect the location of right atrial tissue, such as by sensing for a P-wave using an electrogram captured using an electrode carried at a distal end of the catheter, or by using such electrodes to capture the atrium using atrial pacing pulses. Once the location of the right atria is determined, the electrode array may be deployed in a position known to be proximal to the atrium.

Abstract: A catheter system configured for delivering a neuromodulation therapy, includes a first therapeutic element positionable in a first target vessel selected from the group of blood vessels consisting of the superior vena cava, left brachiocephalic vein, right brachiocephalic vein, azygos vein or azygos arch, and a second therapeutic element in a second target vessel selected from the group of blood vessels consisting of the superior vena cava, left brachiocephalic vein, right brachiocephalic vein, internal jugular vein, azygos vein or azygos arch. The system and associated method deliver therapeutic energy to at least one parasympathetic nerve fiber external to the first target vessel using the first therapeutic element, and deliver therapeutic energy to at least one sympathetic nerve fiber external to the second target vessel using the second therapeutic element.

Abstract: A catheter system configured for delivering a neuromodulation therapy, includes a first therapeutic element positionable in a first target vessel selected from the group of blood vessels consisting of the superior vena cava, left brachiocephalic vein, right brachiocephalic vein, azygos vein or azygos arch, and a second therapeutic element in a second target vessel selected from the group of blood vessels consisting of the superior vena cava, left brachiocephalic vein, right brachiocephalic vein, azygos vein or azygos arch. The system and associated method deliver therapeutic energy to at least one parasympathetic nerve fiber external to the first target vessel using the first therapeutic element, and deliver therapeutic energy to at least one sympathetic nerve fiber external to the second target vessel using the second therapeutic element.

Abstract: A method of treating a patient having a blood pressure comprises delivering neuromodulation therapy to sustain or increase the blood pressure. The neuromodulation therapy includes placing a sympathetic therapy electrode in a posterior portion of a blood vessel and stimulating at least one extravascular cardiac sympathetic nerve fiber using said electrode.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element to deliver therapy to a sympathetic cardiac nerve fiber. At least one of the therapeutic elements is disposed in the vasculature superior to the heart. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed in a superior vena cava of the patient to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element disposed within the superior vena cava to deliver therapy to a sympathetic cardiac nerve fiber. A neuromodulation system includes a parasympathetic therapy element adapted for positioning within a blood vessel, a sympathetic therapy element adapted for positioning within the blood vessel; and a stimulator to energize the parasympathetic therapy element to deliver parasympathetic therapy to a parasympathetic nerve fiber disposed external to the blood vessel and energize the sympathetic therapy element within the blood vessel to deliver sympathetic therapy to a sympathetic nerve fiber disposed external to the blood vessel. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: A method of treating autonomic imbalance in a patient includes energizing a first therapeutic element disposed to deliver therapy to a parasympathetic nerve fiber (e.g. vagus nerve), and energizing a second therapeutic element to deliver therapy to a sympathetic cardiac nerve fiber. At least one of the therapeutic elements is disposed in the vasculature superior to the heart. The therapy decreases the patient's heart rate and elevates or maintains the blood pressure of the patient.

Abstract: A neuromodulation catheter positionable within a blood vessel for transvascular nerve stimulation includes a catheter body and an electrically insulative substrate carried at a distal end of the catheter body. A distal end of the substrate includes a plurality of laterally spaced-apart fingers. The substrate includes a first face and a second face on an opposite side of the substrate from the first face. A plurality of electrodes are disposed on the first face of the substrate such that each of the fingers has a plurality of the electrodes longitudinally spaced thereon. A support at the distal end of the catheter is expandable within the blood vessel to bias the first faces of the fingers against the wall of a blood vessel so as to bias at least a portion of the electrodes in contact with the wall.