Methods and systems for lowering blood pressure through reduction of ventricle filling

• US 10,441,794 B2
• Filed: 09/07/2018
• Issued: 10/15/2019
• Est. Priority Date: 12/21/2012
• Status: Active Grant

• Current Assignee: Backbeat Medical, LLC
• Original Assignee: Backbeat Medical, Inc.
• Inventors: Mika, Yuval, Sherman, Darren, Schwartz, Robert S., Van Tassel, Robert A., Burkhoff, Daniel
• Primary Examiner(s): Morales, Jon Eric C
• Application Number:
  US16/124,283
• Publication Number:
  US 20190001141A1
• Time in Patent Office: 403 Days
• Field of Search: 607 9, 607 17, 607 23
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2424 Ball valves
• CPC Class Codes: A61F 2250/0013 for adjusting fluid pressure
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36528 the parameter being measured by means of ultrasound
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient'"'"'s heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient'"'"'s heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Claims

1. A system for reducing blood pressure comprising:

at least one stimulation electrode for stimulating at least one chamber of a heart of a patient; and

at least one controller that executes a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart,

wherein the at least one stimulation setting causes an atrium of the heart to be at maximum contraction when an atrioventricular valve of the heart is open.

2. The system of claim 1, wherein the at least one stimulation setting prevents at least one atrial contraction of the heart.

3. The system of claim 1, wherein the at least one stimulation setting comprises a first stimulation setting and a second stimulation setting, and

wherein the first stimulation setting has an atrioventricular delay different from an atrioventricular delay of the second stimulation setting.

4. The system of claim 1, wherein the at least one controller receives input relating to the patient'"'"'s atrioventricular valve status, and adjusts the stimulation pattern based on the atrioventricular valve status.

5. The system of claim 4, further comprising a heart sound sensor that provides the input relating to the patient'"'"'s atrioventricular valve status.

6. The system of claim 4, further comprising a blood flow sensor that provides the input relating to the patient'"'"'s atrioventricular valve status.

7. The system of claim 4, wherein the at least one controller adjusts the stimulation pattern by adjusting an atrioventricular delay of at least one stimulation pulse.

8. The system of claim 1, wherein the at least one controller receives input relating to a first maximum post-treatment blood pressure of the patient, and when the first maximum post-treatment blood pressure is greater than a pretreatment blood pressure of the patient, adjusts the stimulation pattern to provide a second maximum post-treatment blood pressure that is less than the first maximum post-treatment blood pressure.

9. The system of claim 8, wherein the at least one controller adjusts the stimulation pattern by adjusting one or more of atrioventricular delay, a number of stimulation pulses, or a time of stimulation pulses.

10. The system of claim 8, wherein the at least one controller adjusts the stimulation pattern by:

calculating a time constant of change in blood pressure; and

adjusting the stimulation pattern to have one or more blood pressure reducing stimulation parameters for an amount of time or number of heartbeats that are set as a certain percentage of the calculated time constant and that are configured to prevent blood pressure of the patient from increasing beyond a given value.

11. A system for reducing blood pressure comprising:

at least one stimulation electrode for stimulating at least one chamber of a heart of a patient; and

at least one controller that executes a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart,

wherein the at least one stimulation setting provides maximum atrial stretch that is at a value about equal to or lower than maximum atrial stretch of the heart when not receiving stimulation.

12. The system of claim 11, wherein the at least one stimulation setting alters mechanics of at least one atrial contraction of the heart such that the mechanics of the at least one atrial contraction are different from mechanics of a previous natural atrial contraction of the heart.

13. The system of claim 11, wherein the at least one stimulation setting reduces a force of at least one atrial contraction of the heart.

14. The system of claim 11, wherein the at least one controller receives input relating to the patient'"'"'s atrioventricular valve status, and adjusts the stimulation pattern based on the atrioventricular valve status.

15. The system of claim 14, further comprising a heart sound sensor that provides the input relating to the patient'"'"'s atrioventricular valve status.

16. The system of claim 14, further comprising a blood flow sensor that provides the input relating to the patient'"'"'s atrioventricular valve status.

17. The system of claim 14, wherein the at least one controller adjusts the stimulation pattern by adjusting an atrioventricular delay of at least one stimulation pulse.

18. A method for reducing blood pressure comprising:

stimulating, through at least one stimulation electrode, at least one chamber of a heart of a patient;

controlling the stimulating of the at least one chamber of the heart using at least one controller,

executing, using the at least one controller, a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart; and

causing, with the at least one stimulation setting, an atrium of the heart to be at maximum contraction when an atrioventricular valve of the heart is open.

19. The method of claim 18, further comprising preventing, with the at least one stimulation setting, at least one atrial contraction of the heart.

20. The method of claim 18, further comprising:

receiving input relating to the patient'"'"'s atrioventricular valve status; and

adjusting the stimulation pattern based on the atrioventricular valve status.