Multi-electrode apparatus and method for treatment of congestive heart failure
First Claim
1. A method for treating congestive heart failure comprising implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a subset of said electrodes for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and stimulating the heart through said set of electrodes.
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Abstract
An apparatus and method for treatment of congestive heart failure from the right side of the heart. An implantable cardiac stimulation system with a multi-electrode lead having three or more selectable electrodes, together with apparatus for identifying an optimal subset of electrodes, apparatus for shaping a propagating wave front, and apparatus for modifying the intrinsic ventricular cardiac activation sequence, or generating simultaneous or near simultaneous pacing pulses to the septum or right ventricular outflow tract during ventricular systole in order to improve left ventricular cardiac efficiency and reduce mitral regurgitation in patients with dilated cardiomyopathy. A three dimensional map of electrode placement may be calculated. A sub set of the available electrodes in the right side of the heart is selected for stimulation such that septal motion during systole is reduced or the mitral valve area is stiffened to reduce mitral regurgitation.
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Citations
69 Claims
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1. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a subset of said electrodes for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and stimulating the heart through said set of electrodes.
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27. An apparatus for treating congestive heart failure comprising
a multi-electrode lead, said multi-electrode lead having at least three selectable electrodes, a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, means for selecting a subset of said electrodes for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and means for stimulating the heart through said subset of electrodes.
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52. An implantable cardiac stimulator for treating congestive heart failure comprising
an implantable lead having at least three electrodes, a cardiac stimulator connectable to said lead to place said electrodes in electrical communication with said stimulator; -
at least one detector coupled to said electrodes for detecting electrical phenomenon in the patient'"'"'s body;
a timer connected to said detector for timing at least one elapsed time between electrical phenomena detected at said electrodes;
at least one logical template of an expected pattern of detected electrical phenomenon at said electrodes, a comparator comparing said detected electrical phenomenon and said elapsed times associated with said phenomenon to said logical template, and an output circuit providing a therapy to said patient in response to said comparison. - View Dependent Claims (53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 66, 67, 68, 69)
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Specification