Atrial pacing therapy for treating mitral regurgitation

• US 20060173502A1
• Filed: 01/28/2005
• Published: 08/03/2006
• Est. Priority Date: 01/28/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Baynham, Tamara Colette
• Granted Patent: US 7,289,849 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method and apparatus are disclosed for treating mitral regurgitation with electrical stimulation. By providing pacing stimulation to the left atrium during ventricular systole, a beneficial effect is obtained which can prevent or reduce the extent of mitral regurgitation.

Claims

1. A method comprising:

identifying a regurgitant mitral or tricuspid valve in a patient;

implanting a cardiac rhythm management device in the patient for delivering pacing therapy to the heart through one or more pacing electrodes; and

,

delivering pacing therapy in a manner which excites an atrium during ventricular systole, referred to as secondary atrial pacing.

2. The method of claim 1 further comprising delivering the secondary atrial pacing with timing based upon atrial events such that a secondary atrial pace is delivered at a secondary atrio-atrio interval subsequent to an atrial event.

3. The method of claim 2 further comprising delivering primary atrial pacing therapy which paces an atrium with a primary pace to begin a cardiac cycle and wherein the secondary atrio-atrio interval is initiated by an atrial sense or primary pace.

4. The method of claim 2 further comprising varying the secondary atrio-atrio interval as a function of heart rate.

5. The method of claim 4 further comprising limiting the secondary atrio-atrio interval to a specified minimum value.

6. The method of claim 1 further comprising pacing delivering the secondary atrial pacing with timing based upon ventricular events such that a secondary atrial pace is delivered at a secondary ventricular-atrio interval subsequent to a ventricular event.

7. The method of claim 6 further comprising delivering ventricular pacing therapy and wherein the secondary ventricular-atrio interval is initiated by a ventricular sense or pace.

8. The method of claim 7 wherein the ventricular pacing therapy is delivered as biventricular pacing.

9. The method of claim 7 further comprising delivering left ventricular pacing therapy based upon right ventricular senses, and wherein a secondary ventricular-atrio interval of one specified duration is initiated by a left ventricular pace while a secondary ventricular-atrio interval of another duration is triggered by a right ventricular sense.

10. The method of claim 1 wherein the secondary atrial pacing is delivered at multiple atrial pacing sites.

15. The device of claim 4 wherein the controller is programmed to limit the secondary atrio-atrio interval to a specified minimum value.

11. An implantable cardiac device, comprising:

pulse generating circuitry coupled to one or more electrodes and configured to deliver pacing pulses to a cardiac chamber;

sensing circuitry coupled to one or more electrodes and configured to detect electrical activity from a cardiac chamber;

a controller coupled to the pulse generating and sensing circuitry and configured to control the delivery of pacing pulses; and

,

wherein the controller is programmed to delivering pacing therapy in a manner which excites an atrium during ventricular systole, referred to as secondary atrial pacing.

12. The device of claim 11 wherein the controller is programmed to deliver the secondary atrial pacing with timing based upon atrial events such that a secondary atrial pace is delivered at a secondary atrio-atrio interval subsequent to an atrial event.

13. The device of claim 12 wherein the controller is programmed to deliver primary atrial pacing therapy which paces an atrium with a primary pace to begin a cardiac cycle and wherein the secondary atrio-atrio interval is initiated by an atrial sense or primary pace.

14. The device of claim 12 wherein the controller is programmed to vary the secondary atrio-atrio interval as a function of heart rate.

16. The device of claim 11 wherein the controller is programmed to deliver the secondary atrial pacing with timing based upon ventricular events such that a secondary atrial pace is delivered at a secondary ventricular-atrio interval subsequent to a ventricular event.

17. The device of claim 16 wherein the controller is programmed to deliver ventricular pacing therapy and wherein the secondary ventricular-atrio interval is initiated by a ventricular sense or pace.

18. The device of claim 17 wherein the ventricular pacing therapy is delivered as biventricular pacing.

19. The device of claim 17 wherein the controller is programmed to deliver left ventricular pacing therapy based upon right ventricular senses, and wherein a secondary ventricular-atrio interval of one specified duration is initiated by a left ventricular pace while a secondary ventricular-atrio interval of another duration is triggered by a right ventricular sense.

20. The device of claim 11 wherein the controller is programmed to deliver the secondary atrial pacing at multiple atrial pacing sites.