Combined neural stimulation and cardiac resynchronization therapy
First Claim
1. An implantable device for delivering cardiac therapy to a patient, comprising:
- a plurality of leads, including at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity; and
a controller to control delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and to control delivery of the neural stimulation, the controller being programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further being programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT.
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Accused Products
Abstract
Methods and devices for delivering cardiac therapy to a patient are provided. Various implantable device embodiments comprise a plurality of leads and a controller. The leads include at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity. The controller controls delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and controls delivery of the neural stimulation. The controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further is programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. Other embodiments are provided herein.
207 Citations
42 Claims
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1. An implantable device for delivering cardiac therapy to a patient, comprising:
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a plurality of leads, including at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity; and
a controller to control delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and to control delivery of the neural stimulation, the controller being programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further being programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. An implantable device for delivering cardiac therapy to a patient, comprising:
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a number of leads, each with at least one electrode, to provide one or more pacing channels to deliver ventricular pacing pulses to one or more ventricular sites, and a sympathetic inhibition channel to stimulate nerves to inhibit sympathetic nerve activity, the number of leads including at least one intravascularly-fed lead to transvascularly stimulate the nerves to inhibit sympathetic nerve activity and to deliver ventricular pacing pulses;
a controller for controlling the delivery of pacing pulses to one or more ventricular sites during a cardiac cycle in accordance with a programmed pacing mode;
wherein the controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium to mechanically unload that region during systole, and to deliver anti-remodeling therapy (ART) in conjunction with RCT by inhibiting sympathetic nerve activity via the sympathetic inhibition channel. - View Dependent Claims (24, 25, 26, 27, 28, 29)
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30. An implantable device for delivering cardiac therapy to a patient, comprising:
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a number of leads, each with at least one electrode, to provide one or more pacing channels to deliver ventricular pacing pulses to one or more ventricular sites, and a sympathetic inhibition channel to stimulate nerves to inhibit sympathetic nerve activity, the number of leads including at least one lead to epicardially stimulate the nerves to inhibit sympathetic nerve activity and to epicardially deliver ventricular pacing pulses;
a controller for controlling the delivery of pacing pulses to one or more ventricular sites during a cardiac cycle in accordance with a programmed pacing mode;
wherein the controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium to mechanically unload that region during systole, and to deliver anti-remodeling therapy (ART) in conjunction with RCT by inhibiting sympathetic nerve activity via the sympathetic inhibition channel. - View Dependent Claims (31, 32, 33, 34)
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35. A method for delivering cardiac therapy to a patient, comprising:
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routing a plurality of leads adapted to provide cardiac pacing as part of a cardiac resynchronization therapy (CRT) and to provide neural stimulation, including routing at least one of the leads through a lead path;
delivering CRT, including delivering cardiac pacing signals using the lead path to pace cardiac tissue; and
delivering neural stimulation signals using the lead path to inhibit sympathetic nerve activity. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42)
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Specification