System and method for achieving regular slow ventricular rhythm in response to atrial fibrillation

• US 20070083242A1
• Filed: 10/06/2005
• Published: 04/12/2007
• Est. Priority Date: 10/06/2005
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Zhang, Youhua, Mazgalev, Todor
• Granted Patent: US 7,860,566 B2
• Time in Patent Office: Days
• US Class Current: 607/9
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions

Abstract

A system (10) for achieving a desired cardiac rate and cardiac rhythm in response to atrial fibrillation in a heart includes an atrial fibrillation (AF) detector (40) for detecting AF. The system also includes an atrioventricular node vagal stimulator (AVN-VS) (30) for stimulating vagal nerves associated with an atrioventricular (AV) node of the heart. The system further includes an on-demand pace maker (40) for providing ventricular pacing stimulation to the heart. A control unit (20) is operatively connected with the AF detection device, the AVN-VS device, and the on-demand pacing device. The control unit is responsive to AF detection by the AF detector to cause the AVN-VS to stimulate the vagal nerves to help reduce the ventricular rate of the heart. The control unit is further responsive to AF detection by the AF detector to cause the on-demand pace maker to help regulate the ventricular rate of the heart.

Claims

1. A system for achieving a desired cardiac rate and cardiac rhythm in response to atrial fibrillation in a heart, the system comprising:

atrial fibrillation (AF) detecting means for detecting AF;

atrioventricular node vagal stimulation (AVN-VS) means for stimulating vagal nerves associated with an atrioventricular (AV) node of the heart;

on-demand pacing means for providing ventricular pacing stimulation to the heart; and

control means operatively connected with the AF detecting means, the AVN-VS means, and the on-demand pacing means;

the control means being responsive to AF detection by the AF detecting means to cause the AVN-VS means to stimulate the vagal nerves to help reduce the ventricular rate of the heart;

the control means being further responsive to AF detection by the AF detecting means to cause the on-demand pacing means to help regulate the ventricular rate of the heart.

2. The system recited in claim 1, wherein the AVN-VS means comprises one or more AVN-VS electrodes, the control means being operative to provide stimulation signals to the AVN-VS electrodes in response to the detection of AF.

3. The system recited in claim 1, wherein the AVN-VS means is operative to stimulate an AV nodal fat pad to reduce the ventricular rate.

4. The system recited in claim 1, wherein the AVN-VS means is operative to stimulate a vagus nerve to reduce the ventricular rate.

5. The system recited in claim 4, wherein the vagus nerve comprises a left vagus nerve.

6. The system recited in claim 4, wherein the vagus nerve comprises a cervical vagus nerve.

7. The system recited in claim 1, wherein the AVN-VS means is operative to stimulate endocardial tissue to reduce the ventricular rate.

8. The system recited in claim 7, wherein the endocardial tissue comprises at least one of an AV node, superior vena cava, coronary sinus, and right pulmonary artery of the heart.

9. The system recited in claim 1, wherein the on-demand pacing means comprises a VVI pacing electrode.

10. The system recited in claim 1, wherein the control means implements a closed loop control algorithm operative to adjust the intensity of energy applied by the AVN-VS means to control the ventricular rate of the heart to a desired rate.

11. A system for achieving a desired cardiac rate and cardiac rhythm in response to atrial fibrillation in a heart, the system comprising:

an atrial fibrillation (AF) detector for detecting atrial fibrillation in the heart;

an atrioventricular node vagal stimulation (AVN-VS) electrode for stimulating vagal nerves associated with an atrioventricular (AV) node of the heart;

an on-demand pacing electrode for providing ventricular pacing stimulation to the heart; and

a control unit operatively connected with the AF detector, the AVN-VS electrode, and the on-demand pacing electrode;

the control unit being operative to determine an AF episode via the AF detector;

the control unit being operative to provide an electrical signal to the AVN-VS electrode to stimulate the vagal nerves to help reduce the ventricular rate of the heart in response to determining an AF episode;

the control means being further operative to provide an electrical signal to the on-demand pacing electrode to stimulate the heart to help regulate the ventricular rate of the heart in response to determining an AF episode.

12. The system recited in claim 11, wherein the AF detector comprises at least a portion of the on-demand pacing electrode.

13. A method for achieving a desired cardiac rate and cardiac rhythm in response to atrial fibrillation in a heart, the method comprising the steps of:

stimulating vagal nerves associated with an atrioventricular (AV) node of the heart to reduce the cardiac rate; and

applying ventricular pacing stimulation to regulate the ventricular rhythm of the heart.

14. The method recited in claim 13, wherein the step of applying ventricular pacing is performed once the cardiac rate is reduced by stimulating the vagal nerves.

15. The method recited in claim 13, wherein the step of stimulating vagal nerves comprises the step of applying electrical stimulation to the vagal nerves via an atrioventricular node vagal stimulation (AVN-VS) electrode.

16. The method recited in claim 13, wherein the step of stimulating vagal nerves comprises the step of stimulating an AV nodal fat pad to reduce the ventricular rate.

17. The method recited in claim 13, wherein the step of stimulating vagal nerves comprises the step of stimulating a vagus nerve to reduce the ventricular rate.

18. The method recited in claim 17, wherein the step of stimulating a vagus nerve comprises the step of stimulating a left vagus nerve.

19. The method recited in claim 18, wherein the step of stimulating a vagus nerve comprises the step of stimulating a left vagus nerve.

20. The method recited in claim 18, wherein the step of stimulating a vagus nerve comprises the step of stimulating a cervical vagus nerve.

21. The method recited in claim 13, wherein the step of stimulating vagal nerves comprises the step of stimulating endocardial tissue.

22. The method recited in claim 13, wherein the step of stimulating vagal nerves comprises the step of stimulating at least one of an AV node, superior vena cava, coronary sinus, and right pulmonary artery of the heart.