Electrical Muscle Controller

• US 20080058879A1
• Filed: 10/31/2007
• Published: 03/06/2008
• Est. Priority Date: 01/08/1996
• Status: Active Grant

• Current Assignee: Impulse Dynamics NV
• Original Assignee: Impulse Dynamics NV
• Inventors: Yuval, Mike, Ben-Haim, Shlomo, Darvish, Nissim, Fenster, Maier
• Granted Patent: US 8,306,617 B2
• Time in Patent Office: Days
• US Class Current: 607/5
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6859 with multiple distal splines
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/326 : for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36146 : specified by the stimulation parameters
• CPC Class Codes: A61N 1/3621 : for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3627 : for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/365 : controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• 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 1/36557 : controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure
• CPC Class Codes: A61N 1/368 : comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Claims

1. A method of treating abnormal activation of the heart, the method comprising:

detecting fibrillation in a heart or a portion thereof, and

applying to said heart or a portion thereof a non-excitatory electric field of a magnitude, shape, duty cycle, phase, frequency and duration suitable to stop the fibrillation wherein said field is applied at a time at which it is unable to generate a propagating action potential responsive to the detection.

2. A method according to claim 1, wherein applying a non-excitatory electric field comprises applying an alternating current electric field.

3. A method according to claim 1, wherein applying non-excitatory electric field comprises applying an electric field that has a temporal envelope selected from the group consisting of an exponential temporal envelope, a sinusoidal temporal envelope, a square temporal envelope, a triangular temporal envelope, a ramped temporal envelope, a sawtooth temporal envelope and a biphasic temporal envelope.

4. A method according to claim 1, comprising sensing an activation of a portion of the heart at a suitable location, and thereafter calculating or estimating therefrom the activation time of the portion of the heart activity of which it is desired to modify.

5. A method according to claim 4, further comprising determining the delay at which the non-excitatory electric field is to be applied from said activation time.

6. A method according to claim 1, wherein the electric field is applied at one or more of the positions selected from among the group consisting essentially of internally or externally to the heart, within a blood vessel, intramuscularly, along the normal conduction direction or perpendicularly thereto.

7. A method according to claim 1 wherein the electric field is applied using electrodes selected from unipolar electrodes and bipolar electrodes.

8. Heart control apparatus, the apparatus comprising:

circuitry for generating a non-excitatory electric field adapted to stop fibrillation;

a sensor configured to detect fibrillation;

a controller adapted to operate the circuitry in response to the detected fibrillation; and

elongate electrodes for applying said non-excitatory electric field, wherein said field generates is characterize by a timing relative to the activation of the heart or of a portion thereof, and of a magnitude, shape, duty, cycle, phase, frequency, and duration which is unable to generate a propagating action potential.

9. Apparatus according to claim 8, wherein the elongate electrodes are characterized by a length of at least 1 cm.

10. Apparatus according to claim 9, wherein the electrodes are characterized by a length of at least 2 cm.

11. Apparatus according to claim 10, wherein the electrodes are characterized by a length of at least 4 cm.

12. Apparatus according to claim 8, wherein the circuitry includes an AC non-excitatory electric field generator.

13. Apparatus according to claim 8, wherein the circuitry is adapted to impart to the non-excitatory electric field a temporal envelope selected from exponential temporal envelope, sinusoidal temporal envelope, square temporal envelope, triangular temporal envelope, ramped temporal envelope, sawtooth temporal envelope, and biphasic temporal envelope.

14. Apparatus according to claim 8, further comprising circuitry for modifying a conduction velocity in a non-arrhythmic segment of a heart portion.

15. Apparatus according to claim 8, wherein the electrodes are suitable to be positioned externally to the body.

16. Apparatus according to claim 8, said apparatus adapted for controlling an additional parameter selected from the force of contraction, heart rate, stroke volume, chamber or aortic pressure, or output flow.

17. Apparatus according to claim 8, wherein the electrodes comprise at least one unipolar electrode and a housing which functions as a second electrode.

18. Apparatus according to claim 8, comprising at least two electrodes, suitable to apply said non-excitatory electric field across at least one predetermined portion of the heart.

19. Apparatus according to claim 8, comprising at least three electrodes, wherein each pair of said at least three electrodes is selectively and separately electrifiable.