CARDIAC FUNCTION MANAGEMENT INTEGRATING CARDIAC CONTRACTILITY MODULATION

• US 20100069977A1
• Filed: 09/16/2009
• Published: 03/18/2010
• Est. Priority Date: 09/16/2008
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Stahmann, Jeffrey E.
• Granted Patent: US 8,712,520 B2
• Time in Patent Office: Days
• US Class Current: 607/4
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• 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 1/3686 configured for selecting the electrode configuration on a lead A61N1/3688 takes precedence
• CPC Class Codes: A61N 1/37 Monitoring; Protecting
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/3708 for power depletion
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

An implantable cardiac rhythm/function management system integrates cardiac contractility modulation (CCM) and one or more other therapies, such as to preserve device safety, improve efficacy, enhance sensing and detection, or enhance therapy effectiveness and delivery. Examples of the one or more other therapies can include pacing, defibrillation/cardioversion, cardiac resynchronization therapy (CRT), or neurostimulation.

Claims

1. An apparatus comprising:

an implantable cardiac rhythm/function management device comprising;

a cardiac contractility modulation (CCM) therapy circuit configured to deliver a non-stimulatory electrical energy during a refractory period of the heart;

a tachyarrhythmia circuit, configured to perform a tachyarrhythmia function comprising at least one of detecting a tachyarrhythmia or delivering tachyarrhythmia therapy; and

a controller circuit, coupled to the CCM therapy circuit and the tachyarrhythmia circuit, the controller circuit configured to adjust at least one of a CCM therapy or the tachyarrhythmia function using information about the other of the CCM therapy or the tachyarrhythmia function.

2. The apparatus of claim 1, wherein the tachyarrhythmia function comprises delivering tachyarrhythmia therapy;

wherein the tachyarrhythmia circuit comprises a shock therapy circuit configured to deliver shock therapy; and

wherein the controller circuit is configured to isolate the CCM therapy circuit from shock therapy circuit during shock therapy delivery.

3. The apparatus of claim 1, wherein the tachyarrhythmia function comprises detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit;

wherein the controller circuit is configured to adjust the morphology analysis using information about whether a CCM condition is present.

4. The apparatus of claim 3, wherein a CCM condition is deemed present if (a) CCM has been delivered within a specified preceding time period or (b) CCM is enabled.

5. The apparatus of claim 3, wherein the controller circuit is configured to select a morphology template based on whether a CCM condition is present.

6. The apparatus of claim 5, wherein the controller is configured such that, when CCM is enabled, the controller circuit is configured to select a morphology template obtained with CCM having been enabled.

7. The apparatus of claim 5, wherein the controller is configured such that, when a CCM condition is present, morphology analysis is disabled.

8. The apparatus of claim 1, comprising a user interface configured to receive user-input information about at least one of the tachyarrhythmia function or the CCM therapy.

9. An apparatus comprising:

an implantable cardiac rhythm/function management device comprising;

a cardiac contractility modulation (CCM) therapy circuit configured to deliver a non-stimulatory electrical energy during a refractory period of the heart;

a tachyarrhythmia circuit, configured to perform a tachyarrhythmia function comprising at least one of detecting a tachyarrhythmia or delivering tachyarrhythmia therapy; and

a controller circuit, coupled to the CCM therapy circuit and the tachyarrhythmia circuit, the controller circuit configured to adjust at least one of a CCM therapy or the tachyarrhythmia function using information about the other of the CCM therapy or the tachyarrhythmia function;

wherein the tachyarrhythmia circuit comprises a shock therapy circuit configured to deliver shock therapy; and

wherein the controller circuit is configured to isolate the CCM therapy circuit from shock therapy circuit during shock therapy delivery; and

wherein the tachyarrhythmia circuit is configured to detect a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit;

wherein the controller circuit is configured to adjust the morphology analysis using information about whether a CCM condition is present;

wherein a CCM condition is deemed present if (a) CCM has been delivered within a specified preceding time period or (b) CCM is enabled; and

wherein the controller circuit is configured to select a morphology template based on whether a CCM condition is present.

10. A method comprising:

delivering a cardiac contractility modulation (CCM) therapy, wherein delivering the CCM therapy comprises delivering a non-stimulatory electrical energy during a refractory period of the heart;

performing a tachyarrhythmia function comprising at least one of detecting a tachyarrhythmia or delivering tachyarrhythmia therapy; and

adjusting at least one of the CCM therapy or the tachyarrhythmia function using information about the other of the CCM therapy or the tachyarrhythmia function.

11. The method of claim 10, wherein performing the tachyarrhythmia function comprises delivering tachyarrhythmia therapy;

wherein delivering tachyarrhythmia therapy comprises delivering shock therapy; and

wherein adjusting at least one of the CCM therapy or the tachyarrhythmia function comprises isolating CCM therapy delivery from shock therapy delivery.

12. The method of claim 10, wherein performing the tachyarrhythmia function comprises detecting a tachyarrhythmia using an intrinsic cardiac signal morphology analysis circuit;

and

wherein adjusting at least one of the CCM therapy or the tachyarrhythmia function comprises adjusting the morphology analysis using information about whether a CCM condition is present.

13. The method of claim 12, wherein a CCM condition is deemed present if (a) CCM has been delivered within a specified preceding time period or (b) CCM is enabled.

14. The method of claim 12, wherein adjusting the morphology analysis comprises selecting a morphology template based on whether a CCM condition is present.

15. The method of claim 14, comprising, when CCM is enabled, selecting a morphology template obtained with CCM having been enabled.

16. The method of claim 14, comprising disabling the morphology analysis when a CCM condition is present.

17. The method of claim 10, comprising providing information about at least one of the tachyarrhythmia function or the CCM therapy to a user interface configured to receive user-input information.