COMBINED REMODELING CONTROL THERAPY AND ANTI-REMODELING THERAPY BY IMPLANTABLE CARDIAC DEVICE
First Claim
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1. An implantable device for delivering cardiac therapy to a patient, comprising:
- one or more pulse generators for incorporating into one or more pacing channels for delivering pacing pulses and for incorporating into a parasympathetic stimulation channel for delivering neural stimulation pulse in order to stimulate parasympathetic nerve activity;
a sensor for measuring blood pressure;
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 controllably delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium so as to mechanically unload that region during systole;
wherein the controller is further programmed to deliver anti-remodeling therapy (ART) by controlling stimulation of parasympathetic nerve activity via the parasympathetic stimulation channel;
wherein the controller is programmed to perform an assessment of cardiac function and to modulate the delivery of RCT and ART in accordance with the assessment of cardiac function, wherein the assessment of cardiac function includes the measurement of blood pressure; and
,wherein ART is modulated in response to the assessment of cardiac function by varying the amplitude of the neural stimulation pulses.
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Abstract
A method and device for delivering ventricular resynchronization pacing therapy in conjunction with electrical stimulation of nerves which alter the activity of the autonomic nervous system is disclosed. Such therapies may be delivered by an implantable device and are useful in preventing the deleterious ventricular remodeling which occurs as a result of a heart attack or heart failure. The device may perform an assessment of cardiac function in order to individually modulate the delivery of the two types of therapy.
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Citations
20 Claims
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1. An implantable device for delivering cardiac therapy to a patient, comprising:
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one or more pulse generators for incorporating into one or more pacing channels for delivering pacing pulses and for incorporating into a parasympathetic stimulation channel for delivering neural stimulation pulse in order to stimulate parasympathetic nerve activity; a sensor for measuring blood pressure; 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 controllably delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium so as to mechanically unload that region during systole; wherein the controller is further programmed to deliver anti-remodeling therapy (ART) by controlling stimulation of parasympathetic nerve activity via the parasympathetic stimulation channel; wherein the controller is programmed to perform an assessment of cardiac function and to modulate the delivery of RCT and ART in accordance with the assessment of cardiac function, wherein the assessment of cardiac function includes the measurement of blood pressure; and
,wherein ART is modulated in response to the assessment of cardiac function by varying the amplitude of the neural stimulation pulses. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method for operating a cardiac device to deliver cardiac therapy to a patient, comprising:
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delivering remodeling control therapy (RCT) by controllably delivering ventricular pacing through one or more pacing channels in accordance with a programmed mode in a manner which pre-excites a region of the ventricular myocardium so as to mechanically unload that region during systole; delivering anti-remodeling therapy (ART) by controlling stimulation of parasympathetic nerve activity via a parasympathetic stimulation channel; measuring blood pressure; and
,performing an assessment of cardiac function and modulating the delivery RCT and ART in accordance with the assessment of cardiac function, wherein the assessment of cardiac function includes the measured blood pressure and wherein ART is modulated by varying an amplitude of the parasympathetic nerve stimulation. - View Dependent Claims (16, 17, 18, 19, 20)
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Specification