METHODS AND APPARATUS TO STIMULATE HEART ATRIA

• US 20110172731A1
• Filed: 01/10/2011
• Published: 07/14/2011
• Est. Priority Date: 09/25/2006
• Status: Active Grant

• Current Assignee: Backbeat Medical, LLC
• Original Assignee: G & L Consulting LLC.
• Inventors: Gelfand, Mark, Levin, Howard
• Granted Patent: US 8,515,536 B2
• Time in Patent Office: Days
• US Class Current: 607/25
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61N 1/3624 occurring in the atrium, i.e. atrial tachycardia
• 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 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer

Abstract

A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Claims

1. An implantable pacemaker assembly for pacing a heart of a patient suffering from hypertension or sodium retention, the implantable pacemaker comprising:

electrically conductive leads adapted to connect to heart tissue in the heart of the patient;

a programmable implantable pacemaker connectable or connected to the conductive leads, wherein the implantable pacemaker is programmed to;

sense electrical signals generated by the heart and conveyed to the pacemaker through one or more of the conductive leads;

based on the sensed electrical signals, determine an atrial refractory period and a ventricular refractory period of the heart;

generate electrical signals to be conveyed to the heart through one or more of the conductive leads, wherein the electrical signals artificially pace an atrium of the heart during a period between an end of the atrial refractory period and an end of the ventricular refractory period,

wherein the generated electrical signals provide excitatory stimulation to the atrium causing the atrium to contract while a heart valve associated with the atrium is closed such that the contraction distends the atrium, and the distending atrium results in a therapeutic effect of a reduction in at least one of vasoconstriction and sodium retention.

2. The pacemaker assembly in claim 1, wherein the electrical leads are connectable to multiple atria of the heart and the artificial pacing is applied to the multiple atria of the heart.

3. The pacemaker assembly of claim 1, wherein the pacemaker is programmed to generate the electrical signals for artificial pacing solely during a period between the end of the atrial period and the end of the ventricular refractory period.

4. The pacemaker assembly of claim 1 wherein the sensed electrical signals includes sensing a P wave of the heart.

5. The pacemaker assembly of claim 1 wherein the sensed electrical signals includes sensing a T wave of the heart.

6. The pacemaker assembly as in claim 1, wherein the pacemaker is programmed to generate the electrical signals for artificial pacing during an absolute refractory phase of a ventricular refectory period.

7. A pacemaker assembly comprising:

at least one electrically conductive lead adapted to connect to a heart of the patient;

a programmable implantable pacemaker connectable or connected to the conductive lead, wherein the implantable pacemaker is programmed to;

sense electrical signals generated by the heart and conveyed the signals to the pacemaker through the at least one conductive lead;

based on the sensed electrical signals, determine an atrial refractory period and a ventricular refractory period of the heart;

generate electrical signals to be conveyed to the heart through the at least one conductive lead, wherein the electrical signals artificially pace an atrium of the heart during a period between an end of the atrial refractory period and an end of the ventricular refractory period,

wherein the generated electrical signals provide excitatory stimulation to the atrium causing the atrium to contract while a heart valve associated with the atrium is closed such that the contraction distends the atrium, and the distending atrium results in a therapeutic effect of a reduction in at least one of vasoconstriction and sodium retention.

8. The pacemaker assembly in claim 7, wherein the at least one electrical lead is a plurality of leads which are connectable to multiple atria of the heart and the artificial pacing is applied to the multiple atria of the heart.

9. The pacemaker assembly of claim 7, wherein the pacemaker is programmed to generate the electrical signals for artificial pacing solely during a period between the end of the atrial period and the end of the ventricular refractory period.

10. The pacemaker assembly of claim 7 wherein the sensed electrical signals includes sensing a P wave of the heart.

11. The pacemaker assembly of claim 7 wherein the sensed electrical signals includes sensing a T wave of the heart.

12. The pacemaker assembly as in claim 7, wherein the pacemaker is programmed to generate the electrical signals for artificial pacing during an absolute refractory phase of a ventricular refectory period.