METHOD AND APPARATUS FOR INTRACHAMBER RESYNCHRONIZATION

• US 20180133485A1
• Filed: 01/12/2018
• Published: 05/17/2018
• Est. Priority Date: 09/08/2003
• Status: Active Grant

• Current Assignee: Mirowski Family Ventures LLC
• Original Assignee: Mirowski Family Ventures LLC
• Inventors: MOWER, Morton M.
• Granted Patent: US 11,207,524 B2
• Time in Patent Office: Days
• 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 1/36592 controlled by the heart rate variability
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods, apparatus, and systems are provided to control contraction of the heart. At least one sensing element receives signals indicating electrical activity of sinus rhythm of the heart. Based on the received signals, the progress of contraction of the heart is determined. Based on the progress of contraction, the chamber of the heart may then be stimulated at a plurality of locations. In another embodiment, a plurality of electrodes are implanted in the left ventricle to stimulate at multiple locations in the left ventricle for the purpose of improving hemodynamic performance and increasing cardiac output in a patient who is suffering from congestive heart failure.

Claims

1. (canceled)

2. A method to improve hemodynamic efficiency of a human heart, comprising:

monitoring, with a processing circuit, contraction progress in a left ventricle of the heart based on an intrinsic signal received from at least one of a first electrode implanted in the left ventricle and a second electrode implanted in the left ventricle and spaced apart from the first electrode;

generating, with a generator circuit and based on the monitored contraction progress, a sub-threshold pre-excitation signal to be delivered to the left ventricle via at least one of the first and second electrodes to slow contraction of the left ventricle; and

generating, with the generator circuit, a signal to stimulate said left ventricle through said first and second electrodes based on the monitored contraction progress.

3. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the first and second electrodes are integrated in a single catheter.

4. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the first and second electrodes are helical coil electrodes.

5. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the first electrode is implanted in a first location in an interventricular septum of the heart, and the second electrode is implanted in a second, different location in the interventricular septum of the heart.

6. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the signal to stimulate the left ventricle is a cathodal signal.

7. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the signal to stimulate the left ventricle is a biphasic signal.

8. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the signal to stimulate the left ventricle is an anodal signal.

9. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the sub-threshold pre-excitation signal is a cathodal signal.

10. The method to improve hemodynamic efficiency of a human heart, as set forth in claim 2, wherein the sub-threshold pre-excitation signal is an anodal signal.

11. A device to improve hemodynamic efficiency of a human heart comprising:

a processor configured to monitor contraction progress in a left ventricle of the heart based on an intrinsic signal received from at least one of a first electrode implanted in the left ventricle and a second electrode implanted in the left ventricle and spaced apart from the first electrode; and

a generator circuit configured to;

generate, based on the monitored contraction progress, a sub-threshold pre-excitation signal to be delivered to the left ventricle via at least one of the first and second electrodes to slow contraction of the left ventricle, and

generate a signal to stimulate said left ventricle through said first and second electrodes based on the monitored contraction progress.

12. The device to improve hemodynamic efficiency of a human heart as set forth in claim 11, wherein the first and second electrodes are integrated in a single catheter.

13. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the first and second electrodes are helical coil electrodes.

14. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the first electrode is implanted in a first location in an interventricular septum of the heart, and the second electrode is implanted in a second, different location in the interventricular septum of the heart.

15. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the signal to stimulate the left ventricle is a cathodal signal.

16. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the signal to stimulate the left ventricle is a biphasic signal.

17. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the signal to stimulate the left ventricle is an anodal signal.

18. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the sub-threshold pre-excitation signal is a cathodal signal.

19. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the sub-threshold pre-excitation signal is an anodal signal.

20. The device to improve hemodynamic efficiency of a human heart, as set forth in claim 11, wherein the device is implantable in a patient.