Method and apparatus for treatment of atrial fibrillation and flutter
First Claim
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1. A method of electrical stimulation, comprising:
- placing an electrode in an appropriate location for stimulating the AV nodal fat pad of a human heart;
defining a first heart rate;
sensing the rate at which said human heart is beating; and
providing said stimulus pulses to said electrode, synchronized to depolarizations of a chamber of said human heart in response to the rate at which said heart is beating exceeding said first heart rate.
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Abstract
A stimulator for applying stimulus pulses to the AV nodal fat pad in response to sensed atrial rate exceeding a predetermined rate, in order to reduce the ventricular rate. The device also includes a cardiac pacemaker which serves to pace the ventricle in the event that the ventricular rate is lowered below a pacing rate, and provides for feedback control of the stimulus parameters applied to the AV nodal fat pad, as a function of the determined effect of the stimulus pulses on the ventricular rate.
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Citations
21 Claims
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1. A method of electrical stimulation, comprising:
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placing an electrode in an appropriate location for stimulating the AV nodal fat pad of a human heart; defining a first heart rate; sensing the rate at which said human heart is beating; and providing said stimulus pulses to said electrode, synchronized to depolarizations of a chamber of said human heart in response to the rate at which said heart is beating exceeding said first heart rate. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. An electrical medical stimulator, comprising:
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electrode means for delivery of electrical stimulation to the fat pad associated with the AV node of a human heart; pulse generator means for generating stimulus pulses and for providing said stimulus pulses to said electrode means; means for sensing the rate at which said human heart is beating; means for defining a first heart rate; and initiating means responsive to said sensing means for initiating the operation of said pulse generator means in response to the rate of said human heart exceeding said first heart rate; means for defining a second heart rate; means for pacing the ventricle of said human heart when the rate of said human heart falls below said second heart rate; and means for defining a third heart rate above said second rate and below said first rate, such that said pulse generator means provides said stimulus pulses to said electrode means only when the rate of said human heart is above said third rate.
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9. An electrical medical stimulator, comprising:
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electrode means for delivery of electrical stimulation to the fat pad associated with the AV node of a human heart; means for sensing depolarizations of a chamber of said human heart to determine the rate at which said human heart is beating; pulse generator means responsive to said sensing means for generating stimulus pulses and for providing said stimulus pulses to said electrode means during the refractory period of said chamber of said heart; means for defining a first heart rate; and initiating means responsive to said sensing means for initiating the operation of said pulse generator means in response to the rate of said human heart exceeding said first heart rate.
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10. An electrical medical stimulator, comprising:
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electrode means for delivery of electrical stimulation to the fat pad associated with the AV node of a human heart; means for sensing depolarizations of a chamber of said human heart to determine the rate at which said human heart is beating; pulse generator means for generating stimulus pulses and for providing said stimulus pulses to said electrode means; means for defining a first heart rate; initiating means responsive to said sensing means for initiating the operation of said pulse generator means in response to the rate of said human heart exceeding said first heart rate; and means for sensing a physiologic parameter other than heart rate; and wherein said means for defining said first heart rate comprises means for defining said first heart rate as a function of said physiologic parameter. - View Dependent Claims (11, 12, 13, 14, 16, 17, 18, 19, 20, 21)
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15. An electrical medical stimulator, comprising:
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electrode means for delivery of electrical stimulation to the fat pad associated with the AV node of a human heart; means for sensing depolarization of a chamber of said human heart to determine the rate at which said human heart is beating; pulse generator means responsive to said sensing means for generating stimulus pulses and for providing said stimulus pulses to said electrode means; means for defining a first heart rate; means for defining an acceptable range of heart rates; initiating means responsive to said sensing means for enabling the operation of said pulse generator means in response to the rate of said human heart exceeding said first heart rate; and means responsive to said sensing means and to said pulse generator means for determining the effect of said stimulus pulses on the rate of said human heart and means for adjusting the energy of said stimulus pulses, while said pulse generator is enabled, as a function of the determined effect of said stimulus pulses, to maintain said heart rate within said acceptable range of heart rates.
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Specification