System for providing hyperpolarization of cardiac to enhance cardiac function
First Claim
1. A method of operating a medical device having electrode means adapted for placement about the heart of a living body for hyperpolarizing cardiac cells and characterized by having means to deliver anodal stimulation through said electrode means comprising the steps of:
- detecting depolarizations of a chamber of a patient'"'"'s heart and providing a sense signal in response thereto;
timing an anodal stimulation delivery interval from the sense signal;
generating an anodal stimulation electrical pulse characterized by a waveform having a characteristic sufficient to hyperpolarize myocardial cells of the heart chamber, said waveform also having no characteristic sufficient to capture said cells;
delivering the anodal stimulation therapy to the heart chamber during a delivery interval timed in relation to the sensed signal.
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Accused Products
Abstract
An implantable system providing cardiac anodal stimulation (AS) as a system for effecting hyperpolarization of myocardial cells of a heart chamber to enhance the relaxation thereof in the diastolic phase and to thereby enhance cardiac function. The AS system is optimally timed to be delivered in an AS delivery interval following an AS delay interval timed from a preceding ventricular depolarization or pacing pulse to effect maximal cardiac relaxation. The sub-threshold AS pulse or train of pulses is increased in energy (amplitude) and/or decreased in energy to and from a peak energy level gradually rather than abruptly. The AS characteristics are optimized in an initialization process that determines the AS characteristics that provide the optimum blood pressure parameters and thereafter continually or from time to time in a confirmation process. Confirmation of the AS characteristics is determined by measuring one or more blood pressure parameter in the right atrium or ventricle reflecting the blood pressure in the heart chamber subjected to the AS pulses and comparing the measured blood pressure parameter to the corresponding optimum blood pressure parameter determined in the initialization process. The initialization process is repeated if the comparison shows a deterioration in cardiac function response to the AS. The AS pulse waveforms are preferrably delivered through a plurality of discrete AS electrodes distributed about the heart chamber or through or large surface area epicardial patch or endocardial AS electrodes.
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Citations
20 Claims
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1. A method of operating a medical device having electrode means adapted for placement about the heart of a living body for hyperpolarizing cardiac cells and characterized by having means to deliver anodal stimulation through said electrode means comprising the steps of:
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detecting depolarizations of a chamber of a patient'"'"'s heart and providing a sense signal in response thereto; timing an anodal stimulation delivery interval from the sense signal; generating an anodal stimulation electrical pulse characterized by a waveform having a characteristic sufficient to hyperpolarize myocardial cells of the heart chamber, said waveform also having no characteristic sufficient to capture said cells; delivering the anodal stimulation therapy to the heart chamber during a delivery interval timed in relation to the sensed signal. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A cardiac pacemaker, having anodal stimulation generating means adapted to deliver anodal stimulation pulses comprising:
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timing means for determining the timing of pacing pulses to at least one chamber of a patients heart, sensing means to detect depolarizations of a chamber of a patient'"'"'s heart and providing a sense signal in response thereto; escape interval means for maintaining and initiating an escape interval upon delivery of a pacing pulse to the heart chamber or in response to a sense signal and for generating an escape interval time-out signal when one said escape interval times out; pacing pulse delivery means to provide said pacing pulses to the heart chamber at the time out of one of said pacing escape intervals said pacing pulses being capable of depolarization of the heart chamber; means for timing an anodal stimulation delivery interval from a sense signal or a pacing pulse; means for generating an anodal stimulation pulse having pulse characteristics insufficient to elicit a depolarization of myocardial cells of the heart chamber;
means for delivering the anodal stimulation pulse to the heart chamber during an anodal stimulation delivery interval.
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12. Apparatus for hyperpolarizing cardiac cells employing anodal stimulation comprising:
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means for detecting depolarizations of a chamber of a patient'"'"'s heart and providing a sense signal in response thereto; means for timing an anodal stimulation delivery interval from the sense signal; means for generating an anodal stimulation pulse having a characteristic sufficient to hyperpolarize myocardial cells of the heart chamber said stimulation pulse also having no characteristic sufficient to capture said cells; means for delivering the anodal stimulation pulse to the heart chamber during the delivery interval to effect maximal cardiac relaxation of the myocardial cells of the heart. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20)
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Specification