Myostimulator control using metabolic demand and muscle performance
First Claim
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1. A control device for stimulating a patient'"'"'s heart and a muscle arranged to augment cardiac function, said control device comprising:
- a cardiac sensor for sensing intrinsic activity in said heart and generating in response cardiac sensed signalsa pace generator for generating pacing signals to said heart in response to pacing commands;
a muscle generator for generating stimulation signals to said muscle in response to stimulation commands;
a metabolic demand sensor for determining a metabolic demand of said patient and generating a metabolic demand parameter; and
a controller receiving said cardiac sensed signals and said metabolic demand parameter and generating in response said pacing and said stimulation commands.
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Abstract
In a cardiomyoplasty system, a rate responsive implantable device is disclosed which controls the stimulation of both the heart and a myoplasty muscle. The metabolic demand is used as a rate response parameter and one or both of the heart and the muscle stimulation are increased with metabolic demand. Under certain conditions, for example, if the muscle is tired, its stimulation is maintained constant or reduced and the cardiac stimulation is used to compensate for increased metabolic demand.
81 Citations
40 Claims
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1. A control device for stimulating a patient'"'"'s heart and a muscle arranged to augment cardiac function, said control device comprising:
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a cardiac sensor for sensing intrinsic activity in said heart and generating in response cardiac sensed signals a pace generator for generating pacing signals to said heart in response to pacing commands; a muscle generator for generating stimulation signals to said muscle in response to stimulation commands; a metabolic demand sensor for determining a metabolic demand of said patient and generating a metabolic demand parameter; and a controller receiving said cardiac sensed signals and said metabolic demand parameter and generating in response said pacing and said stimulation commands. - View Dependent Claims (2, 3, 4, 5, 6)
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7. An implantable cardiac device for stimulating on demand a patient'"'"'s heart and a muscle arranged and constructed to assist said heart, said device comprising:
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a cardiac sensor for sensing intrinsic activity in said heart and generating corresponding sensed cardiac signals; a pace generator for generating pacing signals for said heart in response to pacing commands; a muscle generator for generating stimulation signals to said muscle in response to stimulation commands; a muscle sensor for generating a status of said muscle and generating in response sensed muscle signals; and a controller receiving said sensed cardiac signals and said sensed muscle signals and generating in response said pacing and said stimulation signals, synchronously. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. An implantable cardiac device for controlling the simultaneous stimulation of a patient'"'"'s heart and a muscle constructed and arranged to augment the patient'"'"'s cardiac function, said device comprising:
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a pacing generator for generating pacing pulses for said heart in response to pacing commands; a muscle stimulator for generating stimulation pulses for said muscle in response to stimulation commands; a demand sensor for sensing a metabolic demand of said patient and generating a corresponding demand parameter; and a controller receiving said metabolic demand and selecting said pacing and stimulation commands to increase said cardiac function when said metabolic demand increases. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A method of simultaneously stimulating a heart and a muscle constructed and arranged to augment cardiac functions in a patient by using an implantable device, said method comprising the steps of:
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generating pacing pulses to the heart at a pacing rate; generating stimulation pulses to the muscle at a stimulation rate; sensing a metabolic demand of said patient; and increasing the stimulation of one of heart and muscle if said metabolic demand increases while maintaining the stimulation of the other of said heart and muscle substantially constant. - View Dependent Claims (30, 31, 32, 33, 34, 35)
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36. An implantable cardiac device for controlling the simultaneous stimulation of a patient'"'"'s heart and a muscle constructed and arranged to augment the patient'"'"'s cardiac function, said device comprising:
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a cardiac sensor for sensing intrinsic activity in said heart and generating cardiac sensed signals; a pacing generator for generating pacing pulses for said heart in response to pacing commands; a muscle stimulator for generating stimulation pulses for said muscle in response to stimulation commands; a muscle sensor for sensing a status of the muscle and generating muscle status signals; a cardiac lead associated with said cardiac sensor and extending to said heart; a myostimulation lead associated with one of said muscle stimulator and said muscle sensor and extending from said muscle stimulator to said muscle; a demand detector for sensing a metabolic demand of said patient and generating a corresponding demand parameter, said metabolic demand parameter being generated using said myostimulation lead; and a controller receiving said cardiac sensed signals, said muscle status signals and said metabolic demand and selecting said pacing and stimulation commands to increase said cardiac function when said metabolic demand increases. - View Dependent Claims (37, 38, 39, 40)
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Specification