Apparatus and method for timing the delivery of non-excitatory ETC signals to a heart
First Claim
1. A method for timing the delivery of a non-excitatory signal to a heart within a cardiac beat cycle, the method comprising the steps of:
- applying electrodes to a plurality of cardiac sites;
sensing electrical activity in at least a first site of said plurality of cardiac sites through at least a first electrode of said electrodes for detecting a first electrical depolarization event within said beat cycle;
sensing electrical activity in at least a second site of said plurality of sites through at least a second electrode of said electrodes for detecting at least a second electrical depolarization event within said beat cycle; and
applying said non-excitatory signal to at least one of said cardiac sites through at least one of said electrodes in response to detecting said second electrical depolarization event within an alert window period, said alert window period starts at a first delay from the time of detection of said first electrical depolarization event and has a first duration, said applying is delayed from the time of detecting of said at least second electrical depolarization event.
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Abstract
A method and devices for timing the delivery of non-excitatory signals for modifying myocardial contractility of a portion of the heart. The method includes the steps of applying electrodes to a plurality of cardiac sites, sensing electrical activity in a first cardiac site through a first electrode for detecting a first electrical depolarization event within a beat cycle, sensing electrical activity in a second cardiac site through a second electrode for detecting a second electrical depolarization event within the beat cycle, and applying a non-excitatory signal to the heart at or near at least the second cardiac site through at least one of the electrodes in response to detecting the second electrical depolarization event within an alert window period. The alert window period starts at a first delay from the time of detection of the first electrical depolarization event and has a first duration. The applying of the non-excitatory signal is delayed from the time of detecting of the second electrical depolarization event. The method may include steps for reducing the probability of delivering of improperly timed non-excitatory signals due to electrical noise and/or ectopic beats and may also include steps for preventing delivery of multiple non-excitatory signals at or near the second cardiac site within a single cardiac beat cycle. Preferably, the first cardiac site is located about the right ventricle or the right atrium of the heart and the second cardiac site is located about the left ventricle of the heart. The devices may also be adapted for pacing the heart and/or for delivering defibrillation signals to the heart.
193 Citations
84 Claims
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1. A method for timing the delivery of a non-excitatory signal to a heart within a cardiac beat cycle, the method comprising the steps of:
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applying electrodes to a plurality of cardiac sites;
sensing electrical activity in at least a first site of said plurality of cardiac sites through at least a first electrode of said electrodes for detecting a first electrical depolarization event within said beat cycle;
sensing electrical activity in at least a second site of said plurality of sites through at least a second electrode of said electrodes for detecting at least a second electrical depolarization event within said beat cycle; and
applying said non-excitatory signal to at least one of said cardiac sites through at least one of said electrodes in response to detecting said second electrical depolarization event within an alert window period, said alert window period starts at a first delay from the time of detection of said first electrical depolarization event and has a first duration, said applying is delayed from the time of detecting of said at least second electrical depolarization event. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28)
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29. A method for timing the delivery of a non-excitatory signal to a heart within a cardiac beat cycle, the method comprising the steps of:
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sensing electrical activity in at least a first site of said heart through at least a first electrode applied to said at least first site for detecting a first electrical depolarization event within said beat cycle;
sensing electrical activity in at least a second site of said heart through at least a second electrode applied to said at least second site for detecting at least a second electrical depolarization event within said beat cycle; and
applying said non-excitatory signal at or in the vicinity of said at least second site of said heart in response to detecting said second electrical depolarization event within an alert window period, said alert window period starts at a first delay from the time of detection of said first electrical depolarization event and has a first duration, said applying is delayed from the time of detecting of said at least second electrical depolarization event. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56)
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57. Apparatus for timing the delivery of a non-excitatory signal to a heart within a cardiac beat cycle of said heart, the apparatus comprising:
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a plurality of electrodes adapted to be implanted in said heart;
an excitable tissue control unit operatively connected to at least one electrode of said plurality of electrodes for delivering said non-excitatory signal to said heart;
a detecting unit operatively connected to a first electrode of said plurality of electrodes for sensing electrical activity in a first cardiac site and for detecting a first electrical depolarization event within said beat cycle, said detecting unit is also connected to a second electrode of said plurality of electrodes for sensing electrical activity in a second cardiac site and for detecting at least a second electrical depolarization event within said beat cycle;
a controller unit operatively connected to said excitable tissue control unit and said detecting unit for controlling the operation of said excitable tissue control unit and said detecting unit, for receiving from said detecting unit signals representing the detection of said first electrical depolarization event and said second electrical depolarization event and for controlling the applying, through at least one of said plurality of electrodes, of said non-excitatory signal to said second cardiac site or in the vicinity thereof in response to the detecting of said at least second electrical depolarization event by said detecting unit within an alert window period, said alert window period starts at a first delay from the time of detection of said first electrical depolarization event and has a first duration, said applying is delayed from the time of detecting of said at least second electrical depolarization event; and
a power source for providing power to said excitable tissue control unit, said detection unit and said controller unit. - View Dependent Claims (58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84)
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Specification