Cardiac output controller
First Claim
Patent Images
1. Apparatus for modifying cardiac output of the heart of a subject, comprising:
- one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates non-excitatory stimulation pulses, only at a time at which they are unable to propagate action potentials responsive to the signals, wherein the signal generation circuitry identifies an arrhythmia in the signals and controls the stimulation pulses responsive thereto.
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Reexamination
Accused Products
Abstract
This invention is an apparatus for modifying cardiac output of the heart of a subject, including one or more sensors which sense signals responsive to cardiac activity, and a stimulation probe including one or more stimulation electrodes which apply non-excitatory stimulation pulses to a cardiac muscle segment. Signal generation circuitry is coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses responsive to the signals.
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Citations
42 Claims
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1. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates non-excitatory stimulation pulses, only at a time at which they are unable to propagate action potentials responsive to the signals, wherein the signal generation circuitry identifies an arrhythmia in the signals and controls the stimulation pulses responsive thereto.
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2. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the signal generation circuitry detects a QT interval in the signals and controls the stimulation pulses responsive thereto.
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3. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more stimulation electrodes apply the stimulation pulse to a heart segment having an area of at least 1 cm2. - View Dependent Claims (4)
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5. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more stimulation electrodes apply the stimulation pulse to a heart segment having an area of at least 5 mm2, and wherein the signal generation circuitry varies the area of the heart segment to which the stimulation pulse is applied.
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6. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates non-excitatory stimulation pulses, only at a time at which they are unable to propagate action potentials responsive to the signals, wherein the stimulation probes comprises a net of electrodes. - View Dependent Claims (7, 8, 9, 20, 21)
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10. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more sensors comprise an intracardiac electrode, and wherein the signal generation circuitry synchronizes the stimulation pulse to electrical activity of the heart, and wherein the stimulation probe comprises a hybrid electrode, including the intracardiac electrode together with at least one of the one or more stimulation electrodes. - View Dependent Claims (11, 12)
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13. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more sensors comprise a hemodynamic sensor, which generates signals responsive to blood flow.
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14. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more sensors comprise a hemodynamic sensor, which generates signals responsive to blood oxygenation.
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15. Apparatus for modifying cardiac output of the heart of a subject, comprising:
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one or more sensors, which sense signals responsive to cardiac activity;
a stimulation probe comprising one or more stimulation electrodes, which apply non-excitatory stimulation pulses to a cardiac muscle segment; and
signal generation circuitry, coupled to the one or more sensors and the stimulation probe, which circuitry receives the signals from the one or more sensors and generates the non-excitatory stimulation pulses, responsive to the signals, wherein the one or more sensors comprise a hemodynamic sensor, which generates signals responsive to a temperature.
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16. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein applying the stimulation probe comprises applying a probe comprising a plurality of stimulation electrodes, and wherein generating and conveying the pulse comprises generating a sequence of pulses and applying each pulse in the sequence to a different one of the plurality of stimulation electrodes.
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17. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse only at a time at which it is unable to propagate action potentials responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein generating and conveying the pulse comprises detecting a cardiac arrhythmia and adjusting the application of the pulses responsive thereto.
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18. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein generating and conveying the pulse comprises detecting a QT interval in the signals and generating pulses responsive thereto.
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19. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein the pulse comprises a baseline pulse and a waveform of substantially higher frequency than the baseline pulse superimposed thereon.
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22. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein applying the stimulation probe comprises varying the extent of a portion of the area of the heart segment to which the stimulation pulse is applied.
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23. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein applying the stimulation probe comprises inserting at least one of the one or more stimulation electrodes into the coronary sinus. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30)
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31. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing cardiac output, and wherein generating the pulse comprises changing the pulse responsive to the signal to increase the cardiac output.
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32. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing cardiac output, and wherein generating the pulse comprises changing the pulse responsive to the signal to decrease the cardiac output.
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33. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing a pressure.
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34. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing a flow rate.
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35. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing oxygenation.
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36. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein receiving the signal comprises sensing a temperature.
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37. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein generating and conveying the pulse comprises generating and conveying pulses at selected times of day. - View Dependent Claims (38, 39)
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40. A method for modifying cardiac output, comprising:
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applying a stimulation probe comprising one or more stimulation electrodes to a subject'"'"'s heart;
receiving a signal from at least one sensor responsive to the subject'"'"'s cardiac muscle activity; and
generating a non-excitatory stimulation pulse responsive to the signal and conveying the pulse to at least one of the one or more electrodes, wherein conveying the pulses comprises applying pulses to a heart segment having an area of at least 1 cm2. - View Dependent Claims (41, 42)
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Specification