Apparatus and method for timing the delivery of non-excitatory ETC signals to a heart
First Claim
1. Apparatus for timing the delivery of a non-excitatory cardiac contractility modulating signal to a heart within a cardiac beat cycle of said heart, the apparatus is operatively connectable to a plurality of electrodes adapted to be implanted in said heart, the apparatus comprising:
- an excitable tissue control unit operatively connectable to at least one electrode of said plurality of electrodes for delivering said non-excitatory signal to said heart;
a detecting unit operatively connectable to a first electrode of said plurality of electrodes for sensing activity in a first cardiac site and for detecting a first electrical depolarization event within said cycle, said detecting unit is also operatively connectable 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 to 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.
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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 are disclosed. 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 defibrilation signals to the heart.
131 Citations
32 Claims
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1. Apparatus for timing the delivery of a non-excitatory cardiac contractility modulating signal to a heart within a cardiac beat cycle of said heart, the apparatus is operatively connectable to a plurality of electrodes adapted to be implanted in said heart, the apparatus comprising:
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an excitable tissue control unit operatively connectable to at least one electrode of said plurality of electrodes for delivering said non-excitatory signal to said heart;
a detecting unit operatively connectable to a first electrode of said plurality of electrodes for sensing activity in a first cardiac site and for detecting a first electrical depolarization event within said cycle, said detecting unit is also operatively connectable 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 to 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. - 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. Apparatus for timing the delivery of a non-excitatory cardiac contractility modulating signal to a heart within a cardiac beat cycle of said heart, the apparatus is operatively connectable to a plurality of electrodes adapted to be implanted in said heart, the apparatus comprising:
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means for delivering non-excitatory cardiac contractility modulating signals to said heart;
event detecting means operatively connectable to a first electrode of said plurality of electrodes for sensing electrical activity at or about a first cardiac site and for detecting a first event within said beat cycle, said first event is associated with cardiac activation at or about said first cardiac site, said event detecting means is also operatively connectable to a second electrode of said plurality of electrode for sensing electrical activity at or about a second cardiac site and for detecting at least a second event at or about said first cardiac site within said beat cycle, said at least second event is associated with cardiac activation at or about said second cardiac site;
controller means operatively connected to said means for delivering non-excitatory cardiac contractility modulating signals and to said event detecting means, for controlling the operation of said means for delivering non-excitatory cardiac contractility modulating signals, for receiving from said event detecting means signals representing the detection of said first event and said second event and for controlling the applying by said means for delivering, of said non-excitatory cardiac contractility modulating signal to said second cardiac site, in response to the detecting of said at least second event by said event detecting means within an alert window period, said alert window period starts at a first delay from the time of detection of said first event and has a first duration, said applying is delayed from the time of detecting of said at least second event.
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30. Apparatus for timing the delivery of a non-excitatory cardiac contractility modulating signal to a heart within a cardiac beat cycle of said heart, the apparatus is operatively connectable to a plurality of electrodes adapted to be implanted in said heart, the apparatus comprising:
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an excitable tissue control unit operatively connectable to at least one electrode of said plurality of electrodes and configured for delivering said non-excitatory signal to said heart;
at least one detecting unit operatively connectable 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 at least one detecting unit is operatively connectable 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; and
a controller unit operatively connected to said excitable tissue control unit and to said at least one 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.
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31. Apparatus for timing the delivery of a non-excitatory cardiac contractility modulating signal to a heart within a cardiac beat cycle of said heart, the apparatus is operatively connectable to a plurality of electrodes adapted to be implanted in said heart, the apparatus comprising:
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an excitable tissue control unit operatively connectable to at least one electrode of said plurality of electrodes for delivering said non-excitatory signal to said heart;
a detecting unit operatively connectable 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 operatively connectable 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 to 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 detection 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 detecting unit and said controller unit. - View Dependent Claims (32)
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Specification