Multi-electrode apparatus and method for treatment of congestive heart failure
First Claim
1. A method for treating congestive heart failure comprisingimplanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a subset of said electrodes lying on the right septal wall for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and stimulating the heart through said set of electrodes.
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Abstract
An apparatus and method for treatment of congestive heart failure from the right side of the heart. An implantable cardiac stimulation system with a multi-electrode lead having three or more selectable electrodes, together with apparatus for identifying an optimal subset of electrodes, apparatus for shaping a propagating wave front, and apparatus for modifying the intrinsic ventricular cardiac activation sequence, or generating simultaneous or near simultaneous pacing pulses to the septum or right ventricular outflow tract during ventricular systole in order to improve left ventricular cardiac efficiency and reduce mitral regurgitation in patients with dilated cardiomyopathy. A three dimensional map of electrode placement may be calculated. A sub set of the available electrodes in the right side of the heart is selected for stimulation such that septal motion during systole is reduced or the mitral valve area is stiffened to reduce mitral regurgitation.
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Citations
32 Claims
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1. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a subset of said electrodes lying on the right septal wall for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and stimulating the heart through said set of electrodes.
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26. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, developing a plurality of template patterns of wave fronts passing said electrodes; -
distinguishing between intrinsic and ectopic wave fronts by comparing sensed wave fronts to said template patterns;
selecting a subset of said electrodes for stimulating the heart such that stimulation through said set of electrodes improves cardiac performance, and stimulating the heart through said set of electrodes.
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27. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a first subset of said electrodes near the right ventricular outflow tract; -
stimulating the heart through said first subset of said electrodes;
determining a first regurgitation through the mitral valve;
selecting a second subset of said electrodes near the right ventricular outflow tract, stimulating the heart through said second set of electrodes, determining a second regurgitation through the mitral valve, and choosing the subset of electrodes such that regurgitation through the mitral valve is minimized. - View Dependent Claims (28)
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29. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, selecting a subset of said electrodes lying on the right septal wall by selecting a first electrode near the right ventricular outflow tract, selecting a second electrode near the apex of the right ventricular chamber, and identifying electrodes on the septal wall adjacent a shortest path connecting said first and second electrodes, and stimulating the heart through said set of electrodes.
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30. A method for treating congestive heart failure comprising
implanting a multi-electrode lead in at least the right ventricle of the heart of a patient, said multi-electrode lead having at least three selectable electrodes, implanting a cardiac stimulator in the body of said patient, said cardiac stimulator being connected to said multi-electrode lead, mapping the progress of a wave front past said electrodes; -
selecting a subset of said electrodes for stimulating the heart in a sequence such that recreates the progress of said mapped wave front, and stimulating the heart through said set of electrodes in said sequence. - View Dependent Claims (31, 32)
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Specification