System and method for enhancing cardiac signal sensing by cardiac pacemakers through genetic treatment
First Claim
1. A delivery system for delivering a therapeutically effective amount of a predetermined genetic material to myocardial cells of a chosen location of a patient'"'"'s heart, said genetic material being selected for the function of increasing the amplitude of the patient'"'"'s cardiac signal so that it can be better sensed by an electrode, comprising:
- a supply of said genetic material;
reservoir means for containing said genetic material; and
delivery means for delivering said genetic material from said reservoir to said myocardial cells, thereby increasing the amplitude of the cardiac signal and improving the signal to noise ratio that can be sensed by a pacemaker.
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Abstract
The present invention provides delivery systems for and methods of delivering ion channel protein genetic material to cardiac cells in areas adjacent to where an electrode is to be positioned in a patient'"'"'s heart to improve or correct the signal to noise ratio of cardiac signals, such as the P-wave. More specifically, there is provided a system and method for delivering sodium ion channel proteins or nucleic acid molecules encoding sodium ion channel proteins to a site in the heart adjacent to an electrode to increase the expression of the same, thereby enhancing the cardiac signal amplitude and enabling improved sensing of cardiac signals by an implanted pacemaker.
50 Citations
48 Claims
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1. A delivery system for delivering a therapeutically effective amount of a predetermined genetic material to myocardial cells of a chosen location of a patient'"'"'s heart, said genetic material being selected for the function of increasing the amplitude of the patient'"'"'s cardiac signal so that it can be better sensed by an electrode, comprising:
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a supply of said genetic material;
reservoir means for containing said genetic material; and
delivery means for delivering said genetic material from said reservoir to said myocardial cells, thereby increasing the amplitude of the cardiac signal and improving the signal to noise ratio that can be sensed by a pacemaker. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 23, 24, 25)
control means for controlling operation of said delivery means to deliver respective said doses.
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24. The implantable delivery system of claim 23, wherein said control means comprises initiating means for initiating delivery of said genetic material, said initiating means comprising an external programmer.
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25. The implantable delivery system of claim 23, wherein said control means comprises automatic means for automatically initiating delivery of said genetic material.
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22. An implantable delivery system for delivering doses of a therapeutically effective amount of a predetermined genetic material to myocardial cells in a chosen location of a patient'"'"'s heart, comprising:
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a supply of genetic material of the class having the property of increasing the expression of ion channels in the myocardial cells to which it is delivered;
a catheter, said catheter having a distal tip portion for engaging the cells of said chosen location and delivering thereto said genetic material;
reservoir means for holding said supply of genetic material and providing it to said distal tip portion of said catheter; and
delivery means for delivering a therapeutically effective amount of said genetic material from said reservoir means through said distal tip portion to said chosen location.
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26. An implantable delivery system for delivering predetermined genetic material to cardiac cells adjacent to a pacing electrode positioned against the inner wall of a patient'"'"'s heart, comprising:
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a supply of genetic material of the class having the property of increasing the expression of ion channels in cardiac cells to which it is delivered;
a catheter, said catheter having a distal tip portion for engaging said cardiac cells and delivering thereto said genetic material;
reservoir means for holding said supply of genetic material and providing it to said distal tip portion of said catheter; and
delivery means for delivering a therapeutically effective amount of said genetic material from said reservoir means through said distal tip portion to said cardiac cells. - View Dependent Claims (27, 28, 29, 30)
control means for controlling operation of said delivery means to deliver respective said doses.
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29. The implantable delivery system of claim 26, wherein said control means comprises initiating means for initiating delivery of said genetic material, said initiating means comprising an external programmer.
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30. The implantable delivery system of claim 26, wherein said control means comprises automatic means for automatically initiating delivery of said genetic material.
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31. A method of treatment to improve the signal to noise ratio of cardiac signals sensed by a pacemaker system implanted in a patient, comprising:
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determining a location in said patient'"'"'s heart which is in proximity to the anticipated or actual location of a sensing electrode;
selecting a genetic material which increases the expression of ion channels in at least some of the cardiac cells of said selected location; and
contacting said cardiac cells with a therapeutically effective amount of said genetic material, thereby improving the signal to noise ratio of cardiac signals that can be sensed at said electrode location. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42)
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43. An implantable system for pacing a patient'"'"'s heart and for delivering a predetermined genetic material to cardiac cells adjacent to a pacing electrode positioned in said patient'"'"'s heart, comprising:
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a supply of genetic material of the class having the property of increasing the expression of ion channels in cardiac cells to which it is delivered;
a catheter, said catheter having proximal and distal ends, a lumen through at least a part thereof and connecting to said distal end, a pacing electrode positioned at said distal end for engaging said patient'"'"'s heart wall, said electrode having a channel therethrough in communication with said lumen, and a conductor connecting said proximal end to said electrode, a pulse generator connected electrically to said conductor at said catheter proximal end for delivering pace pulses to said electrode, reservoir means for holding said supply of genetic material, and delivery means for delivering said genetic material from said reservoir to said lumen, whereby said material passes through said lumen and said channel to said heart wall. - View Dependent Claims (44, 45, 46, 47)
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48. A method of pacing and enhancing the detectability of sensed cardiac signals, comprising:
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selecting a supply of a genetic material of the class having the property of increasing the expression of ion channels in cardiac cells to which it is delivered;
introducing a transvenous catheter into said patient, said catheter having proximal and distal ends and a pacing electrode at said distal end, positioning said distal end against the patient'"'"'s heart wall, delivering said genetic material through said catheter and out of said distal end, to the cardiac cells adjacent said pacing electrode, thereby enhancing cardiac signals produced by said cells, delivering pacing pulses through said electrode, and sensing cardiac signals at said electrode.
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Specification