Cardiac stimulation at high ventricular wall stress areas
First Claim
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1. A lead implantation method, comprising:
- accessing a heart of a patient, the heart having a heart wall;
detecting, proximate the heart wall, a target region of the heart wall having a level of abnormal wall motion relative to neighboring regions of the heart wall;
implanting an electrode of the lead at the target region; and
pre-exciting the target region relative to the neighboring regions of the heart wall using the lead electrode in order to alter stress at the target region for treating cardiac remodeling, wherein pre-exciting the target region is initiated in response to an atrial sense or an atrial pace.
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Abstract
An apparatus and method for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.
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Citations
24 Claims
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1. A lead implantation method, comprising:
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accessing a heart of a patient, the heart having a heart wall; detecting, proximate the heart wall, a target region of the heart wall having a level of abnormal wall motion relative to neighboring regions of the heart wall; implanting an electrode of the lead at the target region; and pre-exciting the target region relative to the neighboring regions of the heart wall using the lead electrode in order to alter stress at the target region for treating cardiac remodeling, wherein pre-exciting the target region is initiated in response to an atrial sense or an atrial pace. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A lead implantation method, comprising:
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accessing a heart of a patient, the heart having a heart wall; detecting, proximate the heart wall, a target region of the heart wall having asynchronic depolarization characteristics relative to neighboring regions of the heart wall; implanting an electrode of the lead at the target region; and pre-exciting the target region relative to the neighboring regions of the heart wall using the lead electrode in order to alter stress of the target region for treating cardiac remodeling, wherein pre-exciting the target region is initiated in response to an atrial sense or pace event. - View Dependent Claims (10, 11, 12, 13, 14, 15)
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16. A cardiac system, comprising:
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an implantable housing; a controller provided in the housing and configured to control cardiac monitoring and cardiac stimulation; detection circuitry provided in the housing and coupled to the controller; energy delivery circuitry provided in the housing and coupled to the controller; and a lead coupled to the detection circuitry and the energy delivery circuitry, the lead comprising; a lead body; at least one cardiac electrode coupled to the lead body; and at least one sensor supported by the lead body and configured to detect abnormal cardiac wall motion, the sensor providing information useful for positioning the cardiac electrode proximate a target heart wall location associated with increased stress relative to neighboring heart wall locations; wherein the controller is configured to coordinate delivery of a pre-excitation stimulus to the target heart wall location prior to at least one of an intrinsic conduction or delivery of a pace pulse. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23)
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24. A system, comprising:
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means for detecting, proximate the heart wall, a target region of the heart wall having asynchronic depolarization characteristics relative to neighboring regions of the heart wall; and means for pre-exciting the target region relative to the neighboring regions in order to alter stress at the target region.
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Specification