Pacing with hemodynamic enhancement
First Claim
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1. Apparatus for heart pacing with hemodynamic improvement, comprising:
- one or more electrodes, which are adapted to convey electrical signals to respective cardiac muscle segments; and
signal generation circuitry, which applies an extended pacing signal, having an overall duration greater than 8 ms, to the one or more electrodes so as to pace the heart,wherein the signal has a leading edge and a trailing edge, and wherein the trailing edge is characterized by an absolute rate of voltage change substantially smaller than that of the leading edge.
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Abstract
Apparatus (170) for heart pacing with hemodynamic improvement, including one or more electrodes (36), which convey electrical signals to respective cardiac muscle segments. Signal generation circuitry (50) applies an extended pacing signal (60, 61), having an overall duration greater than three times a chronaxie time, to the one or more electrodes so as to pace the heart. The signal preferably includes a train of a plurality of biphasic pulses, and has an amplitude at least three times as great as a threshold for pacing the heart, but not sufficient for cardioversion.
229 Citations
78 Claims
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1. Apparatus for heart pacing with hemodynamic improvement, comprising:
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one or more electrodes, which are adapted to convey electrical signals to respective cardiac muscle segments; and signal generation circuitry, which applies an extended pacing signal, having an overall duration greater than 8 ms, to the one or more electrodes so as to pace the heart, wherein the signal has a leading edge and a trailing edge, and wherein the trailing edge is characterized by an absolute rate of voltage change substantially smaller than that of the leading edge. - View Dependent Claims (2)
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3. A method for heart pacing with enhancement of cardiac contraction, comprising:
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applying one or more electrodes to a subject'"'"'s heart; and conveying an extended pacing signal, having an overall duration greater than 8 ms, to the one or more electrodes so as to pace the heart, wherein the signal has a leading edge and a trailing edge, and wherein the trailing edge is characterized by an absolute rate of voltage change substantially smaller than that of the leading edge. - View Dependent Claims (4)
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5. A method for heart pacing with enhancement of cardiac contraction, comprising:
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applying one or more implantable electrodes to a ventricle of a human subject'"'"'s heart; and conveying an extended pacing signal to the one or more electrodes so as to pace the ventricle, the extended pacing signal having an overall duration greater than 8 ms from a time of initiation of application of that portion of the signal that initiates action potential propagation, wherein conveying the extended pacing signal comprises conveying a train of pulses, wherein the signal has an amplitude that is at least three times as great as a threshold for pacing the ventricle and that is sufficient neither for cardioversion nor for defibrillation, and wherein the cardiac muscle segments to which the one or more electrodes are applied are characterized by a refractory period, and wherein the overall duration of the signal is such that the signal terminates during the refractory period. - View Dependent Claims (6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41)
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42. A method for heart pacing with enhancement of cardiac contraction, comprising:
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applying one or more implantable electrodes to a human subject'"'"'s heart; and conveying a plurality of extended pacing signals to the one or more electrodes so as to pace the heart by initiating a respective plurality of consecutive heartbeats, each of the extended pacing signals having an overall duration greater than 8 ms from a time of initiation of application of that portion of the signal that initiates action potential propagation, wherein conveying each of the extended pacing signals comprises conveying a train of pulses, wherein each of the extended pacing signals has an amplitude that is at least three times as great as a threshold for pacing the heart and that is sufficient neither for cardioversion nor for defibrillation, and wherein the cardiac muscle segments to which the one or more electrodes are applied are characterized by a refractory period, and wherein the overall duration of each of the extended pacing signals is such that the signal terminates during the refractory period. - View Dependent Claims (43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78)
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Specification