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;
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; and
adjusting the pre-excitation in accordance with activity level measurements reflective of metabolic demand.
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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
21 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; 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; and adjusting the pre-excitation in accordance with activity level measurements reflective of metabolic demand. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. 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 using the cardiac electrode in order to alter stress at the target region for treating cardiac remodeling, and the controller is also configured to adjust the pre-excitation stimulus in accordance with activity level measurements reflective of metabolic demand. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
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19. A cardiac system, comprising:
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an implantable lead having a lead electrode and adapted to access a heart of a patient, the heart having a heart wall; means for 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; means for 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; and means for adjusting the pre-excitation in accordance with activity level measurements reflective of metabolic demand. - View Dependent Claims (20, 21)
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Specification