Cardiac stimulation apparatus and method for the control of hypertension

• US 8,086,315 B2
• Filed: 06/10/2008
• Issued: 12/27/2011
• Est. Priority Date: 02/12/2004
• Status: Active Grant

• Current Assignee: Backbeat Medical, LLC
• Original Assignee: Asap Medical, Inc.
• Inventors: Schwartz, Robert S., van Tassel, Robert A.
• Primary Examiner(s): Layno, Carl H.
• Assistant Examiner(s): Heller, Tammie K
• Application Number:
  US12/157,435
• Publication Number:
  US 20090018608A1
• Time in Patent Office: 1,295 Days
• Field of Search: 607/17, 607/23, 607/44
• US Class Current: 607/44
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/36564 controlled by blood pressure

Abstract

A method that electrically stimulates a heart muscle to alter the ejection profile of the heart, to control the mechanical function of the heart and reduce the observed blood pressure of the patient. The therapy may be invoked by an implantable blood pressure sensor associated with a pacemaker like device. In some cases, where a measured pretreatment blood pressure exceeds a treatment threshold, a patient'"'"'s heart may be stimulated with an electrical stimulus timed relative to the patient'"'"'s cardiac ejection cycle. This is done to cause dyssynchrony between at least two cardiac chambers, which alters the patient'"'"'s cardiac ejection profile from a pretreatment cardiac ejection profile. This has the effect of reducing the patient'"'"'s blood pressure from the measured pretreatment blood pressure.

Claims

1. A method, carried out with an implanted heart muscle stimulator associated with a heart of a patient, for treating a blood pressure disorder in the patient, the method comprising:

using a sensor to measure the patient'"'"'s pretreatment blood pressure corresponding to a pretreatment cardiac ejection profile;

comparing the measured pretreatment blood pressure with a treatment threshold; and

when the measured pretreatment blood pressure exceeds the treatment threshold, stimulating the patient'"'"'s heart with an electrical stimulus timed relative to the patient'"'"'s cardiac ejection cycle to cause dyssynchrony between at least two cardiac chambers and alter the patient'"'"'s cardiac ejection profile from the pretreatment cardiac ejection profile, thereby reducing the patient'"'"'s blood pressure from the measured pretreatment blood pressure.

2. The method of claim 1, wherein the dyssynchrony comprises an alteration of a pretreatment contraction sequence between the at least two cardiac chambers.

3. The method of claim 2, wherein the dyssynchrony comprises an alteration of a pretreatment contraction sequence between the at least two cardiac chambers that provides a reduced atrioventricular delay.

4. The method of claim 3, wherein the reduced atrioventricular delay disturbs the spatial contraction sequence between an atrial chamber and a ventricular chamber.

5. The method of claim 3, wherein the reduced atrioventricular delay disturbs the temporal contraction sequence between an atrial chamber and a ventricular chamber.

6. The method of claim 1, wherein the dyssynchrony comprises an alteration of a pretreatment contraction sequence between right and left ventricles of the patient'"'"'s heart.

7. The method of claim 1, wherein the patient'"'"'s heart is stimulated on a beat-by-beat interval.

8. The method of claim 1, wherein the patient'"'"'s heart is stimulated at a pacing rate above sinus rhythm.

9. The method of claim 1, wherein the patient'"'"'s heart is stimulated at a pacing rate within a range of approximately 90 to approximately 100 beats per minute.

10. The method of claim 1, wherein the patient'"'"'s heart is stimulated at a burst pacing rate to approximately 300 beats per minute.

11. The method of claim 1, wherein the electrical stimulus comprises a pacing level stimulus that alters the patient'"'"'s cardiac ejection profile for an individual heartbeat.

12. A method, carried out with an implanted heart muscle stimulator associated with a heart of a patient, for treating a blood pressure disorder in the patient, comprising:

using a sensor to measure the patient'"'"'s pretreatment blood pressure corresponding to a pretreatment cardiac ejection profile;

comparing the measured pretreatment blood pressure with a treatment threshold; and

when the measured pretreatment blood pressure exceeds the treatment threshold, stimulating the patient'"'"'s heart with an electrical stimulus timed relative to the patient'"'"'s cardiac ejection cycle to cause a dyssynchronous timing between at least two cardiac chambers and alter the patient'"'"'s cardiac ejection profile from the pretreatment cardiac ejection profile, thereby reducing the patient'"'"'s blood pressure from the measured pretreatment blood pressure.

13. The method of claim 12, wherein the dyssynchronous timing comprises an alteration of a pretreatment contraction sequence between atrial and ventricular chambers.

14. The method of claim 13, wherein stimulating the patient'"'"'s heart comprises stimulating atrial and ventricular chambers of the patient'"'"'s heart.

15. The method of claim 13, wherein the alteration of the pretreatment contraction sequence between the atrial and ventricular chambers comprises a reduced atrioventricular delay.

16. The method of claim 15, wherein the reduced atrioventricular delay disturbs the spatial contraction sequence between the atrial and ventricular chambers.

17. The method of claim 15, wherein the reduced atrioventricular delay disturbs the temporal contraction sequence between the atrial and ventricular chambers.

18. The method of claim 12, wherein the patient'"'"'s heart is stimulated on a beat-by-beat interval.

19. The method of claim 12, wherein the patient'"'"'s heart is stimulated at a pacing rate above sinus rhythm.

20. The method of claim 12, wherein the patient'"'"'s heart is stimulated at a pacing rate within a range of approximately 90 to approximately 100 beats per minute.

21. The method of claim 12, wherein the patient'"'"'s heart is stimulated at a burst pacing rate to approximately 300 beats per minute.

22. The method of claim 12, wherein the electrical stimulus comprises a pacing level stimulus that alters the patient'"'"'s cardiac ejection profile for an individual heartbeat.