Cardiac protection system and method

• US 8,126,549 B2
• Filed: 07/15/2008
• Issued: 02/28/2012
• Est. Priority Date: 07/15/2008
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Sigg, Daniel C., Coles, James A. Jr., Warkentin, Dwight H., Jaye, Deborah Ann
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US12/173,780
• Publication Number:
  US 20100016740A1
• Time in Patent Office: 1,323 Days
• Field of Search: None
• US Class Current: 607/9
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61N 1/365 controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• CPC Class Codes: A61N 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient

Abstract

A cardiac ischemic protection system and method for conditioning a patient'"'"'s heart is provided. The method can include detecting acute myocardial infarction, angina pectoris, silent ischemia, or stunning and providing closed-loop dyssynchronous pacing to the patient'"'"'s heart to precondition and/or postcondition the patient'"'"'s heart in order to reduce ischemic damage.

Claims

1. A method of providing cardiac ischemic protection to a patient'"'"'s heart, the method comprising:

detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning;

providing closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage,

wherein the dyssynchronous pacing is configured to produce discordant motion of the ventricular walls of the patient'"'"'s heart; and

pacing the right ventricular apex with an atrioventricular delay with a dual chamber ventricular pacemaker,

wherein the atrioventricular delay is about 30 milliseconds.

2. The method of claim 1 and further comprising alerting the patient to seek treatment after detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning.

3. The method of claim 1 and further comprising alerting medical personnel of the patient'"'"'s condition after detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning.

4. The method of claim 1 and further comprising detecting acute myocardial infarction by detecting ST segment changes.

5. The method of claim 1 and further comprising providing pacing to precondition the patient'"'"'s heart by providing one to ten periods of about five minutes of pacing and intermittent periods of sinus rhythm of about five minutes.

6. The method of claim 1 and further comprising providing continuous pacing to the patient'"'"'s heart.

7. The method of claim 1 and further comprising manually activating the dyssynchronous pacing.

8. A cardiac ischemic protection system that conditions a patient'"'"'s heart, the system comprising:

a detector that detects at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning; and

a pulse generator that provides closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage,

wherein the dyssynchronous pacing is configured to produce discordant motion of the ventricular walls of the patient'"'"'s heart,

wherein the pulse generator provides pacing to the right ventricular apex with an atrioventricular delay with a dual chamber ventricular pacemaker, and

wherein the atrioventricular delay is about 30 milliseconds.

9. The system of claim 8 and further comprising an implantable pacing device that includes the detector.

10. The system of claim 8 and further comprising a patient alerting device that alerts the patient to seek treatment after the detector detects at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning.

11. The system of claim 10 wherein the patient alerting device alerts medical personnel of the patient'"'"'s condition after detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning.

12. The system of claim 8 wherein the detector detects acute myocardial infarction by detecting ST segment changes.

13. The system of claim 8 wherein the pulse generator provides pacing to precondition the patient'"'"'s heart by providing one to ten periods of about five minutes of pacing and intermittent periods of sinus rhythm of about five minutes.

14. The system of claim 8 wherein the pulse generator provides pacing to precondition the patient'"'"'s heart by providing continuous pacing.

15. The system of claim 8 wherein the dyssynchronous pacing is manually activated.

16. A method of providing cardiac ischemic protection to a patient'"'"'s heart, the method comprising:

detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning;

providing closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage; and

pacing one of the left ventricular wall and the right ventricular wall with an atrioventricular delay with a triple chamber ventricular pacemaker.

17. The method of claim 16 wherein the atrioventricular delay is about 30 milliseconds.

18. A method of providing cardiac ischemic protection to a patient'"'"'s heart, the method comprising:

detecting at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning;

providing closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage; and

driving the patient'"'"'s heart rate at sinus rate so that oxygen demand does not substantially increase.

19. A cardiac ischemic protection system that conditions a patient'"'"'s heart, the system comprising:

a detector that detects at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning; and

a pulse generator that provides closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage;

wherein the pulse generator provides pacing to one of the left ventricular wall and the right ventricular wall with an atrioventricular delay with a triple chamber ventricular pacemaker.

20. The system of claim 19 wherein the atrioventricular delay is about 30 milliseconds.

21. A cardiac ischemic protection system that conditions a patient'"'"'s heart, the system comprising:

a detector that detects at least one of acute myocardial infarction, angina pectoris, silent ischemia, and stunning; and

a pulse generator that provides closed-loop dyssynchronous pacing to the patient'"'"'s heart to at least one of precondition and postcondition the patient'"'"'s heart in order to reduce ischemic damage;

wherein the patient'"'"'s heart rate is driven at sinus rate so that oxygen demand does not substantially increase.