Methods and apparatus to increase secretion of endogenous naturetic hormones
First Claim
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1. A method for pacing a heart of a patient comprising:
- determining the patient is suffering from at least one of hypertension, and excessive retention of fluid and sodium;
during a first pacing period synchronously pacing at least one atria and at least one ventricle of the patient'"'"'s heart;
during a second pacing period, asynchronously pacing the at least one atria of the patient'"'"'s heart at an atrial pacing rate and synchronously pacing the at least one ventricle of the patient'"'"'s heart at a ventricular pacing rate, such that the atrial pacing rate exceeds the ventricular pacing rate;
during the pacing of the second pacing period, stressing, beyond a natural stress condition, a wall of the at least one atria due to the atrial pacing rate, wherein the stressed wall secretes a hormone at an elevated secretion level above a secretion level occurring while a natural atrial rate and a natural ventricular rate are equal;
achieving a beneficial therapeutic effect in the patient by the elevated level of the secreted hormone, wherein the beneficial therapeutic effect includes at least one of;
limiting a degree of vasoconstriction, limiting a degree of sodium retention, increasing urine output, inhibiting a renin-angiotensin system, inhibiting endothelin secretion, inhibiting systemic and renal sympathetic activity, and counteracting effects of at least one of norepinephrine, endothelin, and angiotensin II, andrepeatedly alternating the first pacing period and the second pacing period to pace the patient'"'"'s heart, wherein each alternating second pacing period has a duration of at least ten minutes.
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Abstract
A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.
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Citations
18 Claims
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1. A method for pacing a heart of a patient comprising:
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determining the patient is suffering from at least one of hypertension, and excessive retention of fluid and sodium; during a first pacing period synchronously pacing at least one atria and at least one ventricle of the patient'"'"'s heart; during a second pacing period, asynchronously pacing the at least one atria of the patient'"'"'s heart at an atrial pacing rate and synchronously pacing the at least one ventricle of the patient'"'"'s heart at a ventricular pacing rate, such that the atrial pacing rate exceeds the ventricular pacing rate; during the pacing of the second pacing period, stressing, beyond a natural stress condition, a wall of the at least one atria due to the atrial pacing rate, wherein the stressed wall secretes a hormone at an elevated secretion level above a secretion level occurring while a natural atrial rate and a natural ventricular rate are equal; achieving a beneficial therapeutic effect in the patient by the elevated level of the secreted hormone, wherein the beneficial therapeutic effect includes at least one of;
limiting a degree of vasoconstriction, limiting a degree of sodium retention, increasing urine output, inhibiting a renin-angiotensin system, inhibiting endothelin secretion, inhibiting systemic and renal sympathetic activity, and counteracting effects of at least one of norepinephrine, endothelin, and angiotensin II, andrepeatedly alternating the first pacing period and the second pacing period to pace the patient'"'"'s heart, wherein each alternating second pacing period has a duration of at least ten minutes. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method for treating heart disease in a patient having a heart, the method comprising:
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determining the patient is suffering from at least one of hypertension, and excessive retention of fluid and sodium; during a first pacing period synchronously pacing at least one atria and at least one ventricle of the patient'"'"'s heart; during a second pacing period, pacing the patient'"'"'s heart to cyclically stress walls of the at least one atria of the patient'"'"'s heart and restore the walls of the atria to a substantially pre-stressed condition; causing the stressed walls to secrete a hormone at an elevated level above a natural secretion level occurring naturally when the patient'"'"'s heart is not paced; achieving a beneficial therapeutic effect to the patient by the hormone secreted at the elevated level, wherein the beneficial therapeutic effect includes at least one of;
limiting a degree of vasoconstriction, limiting a degree of sodium retention, increasing urine output, inhibiting a renin-angiotensin system, inhibiting endothelin secretion, inhibiting systemic and renal sympathetic activity, and counteracting effects of at least one of norepinephrine, endothelin, and angiotensin II, andrepeatedly alternating the first pacing period and the second pacing period to pace the patient'"'"'s heart, wherein each alternating second pacing period has a duration of at least ten minutes. - View Dependent Claims (9, 10, 11, 12)
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13. A method for treating disease in a patient having a heart, the method comprising:
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determining the patient is suffering from at least one of hypertension, or excessive retention of fluid and sodium; during a first pacing period synchronously pacing at least one atria and at least one ventricle of the patient'"'"'s heart; during a second pacing period, pacing the patient'"'"'s heart to achieve an atrial contraction rate faster than a ventricular contraction rate, and due to the faster atrial contraction rate, stressing the at least one wall of at least one atria of the patient'"'"'s heart due to the pacing during the second pacing period; due to the stressing of the at least one wall, inducing a tissue in the at lest one stressed wall to secrete greater amounts of a hormone as compared to a secretion amount of the hormone occurring when said pacing is not applied to the patient'"'"'s heart, and achieving a beneficial therapeutic effect to the patient due to the secretion of the greater amounts of the hormone, wherein the beneficial therapeutic effect includes at least one of;
limiting a degree of vasoconstriction, limiting a degree of sodium retention, increasing urine output, inhibiting a renin-angiotensin system, inhibiting endothelin secretion, inhibiting systemic and renal sympathetic activity, and counteracting effects of at least one of;
norepinephrine, endothelin, and angiotensin II, andrepeatedly alternating the first pacing period and the second pacing period to pace the patient'"'"'s heart, wherein each alternating second pacing period has a duration of at least ten minutes. - View Dependent Claims (14, 15, 16, 17, 18)
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Specification