Electrical muscle controller

• US 8,260,416 B2
• Filed: 10/31/2007
• Issued: 09/04/2012
• Est. Priority Date: 01/08/1996
• Status: Expired due to Term

• Current Assignee: Impulse Dynamics NV
• Original Assignee: Impulse Dynamics NV
• Inventors: Darvish, Nissim, Fenster, Maier, Yuval, Mika, Ben-Haim, Shlomo
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US11/932,149
• Publication Number:
  US 20080065159A1
• Time in Patent Office: 1,770 Days
• Field of Search: 607/4, 607/7, 607/9
• US Class Current: 607/7
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6859 with multiple distal splines
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/326 : for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36146 : specified by the stimulation parameters
• CPC Class Codes: A61N 1/3621 : for treating or preventing abnormally high heart rate
• 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 1/365 : controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• 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 1/36557 : controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure
• CPC Class Codes: A61N 1/368 : comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Claims

1. A method of treating reduced cardiac output of a beating heart, the method comprising applying an electric signal to cardiac tissue which is applied during an absolute refractory period and which is adapted to exert positive control to cardiac tissue,

wherein said applying comprises applying said signal to a non-arrhythmic segment of a beating heart for at least 100 beats out of 50,000 consecutive beats.

2. A method according to claim 1, wherein said applying comprises applying said signal at least 1000 beats out of 50,000 consecutive beats.

3. A method according to claim 1, wherein said applying comprises applying said signal at least 4000 beats out of 50,000 consecutive beats.

4. A method according to claim 1, wherein said applying causes an increase in flow volume of at least 5%.

5. A method according to claim 1, wherein said applying comprises determining a state of reduced cardiac output and applying said signal in response to said determining.

6. A method according to claim 1, comprising modifying said applying in response to feedback indicating cardiac output.

7. A method according to claim 1, wherein said applying comprises applying said signal for between 3 and 5000 consecutive beats.

8. A method according to claim 1, wherein said applying comprises applying said signal periodically according to a therapy schedule.

9. A method according to claim 8, wherein said applying comprises applying said signal on a daily basis.

10. A method according to claim 1, wherein said applying causes an increase in cardiac output.

11. A method according to claim 1, wherein said applying causes an increase in contractility of at least 5%.

12. A method for modifying cardiac activity, the method comprising repeatedly applying a non-excitatory signal with a defined control sequence for a finite amount of time including a plurality of consecutive heart beats to a cardiac tissue of a beating heart, during an absolute refractory period of said tissue,

wherein said applying comprises applying said signal to a non-arrhythmic segment of a beating heart for at least 100 beats out of 50,000 consecutive beats.

13. A method according to claim 12, wherein the defined control sequence is not responsive to a signal from a sensor.

14. A method according to claim 12, wherein the control sequence is defined in terms of heartbeats.

15. A method according to claim 12, wherein modification of the cardiac activity persists after the finite amount of time is over.

16. A method according to claim 12, wherein the defined control sequence specifies a first number of beats in which a first control logic is applied and a second number of beats in which a second, different, control logic is applied.

17. A method according to claim 16, wherein said applying is according to a predetermined control sequence.

18. A method according to claim 16, wherein said applying is responsive to a cardiac output parameter.

19. A method according to claim 16, wherein the control sequence specifies application of the signal during 1% to 70% of heartbeats.

20. A method according to claim 16, wherein the control sequence specifies rest periods during which no signal is applied.

21. A method according to claim 16, wherein said applying comprises modifying the control sequence responsive to the output of a parametric sensor.

22. A method according to claim 12, comprising alternating said defined control sequence wherein a first control logic is applied for a first number of beats with at least a second, different, defined control sequence where a second control logic is applied for a second number of beats.

23. A method of ameliorating a clinical severity of reduced cardiac output of a beating heart in a patient with a long term therapeutic goal of increased cardiac output, the method comprising:

repeatedly applying a non-excitatory electric field to at least a portion of a beating heart, the electric field characterized by a magnitude, shape, duty cycle, phase, frequency and duration suitable to obtain an increase in stroke volume,

wherein said applying comprises applying said signal to a non-arrhythmic segment of a beating heart for at least 100 beats out of 50,000 consecutive beats.

24. A method according to claim 23, wherein the electric field is altered in response to an output from a sensor.

25. A method according to claim 24, wherein the sensor includes at least one sensor type selected from the group consisting of a pH sensor, an oxygen saturation sensor, a carbon dioxide saturation sensor, blood flow sensor, an acceleration sensor, a respiration sensor and a pressure sensor.

26. A method according to claim 23, wherein the electric field is applied at a time at which it is unable to generate a propagating action potential.

27. A method according to claim 23, wherein the electric field is adapted to influence a physiologic property of cardiac cells.

28. A method according to claim 27, wherein the physiologic property comprises calcium ion transport.

29. A method according to claim 23, comprising ceasing the applying when a desired change a distribution of muscle mass in the heart is achieved.

30. A method according to claim 23, performed on an ongoing basis by an implanted apparatus as a therapy for reduced cardiac output.

31. A method of cardiac modeling, the method comprising:

(a) applying a non-excitatory electric field to at least a portion of a heart to change a distribution of muscle mass in the heart; and

(b) ceasing to apply the non excitatory electric field after a desired change in distribution of muscle mass is achieved,

wherein said applying comprises applying said signal to a non-arrhythmic segment of a beating heart for at least 100 beats of a non-arrhythmically beating heart out of 50,000 consecutive beats.