Augmentation of electrical conduction and contractility by biphasic cardiac pacing administered via the cardiac blood pool

• US 8,290,585 B2
• Filed: 01/21/2002
• Issued: 10/16/2012
• Est. Priority Date: 08/19/1996
• Status: Expired due to Term

• Current Assignee: MR3 Medical, LLC
• Original Assignee: MR3 Medical, LLC
• Inventors: Mower, Morton M.
• Primary Examiner(s): GETZOW, SCOTT M
• Application Number:
  US10/053,750
• Publication Number:
  US 20020099413A1
• Time in Patent Office: 3,921 Days
• Field of Search: 607 4- 28, 607/68, 607/70, 607/74, 128/898
• US Class Current: 607/9
• CPC Class Codes: A61N 1/3622 comprising two or more electrodes co-operating with different heart regions
• 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 1/368 comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence
• CPC Class Codes: A61N 1/3712 Auto-capture, i.e. automatic adjustment of the stimulation threshold

Abstract

Augmentation of electrical conduction and contractility by biphasic cardiac pacing. A first stimulation phase is administered to the cardiac blood pool. This first stimulation phase has a predefined polarity, amplitude and duration. A second stimulation phase is then administered to the cardiac blood pool. This second phase also has a predefined polarity, amplitude and duration. The two phases are applied sequentially. Contrary to current thought, anodal stimulation is first applied and followed by cathodal stimulation. In this fashion, pulse conduction through the cardiac muscle is improved together with the increase in contractility.

Claims

1. Apparatus for heart pacing with cardiac output modification, comprising:

one or more electrodes adapted to apply electrical signals to cardiac muscle segments;

signal generation circuitry adapted to apply an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart and a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac output; and

at least one pressure sensor which senses cardiac activity, wherein the sensor is coupled to the signal generation circuitry, which generates the pulses responsive thereto.

2. Apparatus for heart pacing with cardiac output modification, comprising:

one or more electrodes adapted to apply electrical signals to cardiac muscle segments;

signal generation circuitry adapted to apply an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart and a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac output; and

at least one sensor which senses cardiac activity, wherein the sensor is coupled to the signal generation circuitry, which generates the pulses responsive thereto.

3. Apparatus for heart pacing with cardiac output modification, comprising:

one or more electrodes adapted to apply electrical signals to cardiac muscle segments;

signal generation circuitry adapted to apply an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart and a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac output; and

at least one oxygen sensor which senses cardiac activity, wherein the sensor is coupled to the signal generation circuitry, which generates the pulses responsive thereto.

4. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) implanting a pacing electrode in a first chamber of a subject'"'"'s heart;

(b) implanting a non-excitatory stimulation electrode in another chamber of the subject'"'"'s heart;

(c) conveying an excitatory electrical pulse to at least one of the electrodes to pace the heart; and

(d) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the electrodes to modify the cardiac contraction.

5. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) implanting at least one non-excitatory stimulation electrode in each of a plurality of chambers of a subject'"'"'s heart;

(b) conveying an excitatory electrical pulse to at least one of the electrodes to pace the heart; and

(c) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the electrodes to modify the cardiac contraction.

6. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) fixing at least one electrode to the epicardium of a subject'"'"'s heart;

(b) conveying an excitatory electrical pulse to at least one of the electrodes to pace the heart; and

(c) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the electrodes to modify the cardiac contraction.

7. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) applying one or more electrodes to a subject'"'"'s heart;

(b) conveying an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart;

(c) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac contraction; and

(d) applying a sensor which senses cardiac activity to the subject'"'"'s body, wherein conveying the anodal non-excitatory stimulation pulse comprises generating a pulse responsive to the activity.

8. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) applying one or more electrodes to a subject'"'"'s heart;

(b) conveying an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart;

(c) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac contraction; and

(d) applying a pressure sensor which senses cardiac activity to the subject'"'"'s body, wherein conveying the anodal non-excitatory stimulation pulse comprises generating a pulse responsive to the activity.

9. A method for heart pacing with modification of cardiac contraction, comprising the steps of:

(a) applying one or more electrodes to a subject'"'"'s heart;

(b) conveying an excitatory electrical pulse to at least one of the one or more electrodes to pace the heart;

(c) conveying a non-excitatory anodal stimulation pulse as a first phase of a bi-phasic pacing pulse, the non-excitatory anodal stimulation pulse being of a magnitude and at a timing at which it is unable to generate a propagating action potential to at least one of the one or more electrodes to modify the cardiac contraction; and

(d) applying an oxygen sensor which senses cardiac activity to the subject'"'"'s body, wherein conveying the non-excitatory anodal stimulation pulse comprises generating a pulse responsive to the activity.