Papillary muscle stimulation
First Claim
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1. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
- providing a lead having a first electrode and a second electrode on a distal portion;
inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart;
the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle;
the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and
producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and delivering another pacing pulse via the second electrode in close proximity to the second papillary muscle so as to separately activate the second papillary muscle, the pacing pulses being delivered to the first and second electrodes with a timing relationship that causes closure of a mitral valve prior to a main left ventricular contraction.
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Abstract
A method for pacing a left ventricle of a heart includes delivering a pacing pulse via a first electrode to activate a first papillary muscle and another pacing pulse via a second electrode to activate a second papillary muscle.
23 Citations
19 Claims
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1. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
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providing a lead having a first electrode and a second electrode on a distal portion; inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart; the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle; the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and delivering another pacing pulse via the second electrode in close proximity to the second papillary muscle so as to separately activate the second papillary muscle, the pacing pulses being delivered to the first and second electrodes with a timing relationship that causes closure of a mitral valve prior to a main left ventricular contraction. - View Dependent Claims (2, 5, 6, 7, 8, 9, 12, 13, 17, 18)
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3. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
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providing a lead having a first electrode and a second electrode on a distal portion; inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart; the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle; the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and delivering another a second pacing pulse via the second electrode in close proximity to the second papillary muscle so as to activate the second papillary muscle, the pacing pulses being delivered to the first and second electrodes with a timing relationship that causes closure of a mitral valve prior to a main left ventricular contraction, wherein the pacing pulses, delivered via the first and second electrodes are delivered with a delay between the pulses.
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4. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
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providing a lead having a first electrode and a second electrode on a distal portion; inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart; the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle; the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and delivering another a second pacing pulse via the second electrode in close proximity to the second papillary muscle so as to activate the second papillary muscle, the pacing pulses being delivered to the first and second electrodes with a timing relationship that causes closure of a mitral valve prior to a main left ventricular contraction, wherein the distal portion of the lead further includes a third electrode coupled thereto in between the first electrode and the second electrode in order that the third electrode forms a first bipolar pair with the first electrode and a second bipolar pair with the second electrode.
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10. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
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providing a lead having a first electrode and a second electrode on a distal portion; inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart; the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle; the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and delivering another a second pacing pulse via the second electrode in close proximity to the second papillary muscle so as to activate the second papillary muscle, the pacing pulses being delivered to the first and second electrodes with a timing relationship that causes closure of a mitral valve prior to a main left ventricular contraction, further comprising the step of isolating conduction within the first and second left ventricular papillary muscles from myocardial conduction of the left ventricle prior to delivering the pacing pulses. - View Dependent Claims (11, 19)
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14. A method for pacing a left ventricle of a heart having an apex wall with an outer surface, comprising the steps of:
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providing a lead having a first electrode and a second electrode on a distal portion; inserting the distal portion of the lead into the apex wall such that the distal portion extends into the apex wall of a left ventricle of a heart; the first electrode being beneath the outer surface of the left ventricle and in proximity to a base of a first left ventricular papillary muscle; the second electrode being beneath the outer surface of the left ventricle and in proximity to a base of a second left ventricular papillary muscle; and producing activation in the apex of the left ventricle by delivering a pacing pulse via the first electrode in close proximity to the first papillary muscle so as to activate the first papillary muscle and another pacing pulse via the second electrode in close proximity to the second papillary muscle so as to separately activate the second papillary muscle, wherein the first electrode is positioned in proximity to the base of a posterior left ventricular papillary muscle and the second electrode is positioned in proximity to the base of an anterior left ventricular papillary muscle.
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15. A method for pacing a left ventricle of a heart comprising the steps of:
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positioning a first electrode in proximity to a base of a first left ventricular papillary muscle; positioning a second electrode in proximity to a base of a second left ventricular papillary muscle; and delivering a pacing pulse via the first electrode which activates the first papillary muscle and another pacing pulse via the second electrode which separately activates the second papillary muscle. - View Dependent Claims (16)
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Specification