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 suffering from at least one of hypertension, and excessive retention of fluid and sodium, the method comprising:
- 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,synchronously pacing the at least one ventricle of the patient'"'"'s heart at a ventricular pacing rate, andproducing extra contractions of the at least one atria by asynchronously pacing the at least one atria of the patient'"'"'s heart at an atrial pacing rate that exceeds the ventricular pacing rate,wherein the produced extra contractions stress a wall of the at least one atria beyond a natural stress condition, such that 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; and
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.
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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
24 Claims
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1. A method for pacing a heart of a patient suffering from at least one of hypertension, and excessive retention of fluid and sodium, the method comprising:
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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, synchronously pacing the at least one ventricle of the patient'"'"'s heart at a ventricular pacing rate, and producing extra contractions of the at least one atria by asynchronously pacing the at least one atria of the patient'"'"'s heart at an atrial pacing rate that exceeds the ventricular pacing rate, wherein the produced extra contractions stress a wall of the at least one atria beyond a natural stress condition, such that 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; and 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. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A method for treating a patient suffering from at least one of hypertension, and excessive retention of fluid and sodium, the method comprising:
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during a first pacing period synchronously pacing at least one atria and at least one ventricle of a heart of the patient; during a second pacing period, pacing the patient'"'"'s heart to cyclically contract the at least one atria, stress a wall of the at least one atria, and restore the wall of the at least one atria to a substantially pre-stressed condition; such that the stressed wall secretes a hormone at an elevated level above a natural secretion level occurring naturally when the patient'"'"'s heart is not paced; and achieving a beneficial therapeutic effect in 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. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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17. A method for treating a patient suffering from at least one of hypertension, and excessive retention of fluid and sodium, the method comprising:
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during a first pacing period synchronously pacing at least one atria and at least one ventricle of a heart of the patient; during a second pacing period, producing extra contractions of the at least one atria by pacing the at least one atria at an atrial contraction rate faster than a ventricular contraction rate, wherein the produced extra contractions stress at least one wall of the at least one atria of the patient'"'"'s heart so as to induce a tissue in the at least one stressed wall to secrete greater amounts of a hormone as compared to a secretion amount of the hormone occurring when no pacing is 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. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24)
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Specification