Apparatus for reversal of myocardial remodeling with pre-excitation
First Claim
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1. A cardiac pacing device, comprising:
- sensing and pulse generation circuitry for connecting to a first electrode disposed at a stressed first ventricular site and for connecting to a second electrode disposed at a second ventricular site that is excited earlier during an intrinsic contraction;
a controller for controlling delivery of pacing pulses; and
,wherein the controller is programmed to deliver a pacing pulse to the stressed first ventricular site during a cardiac cycle before excitation of the second ventricular site in order to subject a stressed region to less mechanical stress when the myocardium contracts.
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Abstract
An apparatus for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.
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Citations
20 Claims
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1. A cardiac pacing device, comprising:
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sensing and pulse generation circuitry for connecting to a first electrode disposed at a stressed first ventricular site and for connecting to a second electrode disposed at a second ventricular site that is excited earlier during an intrinsic contraction; a controller for controlling delivery of pacing pulses; and
,wherein the controller is programmed to deliver a pacing pulse to the stressed first ventricular site during a cardiac cycle before excitation of the second ventricular site in order to subject a stressed region to less mechanical stress when the myocardium contracts. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A method for operating a cardiac pacing device, comprising:
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connecting sensing and pulse generation circuitry of the device to a first electrode disposed at a stressed first ventricular site, and to a second electrode disposed at a second ventricular site that is excited earlier during an intrinsic contraction; programming a device controller to deliver pacing pulses to the first ventricular site during a cardiac cycle before excitation of the second ventricular site in order to subject a stressed region to less mechanical stress when the myocardium contracts. - View Dependent Claims (19, 20)
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Specification