Cardiac function management integrating cardiac contractility modulation
First Claim
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1. An implantable cardiac function management device comprising:
- a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart;
a physiologic sensor circuit configured to sense information about a renal parameter;
a neural stimulation circuit configured to deliver neural stimulation therapy; and
a controller circuit, coupled to the CCM therapy circuit, the physiologic sensor circuit, and the neural stimulation circuit, the controller circuit configured to;
obtain or provide information about the CCM therapy;
obtain or provide information about the neural stimulation therapy; and
adjust at least one of the CCM therapy delivered by the CCM therapy circuit or the neural stimulation therapy delivered by the neural stimulation circuit using information about the other of the CCM therapy or the neural stimulation therapy and using the information about the renal parameter.
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Abstract
An implantable cardiac rhythm/function management system integrates cardiac contractility modulation (CCM) and one or more other therapies, such as to preserve device safety, improve efficacy, enhance sensing and detection, or enhance therapy effectiveness and delivery. Examples of the one or more other therapies can include pacing, defibrillation/cardioversion, cardiac resynchronization therapy (CRT), or neurostimulation.
63 Citations
16 Claims
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1. An implantable cardiac function management device comprising:
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a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart; a physiologic sensor circuit configured to sense information about a renal parameter; a neural stimulation circuit configured to deliver neural stimulation therapy; and a controller circuit, coupled to the CCM therapy circuit, the physiologic sensor circuit, and the neural stimulation circuit, the controller circuit configured to; obtain or provide information about the CCM therapy; obtain or provide information about the neural stimulation therapy; and adjust at least one of the CCM therapy delivered by the CCM therapy circuit or the neural stimulation therapy delivered by the neural stimulation circuit using information about the other of the CCM therapy or the neural stimulation therapy and using the information about the renal parameter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. An implantable cardiac function management device comprising:
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a cardiac contractility modulation (CCM) therapy circuit configured to deliver a CCM therapy including a non-stimulatory electrical energy during a refractory period of the heart; a physiologic sensor circuit configured to sense a physiologic parameter; and a controller circuit, coupled to the CCM therapy circuit and the physiologic sensor circuit, the controller circuit configured to obtain or provide information about the CCM therapy and information about the sensed physiologic parameter, the controller circuit configured to coordinate the CCM therapy circuit to adjust the CCM therapy using information about the sensed physiologic parameter; wherein the physiologic sensor circuit is configured to sense an indication of a measure of a renal parameter; and
wherein the controller circuit is configured to use the information about the sensed physiologic parameter including information about the renal parameter to coordinate the CCM therapy circuit to adjust at least one of CCM energy, CCM delivery timing, CCM delivery location, or CCM electrode configuration;wherein the physiologic sensor circuit includes an electrolyte sensor configured to detect an indication of a measure of at least one of;
potassium, sodium, calcium, chloride, or bicarbonate; and
wherein the controller circuit is configured to use information about the measure of the least one of potassium, sodium, calcium, chloride, or bicarbonate, to coordinate the CCM therapy circuit to adjust at least one of CCM energy, CCM delivery timing, CCM delivery location, or CCM electrode configuration;wherein the physiologic sensor circuit is configured to detect an indication of a measure of at least one of;
blood urea nitrogen, serum creatinine, or glomerular filtration rate; andwherein the controller circuit is configured to use information about the measure of the at least one of;
blood urea nitrogen, serum creatinine, or glomerular filtration rate, to coordinate the CCM therapy circuit to adjust at least one of CCM energy, CCM delivery timing, CCM delivery location, or CCM electrode configuration;wherein the physiologic sensor circuit includes a neural sensor configured to sense a neural signal; and
wherein the controller circuit is configured to use information about the neural signal to coordinate the CCM therapy circuit to adjust at least one of CCM energy, CCM delivery timing, CCM delivery location, or CCM electrode configuration; andcomprising a neural stimulation circuit configured to deliver neural stimulation therapy; wherein the controller circuit is configured to coordinate adjustment of at least one of the CCM therapy delivered by the CCM therapy circuit or the neural stimulation therapy delivered by the neural stimulation circuit using information about the other of the CCM therapy or the neural stimulation therapy; and
wherein the controller circuit is configured to coordinate adjustment of at least one of the CCM therapy or the neural stimulation therapy using information about the sensed physiologic parameter.
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Specification