Methods and systems for lowering blood pressure through reduction of ventricle filling

• US 9,333,352 B2
• Filed: 03/10/2015
• Issued: 05/10/2016
• Est. Priority Date: 12/21/2012
• Status: Active Grant

• Current Assignee: Backbeat Medical, LLC
• Original Assignee: Backbeat Medical, Inc.
• Inventors: Mika, Yuval, Sherman, Darren, Schwartz, Robert S., Van Tassel, Robert A., Burkhoff, Daniel
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Morales, Jon Eric C
• Application Number:
  US14/642,952
• Publication Number:
  US 20150174410A1
• Time in Patent Office: 427 Days
• Field of Search: 607/17
• US Class Current: 1/1
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2424 Ball valves
• CPC Class Codes: A61F 2250/0013 for adjusting fluid pressure
• CPC Class Codes: A61N 1/36117 for treating hypertension
• 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 1/36528 the parameter being measured by means of ultrasound
• CPC Class Codes: A61N 1/36564 controlled by blood pressure
• CPC Class Codes: A61N 1/36571 controlled by blood flow rate, e.g. blood velocity or cardiac output
• CPC Class Codes: A61N 1/36578 controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone
• CPC Class Codes: A61N 1/36585 controlled by two or more physical parameters
• CPC Class Codes: A61N 1/3682 with a variable atrioventricular delay
• CPC Class Codes: A61N 1/3684 for stimulating the heart at multiple sites of the ventricle or the atrium
• CPC Class Codes: A61N 1/36842 Multi-site stimulation in the same chamber
• CPC Class Codes: A61N 1/36843 Bi-ventricular stimulation

Abstract

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient'"'"'s heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient'"'"'s heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Claims

1. A system for reducing blood pressure in a patient having a pretreatment blood pressure, comprising:

at least one stimulation electrode for stimulating at least one chamber of a heart of the patient; and

at least one controller configured to execute a stimulation pattern comprising multiple stimulation pulses,

wherein at least one stimulation pulse of the multiple stimulation pulses has a first stimulation setting configured to reduce atrial kick in at least one ventricle of the heart, and

wherein at least one stimulation pulse of the multiple stimulation pulses has a second stimulation setting configured to reduce a baroreflex response to a reduction in blood pressure resulting from the reduction in atrial kick.

2. The system of claim 1, wherein the second stimulation setting has a longer AV delay than the first stimulation setting.

3. The system of claim 1, wherein the second stimulation setting is configured to reduce or prevent atrial kick in at least one ventricle of the heart.

4. The system of claim 1, wherein the stimulation pattern comprises more than two different stimulation settings.

5. The system of claim 1, wherein the at least one controller is configured to execute the stimulation pattern a plurality of times in sequence.

6. The system of claim 1, wherein the second stimulation setting is applied for a period ranging from about 1 heartbeat to about 5 heartbeats.

7. The system of claim 1, wherein the stimulation pattern includes multiple stimulation pulses having the first stimulation setting and multiple stimulation pulses having the second stimulation setting.

8. The system of claim 7, wherein between about 1% and about 40% of the multiple stimulation pulses of the stimulation pattern have the second stimulation setting.

9. The system of claim 1, wherein the stimulation pattern includes a ratio of about 8 stimulation pulses to about 13 stimulation pulses having the first stimulation setting to about 2 stimulation pulses to about 5 stimulation pulses having the second stimulation setting.

10. The system of claim 1, wherein the stimulation pattern includes a ratio of stimulation pulses having the first stimulation setting to stimulation pulses having the second stimulation setting that corresponds to a ratio of time constants of a response to increase and decrease in blood pressure.

11. The system of claim 1, wherein the first stimulation setting reduces ventricular filling volume from a pretreatment ventricular filling volume.

12. The system of claim 1, wherein the second stimulation setting reduces the baroreflex response by limiting increases in blood pressure values between stimulation pulses to a predetermined value or range of values.

13. The system of claim 1, wherein the stimulation pattern includes at least one heartbeat having a natural AV delay.

14. The system of claim 13, wherein the at least one chamber of the heart is stimulated to provide the at least one heartbeat having the natural AV delay.

15. A method for reducing blood pressure in a patient having a pretreatment blood pressure, comprising:

delivering a stimulation pattern comprising multiple stimulation pulses to at least one chamber of a heart of the patient,

wherein at least one stimulation pulse of the multiple stimulation pulses has a first stimulation setting configured to reduce atrial kick in at least one ventricle of the heart, and

wherein at least one stimulation pulse of the multiple stimulation pulses has a second stimulation setting configured to reduce a baroreflex response to a reduction in blood pressure resulting from the reduction in atrial kick.

16. The method of claim 15, wherein the second stimulation setting has a longer AV delay than the first stimulation setting.

17. The method of claim 15, wherein the second stimulation setting is configured to reduce or prevent atrial kick in at least one ventricle of the heart.

18. The method of claim 15, wherein the stimulation pattern comprises more than two different stimulation settings.

19. The method of claim 15, wherein delivering the stimulation pattern comprises delivering the stimulation pattern a plurality of times in sequence.

20. The method of claim 15, wherein the second stimulation setting is applied for a period ranging from about 1 heartbeat to about 5 heartbeats.

21. The method of claim 15, wherein the stimulation pattern includes multiple stimulation pulses having the first stimulation setting and multiple stimulation pulses having the second stimulation setting.

22. The method of claim 21, wherein between about 1% and about 40% of the multiple stimulation pulses of the stimulation pattern have the second stimulation setting.

23. The method of claim 15, wherein the stimulation pattern includes a ratio of about 8 stimulation pulses to about 13 stimulation pulses having the first stimulation setting to about 2 stimulation pulses to about 5 stimulation pulses having the second stimulation setting.

24. The method of claim 15, wherein the stimulation pattern includes a ratio of stimulation pulses having the first stimulation setting to stimulation pulses having the second stimulation setting that corresponds to a ratio of time constants of a response to increase and decrease in blood pressure.

25. The method of claim 15, wherein the first stimulation setting reduces ventricular filling volume from a pretreatment ventricular filling volume.

26. The method of claim 15, wherein the second stimulation setting reduces the baroreflex response by limiting increases in blood pressure values between stimulation pulses to a predetermined value or range of values.

27. The method of claim 15, wherein the stimulation pattern includes at least one heartbeat having a natural AV delay.

28. The method of claim 27, wherein the at least one chamber of the heart is stimulated to provide the at least one heartbeat having the natural AV delay.