Methods and apparatus to stimulate heart atria
First Claim
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1. A method for controllably reducing heart rate by pacing a heart of a patient having an atrium and a ventricle, the method comprising:
- pacing, after a first ventricular contraction of the heart, an atrium of the heart, wherein the atrial pacing occurs after expiration of an atrial refractory period of the heart and during a ventricular refractory period of the heart; and
causing an atrial contraction as a result of the atrial pacing,wherein the atrial contraction does not elicit a second ventricular contraction, andwherein the atrial contraction causes a vasodilation and a release of a natriuretic hormone in the heart.
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Abstract
A method and apparatus for treatment of hypertension and heart failure by increasing secretion of endogenous atrial hormones by pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in premature atrial contraction that does not result in ventricular contraction. Pacing results in the atrial wall stress, peripheral vasodilation, ANP secretion. Concomitant reduction of the heart rate is monitored and controlled as needed with backup pacing.
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Citations
47 Claims
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1. A method for controllably reducing heart rate by pacing a heart of a patient having an atrium and a ventricle, the method comprising:
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pacing, after a first ventricular contraction of the heart, an atrium of the heart, wherein the atrial pacing occurs after expiration of an atrial refractory period of the heart and during a ventricular refractory period of the heart; and causing an atrial contraction as a result of the atrial pacing, wherein the atrial contraction does not elicit a second ventricular contraction, and wherein the atrial contraction causes a vasodilation and a release of a natriuretic hormone in the heart. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method, carried out with an implanted heart muscle stimulator associated with a heart of a patient, for treating a blood pressure disorder in the patient, the patient having a pretreatment blood pressure, the method comprising:
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pacing at least one chamber of the heart of the patient so as to cause an atrium of the heart to contract while a heart valve associated with the atrium is closed; causing increased atrial wall stress as a result of the atrial contraction against the closed heart valve; reducing the patient'"'"'s blood pressure from the pretreatment blood pressure as a result of the increased atrial wall stress; and causing release of a natriuretic hormone as a result of the increased atrial wall stress, wherein the released natriuretic hormone contributes to the reduction in the blood pressure. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A device for treating a blood pressure disorder in a patient, the patient having a pretreatment blood pressure, the device comprising:
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at least one electrically conductive lead configured to connect to a heart of the patient; an electrical pulse generator connectable to the at least one electrically conductive lead and configured to; generate electrical pulses to excitable heart tissue of the heart through the at least one electrically conductive lead, wherein the electrical pulses pace at least one chamber of the heart so as to cause an atrium of the heart to contract while a heart valve associated with the atrium is closed such that the atrial contraction against the closed heart valve causes increased atrial wall stress, and wherein the electrical pulse generator monitors a ventricular contraction rate resulting from the atrial pacing to determine whether the atrial pacing conducts to a ventricle, and adjusts the atrial pacing based on the monitoring. - View Dependent Claims (33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45)
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46. A device for treating a blood pressure disorder in a patient, the patient having a pretreatment blood pressure, the device comprising:
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at least one electrically conductive lead configured to connect to a heart of the patient; an electrical pulse generator connectable to the at least one electrically conductive lead and configured to; generate electrical pulses to excitable heart tissue of the heart through the at least one electrically conductive lead, wherein the electrical pulses pace at least one chamber of the heart so as to; cause an atrium of the heart to contract while a heart valve associated with the atrium is closed, cause increased atrial wall stress as a result of the atrial contraction against the closed heart valve, reduce the patient'"'"'s blood pressure from the pretreatment blood pressure as a result of the increased atrial wall stress, and cause release of a natriuretic hormone as a result of the increased atrial wall stress, wherein the released natriuretic hormone contributes to the reduction in the blood pressure.
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47. A method for controllably reducing heart rate by pacing a heart of a patient having an atrium and a ventricle, the method comprising:
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pacing, after a first ventricular contraction of the heart, an atrium of the heart, wherein the atrial pacing occurs after expiration of an atrial refractory period of the heart and during a ventricular refractory period of the heart; and causing an atrial contraction as a result of the atrial pacing, wherein the atrial contraction does not elicit a second ventricular contraction, and wherein causing the atrial contraction as a result of the atrial pacing comprises causing the atrium to contract when the atrium is distended with blood.
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Specification