Protein activity modification

• US 9,440,080 B2
• Filed: 03/09/2015
• Issued: 09/13/2016
• Est. Priority Date: 03/10/2004
• Status: Active Grant

• Current Assignee: Impulse Dynamics NV
• Original Assignee: Impulse Dynamics NV
• Inventors: Rousso, Benny, Mika, Yuval, Ben-Haim, Shlomo, Sabbah, Hani N.
• Primary Examiner(s): VOORHEES, CATHERINE M
• Application Number:
  US14/641,480
• Publication Number:
  US 20150174404A1
• Time in Patent Office: 554 Days
• US Class Current: 1/1
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/3628 using sub-threshold or non-excitatory signals
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy
• CPC Class Codes: A61N 2/004 specially adapted for a specific therapy
• CPC Class Codes: C12N 13/00 Treatment of microorganisms or enzymes with electrical or wave energy, e.g. magnetism, sonic waves
• CPC Class Codes: C12Q 1/6883 for diseases caused by alterations of genetic material
• CPC Class Codes: C12Q 2600/112 Disease subtyping, staging or classification
• CPC Class Codes: C12Q 2600/158 Expression markers
• CPC Class Codes: G01N 2800/325 Heart failure or cardiac arrest, e.g. cardiomyopathy, congestive heart failure
• CPC Class Codes: G01N 33/6893 related to diseases not provided for elsewhere

Abstract

A method of modifying tissue behavior, comprising:

• determining a desired modification of tissue behavior for at least one of treatment of a disease, short or long term modification of tissue behavior, assessing tissue state and assessing tissue response to stimulation;
• selecting an electric field having an expected effect of modifying protein activity of at least one protein as an immediate response of a tissue to the field, said expected effect correlated with said desired modification; and
• applying said field to said tissue.

Claims

1. A method of treating a patient for chronic heart failure, comprising:

a. selecting a patient having (i) a narrow QRS and (ii) a New York Heart Association (NYHA) class of at least II; and

b. applying a cardiac contractility modifying electrical therapy to a heart of said patient for at least 3 months.

2. A method according to claim 1, wherein said QRS has a duration of less than 105 ms.

3. A method according to claim 1, wherein said QRS has a duration of less than 90 ms.

4. A method according to claim 1, wherein said selecting comprises selecting patients with an EF (ejection fraction) <

40%.

5. A method according to claim 1, wherein said selecting comprises selecting patients with an EF (ejection fraction) <

35%.

6. A method according to claim 1, wherein said selecting comprises selecting patients with a NYHA class of at least III.

7. A method according to claim 1, wherein said selecting comprises selecting patients with a NYHA class of II or III.

8. A method according to claim 1, wherein said selecting comprises selecting patients with a NYHA class of IV.

9. A method according to claim 1, wherein said selecting comprises selecting patients with ischemic heart failure.

10. A method according to claim 1, wherein said selecting comprises selecting patients with idiopathic heart failure.

11. A method according to claim 1, wherein said selecting comprises selecting a patient being treated for heart failure using medication.

12. A method according to claim 1, wherein said selecting comprises selecting with a goal to improve six minute walk by at least 15 meters.

13. A method according to claim 1, wherein said applying comprises applying at least until a six minute walk of the patient improves by at least 15 meters.

14. A method according to claim 1, wherein said selecting comprises selecting with a goal to improve peak oxygen consumption (VO₂) by at least 1 ml O₂/kg/min.

15. A method according to claim 1, wherein said selecting comprises selecting with a peak oxygen consumption (VO₂) <

14.4 ml O₂/kg/min.

16. A method according to claim 1, wherein said selecting comprises selecting with a peak oxygen consumption (VO₂) of about 14.3±

2.8 ml O₂/kg/min.

17. A method according to claim 1, wherein said applying comprises applying at least until peak oxygen consumption (VO₂) improves by at least 1 ml O₂/kg/min.

18. A method according to claim 1, wherein said selecting comprises selecting with a goal to improve NYHA class by at least one class.

19. A method according to claim 1, wherein said applying comprises applying at least until NYHA class improves by at least one class.

20. A method according to claim 1, wherein said selecting comprises selecting with a Minnesota Living With Heart Failure Questionnaire (MLWHFQ) of about 41±

20.

21. A method according to claim 1, wherein said selecting comprises selecting with a goal to improve Minnesota Living With Heart Failure Questionnaire (MLWHFQ) by at least 18.3.

22. A method according to claim 1, wherein said applying comprises applying at least until Minnesota Living With Heart Failure Questionnaire (MLWHFQ) improves by at least 18.3.

23. A method according to claim 1, comprising continuing treating with beta blockers.

24. A method according to claim 1, wherein said applying comprises applying for at least 6 months.

25. A method according to claim 1, wherein said applying comprises stopping applying while allowing therapeutic effect of said applying to continue for at least 3 months.

26. A method according to claim 1, wherein said applying comprises applying using an implantable device and implantable electrodes.

27. A method according to claim 1, wherein said cardiac contractility modifying therapy is applied at a time when the therapy is non-excitatory to said heart.

28. A method according to claim 1, wherein said applying comprises applying intermittently for at least 5 hours a day.