Method and apparatus for treating hemodynamic disfunction
DC CAFCFirst Claim
1. A method for improving the hemodynamic efficiency of a sick heart comprising the steps of:
- (a) detecting respective cardiac signals originating in the left and right ventricles of the heart;
(b) analyzing said cardiac signals and the absence thereof in an electronic control circuit; and
(c) providing electrical pulses from a stimulating circuit controlled by said control circuit to one, the other or both ventricles as required for effecting substantially simultaneous contraction of both ventricles, said step of analyzing including providing a control signal from said control circuit to said stimulating circuit for producing an electrical stimulating pulse to one or both ventricles in response to the absence of a detected cardiac signal from one or both ventricles within a time interval which is a small fraction of the pulse width of a detected cardiac signal.
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Abstract
A method of treating hemodynamic disfunction by simultaneously pacing both ventricles of a heart. At least one ECG amplifier is arranged to separately detect contraction of each ventricle and a stimulator is then activated for issuing stimulating pulses to both ventricles in a manner to assure simultaneous contraction of both ventricles, thereby to assure hemodynamic efficiency. A first ventricle is stimulated simultaneously with contraction of a second ventricle when the first fails to properly contract. Further, both ventricles are stimulated after lapse of a predetermined A-V escape interval. One of a pair of electrodes, connected in series, in placed through the superior vena cava into the right ventricle and a second is placed in the coronary sinus about the left ventricle. Each electrode performs both pacing and sensing functions. The pacer is particularly suitable for treating bundle branch blocks or slow conduction in a portion of the ventricles.
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Citations
331 Claims
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1. A method for improving the hemodynamic efficiency of a sick heart comprising the steps of:
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(a) detecting respective cardiac signals originating in the left and right ventricles of the heart;
(b) analyzing said cardiac signals and the absence thereof in an electronic control circuit; and
(c) providing electrical pulses from a stimulating circuit controlled by said control circuit to one, the other or both ventricles as required for effecting substantially simultaneous contraction of both ventricles, said step of analyzing including providing a control signal from said control circuit to said stimulating circuit for producing an electrical stimulating pulse to one or both ventricles in response to the absence of a detected cardiac signal from one or both ventricles within a time interval which is a small fraction of the pulse width of a detected cardiac signal. - View Dependent Claims (2, 3, 4)
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5. A method for effecting simultaneous contraction of both left and right ventricles of a heart for improving hemodynamic efficiency comprising the steps of:
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separately sensing for the presence of cardiac depolarization signals from both left and right ventricles;
determining whether said cardiac depolarization signals are simultaneously present in both the left and right ventricles; and
stimulating at least one ventricle substantially simultaneously with the contraction of at least one other ventricle in the event that said cardiac depolarization signals are determined not to be simultaneously present in both ventricles.
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6. A method of effecting simultaneous contraction of both left and right ventricles of a heart for improving hemodynamic efficiency comprising the steps of:
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sensing the cardiac signals of the atria and separately sensing the cardiac depolarization signals of both the left and right ventricles;
determining whether said cardiac depolarization signals are simultaneously present in both the left and right ventricles;
stimulating at least one ventricle simultaneously with the contraction of at least one other ventricle after a predetermined A-V period in the event that said cardiac depolarization signals are determined not to be simultaneously present in both ventricles.
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7. A method of increasing the cardiac output of a sick heart comprising the steps of:
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(a) implanting a pacing lead having at least two sensing/pacing electrodes in the body such that one of said sensing/pacing electrodes is in or on the right ventricle and the other of said sensing/ pacing electrodes is in or on the left ventricle;
(b) sensing depolarization signals picked up by said sensing/pacing electrodes upon their occurrence;
(c) determining whether the depolarization signals sensed in step (b) fail to occur within a predetermined time interval of one another and, if so;
(d) applying an electrical stimulating pulse to the sensing/pacing electrode associated with the ventricle not producing a depolarization signal within said time interval at the conclusion of said time interval. - View Dependent Claims (8)
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9. A bi-ventricular pacemaker, comprising:
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(a) sense means for sensing ventricular depolarization signals originating in or on the right and left ventricles;
(b) means coupled to said sense means for initiating a time delay of a predetermined length which is short compared to the period of a QRS complex upon detection of a ventricular depolarization signal in one of said right or left ventricles; and
(c) pulse generator means operative upon the termination of said time delay for producing a ventricular simulating pulse and applying same to the other of said right or left ventricles unless a ventricular depolarization signal occurs in said other of said right of left ventricle prior to the expiration of said time delay. - View Dependent Claims (10, 11, 12)
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13. An atrial-coupled, bi-ventricular pacemaker for implantation or external use comprising atrial and ventricular sensing means for detecting cardiac signals, said sensing means including first and second ventricular electrodes connected in series for sensing and stimulating the right and the left ventricles, respectively, and an atrial electrode adapted to be disposed in an atrial chamber for detecting cardiac signals of the atria, all of said electrodes being connected to separate ECG amplifier means for amplifying the sensed signals;
- a control circuit coupled to said ECG amplifier means for analyzing the cardiac signals picked up by said sensing means and providing a control signal; and
a stimulating circuit means for producing an electrical stimulating pulse to the left ventricle in the absence of a detected cardiac signal from the left ventricle, and to the right ventricle in the absence of a detected cardiac signal from the right ventricle, and to both ventricles in the absence of detected cardiac signals from both ventricles to effect substantially simultaneous contraction of both ventricles after a predetermined A-V delay period. - View Dependent Claims (14)
- a control circuit coupled to said ECG amplifier means for analyzing the cardiac signals picked up by said sensing means and providing a control signal; and
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15. A heart stimulating device for treating heart failure, comprising:
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a sense amplifier to receive ventricular depolarization signals originating from a first ventricle;
a pulse generator, connected to the sense amplifier, to generate a stimulating pulse in the event the sense amplifier receives a ventricular depolarization signal; and
an electrode, connected to the pulse generator, to apply the stimulating pulse to a second ventricle in the event the sense amplifier receives a ventricular depolarization signal. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A heart stimulating device for treating heart failure, comprising:
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means for receiving ventricular depolarization signals originating from a first ventricle;
means for generating a stimulating pulse in the event the receiving means receives a ventricular depolarization signal; and
means for applying the stimulating pulse to a second ventricle in the event the receiving means receives a ventricular depolarization signal. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A method for improving the hemodynamic efficiency of a heart, comprising:
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receiving ventricular depolarization signals originating from a first ventricle;
generating a stimulating pulse in response to the receiving of a ventricular depolarization signal; and
applying the stimulating pulse to a second ventricle in response to the receiving of a ventricular depolarization signal. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50)
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51. A heart stimulating device for treating heart failure comprising:
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an electrode to sense a cardiac depolarization signal from a first ventricle;
a sense amplifier, connected to the electrode, to process the cardiac depolarization signal; and
a stimulator, connected to the sense amplifier, to issue a stimulating pulse to a second ventricle in response to the ventricular cardiac depolarization signal. - View Dependent Claims (52, 53, 54, 55, 56, 57, 58, 59, 60, 61)
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62. A heart stimulating device for treating heart failure comprising:
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means for sensing a cardiac depolarization signal from a first ventricle;
means, connected to the sensing means, for receiving the cardiac depolarization signal; and
means, connected to the receiving means, for issuing a stimulating pulse to a second ventricle in response to the ventricular cardiac depolarization signal. - View Dependent Claims (63, 64, 65, 66, 67, 68, 69, 70, 71, 72)
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73. A method for improving the hemodynamic efficiency of a heart, comprising:
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sensing a cardiac depolarization signal from a first ventricle;
receiving the ventricular cardiac depolarization signal; and
issuing a stimulating pulse to a second ventricle in response to the ventricular cardiac depolarization signal. - View Dependent Claims (74, 75, 76, 77, 78, 79, 80, 81, 82, 83)
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84. A heart stimulating device for treating heart failure, comprising:
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an electrode to sense ventricular depolarization signals originating from the right ventricle; and
a pulse generator, connected to the electrode, operative upon sensing of a ventricular depolarization signal from the right ventricle to apply a stimulating pulse to another ventricle. - View Dependent Claims (85, 86, 87, 88, 89)
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90. A heart stimulating device for treating heart failure, comprising:
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means for sensing ventricular depolarization signals originating from the right ventricle; and
means for applying a stimulating pulse to another ventricle in response to the sensing means sensing a ventricular depolarization signal originating from the right ventricle. - View Dependent Claims (91, 92, 93, 94, 95)
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96. A method for improving the hemodynamic efficiency of a heart, comprising:
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sensing ventricular depolarization signals originating from the right ventricle; and
applying a stimulating pulse to another ventricle in response to the sensing of a ventricular depolarization signal originating from the right ventricle. - View Dependent Claims (97, 98, 99, 100, 101)
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102. A heart stimulating device for treating heart failure, comprising:
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an electrode to sense ventricular depolarization signals originating from the right ventricle; and
a pulse generator operative upon sensing of a ventricular depolarization signal to apply a stimulating pulse to another ventricle. - View Dependent Claims (103, 104, 105, 106, 107)
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108. A heart stimulating device for treating heart failure, comprising:
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means for sensing ventricular depolarization signals originating from the left ventricle; and
means for applying a stimulating pulse to another ventricle in response to the sensing means sensing ventricular depolarization signals originating from the left ventricle. - View Dependent Claims (109, 110, 111, 112, 113)
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114. A method for improving the hemodynamic efficiency of a heart, comprising:
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sensing ventricular depolarization signals originating from the left ventricle; and
applying a stimulating pulse to another ventricle in response to the sensing of the ventricular depolarization signals originating from the left ventricle. - View Dependent Claims (115, 116, 117, 118, 119)
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120. A heart stimulating device for treating heart failure, comprising:
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a first electrode to sense atrial cardiac depolarization signals originating from an atrial chamber;
a second electrode to sense ventricular cardiac depolarization signals originating from a ventricular chamber;
a pulse generator operative to apply stimulating pulses to both ventricles in the event that no ventricular cardiac depolarization signals are sensed within a predetermined atrial-ventricular delay period. - View Dependent Claims (121, 122, 123)
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124. A heart stimulating device for treating heart failure, comprising:
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means for sensing atrial cardiac depolarization signals originating from an atrial chamber;
means for sensing ventricular cardiac depolarization signals originating from a ventricular chamber;
means for applying stimulating pulses to both ventricles in the event that no ventricular cardiac depolarization signals are sensed within a predetermined atrial-ventricular delay period. - View Dependent Claims (125, 126, 127)
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128. A method for improving the hemodynamic efficiency of a heart, comprising:
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sensing for the presence of cardiac depolarization signals from a ventricle; and
stimulating both ventricles in the event that no cardiac depolarization signals are sensed from either ventricle within a predetermined atrial-ventricular delay period. - View Dependent Claims (129, 130, 131)
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132. An atrial-coupled bi-ventricular stimulating device for treatment of congestive heart failure comprising:
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atrial and ventricular sensing means for detecting cardiac signals originating in an atrium and in a ventricle;
a control circuit connected to said sensing means to receive the cardiac signals and provide a control signal; and
a stimulating circuit for effecting simultaneous contraction of both ventricles in response to the control signal of the control circuit after a predetermined A-V delay period.
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133. An atrial-coupled bi-ventricular stimulating device for implantation or external use for treating heart failure comprising:
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a sensing electrode adapted to be located in an atrium;
a pacing electrode adapted to be located through the coronary sinus in the left ventricle;
a sensing electrode adapted to be located in the right ventricle;
ventricular sensing means for detecting cardiac signals from the sensing electrode adapted to be in the right ventricle;
a control circuit connected to said sensing means to provide a control signal in response to detecting a cardiac signal; and
a stimulating circuit for effecting simultaneous contraction of both ventricles in response to the control signal of the control circuit after a predetermined A-V delay period. - View Dependent Claims (134, 135)
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136. A method for treating congestive heart failure comprising:
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locating a sensing electrode in an atrium;
locating a pacing electrode through the coronary sinus in the left ventricle;
locating a sensing electrode in the right ventricle;
sensing for cardiac signals from the sensing electrode in the right ventricle;
detecting the cardiac signals; and
effecting simultaneous contraction of both ventricles after a predetermined A-V delay period. - View Dependent Claims (137, 138, 139)
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140. A method of effecting simultaneous contraction of both left and right ventricles of a heart for improving hemodynamic efficiency comprising:
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locating a pacing electrode through the coronary sinus to the left ventricle;
sensing the cardiac signals of the atria and separately sensing the cardiac depolarization signals of the right ventricle;
detecting the cardiac signals of the atria and the cardiac depolarization signals of the right ventricle; and
stimulating the left ventricle simultaneously with the contraction of the right ventricle after a predetermined A-V delay period. - View Dependent Claims (141, 142)
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143. A heart stimulating device for treating heart failure, comprising:
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an electrode adapted to be disposed in or about the right ventricle to sense ventricular depolarization signals originating from the right ventricle;
a sense amplifier to receive the ventricular depolarization signals originating from the right ventricle;
a pulse generator, connected to the sense amplifier, to generate a stimulating pulse in the event the sense amplifier receives a ventricular depolarization signal originating from the right ventricle; and
an electrode, adapted to be disposed in or about the left ventricle and connected to the pulse generator, to apply the stimulating pulse to the left ventricle in the event the sense amplifier receives a ventricular depolarization signal originating from the right ventricle. - View Dependent Claims (144, 145)
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146. A method for treating congestive heart failure, comprising:
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receiving ventricular depolarization signals originating from the right ventricle;
generating a stimulating pulse in response to the receiving of a ventricular depolarization signal in the right ventricle; and
applying the stimulating pulse to the left ventricle in response to the receiving of a ventricular depolarization signal in the right ventricle. - View Dependent Claims (147, 148)
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149. A heart stimulating device for treating heart failure, comprising:
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an electrode adapted to be disposed in or about the left ventricle to sense ventricular depolarization signals originating from the left ventricle;
a sense amplifier to receive the ventricular depolarization signals originating from the left ventricle;
a pulse generator, connected to the sense amplifier, to generate a stimulating pulse in the event the sense amplifier receives a ventricular depolarization signal originating from the left ventricle; and
an electrode, adapted to be disposed in or about the right ventricle and connected to the pulse generator, to apply the stimulating pulse to the right ventricle in the event the sense amplifier receives a ventricular depolarization signal originating from the left ventricle. - View Dependent Claims (150, 151)
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152. A method for treating a heart suffering from heart failure, comprising:
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receiving ventricular depolarization signals originating from the left ventricle;
generating a stimulating pulse in response to the receiving of a ventricular depolarization signal in the left ventricle; and
applying the stimulating pulse to the right ventricle in response to the receiving of a ventricular depolarization signal in the left ventricle. - View Dependent Claims (153, 154)
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155. A method for improving the hemodynamic efficiency of a heart, comprising:
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detecting a cardiac depolarization signal originating from a first ventricle; and
unconditionally stimulating both ventricles for effecting a coordinated contraction of both ventricles when a cardiac depolarization signal originating from the first ventricle is detected. - View Dependent Claims (156, 157)
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158. A heart stimulating device for treating heart failure, comprising:
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an electrode adapted to be disposed in or about a first ventricle for detecting a cardiac depolarization signal originating from the first ventricle;
a sense amplifier to receive the cardiac depolarization signal originating from the first ventricle;
a pulse generator, connected to the sense amplifier, to unconditionally stimulate both ventricles for effecting a coordinated contraction of both ventricles when the cardiac depolarization signal from the first ventricle is detected. - View Dependent Claims (159, 160)
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161. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle; and
stimulating the left ventricle and the right ventricle when a depolarization signal from either the left ventricle or the right ventricle is detected for effecting a coordinate contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (162, 163, 164, 165, 166, 167, 168, 169, 170)
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171. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals only from one ventricle of the heart;
stimulating the left ventricle and the right ventricle when a depolarization signal from the one ventricle is detected for effecting a coordinate contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182)
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183. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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a sense amplifier for receiving depolarization signals originating from left and right ventricles; and
a pulse generator, connected to the sense amplifier, that generates stimulation pulses for application to the left ventricle and the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from either the left ventricle or the right ventricle for effecting a coordinated contraction of the ventricles to improve the pumping ability of the heart suffering from heart failure;
a first electrode connected to the pulse generator and adapted to be disposed in or about the left ventricle for sensing depolarization signals originating from the left ventricle and for applying a stimulation pulse to the left ventricle when the sense amplifier receives a ventricular depolarization signal originating from either the left ventricle or the right ventricle; and
a second electrode connected to the pulse generator and adapted to be disposed in or about the right ventricle for sensing depolarization signals originating from the right ventricle and for applying a stimulation pulse to the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from either the left ventricle or the right ventricle. - View Dependent Claims (184, 185, 186, 187, 188, 189, 190, 191)
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192. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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a sense amplifier for receiving depolarization signals originating from a left ventricle or a right ventricle;
a pulse generator, connected to the sense amplifier, that generates stimulation pulses for application to the left ventricle and the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from the left ventricle or the right ventricle for effecting a coordinated contraction of the ventricles to improve the pumping ability of the heart suffering from heart failure;
a first electrode connected to the pulse generator and adapted to be disposed in or about the left ventricle, the first electrode capable of sensing depolarization signals originating from the left ventricle and capable of applying a stimulation pulse to the left ventricle when the sense amplifier receives a ventricular depolarization signal originating from the left ventricle or the right ventricle; and
a second electrode connected to the pulse generator and adapted to be disposed in or about the right ventricle, the second electrode capable of sensing depolarization signals originating from the right ventricle and capable of applying a stimulation pulse to the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from the left ventricle or the right ventricle. - View Dependent Claims (193, 194, 195, 196, 197, 198, 199)
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200. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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a sense amplifier for receiving depolarization signals originating from only one ventricle of the heart;
a pulse generator, connected to the amplifier for generating stimulation pulses for application to the left ventricle and the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from the one ventricle for effecting a coordinated contraction of the ventricles to improve the pumping ability of the heart suffering from heart failure;
a first electrode connected to the pulse generator and adapted to be disposed in or about the left ventricle for applying a stimulation pulse to the left ventricle when the sense amplifier receives a ventricular depolarization signal originating from the one ventricle; and
a second electrode connected to the pulse generator and adapted to be disposed in or about the right ventricle for applying a stimulation pulse to the right ventricle when the sense amplifier receives a ventricular depolarization signal originating from the one ventricle. - View Dependent Claims (201, 202, 203, 204, 205, 206, 207, 208, 209)
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210. A method for improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability to the heart suffering form heart failure. - View Dependent Claims (211, 212, 213, 214, 215)
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216. A method for improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from only one ventricle; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability to the heart suffering form heart failure. - View Dependent Claims (217, 218, 219, 220, 221, 222, 223)
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224. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
a ventricular sense amplifier for detecting depolarization signals originating from a left ventricle and a right ventricle;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal; and
a stimulating circuit capable of stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability to the heart suffering form heart failure. - View Dependent Claims (225, 226, 227, 228)
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229. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier capable of detecting depolarization signals originating from an atrium;
a ventricular sense amplifier capable of detecting depolarization signals originating from a left ventricle or a right ventricle;
pacing control circuitry, connected to the atrial sense amplifier, capable of starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal;
a stimulating circuit capable of providing stimulating pulses for application to the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability to the heart suffering form heart failure;
a first electrode responsive to the stimulating circuit and adapted to be disposed in or about the left ventricle, the first electrode capable of sensing depolarization signals originating from the left ventricle and capable of providing stimulating pulses to the left ventricle when the ventricular sense amplifier receives a depolarization signal from the left ventricle or the right ventricle; and
a second electrode responsive to the stimulating circuit and adapted to be disposed in or about the right ventricle, the second electrode capable of sensing depolarization signals originating from the right ventricle and capable of providing stimulating pulses to the right ventricle when the sense amplifier receives a depolarization signal from the left ventricle or the right ventricle. - View Dependent Claims (230, 231)
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232. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
a ventricular sense amplifier for detecting depolarization signals originating from only one ventricle;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal; and
a stimulating circuit capable of stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period for effecting coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability to the heart suffering form heart failure. - View Dependent Claims (233, 234, 235, 236, 237)
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238. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle; and
stimulating the left ventricle and the right ventricle when a depolarization signal from either the left ventricle or the right ventricle is detected during the atrial-ventricular delay period for effecting a coordinated contraction of the ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of the ventricles. - View Dependent Claims (239, 240, 241, 242, 243, 244, 245, 246)
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247. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from only one ventricle;
stimulating the left ventricle and the right ventricle when a depolarization signal from the one ventricle is detected during the atrial-ventricular delay period for effecting a coordinated contraction of the ventricles; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (248, 249, 250, 251, 252, 253, 254, 255, 256, 257)
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258. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal;
a ventricular sense amplifier for detecting depolarization signals originating from a left ventricle and a right ventricle; and
a stimulating circuit for stimulating the left ventricle and the right ventricle when a depolarization signal from either the left or the right ventricle is detected by the ventricular sense amplifier during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure; and
for stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left or right ventricles during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (260, 261, 262, 263, 264, 265)
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259. The heart failure treatment device of claim 259, further comprising an electrode adapted to be positioned through the coronary sinus to the left ventricle for stimulating the left ventricle.
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266. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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a atrial sense amplifier for detecting depolarization signals originating from an atrium;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal;
a ventricular sense amplifier for detecting depolarization signals originating from the left ventricle or the right ventricle;
a stimulating circuit for stimulating the left ventricle and the right ventricle when a depolarization signal from the left ventricle or the right ventricle is detected by the ventricular sense amplifier during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure; and
for stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure;
a first electrode adapted to be disposed in or about the left ventricle, the first electrode capable of sensing depolarization signals originating from the left ventricle and capable of providing a stimulating pulse to the left ventricle in response to the stimulating circuit; and
a second electrode adapted to be disposed in or about the right ventricle, the second electrode capable of sensing depolarization signals originating from the right ventricle and capable of providing a stimulating pulse to the right ventricle in response to the stimulating circuit. - View Dependent Claims (267, 268, 269, 270, 271)
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272. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal;
a ventricular sense amplifier for detecting depolarization signals originating from only one ventricle; and
a stimulating circuit for stimulating the left ventricle and the right ventricle when a depolarization signal from the one ventricle is detected by the ventricular sense amplifier during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure; and
for stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (273, 274, 275, 276, 277, 278, 279, 280)
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281. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle;
inhibiting stimulation of the left ventricle and the right ventricle when a depolarization signal from either the left ventricle or the right ventricle is detected during the atrial-ventricular delay period; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the atrial-ventricular delay period. - View Dependent Claims (282, 283, 284, 285, 286)
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287. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from an atrium;
beginning an atrial-ventricular delay period upon sensing a depolarization signal of the atrium;
sensing for depolarization signals originating from only one ventricle;
inhibiting stimulation of the left ventricle and the right ventricle when a depolarization signal from the one ventricle is detected during the atrial-ventricular delay period; and
stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period. - View Dependent Claims (288, 289, 290, 291, 292)
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293. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
a ventricular sense amplifier for detecting depolarization signals originating from a left ventricle and a right ventricle;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal, and for inhibiting stimulation of the left ventricle and the right ventricle when a depolarization signal from either the left or the right ventricle is detected during the atrial-ventricular delay period; and
a stimulating circuit for stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (294, 295, 296, 297)
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298. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
a ventricular sense amplifier for detecting depolarization signals originating from a left ventricle or a right ventricle;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal, and for inhibiting stimulation of the left ventricle and the right ventricle when a depolarization signal from either the left or the right ventricle is detected during the atrial-ventricular delay period;
a stimulating circuit for providing stimulating pulses for application to the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the left ventricle or the right ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure;
a first electrode adapted to be disposed in or about the left ventricle, the first electrode capable of sensing depolarization signals originating from the left ventricle and capable of providing a stimulating pulse to the left ventricle in response to the stimulating circuit; and
a second electrode adapted to be disposed in or about the right ventricle, the second electrode capable of sensing depolarization signals originating from the right ventricle and capable of providing a stimulating pulse to the right ventricle in response to the stimulating circuit. - View Dependent Claims (299, 300, 301)
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302. A heart failure treatment device for improving the pumping ability of a heart suffering from heart failure comprising:
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an atrial sense amplifier for detecting depolarization signals originating from an atrium;
a ventricular sense amplifier for detecting depolarization signals originating from only one ventricle;
pacing control circuitry, connected to the atrial sense amplifier, for starting an atrial-ventricular delay period when the atrial sense amplifier detects an atrial depolarization signal, and for inhibiting stimulation of the left ventricle and the right ventricle when a depolarization signal from the one ventricle is detected during the atrial-ventricular delay period; and
a stimulating circuit for stimulating the left ventricle and the right ventricle at the end of the atrial-ventricular delay period if a depolarization signal is not detected from the one ventricle during the atrial-ventricular delay period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (303, 304, 305, 306, 307)
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308. A method for improving the pumping ability of a heart suffering from heart failure comprising:
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positioning a first electrode through the coronary sinus to the left ventricle;
positioning a second electrode in the right ventricle;
applying a pacing pulse to the left ventricle through the first electrode;
applying a pacing pulse to the right ventricle through the second electrode substantially simultaneously with application of the pacing pulse to the left ventricle, wherein the pacing pulses are applied to the left ventricle and the right ventricle at a programmed rate. - View Dependent Claims (309)
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310. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from a first ventricle; and
stimulating a second ventricle when a depolarization signal from the first ventricle is detected for effecting a coordinate contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of the heart suffering from heart failure. - View Dependent Claims (312, 313)
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311. The method of 310, further comprising locating an electrode through the coronary sinus to the left ventricle.
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314. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle; and
stimulating the left ventricle and the right ventricle after a time period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the time period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of a heart suffering from heart failure.
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315. A method of improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals originating from only one ventricle; and
stimulating a right ventricle and a left ventricle if a depolarization signal is not detected from the one ventricle during a time period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of a heart suffering from heart failure.
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316. A method for improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals origination in an atrium;
sensing for depolarization signals originating from a left ventricle;
sensing for depolarization signals originating from a right ventricle; and
stimulating the left ventricle and the right ventricle after a time period if a depolarization signal is not detected from either the left ventricle or the right ventricle during the time period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of a heart suffering from heart failure. - View Dependent Claims (317, 318, 319, 320, 321, 322, 323)
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324. A method for improving the pumping ability of a heart suffering from heart failure comprising:
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sensing for depolarization signals origination in an atrium;
sensing for depolarization signals originating from only one ventricle; and
stimulating the left ventricle and the right ventricle after a time period if a depolarization signal is not detected from the one ventricle during the time period for effecting a coordinated contraction of ventricles contracting in an incoordinate manner to improve the pumping ability of a heart suffering from heart failure. - View Dependent Claims (325, 326, 327, 328, 329, 330, 331)
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Specification