Combined neural stimulation and cardiac resynchronization therapy
First Claim
1. An implantable device for delivering cardiac therapy to a patient, comprising:
- a plurality of leads, including at least one lead to be positioned within a lead path to deliver ventricular pacing pulses from the lead path and to deliver neural stimulation from the lead path at a site proximate to the heart to inhibit sympathetic nerve activity; and
a controller to control delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and to control delivery of the neural stimulation, the controller being programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further being programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT.
1 Assignment
0 Petitions
Accused Products
Abstract
Methods and devices for delivering cardiac therapy to a patient are provided. Various implantable device embodiments comprise a plurality of leads and a controller. The leads include at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity. The controller controls delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and controls delivery of the neural stimulation. The controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further is programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. Other embodiments are provided herein.
283 Citations
42 Claims
-
1. An implantable device for delivering cardiac therapy to a patient, comprising:
a plurality of leads, including at least one lead to be positioned within a lead path to deliver ventricular pacing pulses from the lead path and to deliver neural stimulation from the lead path at a site proximate to the heart to inhibit sympathetic nerve activity; and a controller to control delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and to control delivery of the neural stimulation, the controller being programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further being programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
-
23. An implantable device for delivering cardiac therapy to a patient, comprising:
-
a number of leads, each with at least one electrode, to provide one or more pacing channels to deliver ventricular pacing pulses to one or more ventricular sites, and a sympathetic inhibition channel to stimulate nerves to inhibit sympathetic nerve activity, the number of leads including an intravascularly-fed lead to both transvascularly stimulate the nerves to inhibit sympathetic nerve activity and deliver ventricular pacing pulses; a controller for controlling the delivery of pacing pulses to one or more ventricular sites during a cardiac cycle in accordance with a programmed pacing mode; wherein the controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium to mechanically unload that region during systole, and to deliver anti-remodeling therapy (ART) in conjunction with RCT by inhibiting sympathetic nerve activity via the sympathetic inhibition. - View Dependent Claims (24, 25, 26, 27, 28, 29)
-
-
30. An implantable device for delivering cardiac therapy to a patient, comprising:
-
a number of leads, each with at least one electrode, to provide one or more pacing channels to deliver ventricular pacing pulses to one or more ventricular sites, and a sympathetic inhibition channel to stimulate nerves to inhibit sympathetic nerve activity, the number of leads including a lead to both epicardially stimulate the nerves to inhibit sympathetic nerve activity and epicardially deliver ventricular pacing pulses; a controller for controlling the delivery of pacing pulses to one or more ventricular sites during a cardiac cycle in accordance with a programmed pacing mode; wherein the controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing in a manner which pre-excites a region of the ventricular myocardium to mechanically unload that region during systole, and to deliver anti-remodeling therapy (ART) in conjunction with RCT by inhibiting sympathetic nerve activity via the sympathetic inhibition channel. - View Dependent Claims (31, 32, 33, 34)
-
-
35. A method for delivering cardiac therapy to a patient, comprising:
-
routing a plurality of leads adapted to provide cardiac pacing as part of a cardiac resynchronization therapy (CRT) and to provide neural stimulation, including routing at least one of the leads through a lead path; delivering CRT, including delivering cardiac pacing signals using the lead path to pace cardiac tissue; and delivering neural stimulation signals using the lead path to inhibit sympathetic nerve activity, wherein delivering neural stimulation signals includes delivering neural stimulation signals during a cardiac refractory period to avoid capturing cardiac tissue. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42)
-
Specification