Electrical muscle controller

• US 8,306,616 B2
• Filed: 10/31/2007
• Issued: 11/06/2012
• Est. Priority Date: 01/08/1996
• Status: Expired due to Fees

• Current Assignee: Impulse Dynamics NV
• Original Assignee: Impulse Dynamics NV
• Inventors: Ben-Haim, Shlomo, Darvish, Nissim, Fenster, Maier, Yuval, Mike
• Primary Examiner(s): Lavert, Nicole F
• Application Number:
  US11/931,724
• Publication Number:
  US 20080065163A1
• Time in Patent Office: 1,833 Days
• Field of Search: 607/4, 607/7, 607/9
• US Class Current: 607/9
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/14503 invasive, e.g. introduced into the body by a catheter or needle or using implanted sensors A61B5/1459, A61B5/1464, A61B5/1473, A61B5/1482, A61B5/14865 take precedence
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/6843 Monitoring or controlling sensor contact pressure
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6856 with a distal loop
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6859 with multiple distal splines
• CPC Class Codes: A61M 2025/0166 Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• 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 1/326 : for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36146 : specified by the stimulation parameters
• CPC Class Codes: A61N 1/3621 : for treating or preventing abnormally high heart rate
• 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 1/365 : controlled by a physiological parameter, e.g. heart potential evoked response A61N1/371
• 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 1/36557 : controlled by chemical substances in blood
• CPC Class Codes: A61N 1/36564 : controlled by blood pressure
• CPC Class Codes: A61N 1/368 : comprising more than one electrode co-operating with different heart regions A61N1/3622, A61N1/3627 take precedence

Abstract

A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.

Claims

1. A method of modifying an activity of a heart or of a portion thereof, the method comprising:

applying to cardiac neural tissue which is nervous tissue contacting heart muscle an electric field of a magnitude, shape, duty cycle, phase, frequency, and duration suitable to obtain a desired change, to modify an activity of the heart or a portion thereof, wherein said field is applied at a time at which it is non-excitatory and thereof unable to generate a propagating action potential in the heart muscle, wherein said field has a strength insufficient for defibrillation the heart by synchronization of refractory and non-refractory cells to which it is applied and wherein said field is applied during an absolute refractory phase of cardiac muscle cells in tissue adjacent said cardiac neural tissue an in synchrony with activation thereof.

2. A method according to claim 1, wherein the non-excitatory electric field dampens excitability of neural tissue.

3. A method according to claim 1, wherein the non-excitatory electric field blocks conduction of stimuli along a neural pathway.

4. A method according to claim 1, wherein the non-excitatory electric field enhances conduction of stimuli along a neural pathway.

5. A method according to claim 1, wherein the non-excitatory electric field reduces an excitability of the cardiac neural tissue.

6. A method according to claim 5, the excitability of the cardiac neural tissue is reduced by reducing an amount of available calcium.

7. A method according to claim 1, comprising:

monitoring an activity of the heart or a portion thereof; and

adjusting the applying responsive to the monitoring.

8. A method according to claim 7, wherein the non-excitatory electric field dampens excitability of neural tissue.

9. A method according to claim 7, wherein the non-excitatory electric field blocks conduction of stimuli along a neural pathway.

10. A method according to claim 7, wherein the non-excitatory electric field enhances conduction of stimuli along a neural pathway.

11. A method according to claim 7, wherein the non-excitatory electric field reduces an excitability of the cardiac neural tissue.

12. A method according to claim 11, the excitability of the cardiac neural tissue is reduced by reducing an amount of available calcium.

13. A method according to claim 1, comprising applying said non- excitatory electric field as a continuation of a pacing field.

14. A method according to claim 1, comprising also pacing said heart.

15. A method according to claim 1, wherein said applying comprises applying for a plurality of non-contiguous beats with a plurality of non-applied beats between.

16. A method according to claim 1, wherein said applying comprises applying with a magnitude greater than needed for pacing of said heart.

17. A method according to claim 1, wherein said applying comprises applying in a manner suitable for a desired effect of increasing stroke volume of said heart.

18. A method according to claim 1, wherein said applying comprises applying in a manner suitable for a desired effect of increasing cardiac output of said heart.

19. A method according to claim 1, wherein said applying comprises applying in a manner suitable for a desired effect of controlling heart rate.

20. A method according to claim 19, wherein said applying comprises applying in a manner suitable for a desired effect of reducing heart rate.

21. A method according to claim 19, wherein said applying comprises applying in a manner suitable for a desired effect of one or both of stopping arrhythmia and preventing arrhythmia.

22. A method according to claim 1, wherein said applying comprises applying said field at least 100 beats out of 50,000 consecutive beats.

23. A method according to claim 1, wherein said applying comprises applying said field at least 1000 beats out of 50,000 consecutive beats.

24. A method according to claim 1, wherein said applying comprises applying said field at least 4000 beats out of 50,000 consecutive beats.

25. A method according to claim 1, wherein said applying causes an increase in flow volume of at least 5%.

26. A method according to claim 1, wherein said applying comprises determining a state of reduced cardiac output and applying said field in response to said determining.

27. A method according to claim 1, comprising, as part of an ongoing schedule of applying to a paced heart or a heart in a non-arrhythmic state, modifying said applying in response to feedback indicating cardiac output.

28. A method according to claim 1, wherein said applying comprises applying said field for between 3 and 5000 consecutive beats.

29. A method according to claim 1, wherein said applying comprises applying said field periodically according to a therapy schedule.

30. A method according to claim 29, wherein said applying comprises applying said field on a daily basis.

31. A method according to claim 1, wherein said applying causes an increase in cardiac output.

32. A method according to claim 1, wherein said applying causes an increase in contractility of at least 5%.

33. A method according to claim 1, wherein said electric field has a frequency selected to open some ion channels and not others.