Abstract:
Pacing left and right ventricles of the heart for delivery of heart failure therapy involves measuring right ventricular (RV) pressure and a left ventricular (LV) pressure, and computing a parameter developed from one or both of the RV and LV pressure measurements. The parameter is indicative of a degree of left and right ventricular synchronization. At least one parameter of a heart failure pacing therapy is adjusted based on the parameter to improve synchronization of the right and left ventricles.
Abstract:
A method and apparatus for pacing left and right ventricles of the heart involve measuring one or both of a right ventricular (RV) pressure and a left ventricular (LV) pressure, and computing a parameter developed from one or both of the RV and LV pressure measurements. The parameter is indicative of a degree of left and right ventricular synchronization. The parameter is assessed, and an interventricular (V-V) delay is adjusted in response to the parameter assessment. The V-V delay is adjusted to effect a change in the parameter that improves synchronization of the right and left ventricles. The computed parameter is a parameter indicative of hemodyamic state, such as a PP Loop or a pre-ejection period.
Abstract:
Pacing left and right ventricles of the heart for delivery of heart failure therapy involves measuring right ventricular (RV) pressure and a left ventricular (LV) pressure, and computing a parameter developed from one or both of the RV and LV pressure measurements. The parameter is indicative of a degree of left and right ventricular synchronization. At least one parameter of a heart failure pacing therapy is adjusted based on the parameter to improve synchronization of the right and left ventricles.
Abstract:
A body implantable system employs a lead system having at least one electrode and at least one pressure transducer at a distal end. The lead system is implanted within a patient's heart in a coronary vein of the left ventricle. The lead system includes an occlusion device at a distal end to occlude flow in the coronary vein. The pressure transducer is attached to a catheter that is disposed within an open lumen of the lead system. The pressure transducer senses a coronary vein pressure, the coronary vein pressure being proportional to the left ventricular pressure. The sensed coronary vein pressure gives indications of hemodynamic state of the left ventricle, and measured coronary vein pressure can be used to change a signal sent to the electrode to adaptively pace the patient's heart. The body implantable system can further utilize a right ventricular pressure measurement in concert with the left ventricular pressure measurement to modify pacing therapy parameters.
Abstract:
An apparatus and method for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.
Abstract:
A cardiac electro-stimulatory device and method for operating same in which stimulation pulses are distributed among a plurality of electrodes fixed at different sites of the myocardium in order to reduce myocardial hypertrophy brought about by repeated pacing at a single site and/or increase myocardial contractility. In order to spatially and temporally distribute the stimulation, the pulses are delivered through a switchable pulse output configuration during a single cardiac cycle, with each configuration comprising one or more electrodes fixed to different sites in the myocardium.
Abstract:
A method includes mounting an anchor member to a surface of a heart, the anchor member having a tension member coupled to the anchor member, advancing a lead body along the tension member, the lead body including a plurality of electrodes disposed along the lead body, identifying an MI region of the heart, positioning the plurality of electrodes at or near the MI region, affixing the tension member to the lead body to hold the electrodes in position, and delivering pulses through the plurality of electrodes to the heart.
Abstract:
Devices and methods for therapy control based on electromechanical timing involve detecting electrical activation of a patient's heart, and detecting mechanical cardiac activity resulting from the electrical activation. A timing relationship is determined between the electrical activation and the mechanical activity. A therapy is controlled based on the timing relationship. The therapy may improve intraventricular dyssynchrony of the patient's heart, or treat at least one of diastolic and systolic dysfunction and/or dyssynchrony of the patient's heart, for example. Electrical activation may be detected by sensing delivery of an electrical stimulation pulse to the heart or sensing intrinsic depolarization of the patient's heart. Mechanical activity may be detected by sensing heart sounds, a change in one or more of left ventricular impedance, ventricular pressure, right ventricular pressure, left atrial pressure, right atrial pressure, systemic arterial pressure and pulmonary artery pressure.
Abstract:
A method and apparatus are disclosed for treating mitral or tricuspid regurgitation with electrical stimulation. By providing pacing stimulation to a selected region of the left ventricle, such as one in proximity to the mitral valve apparatus in a manner which pre-excites the region during early ventricular systole, a beneficial effect is obtained which can prevent or reduce the extent of mitral regurgitation.
Abstract:
A cardiac rhythm management system modulates the delivery of pacing and/or autonomic neurostimulation pulses based on heart rate variability (HRV). An HRV parameter being a measure of the HRV is produced to indicate a patient's cardiac condition, based on which the delivery of pacing and/or autonomic neurostimulation pulses is started, stopped, adjusted, or optimized. In one embodiment, the HRV parameter is used to adjust a maximum tracking rate in an atrial tracking pacing mode.