摘要:
A method of operating a cardiac pacing device that optimizes the mechanical heart rate using coordinated potentiation therapy while maximizing the opportunity for intrinsic AV conduction to occur. The method may include adjusting the timing of extra stimulus intervals during coupled or paired pacing to promote AV conduction and to effect changes in rate according to certain embodiments of the invention. Other embodiments may include adjusting the atrial pacing rate to achieve a desired target rate consistent with AV conduction. A mode switch to a dual-chamber pacing mode may be provided according to certain embodiments of the invention to ensure a ventricular rate that meets or exceeds a minimum mechanical rate.
摘要:
An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要:
The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an “extra-systolic interval” or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要:
A method of stimulation therapy and an apparatus for providing the therapy which addresses cardiac dysfunction including heart failure. The therapy employs atrial pacing pulses delivered to a heart after the atrial refractory period and timed so that they will not cause a ventricular contraction. These atrial pacing are timed to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要:
The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.
摘要:
The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.
摘要:
An external cardiac medical device for delivering Cardiac Potentiation Therapy (CPT). Techniques used with the device include initial diagnosis of the patient, delivery of the CPT, and configuration of the external device, so that CPT can be effectively and efficiently provided. In particular, these techniques include initially determining whether a patient should receive CPT, how to set the coupling interval for delivering CPT, how to configure the external medical device to deliver CPT stimulation pulses while not adversely affecting the device's ability to sense a patient's cardiac parameters and/or signals.
摘要:
An external cardiac medical device for delivering Cardiac Potentiation Therapy (CPT). Techniques used with the device include initial diagnosis of the patient, delivery of the CPT, and configuration of the external device, so that CPT can be effectively and efficiently provided. In particular, these techniques include initially determining whether a patient should receive CPT, how to set the coupling interval for delivering CPT, how to configure the external medical device to deliver CPT stimulation pulses while not adversely affecting the device's ability to sense a patient's cardiac parameters and/or signals.
摘要:
Techniques and apparatus for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy In some aspects, probe pulses are periodically delivered to estimate the location of the end boundary of the refractory period, and accordingly estimate its length. In some embodiments, the parameter is adjusted based on estimated length of the refractory period. For example, an extra-systolic interval (ESI) for delivery of ESS is adjusted to be a fixed interval longer than estimated lengths of the refractory period. In other aspects, the parameter is adjusted based on a measured delay (or latency) between delivery of an ESS pulse and detection of an evoked response resulting from the pulse. Also, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.
摘要:
The disclosure provides methods and apparatus of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants thereof. According to the disclosure monitoring and therapy delivery for a wide variety of acute and chronic cardiac dysfunctions are described and depicted. Various forms of paired or coupled pacing therapy delivery provided alone or in combination with neurostimulation therapy delivered by both implantable and external apparatus, including defibrillation therapy are also provided herein.