Source: https://patents.google.com/patent/US20050055057A1/en
Timestamp: 2019-08-17 23:20:50
Document Index: 423821347

Matched Legal Cases: ['art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art.\n6', 'art.\n20', 'art.\n28', 'art.\n29', 'art.\n31', 'art.\n36']

US20050055057A1 - Method and apparatus for providing ipselateral therapy - Google Patents
Method and apparatus for providing ipselateral therapy Download PDF
US20050055057A1
US20050055057A1 US10/654,959 US65495903A US2005055057A1 US 20050055057 A1 US20050055057 A1 US 20050055057A1 US 65495903 A US65495903 A US 65495903A US 2005055057 A1 US2005055057 A1 US 2005055057A1
US10/654,959
Mirowski Famliy Ventures LLC
2003-09-05 Application filed by Mirowski Famliy Ventures LLC filed Critical Mirowski Famliy Ventures LLC
2003-09-05 Assigned to MIROWSKI FAMILY VENTURES, L.L.C. reassignment MIROWSKI FAMILY VENTURES, L.L.C. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MOWER, MORTON M.
2005-03-10 Publication of US20050055057A1 publication Critical patent/US20050055057A1/en
Methods, apparatus, and systems are provided to control contraction of the heart. At least one sensing element receives signals indicating electrical activity of sinus rhythm of the heart. The electrical activity is monitored and analyzed to detect an event. In addition, the electrical activity is monitored to detect, for example, premature stimulation and contraction of a portion of the heart, such as the left ventricle. Contraction in the pre-excited portion of the heart is then suppressed using, for example, one or more anodal electrical pulses. The heart may then be allowed to contract naturally, or a stimulating pulse may be applied to assist the heart in contracting.
The present invention relates to medical devices, and in particular, to methods, devices, and systems for controlling contraction of a heart.
During a normal heart beat, the heart contracts in a coordinated fashion to pump blood. In particular, the heart contracts based on rhythmic electrical impulses, which are spread over the heart using specialized fibers. These rhythmic electrical pulses are initiated by the heart's natural pacemaker called the sino-atrial node (SA node). In a normal heart there is a main pathway for the electrical current, which passes from the upper part of the heart (the atria) to the lower part (the ventricles). First, the SA node initiates electrical impulses to cause the right and left atria to contract. As the atria contract, the electrical impulses from the SA node propagate to the atrial-ventricular node (“AV node”). The time these impulses take to propagate from the SA node through the AV node is known as the A-V delay. The A-V delay allows the atria to fully contract and fill the ventricles with blood. The AV node then transmits a second impulse, which causes contraction in the right and left ventricles. Blood from the ventricles then flows out of the heart and to the rest of the body. Therefore, the heart relies upon a rhythmic cycle of electrical impulses to pump blood efficiently.
Controller 104 assists heart 102 to contract in a coordinated fashion. For example, controller 104 may apply one or more electrical pulses that suppress or stimulate contraction in the cardiac muscle of heart 102 as needed. As noted above, in order to contract, cardiac muscle in heart 102 must be depolarized above a threshold voltage of approximately −80 mV. In addition, when recovering from contraction, the cardiac muscle repolarizes to a resting voltage of approximately −90 mV. Thus, controller 104 may selectively suppress or stimulate contraction in heart 102 by applying electrical pulses to repolarize or depolarize the cardiac muscle. In general, cathodal electrical pulses tend to stimulate contraction while anodal electrical pulses tend to suppress contraction.
Signal generator 312 may generate one or more electrical pulses to suppress contraction in heart 102 and compensate for premature stimulation, such as from premature electrical activity 210. In particular, signal generator 312 may generate an anodal electrical pulse of approximately 5 volts and with a duration of approximately 2-4 milliseconds to suppress contraction in heart 102. However, signal generator 312 may use other types of pulses, such as biphasic pulses, which can also be configured to suppress contraction in heart 102. For example, signal generator 312 could use pulses of the type disclosed in U.S. Pat. No. 5,871,506, entitled “AUGMENTATION OF ELECTRICAL CONDUCTION AND CONTRACTILITY BY BIPHASIC CARDIAC PACING,” U.S. Pat. No. 6,067,470, entitled “SYSTEM AND METHOD FOR MULTIPLE SITE BIPHASIC STIMULATION TO REVERT VENTRICULAR ARRHYTHMIAS”, U.S. Pat. No. 6,411,845, entitled “SYSTEM AND METHOD FOR MULTIPLE SITE BIPHASIC STIMULATION TO REVERT VENTRICULAR ARRHYTHMIAS,” U.S. Pat. No. 6,141,587, entitled “AUGMENTATION OF MUSCLE CONTRACTILITY BY BIPHASIC STIMULATION,” U.S. Pat. No. 6,136,019, entitled “AUGMENTATION OF ELECTRICAL CONDUCTION AND CONTRACTILITY BY BIPHASIC CARDIAC PACING ADMINISTERED VIA THE CARDIAC BLOOD POOL,” U.S. Pat. No. 6,141,586, entitled “METHOD AND APPARATUS TO ALLOW CYCLIC PACING AT AN AVERAGE RATE JUST ABOVE THE INTRINSIC HEART RATE SO AS TO MAXIMIZE INOTROPIC PACING EFFECTS AT MINIMAL HEART RATES,” U.S. Patent No. 6,178,351, entitled “ATRIAL SENSING AND MULTIPLE SITE STIMULATION AS INTERVENTION MEANS FOR ATRIAL FIBRILLATION,” U.S. Pat. No. 6,343,232, entitled “AUGMENTATION OF MUSCLE CONTRACTILITY BY BIPHASIC STIMULATION,” U.S. Pat. No. 6,341,235, entitled AUGMENTATION OF ELECTRICAL CONDUCTION AND CONTRACTILITY BY BIPHASIC CARDIAC PACING VIA THE CARDIAC BLOOD POOL,” U.S. Pat. No. 6,337,995, entitled “ATRIAL SENSING AND MULTIPLE SITE STIMULATION FOR ATRIAL FIBRILLATION,” U.S. Pat. No. 6,332,096, entitled “AUGMENTATION OF ELECTRICAL CONDUCTION AND CONTRACTILITY BY BIPHASIC CARDIAC PACING,” and U.S. Pat. No. 6,295,470, entitled “ANTITACHYCARDIAL PACING,” all incorporated herein by reference.
Furthermore, signal generator 312 may be configured to provide one or more electrical pulses to stimulate contraction in heart 102. For example, signal generator 312 may provide a cathodal pulse of 5 V for a duration of approximately 2 milliseconds to stimulate contraction in heart 102. Signal generator 312 may use other types of pulses, such as biphasic pulses or anodal pulses, to stimulate or suppress contraction in heart 102.
In stage 406, processor 306 provides a control signal to signal generator 312 to suppress contraction in heart 102. The control signal may specify specific sites in heart 102 and the type of electrical pulses used to suppress contraction. For example, processor 306 may provide a control signal specifying either right ventricle 112, or left ventricle 114, or both. In addition, processor 306 may specify a pulse type, such as cathodal, anodal, or biphasic, a pulse width, and a pulse amplitude.
In stage 504, controller 104 suppresses contraction in the one or more portions of heart 102. In one embodiment, processor 306 provides a control signal to signal generator 312 to suppress contraction in heart 102. The control signal may specify specific sites in heart 102 and the type of electrical pulses used to suppress contraction. For example, processor 306 may provide a control signal specifying either right ventricle 112, or left ventricle 114, or both. In addition, processor 306 may specify a pulse type, such as cathodal, anodal, or biphasic, a pulse width, and a pulse amplitude.
receiving signals indicating electrical activity of sinus rhythm at a portion of the heart;
detecting an event in the electrical activity at the portion of the heart;
detecting when the electrical activity at an additional portion of the heart reaches a threshold within a predetermined period of time of the event; and
suppressing contraction in the additional portion of the heart based on when the electrical activity reaches the threshold.
3. The method of claim 2, wherein suppressing contraction of the additional portion of the heart comprises suppressing contraction of a ventricle.
5. The method of claim 1, wherein detecting an event in the electrical activity comprises detecting a P-wave in an electrocardiagram signal of the heart.
6. The method of claim 1, wherein suppressing contraction in the additional portion of the heart comprises applying, to the portion of the heart, at least one pulse that repolarizes the additional portion of the heart to a voltage less than a threshold sufficient for contraction.
7. The method of claim 6, wherein applying the voltage comprises applying at least one anodal pulse.
applying a pulse to stimulate contraction in the additional portion of the heart after suppressing contraction.
9. The method of claim 8, wherein applying the pulse to stimulate contraction comprises applying the pulse to stimulate contraction in a ventricle.
10. An apparatus for controlling contraction of a heart, comprising:
means for receiving signals indicating electrical activity of sinus rhythm at a portion of the heart;
means for detecting an event in the electrical activity at the portion of the heart;
means for detecting when the electrical activity at an additional portion of the heart reaches a threshold within a predetermined period of time of the event; and
means for suppressing contraction in the additional portion of the heart based on when the electrical activity reaches the threshold.
11. A system for controlling contraction of a heart, comprising:
at least one sensing element configured to receive signals indicating electrical activity of sinus rhythm of the heart;
a processor coupled to the at least one sensing element, configured to detect an event in the electrical activity, and provide a control signal based on when the electrical activity reaches a threshold within a predetermined period of time of the event; and
a signal generator, coupled to the processor, to provide an electrical signal suppressing contraction in a portion of the heart responsive to the control signal.
12. The system of claim 11, wherein the signal generator comprises a pulse generator configured to generate at least one pulse that repolarizes the portion of the heart to a voltage less than a threshold sufficient for contraction.
13. The system of claim 12, wherein the pulse generator is further configured to generate at least one pulse to stimulate contraction of the portion of the heart after suppressing contraction.
14. A method for controlling contraction of a heart, comprising:
receiving signals indicating electrical activity of sinus rhythm from a portion of the heart;
detecting an event in the electrical activity; and
suppressing contraction in an additional portion of the heart for a predetermined period of time from the detected event.
stimulating contraction in the at least one additional portion of the heart subsequent to suppressing contraction.
16. The method of claim 14, wherein receiving signals indicating electrical activity comprises sensing depolarization signals originating from an atrium.
17. The method of claim 16, wherein sensing depolarization signals comprises sensing depolarization signals from both the left atrium and the right atrium.
18. The method of claim 14, wherein suppressing contraction in the additional portion of the heart comprises suppressing contraction of a ventricle.
19. The method of claim 14, wherein detecting an event in the electrical activity comprises detecting a P-wave in an electrocardiogram signal of the heart.
20. The method of claim 14, wherein suppressing contraction in the additional portion of the heart comprises applying, to the additional portion of the heart, at least one pulse that repolarizes the additional portion of the heart to a voltage less than a threshold sufficient for contraction.
21. The method of claim 20, wherein applying the voltage comprises applying at least one anodal pulse.
23. The method of claim 22, wherein applying the pulse to stimulate contraction comprises applying the pulse to stimulate contraction in a ventricle.
24. An apparatus for controlling contraction of a heart, comprising:
means for receiving signals indicating electrical activity of sinus rhythm from a portion of the heart;
means for detecting an event in the electrical activity; and
means for suppressing contraction in an additional portion of the heart for a predetermined period of time from the detected event.
means for stimulating contraction in the additional portion of the heart after suppressing contraction.
26. A system for controlling contraction of a heart, comprising:
at least one sensing element configured to receive signals indicating electrical activity of sinus rhythm from at least a portion of the heart;
a processor coupled to the at least one sensing element, configured to detect an event in the electrical activity, and provide a control signal in response to the detected event; and
a signal generator configured to provide an electrical signal to suppress contraction in an additional portion of the heart for a predetermined period of time from the event in response to the control signal.
27. The system of claim 26, wherein the signal generator is configured to provide a stimulating electrical signal to stimulate contraction in the additional portion of the heart.
28. The system of claim 26, further comprising a stimulator configured to provide at least one stimulating electrical pulse to stimulate contraction in the at least one additional portion of the heart.
29. A method of controlling contraction of a heart, comprising:
receiving signals indicating electrical activity of sinus rhythm from the heart;
suppressing premature contraction of a first chamber of the heart;
detecting when electrical activity at a second chamber of the heart reaches a threshold; and
ceasing the suppression of contraction of the first chamber of the heart based on when the electrical activity at the second chamber of the heart reaches the threshold.
30. The method of claim 29, wherein receiving the signals indicating electrical activity comprises sensing depolarization signals originating from a ventricle of the heart.
31. The method of claim 30, wherein suppressing contraction of the first chamber of the heart comprises suppressing contraction of a ventricle.
32. The method of claim 29, wherein suppressing contraction in the first chamber of the heart comprises applying, to the first chamber, at least one pulse that repolarizes at least a portion of the first chamber to a voltage less than a threshold sufficient for contraction.
33. The method of claim 32, wherein applying the voltage comprises applying at least one anodal pulse.
34. The method of claim 29, further comprising stimulating contraction of the first chamber of the heart when the electrical activity at the second chamber of the heart reaches the threshold.
35. The method of claim 29, wherein suppressing contraction of the first chamber of the heart comprises suppressing contraction of a left ventricle of the heart.
36. The method of claim 35, wherein detecting when the electrical activity at the second chamber reaches the threshold comprises detecting when the electrical activity at a right ventricle of the heart reaches the threshold.
37. The method of claim 36, wherein ceasing the suppression of contraction of the first chamber of the heart comprises allowing the left ventricle to contract.
38. An apparatus for controlling contraction of a heart, comprising:
means for receiving signals indicating electrical activity of sinus rhythm from the heart;
means for suppressing contraction of a first chamber of the heart based on the received signals;
means for detecting when electrical activity at a second chamber of the heart reaches a threshold based on the received signals; and
means for ceasing the suppression of contraction of the first chamber of the heart based on when the electrical activity at the second chamber of the heart reaches the threshold.
39. A system for controlling contraction of a heart, comprising:
a processor coupled to the at least one sensing element, configured to determine when a first chamber of the heart is contracting, and provide a control signal based on when the electrical activity of a second chamber of the heart reaches a threshold; and
a signal generator, coupled to the processor, to selectively provide an electrical signal suppressing contraction in the first chamber of the heart responsive to the control signal.
40. The system of claim 39, wherein the signal generator comprises a pulse generator configured to generate at least one pulse that repolarizes at least a portion of the first chamber of the heart to a voltage less than a threshold sufficient for contraction.
41. The system of claim 40, wherein the pulse generator is further configured to generate at least one pulse to stimulate contraction of the first chamber of the heart in response to the control signal.
US10/654,959 2003-09-05 2003-09-05 Method and apparatus for providing ipselateral therapy Abandoned US20050055057A1 (en)
US11/692,114 Continuation US8744558B2 (en) 2003-09-05 2007-03-27 Method and apparatus for providing ipselateral therapy
US20050055057A1 true US20050055057A1 (en) 2005-03-10
US20070191893A1 (en) 2007-08-16
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MOWER, MORTON M.;REEL/FRAME:014480/0469