Methods and apparatus to stimulate heart atria
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Publication Number
US-11529520-B2
Publication Date
2022-12-20
Expiration Date
Abstract
A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.
Core Innovation
The patent describes a method for treatment of heart failure in which an atrium of a heart of a patient is artificially paced by delivering excitatory stimulation to the atrium. The excitatory stimulation causes the atrium to contract against a closed heart valve associated with the atrium such that the contraction distends the atrium with blood.
The distending atrium results in a therapeutic increase in secretion of at least one of atrial natriuretic peptide or brain natriuretic peptide. The therapeutic increase in at least one of atrial natriuretic peptide or brain natriuretic peptide limits at least one of vasoconstriction or sodium retention.
Electrical signals configured to deliver excitatory stimulation are delivered through at least one electrically conductive lead connected to the heart. Excitatory stimulation is configured to cause the atrium to begin contracting against a closed heart valve after the closed heart valve has stopped blood flow from the atrium to a ventricle associated with the atrium, including embodiments where the closed heart valve associated with the atrium is a normally-functioning heart valve.
Claims Coverage
The independent claims (clm-00001, clm-00019, clm-00020) cover a heart failure treatment method defined by atrial excitatory pacing delivered so the atrium contracts against a closed atrial-associated heart valve, causing atrial distension and increased secretion of atrial natriuretic peptide/brain natriuretic peptide or an atrial hormone that reduces vasoconstriction and/or sodium retention. Across the independents, three inventive-feature themes are present: valve-closed atrial contraction to distend the atrium, secretion of atrial natriuretic peptides/atrial hormone to limit vasoconstriction and sodium retention, and electrical delivery configuration including timing after valve closure and use of a normally-functioning valve.
Contracting the atrium against a closed valve to distend the atrium with blood
Artificially pacing an atrium includes delivery of excitatory stimulation to the atrium such that the contraction occurs against a closed heart valve associated with the atrium and distends the atrium with blood.
Increasing secretion of atrial natriuretic peptide or brain natriuretic peptide to limit vasoconstriction or sodium retention
The distending atrium results in a therapeutic increase in secretion of at least one of atrial natriuretic peptide or brain natriuretic peptide, which limits at least one of vasoconstriction or sodium retention.
Timing atrial contraction after a closed valve stops atrial-to-ventricle blood flow
Excitatory stimulation is configured to cause the atrium to begin contracting against a closed heart valve after the closed heart valve has stopped blood flow from the atrium to a ventricle associated with the atrium such that the contraction distends the atrium with blood.
Atrial hormone increasing secretion to reduce vasoconstriction and/or sodium retention
The distending atrium results in an increased secretion of an atrial hormone that reduces vasoconstriction and/or sodium retention.
Using an electrically conductive lead to deliver excitatory stimulation
Electrical signals configured to deliver excitatory stimulation are delivered through at least one electrically conductive lead connected to a heart of a patient.
Closed atrial-associated heart valve is normally-functioning
The closed heart valve associated with the atrium is a normally-functioning heart valve.
Overall, the independent claim set is directed to electrically delivered atrial excitatory stimulation that initiates atrial contraction against a closed atrial-associated valve to distend the atrium with blood, thereby increasing secretion of atrial natriuretic peptides or an atrial hormone that reduces vasoconstriction and/or sodium retention, including embodiments specifying timing after valve flow cessation and requiring the closed valve to be normally-functioning.
Stated Advantages
Limits at least one of vasoconstriction or sodium retention.
Therapeutic increase in secretion of at least one of atrial natriuretic peptide or brain natriuretic peptide.
Documented Applications
Treatment of heart failure of a patient using atrial pacing/excitatory stimulation configured to induce atrial contraction against a closed heart valve and increase secretion of atrial natriuretic peptide/brain natriuretic peptide (or atrial hormone) to limit vasoconstriction or sodium retention.
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