Methods and systems for controlling blood pressure
Inventors
Mika, Yuval • Sherman, Darren • Schwartz, Robert S. • Van Tassel, Robert A. • Burkhoff, Daniel
Assignees
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Publication Number
US-11969598-B2
Publication Date
2024-04-30
Expiration Date
Abstract
Systems and methods for controlling blood pressure via electrical stimulation of the heart are disclosed. Embodiments may include at least two different stimulation patterns, each configured to reduce blood pressure to a different degree, and may alternate between stimulation patterns based on the need of a patient, for example, alternating between day and night or between periods of strenuous and light activity. Some embodiments may take advantage of a slow baroreflex response that occurs after treatment is stopped, suspending treatment for extended periods, and then resuming treatment before blood pressure levels reach pretreatment values. Embodiments may control blood pressure by controlling atrial pressure and atrial stretch.
Core Innovation
A blood-pressure-reducing cardiac stimulation system and methods deliver stimulation pulses to at least one cardiac chamber of a heart of a patient. The system includes a sensor configured to sense parameters indicative of blood pressure and at least one controller configured to execute delivery of one or more stimulation patterns over a time interval. A first stimulation pattern reduces blood pressure by a first reduction amount, and a second stimulation pattern reduces blood pressure by a second reduction amount, where the first reduction amount is greater than the second reduction amount and the second reduction amount is greater than zero.
The controller continuously performs receiving, analyzing, and adjusting the stimulation patterns according to the analysis during operation. The adjustment of the stimulation patterns comprises at least one of adjusting a ratio between a shorter atrioventricular delay of the first stimulation pattern and a longer atrioventricular delay of the second stimulation pattern, or adjusting a number of heartbeats for which pulses with shorter atrioventricular delay are delivered for the first stimulation pattern compared to a number of heartbeats for which pulses with longer atrioventricular delay are delivered for the second stimulation pattern.
In method embodiments, delivering one or more stimulation patterns reduces blood pressure by a first reduction amount using a treatment stimulation pattern, and includes continuous receiving, analyzing, and adjusting of stimulation patterns during delivery. In additional embodiments carried out with an implanted heart muscle stimulator, the method includes delivering to at least one cardiac chamber a treatment stimulation pattern for at least a plurality of days, and discontinuing delivery of the treatment stimulation pattern while delivering, for at least a plurality of days, a resting stimulation pattern that provides a lesser blood pressure reduction than the first reduction amount.
Claims Coverage
The document includes three independent claims (system, method, and implanted stimulator treatment/rest pattern), each focused on reducing blood pressure using stimulation patterns and controller-driven adjustment based on sensed blood-pressure-indicative information. Across the independent claims, the inventive features include pattern-dependent reduction amounts, continuous parameter-based adjustment, and treatment versus resting delivery over a plurality of days with different durations.
Blood-pressure-reducing stimulation patterns with sensor-driven continuous adjustment
A system for reducing blood pressure comprising a stimulation circuit configured to deliver a stimulation pulse to at least one cardiac chamber, a sensor configured to sense parameters indicative of blood pressure, and at least one controller configured to execute delivery of one or more stimulation patterns over a time interval, wherein a first stimulation pattern reduces the blood pressure by a first reduction amount, a second stimulation pattern reduces the blood pressure by a second reduction amount, the first reduction amount is greater than the second reduction amount, the second reduction amount is greater than zero, and the controller is configured to continuously perform receiving parameter information, analyzing the parameter information, and adjusting the one or more stimulation patterns according to the analysis.
Adjusting atrioventricular delay ratio or heartbeat counts between stimulation patterns
Wherein adjusting the one or more stimulation patterns comprises at least one of adjusting a ratio between a shorter atrioventricular delay of the first stimulation pattern and a longer atrioventricular delay of the second stimulation pattern, or adjusting a number of heartbeats for which pulses with shorter atrioventricular delay are delivered for the first stimulation pattern compared to a number of heartbeats for which pulses with longer atrioventricular delay are delivered for the second stimulation pattern.
Method of reducing blood pressure using stimulation patterns with continuous analysis and adjustment
A method for reducing blood pressure comprising delivering one or more stimulation patterns of stimulation pulses to at least one cardiac chamber over a time interval, wherein a first stimulation pattern reduces blood pressure of the patient by a first reduction amount, a second stimulation pattern reduces blood pressure of the patient by a second reduction amount, the first reduction amount is greater than the second reduction amount, and the second reduction amount is greater than zero; and performing continuously during delivering of the one or more stimulation patterns receiving parameter information indicative of the blood pressure, analyzing the parameter information, and adjusting the one or more stimulation patterns according to the analysis, wherein adjusting comprises at least one of adjusting a ratio between a shorter atrioventricular delay of the first stimulation pattern and a longer atrioventricular delay of the second stimulation pattern, or adjusting a number of heartbeats for which pulses with shorter atrioventricular delay are delivered for the first stimulation pattern compared to a number of heartbeats for which pulses with longer atrioventricular delay are delivered for the second stimulation pattern.
Implanted stimulator treatment pattern followed by resting pattern with longer resting duration
A method, carried out with an implanted heart muscle stimulator associated with a heart of a patient, for reducing blood pressure of the patient, comprising delivering, for at least a plurality of days, to at least one cardiac chamber a treatment stimulation pattern that reduces the blood pressure by a first reduction amount; discontinuing delivery of the treatment stimulation pattern and delivering, for at least a plurality of days, to the at least one cardiac chamber a resting stimulation pattern providing a lesser amount of blood pressure reduction than the first reduction amount; wherein the duration of the resting stimulation pattern is longer than the duration of the treatment stimulation pattern.
Overall, the independent claims cover delivering two or more blood-pressure-reducing stimulation patterns with differing reduction amounts while continuously receiving and analyzing blood-pressure-indicative parameter information, adjusting stimulation using atrioventricular delay ratio and/or heartbeat count between patterns, and using an implanted heart muscle stimulator to alternate between treatment and resting stimulation patterns over at least a plurality of days, with the resting duration longer than the treatment duration.
Stated Advantages
Reduces blood pressure by reducing or preventing atrial kick while controlling atrioventricular valve closure relative to atrial contraction.
Reduces blood pressure without increasing atrial pressure or invoking hormonal response.
Faster onset of blood pressure reduction (on the order of seconds or heartbeats).
Provides blood pressure reduction by delivering stimulation patterns that reduce blood pressure by different reduction amounts.
Enables ongoing adaptation of stimulation patterns by continuously receiving and analyzing blood-pressure-indicative parameter information and adjusting the stimulation patterns accordingly.
Implements a treatment/resting schedule where the resting stimulation pattern provides a lesser blood pressure reduction than the treatment pattern while lasting longer than the treatment duration.
Documented Applications
Reducing blood pressure in a patient using an implanted heart muscle stimulator and stimulation patterns that vary atrioventricular delay timing to control atrioventricular valve closure relative to atrial contraction.
Using treatment and resting stimulation patterns delivered for at least a plurality of days to provide a lesser amount of blood pressure reduction during resting.
Reducing blood pressure in a patient using an implanted heart muscle stimulator delivering treatment and resting stimulation patterns over at least a plurality of days.
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