Methods and systems for controlling blood pressure by controlling atrial pressure

Inventors

Mika, Yuval • Sherman, Darren • Schwartz, Robert S. • van Tassel, Robert A • Burkhoff, Daniel

Assignees

BackBeat Medical LLC

Abstract

Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.

Core Innovation

The invention relates to reducing ventricular filling volume in a patient having a pretreatment ventricular filling volume and reducing blood pressure of a patient by delivering one or more stimulation patterns of stimulation pulses to at least one cardiac chamber. At least one stimulation pulse reduces cardiac filling at an end of diastole and at least one stimulation pulse is configured to pace the heart at a higher rate than the patient’s natural rhythm. At least one stimulation pulse comprises an atrial contraction stimulation pulse configured to pace an atrium at an atrial rate greater than an intrinsic ventricular rate.

The disclosed techniques further reduce ventricular filling volume by reducing or preventing atrial kick, including use of an atrioventricular delay to reduce or prevent atrial kick. The disclosure also describes cardiac pressure effects in terms of atrial pressure and atrial stretch, including that an atrial contraction-induced pressure and stretch overlap a passive atrial pressure build-up.

To address adaptation and maintain performance, the invention includes delivering one or more stimulation patterns using a first stimulation setting that reduces the ventricular filling volume and a second stimulation setting that reduces or prevents adaptation associated with the first stimulation setting. In further configurations, the second stimulation setting is configured to pace the heart with an atrial kick higher than an atrial kick of the first stimulation setting to maintain a desired cardiac output.

Claims Coverage

The independent claims cover three related inventive concepts: a system and method for reducing ventricular filling at end of diastole with higher-rate pacing, multi-setting stimulation to reduce adaptation while maintaining desired cardiac output, and a method for reducing blood pressure using atrial contraction stimulation. The core inventive theme is stimulation-controlled cardiac timing/rate used to reduce ventricular filling and/or blood pressure while managing cardiac output and adaptation.

Overall, the independent claims cover stimulation-controlled reduction of cardiac filling at end of diastole and reduction of blood pressure using atrial and/or cardiac chamber stimulation, including configurations that pace at a higher rate than natural rhythm and configurations that use multiple stimulation settings to reduce or prevent adaptation while maintaining desired cardiac output.

Stated Advantages

Documented Applications