# US 10,441,794 B2 · Methods and systems for lowering blood pressure through reduction of ventricle filling > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,441,794 B2 - Document ID: US10441794B2 - Status: Granted - Kind: B2 - Application number: 16/124,283 - Filed: 2018-09-07 - Published: 2019-01-03 - Granted: 2019-10-15 - Earliest claimed: 2012-12-21 - Assignees: BackBeat Medical, Inc. - Applicants: BackBeat Medical, Inc. - Inventors: Yuval Mika; Darren Sherman; Robert S. Schwartz; Robert A. Van Tassel; Daniel Burkhoff - Web page: https://patentgrep.com/patent/US10441794B2 ## CPC - A61N 1/36564: {controlled by blood pressure} - A61F 2/2412: {with soft flexible valve members, e.g. tissue valves shaped like natural valves} - A61F 2/2424: {Ball valves} - A61N 1/36117: {for treating hypertension} - A61N 1/36514: {controlled by a physiological quantity other than heart potential, e.g. blood pressure (controlled by two or more physical parameters A61N1/36585)} - A61N 1/36528: {the parameter being measured by means of ultrasound} - A61N 1/36571: {controlled by blood flow rate, e.g. blood velocity or cardiac output} - A61N 1/36578: {controlled by mechanical motion of the heart wall, e.g. measured by an accelerometer or microphone} - A61N 1/36585: {controlled by two or more physical parameters} - A61N 1/3682: {with a variable atrioventricular delay} - A61N 1/3684: {for stimulating the heart at multiple sites of the ventricle or the atrium} - A61F 2250/0013: for adjusting fluid pressure - A61N 1/36842: {Multi-site stimulation in the same chamber} - A61N 1/36843: {Bi-ventricular stimulation} - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction. ## Claims ### Claim 1 A system for reducing blood pressure comprising: at least one stimulation electrode for stimulating at least one chamber of a heart of a patient; and at least one controller that executes a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart, wherein the at least one stimulation setting causes an atrium of the heart to be at maximum contraction when an atrioventricular valve of the heart is open. ### Claim 2 (depends on 1) The system of claim 1, wherein the at least one stimulation setting prevents at least one atrial contraction of the heart. ### Claim 3 (depends on 1) The system of claim 1, wherein the at least one stimulation setting comprises a first stimulation setting and a second stimulation setting, and wherein the first stimulation setting has an atrioventricular delay different from an atrioventricular delay of the second stimulation setting. ### Claim 4 (depends on 1) The system of claim 1, wherein the at least one controller receives input relating to the patient's atrioventricular valve status, and adjusts the stimulation pattern based on the atrioventricular valve status. ### Claim 5 (depends on 4) The system of claim 4, further comprising a heart sound sensor that provides the input relating to the patient's atrioventricular valve status. ### Claim 6 (depends on 4) The system of claim 4, further comprising a blood flow sensor that provides the input relating to the patient's atrioventricular valve status. ### Claim 7 (depends on 4) The system of claim 4, wherein the at least one controller adjusts the stimulation pattern by adjusting an atrioventricular delay of at least one stimulation pulse. ### Claim 8 (depends on 1) The system of claim 1, wherein the at least one controller receives input relating to a first maximum post-treatment blood pressure of the patient, and when the first maximum post-treatment blood pressure is greater than a pretreatment blood pressure of the patient, adjusts the stimulation pattern to provide a second maximum post-treatment blood pressure that is less than the first maximum post-treatment blood pressure. ### Claim 9 (depends on 8) The system of claim 8, wherein the at least one controller adjusts the stimulation pattern by adjusting one or more of atrioventricular delay, a number of stimulation pulses, or a time of stimulation pulses. ### Claim 10 (depends on 8) The system of claim 8, wherein the at least one controller adjusts the stimulation pattern by: calculating a time constant of change in blood pressure; and adjusting the stimulation pattern to have one or more blood pressure reducing stimulation parameters for an amount of time or number of heartbeats that are set as a certain percentage of the calculated time constant and that are configured to prevent blood pressure of the patient from increasing beyond a given value. ### Claim 11 A system for reducing blood pressure comprising: at least one stimulation electrode for stimulating at least one chamber of a heart of a patient; and at least one controller that executes a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart, wherein the at least one stimulation setting provides maximum atrial stretch that is at a value about equal to or lower than maximum atrial stretch of the heart when not receiving stimulation. ### Claim 12 (depends on 11) The system of claim 11, wherein the at least one stimulation setting alters mechanics of at least one atrial contraction of the heart such that the mechanics of the at least one atrial contraction are different from mechanics of a previous natural atrial contraction of the heart. ### Claim 13 (depends on 11) The system of claim 11, wherein the at least one stimulation setting reduces a force of at least one atrial contraction of the heart. ### Claim 14 (depends on 11) The system of claim 11, wherein the at least one controller receives input relating to the patient's atrioventricular valve status, and adjusts the stimulation pattern based on the atrioventricular valve status. ### Claim 15 (depends on 14) The system of claim 14, further comprising a heart sound sensor that provides the input relating to the patient's atrioventricular valve status. ### Claim 16 (depends on 14) The system of claim 14, further comprising a blood flow sensor that provides the input relating to the patient's atrioventricular valve status. ### Claim 17 (depends on 14) The system of claim 14, wherein the at least one controller adjusts the stimulation pattern by adjusting an atrioventricular delay of at least one stimulation pulse. ### Claim 18 A method for reducing blood pressure comprising: stimulating, through at least one stimulation electrode, at least one chamber of a heart of a patient; controlling the stimulating of the at least one chamber of the heart using at least one controller, executing, using the at least one controller, a stimulation pattern comprising at least one stimulation pulse having at least one stimulation setting that reduces or prevents atrial kick in at least one ventricle of the heart; and causing, with the at least one stimulation setting, an atrium of the heart to be at maximum contraction when an atrioventricular valve of the heart is open. ### Claim 19 (depends on 18) The method of claim 18, further comprising preventing, with the at least one stimulation setting, at least one atrial contraction of the heart. ### Claim 20 (depends on 18) The method of claim 18, further comprising: receiving input relating to the patient's atrioventricular valve status; and adjusting the stimulation pattern based on the atrioventricular valve status.