# US 12,642,973 B2 · Method and apparatus for intrachamber resynchronization

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- Number: US 12,642,973 B2
- Document ID: US12642973B2
- Status: Granted
- Kind: B2
- Application number: 17/543,917
- Filed: 2021-12-07
- Published: 2022-03-24
- Granted: 2026-06-02
- Earliest claimed: 2003-09-08
- Assignees: Mirowski Family Ventures, L.L.C.
- Applicants: Mirowski Family Ventures, LLC
- Inventors: Morton M. Mower
- Web page: https://patentgrep.com/patent/US12642973B2

## CPC

- A61N 1/3627: {for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy}
- A61N 1/36592: {controlled by the heart rate variability}
- 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)

## Abstract

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. Based on the received signals, the progress of contraction of the heart is determined. Based on the progress of contraction, the chamber of the heart may then be stimulated at a plurality of locations. In another embodiment, a plurality of electrodes are implanted in the left ventricle to stimulate at multiple locations in the left ventricle for the purpose of improving hemodynamic performance and increasing cardiac output in a patient who is suffering from congestive heart failure.

## Claims

### Claim 1

A method of controlling contraction of a heart to improve hemodynamic performance, comprising:
monitoring, with a processing circuit, a progress of contraction in a portion of the heart based on at least a signal received from an electrode implanted in the heart to detect a first condition where the portion of the heart is contracting more slowly than desired or a second condition where the portion of the heart is contracting earlier than desired;
and
causing a rate of contraction to one of speed up and slow in the portion of the heart by:
generating, with a generator circuit and based on the detection in the progress monitoring, at least one of anodal and cathodal sub-threshold pre-excitation signals,
when the first condition is detected, delivering the anodal sub-threshold pre-excitation signal to the portion of the heart, and
when the second condition is detected, delivering the cathodal sub-threshold pre-excitation signal to the portion of the heart.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the electrode is implanted in the interventricular septum of the heart.

### Claim 3 (depends on 1)

The method according to claim 1, wherein the electrode is implanted in the right ventricle of the heart.

### Claim 4 (depends on 1)

The method according to claim 1, wherein the electrode is implanted in the left ventricle of the heart.

### Claim 5 (depends on 1)

The method according to claim 1, comprising delivering the one of the anodal and cathodal sub-threshold pre-excitation signals to the right ventricle of the heart.

### Claim 6 (depends on 1)

The method according to claim 1, comprising delivering the one of the anodal and cathodal sub-threshold pre-excitation signals to the left ventricle of the heart.

### Claim 7 (depends on 1)

The method according to claim 1, comprising causing the rate of contraction to speed up.

### Claim 8 (depends on 1)

The method according to claim 1, comprising causing the rate of contraction to slow.

### Claim 9 (depends on 1)

The method according to claim 1, comprising delivering the one of the anodal and cathodal sub-threshold pre-excitation signals to an electrode implanted in the portion of the heart.

### Claim 10 (depends on 1)

The method according to claim 1, comprising delivering the one of the anodal and cathodal sub-threshold pre-excitation signals to more than one electrode implanted in the portion of the heart.

### Claim 11 (depends on 1)

The method according to claim 1, comprising stimulating the portion of the heart with an above-threshold stimulating pulse.

### Claim 12 (depends on 1)

The method according to claim 1, comprising:
sensing progression of the contraction; and
stimulating the portion of the heart with an above-threshold stimulating pulse if the sensing indicates the contraction does not progress sufficiently.