Apparatus and method for spatially and temporally distributing cardiac electrical stimulation
AssigneeCardiac Pacemakers, Inc.
InventorsRodney W. Salo, Julio C. Spinelli, Bruce H. KenKnight
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Abstract
A cardiac electro-stimulatory device and method for operating same in which stimulation pulses are distributed among a plurality of electrodes fixed at different sites of the myocardium in order to reduce myocardial hypertrophy brought about by repeated pacing at a single site and/or increase myocardial contractility. In order to spatially and temporally distribute the stimulation, the pulses are delivered through a switchable pulse output configuration during a single cardiac cycle, with each configuration comprising one or more electrodes fixed to different sites in the myocardium.
Claims36
A cardiac electro-stimulatory device for spatially and temporally distributing stimulation pulses to a heart chamber, comprising:
- a plurality of electrodes adapted for fixation to a heart chamber;
- a plurality of defined pulse output configurations, wherein each pulse output configuration constitutes a subset of the plurality of the fixed electrodes;
- and,
- a control unit and pulse generating circuitry for outputting non-excitatory stimulation pulses to a selected one of the plurality of pulse output configurations in order to stimulate the heart chamber during a refractory period, wherein the pulse generating circuitry includes a separate pulse generator for each electrode of the selected pulse output configuration.
A method for operating a cardiac pacing device, comprising:
- outputting pacing pulses to a selected subset of a plurality of pacing electrodes in accordance with a programmed pacing mode, wherein the subset of electrodes to which pulses are output is defined by a pulse output configuration;
- and,
- switching the pulse output configuration utilized for one or more cardiac cycles to another pulse output configuration for one or more subsequent cardiac cycles in accordance with a sensed time delay of a depolarization occurring in an area of the myocardium after delivery of a pacing pulse.
A cardiac pacemaker for spatially and temporally distributing pacing pulses, comprising:
- a plurality of electrodes adapted for disposition near a heart chamber;
- a plurality of defined pulse output configurations, wherein each pulse output configuration constitutes a subset of the plurality of the electrodes;
- a control unit and pulse generating circuitry for outputting pacing pulses to a selected one of the plurality of pulse output configurations in accordance with a programmed mode;
- wherein the control unit is programmed to utilize a first pulse output configuration during one or more cardiac cycles and switch to a second pulse output configuration during one or more subsequent cardiac cycles in accordance with a sensed time delay of a depolarization occurring in an area of the myocardium after delivery of a pacing pulse.
A cardiac pacemaker for spatially and temporally distributing pacing pulses, comprising:
- a plurality of electrodes adapted for disposition near a heart chamber;
- a plurality of defined pulse output configurations, wherein each pulse output configuration constitutes a subset of the plurality of electrodes;
- a control unit and pulse generating circuitry for outputting stimulation pulses to a selected one of the plurality of pulse output configurations in response to sensed cardiac activity and lapsed time intervals in accordance with a programmed mode;
- wherein the control unit is programmed to switch the pulse output configuration in accordance with the mean or minimum heart rate measured over a time interval.
Dependencies are inferred from the claim text.