WO2009006321A3 - Systems, devices and methods relating to endocardial pacing for resynchronization - Google Patents

Systems, devices and methods relating to endocardial pacing for resynchronization Download PDF

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Publication number
WO2009006321A3
WO2009006321A3 PCT/US2008/068618 US2008068618W WO2009006321A3 WO 2009006321 A3 WO2009006321 A3 WO 2009006321A3 US 2008068618 W US2008068618 W US 2008068618W WO 2009006321 A3 WO2009006321 A3 WO 2009006321A3
Authority
WO
WIPO (PCT)
Prior art keywords
pacing
opposite polarity
delivering
pulses
bundle
Prior art date
Application number
PCT/US2008/068618
Other languages
French (fr)
Other versions
WO2009006321A2 (en
Inventor
Qingsheng Zhu
Daniel Felipe Ortega
Original Assignee
Action Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Action Medical Inc filed Critical Action Medical Inc
Priority to AU2008269993A priority Critical patent/AU2008269993A1/en
Priority to JP2010515189A priority patent/JP2011502552A/en
Priority to EP08781107A priority patent/EP2164561A4/en
Publication of WO2009006321A2 publication Critical patent/WO2009006321A2/en
Publication of WO2009006321A3 publication Critical patent/WO2009006321A3/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3627—Heart stimulators for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
    • A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
    • A61N1/36114—Cardiac control, e.g. by vagal stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
    • A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
    • A61N1/36842—Multi-site stimulation in the same chamber
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/0565—Electrode heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/3625—External stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
    • A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
    • A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
    • A61N1/36843—Bi-ventricular stimulation

Abstract

Tools and methods are suited for cardiac pacing of right and left ventricles from a lead in the right ventricle, to facilitate synchronous contractions. Aspects involve pacing by delivering pulses to a cardiac site for improving function measured by QRS width, fractionation, late LV activation timing, mechanical synchronicity of the free wall and septal wall, or effective throughput/pressure. Aspects include determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity; bi-ventricular pacing from a lead in the right ventricle; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His pacing, without penetrating the myocardium; generating multiple pacing profiles including pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV; and treating LBBB by pacing near the His bundle.
PCT/US2008/068618 2007-06-29 2008-06-27 Systems, devices and methods relating to endocardial pacing for resynchronization WO2009006321A2 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU2008269993A AU2008269993A1 (en) 2007-06-29 2008-06-27 Systems, devices and methods relating to endocardial pacing for resynchronization
JP2010515189A JP2011502552A (en) 2007-06-29 2008-06-27 System, apparatus, and method for intracardiac pacing for resynchronization
EP08781107A EP2164561A4 (en) 2007-06-29 2008-06-27 Systems, devices and methods relating to endocardial pacing for resynchronization

Applications Claiming Priority (16)

Application Number Priority Date Filing Date Title
US94733607P 2007-06-29 2007-06-29
US94732207P 2007-06-29 2007-06-29
US94732707P 2007-06-29 2007-06-29
US94730807P 2007-06-29 2007-06-29
US94731007P 2007-06-29 2007-06-29
US94734207P 2007-06-29 2007-06-29
US60/947,322 2007-06-29
US60/947,327 2007-06-29
US60/947,308 2007-06-29
US60/947,342 2007-06-29
US60/947,310 2007-06-29
US60/947,336 2007-06-29
US2051108P 2008-01-11 2008-01-11
US61/020,511 2008-01-11
US12/147,293 US8014861B2 (en) 2004-12-20 2008-06-26 Systems, devices and methods relating to endocardial pacing for resynchronization
US12/147,293 2008-06-26

Publications (2)

Publication Number Publication Date
WO2009006321A2 WO2009006321A2 (en) 2009-01-08
WO2009006321A3 true WO2009006321A3 (en) 2009-04-09

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2008/068618 WO2009006321A2 (en) 2007-06-29 2008-06-27 Systems, devices and methods relating to endocardial pacing for resynchronization

Country Status (5)

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US (2) US8014861B2 (en)
EP (1) EP2164561A4 (en)
JP (1) JP2011502552A (en)
AU (1) AU2008269993A1 (en)
WO (1) WO2009006321A2 (en)

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WO2009006321A2 (en) 2009-01-08
US8825155B2 (en) 2014-09-02
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US20110319956A1 (en) 2011-12-29

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