US20040133240A1 — Electrotherapy system, device, and method for tre…

Claim 1

Independent Claim 86 words

1 . A system for treating cardiac valve dysfunction, comprising: (a) a lead with electrodes configured for implantation in a patient such that the electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated; (b) stimulation circuitry in electrical communication with the lead for delivering electrical energy to the lead electrodes to stimulate contraction of the muscle tissue; and (c) control circuitry in communication with the stimulation circuitry for controlling the delivery of the electrical energy to the lead electrodes.

Claim 2

Dependent Claim 86 words

1 . A system for treating cardiac valve dysfunction, comprising: (a) a lead with electrodes configured for implantation in a patient such that the electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated; (b) stimulation circuitry in electrical communication with the lead for delivering electrical energy to the lead electrodes to stimulate contraction of the muscle tissue; and (c) control circuitry in communication with the stimulation circuitry for controlling the delivery of the electrical energy to the lead electrodes.

Claim 3

Dependent Claim 24 words

2 . The system of claim 1 , in which the lead is configured to be received within a blood vessel in the patient.

Claim 4

Dependent Claim 32 words

3 . The system of claim 2 , in which the blood vessel is the coronary sinus positioned next to muscle tissue that is proximate to the mitral valve of the patient.

Claim 5

Dependent Claim 46 words

4 . The system of claim 1 , further comprising detection circuitry with electrodes configured to detect an electrical complex in the patient's heart, wherein the control circuitry is further configured to control the delivery of electrical energy based on the detection of an electrical complex.

Claim 6

Dependent Claim 23 words

5 . The system of claim 4 , in which the detection circuitry is configured to detect a P-wave in the patient's heart.

Claim 7

Dependent Claim 31 words

6 . The system of claim 4 , in which the detection circuitry further produces a control signal that is communicated to the control circuitry signifying detection of an electrical complex.

Claim 8

Dependent Claim 34 words

7 . The system of claim 6 , in which the control circuitry is configured to cause the stimulation circuitry to deliver the electrical energy at a time determined based on the control signal.

Claim 9

Dependent Claim 20 words

8 . The system of claim 1 , in which the lead is formed to have one or more undulations.

Claim 10

Dependent Claim 41 words

9 . The system of claim 1 , in which the lead has one or more undulations that place the electrodes toward the muscle tissue proximate to the cardiac valve to be treated when the lead is implanted in the patient.

Claim 11

Dependent Claim 17 words

10 . The system of claim 1 , in which the lead is combined with a prosthesis.

Claim 12

Dependent Claim 17 words

11 . The system of claim 10 , in which the lead is attached to the prosthesis.

Claim 13

Dependent Claim 18 words

12 . The system of claim 10 , in which the lead is formed integrally with the prosthesis.

Claim 14

Dependent Claim 27 words

13 . The system of claim 10 , in which the prosthesis is formed to exert a mechanical pressure directed toward the cardiac valve to be treated.

Claim 15

Dependent Claim 108 words

14 . A cardiac valve constricting device, comprising: (a) electrodes configured for implantation in a patient such that the electrodes are in electrical communication with muscle tissue that is proximate to a cardiac valve to be constricted; (b) a detector configured to receive a physiological signal from the patient and, based on the physiological signal, produce a detection signal signifying detection of a contraction in the patient's heart; and (c) a stimulator configured to receive the detection signal and deliver electrical energy to the electrodes in time relation to the detection signal to cause the muscle tissue to contract and exert a constricting pressure on the cardiac valve.

Claim 16

Dependent Claim 108 words

14 . A cardiac valve constricting device, comprising: (a) electrodes configured for implantation in a patient such that the electrodes are in electrical communication with muscle tissue that is proximate to a cardiac valve to be constricted; (b) a detector configured to receive a physiological signal from the patient and, based on the physiological signal, produce a detection signal signifying detection of a contraction in the patient's heart; and (c) a stimulator configured to receive the detection signal and deliver electrical energy to the electrodes in time relation to the detection signal to cause the muscle tissue to contract and exert a constricting pressure on the cardiac valve.

Claim 17

Dependent Claim 25 words

15 . The cardiac valve constricting device of claim 14 , in which the physiological signal is an electrogram signal detected in the patient's heart.

Claim 18

Dependent Claim 25 words

16 . The cardiac valve constricting device of claim 15 , in which the detector is configured to detect a P-wave in the patient's heart.

Claim 19

Dependent Claim 40 words

17 . The cardiac valve constricting device of claim 14 , in which the stimulator is configured to deliver the electrical energy prior to or concurrent with another contraction in the patient's heart following the receipt of the detection signal.

Claim 20

Dependent Claim 36 words

18 . The cardiac valve constricting device of claim 17 , in which the detection signal signifies detection of an atrial contraction and the electrical energy is delivered prior to or concurrent with a ventricular contraction.

Claim 21

Dependent Claim 27 words

19 . The cardiac valve constricting device of claim 14 , in which the lead is configured to be received within a blood vessel in the patient.

Claim 22

Dependent Claim 38 words

20 . The cardiac valve constricting device of claim 19 , in which the blood vessel is the coronary sinus that places the electrodes next to muscle tissue that is proximate to the mitral valve of the patient.

Claim 23

Dependent Claim 99 words

21 . An electrical lead for treatment of cardiac valve dysfunction, comprising: (a) a length of electrically conductive material in an insulating substrate; and (b) a plurality of electrodes electrically connected to the conductive material; in which the electrically conductive material is configured for implementation in a patient such that the plurality of electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated, the plurality of electrodes being configured to deliver electrical energy to the muscle tissue to cause the muscle tissue to contract and exert a constricting pressure on the cardiac valve.

Claim 24

Dependent Claim 99 words

21 . An electrical lead for treatment of cardiac valve dysfunction, comprising: (a) a length of electrically conductive material in an insulating substrate; and (b) a plurality of electrodes electrically connected to the conductive material; in which the electrically conductive material is configured for implementation in a patient such that the plurality of electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated, the plurality of electrodes being configured to deliver electrical energy to the muscle tissue to cause the muscle tissue to contract and exert a constricting pressure on the cardiac valve.

Claim 25

Dependent Claim 20 words

22 . The electrical lead of claim 21 , in which the lead is formed with one or more undulations.

Claim 26

Dependent Claim 41 words

23 . The electrical lead of claim 21 , in which the lead has one or more undulations that place the plurality of electrodes in a position toward the muscle tissue that is proximate to the cardiac valve to be treated.

Claim 27

Dependent Claim 18 words

24 . The electrical lead of claim 21 , in which the lead is combined with a prosthesis.

Claim 28

Dependent Claim 18 words

25 . The electrical lead of claim 24 , in which the lead is attached to the prosthesis.

Claim 29

Dependent Claim 20 words

26 . The electrical lead of claim 24 , in which the electrical lead is formed integrally with the prosthesis.

Claim 30

Dependent Claim 39 words

27 . The electrical lead of claim 24 , in which the prosthesis is configured to exert a mechanical pressure directed toward the cardiac valve to be treated when the electrical lead and prosthesis are implanted in the patient.

Claim 31

Dependent Claim 69 words

28 . A device for treating dilated cardiomyopathy of the mitral valve in a patient's heart, comprising: (a) a lead with electrodes configured for implantation in the coronary sinus of the patient's heart; and (b) a stimulator in electrical communication with the lead electrodes for delivering electrical energy to the electrodes and stimulating contraction of muscle tissue proximate to the coronary sinus that causes the mitral valve to constrict.

Claim 32

Dependent Claim 69 words

28 . A device for treating dilated cardiomyopathy of the mitral valve in a patient's heart, comprising: (a) a lead with electrodes configured for implantation in the coronary sinus of the patient's heart; and (b) a stimulator in electrical communication with the lead electrodes for delivering electrical energy to the electrodes and stimulating contraction of muscle tissue proximate to the coronary sinus that causes the mitral valve to constrict.

Claim 33

Dependent Claim 21 words

29 . The device of claim 28 , further comprising a detector configured to detect a P-wave in the patient's heart.

Claim 34

Dependent Claim 32 words

30 . The device of claim 29 , in which the detector is further configured to produce a control signal that is communicated to the stimulator to signify detection of a P-wave.

Claim 35

Dependent Claim 31 words

31 . The device of claim 30 , in which the stimulator is configured to deliver electrical energy at a time determined based on the control signal received from the detector.

Claim 36

Dependent Claim 40 words

32 . The device of claim 30 , in which the control signal signifies detection of an atrial contraction and the stimulator is configured to deliver electrical energy to the lead electrodes prior to or concurrent with a ventricular contraction.

Claim 37

Dependent Claim 30 words

33 . The device of claim 28 , in which the lead has one or more undulations that place the electrodes toward the muscle tissue proximate to the mitral valve.

Claim 38

Dependent Claim 31 words

34 . The device of claim 28 , further comprising a prosthesis configured for implantation in the coronary sinus with the lead to exert constricting mechanical pressure on the mitral valve.

Claim 39

Dependent Claim 108 words

35 . A combined electromechanical therapy system for treatment of cardiac valve dysfunction, comprising: (a) an elongate member configured for implantation in a patient's heart to partially encircle the cardiac valve to be treated; (b) an electrical lead connected to the elongate member, the lead having a plurality of electrodes for delivering electrical energy to muscle tissue proximate to the cardiac valve when the elongate member is placed adjacent to the cardiac valve; and (c) a stimulator in electrical communication with the lead electrodes for delivering electrical energy to the electrodes to stimulate contraction of the muscle tissue and thereby exert a constricting pressure on the cardiac valve.

Claim 40

Dependent Claim 108 words

35 . A combined electromechanical therapy system for treatment of cardiac valve dysfunction, comprising: (a) an elongate member configured for implantation in a patient's heart to partially encircle the cardiac valve to be treated; (b) an electrical lead connected to the elongate member, the lead having a plurality of electrodes for delivering electrical energy to muscle tissue proximate to the cardiac valve when the elongate member is placed adjacent to the cardiac valve; and (c) a stimulator in electrical communication with the lead electrodes for delivering electrical energy to the electrodes to stimulate contraction of the muscle tissue and thereby exert a constricting pressure on the cardiac valve.

Claim 41

Dependent Claim 39 words

36 . The combined electromechanical therapy system of claim 35 , in which the elongate member is further configured to exert an inward constricting pressure on the cardiac valve when the member is placed adjacent to the cardiac valve.

Claim 42

Dependent Claim 27 words

37 . The combined electromechanical therapy system of claim 35 , in which the elongate member is attached to the muscle tissue proximate to the cardiac valve.

Claim 43

Dependent Claim 40 words

38 . The combined electromechanical therapy system of claim 35 , in which the elongate member and electrical lead are configured to be received within a blood vessel next to the muscle tissue and the cardiac valve to be treated.

Claim 44

Dependent Claim 39 words

39 . The combined electromechanical therapy system of claim 38 , in which the elongate member and electrical lead are configured to be implanted in a coronary sinus of the patient proximate to a mitral valve of the patient.

Claim 45

Dependent Claim 53 words

40 . The combined electromechanical therapy system of claim 38 , in which at least one end of the elongate member has a “V” shaped end portion having a leg that exerts a pressure toward a wall of the blood vessel resulting in an opposite inward pressure being directed toward the cardiac valve.

Claim 46

Dependent Claim 25 words

41 . The combined electromechanical therapy system of claim 35 , further comprising a detector configured to detect an electrical complex in the patient's heart.

Claim 47

Dependent Claim 19 words

42 . The combined electromechanical therapy system of claim 41 , in which the electrical complex is a P-wave.

Claim 48

Dependent Claim 35 words

43 . The combined electromechanical therapy system of claim 42 , in which the detector is further configured to produce a control signal that is communicated to the stimulator to signify detection of a P-wave.

Claim 49

Dependent Claim 35 words

44 . The combined electromechanical therapy system of claim 43 , in which the stimulator is configured to deliver the electrical energy to the lead electrodes at a time determined based on the control signal.

Claim 50

Dependent Claim 22 words

45 . The combined electromechanical therapy system of claim 35 , in which the electrical lead is integrated with the elongate member.

Claim 51

Dependent Claim 64 words

46 . A method for treating cardiac valve dysfunction, comprising: (a) implanting a lead with electrodes in a patient such that the electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated; and (b) delivering electrical energy to the lead electrodes to stimulate contraction of the muscle tissue, and thereby exert a constricting pressure on the cardiac valve.

Claim 52

Dependent Claim 64 words

46 . A method for treating cardiac valve dysfunction, comprising: (a) implanting a lead with electrodes in a patient such that the electrodes are in electrical communication with muscle tissue proximate to a cardiac valve to be treated; and (b) delivering electrical energy to the lead electrodes to stimulate contraction of the muscle tissue, and thereby exert a constricting pressure on the cardiac valve.

Claim 53

Dependent Claim 35 words

47 . The method of claim 46 , further comprising detecting an electrical complex in the patient's heart and delivering the electrical energy to the lead electrodes based on the detection of an electrical complex.

Claim 54

Dependent Claim 16 words

48 . The method of claim 47 , in which the electrical complex is a P-wave.

Claim 55

Dependent Claim 20 words

49 . The method of claim 47 , further comprising producing a control signal signifying detection of an electrical complex.

Claim 56

Dependent Claim 26 words

50 . The method of claim 49 , further comprising delivering electrical energy to the lead electrodes at a time determined based on the control signal.

Claim 57

Dependent Claim 21 words

51 . The method of claim 46 , in which the lead is implanted within a blood vessel in the patient.

Claim 58

Dependent Claim 27 words

52 . The method of claim 51 , in which the lead is implanted in the coronary sinus of the patient proximate to the patient's mitral valve.

Claim 59

Dependent Claim 15 words

53 . The method of claim 46 , further comprising forming undulations in the lead.

Claim 60

Dependent Claim 31 words

54 . The method of claim 53 , in which the undulations are formed to place the lead electrodes toward the muscle tissue proximate to the cardiac valve to be treated.

Claim 61

Dependent Claim 16 words

55 . The method of claim 46 , further comprising combining the lead with a prosthesis.

Claim 62

Dependent Claim 31 words

56 . The method of claim 55 , further comprising implanting the prosthesis in the patient such that the prosthesis exerts a mechanical pressure toward the cardiac valve to be treated.

Electrotherapy system, device, and method for treatment of cardiac valve dysfunction

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