Systems and methods for treating acute and chronic heart failure

摘要

Systems and methods and devices are provided for arresting or reversing the effects of myocardial remodeling and degeneration after cardiac injury, without the potential drawbacks associated with previously existing systems and methods, by at least partially occluding flow through the superior vena cava over multiple cardiac cycles, and more preferably, by adjusting the interval or degree of occlusion responsive to a sensed level of patient activity. In some embodiments, a controller is provided that actuates a drive mechanism responsive to a sensed level of patient activity to provide at least partial occlusion of the patient's superior vena cava, while a data transfer circuit of the controller provides bi-directional transfer of physiologic data to the patient's smartphone or tablet to permit display and review of such data.

主权项

1. A system for treating heart failure in a patient, the apparatus comprising:
a catheter having a proximal end and a distal region, the catheter configured for placement though a subclavian or jugular vein of a patient so that the distal region is disposed in a superior vena cava of the patient; a flow limiting element disposed on the distal region of the catheter, the flow limiting element configured to be selectively actuated to at least partially occlude the superior vena cava; and a controller configured to operatively coupled to the catheter to intermittently actuate the flow limiting element to at least partially occlude the superior vena cava over multiple cardiac cycles, the controller including a processor programmed to: apply a stored value corresponding to a predetermined flow limiting interval during which the flow limiting element is to be actuated; receive an input corresponding to a physiologic parameter of the patient indicative of fluctuations in the patient's hemodynamic state resulting from the patient's ambulatory activity; generate an output corresponding to an adjustment of the predetermined flow limiting interval; and apply the output to revise the predetermined flow limiting interval.