Linear electrode array to treat mitral regurgitation

摘要

A method and apparatus are disclosed for treating mitral regurgitation with electrical stimulation. By providing pacing stimulation to a region of the left ventricle in proximity to the mitral valve apparatus in a manner which pre-excites the region during early ventricular systole, a beneficial effect is obtained which can prevent or reduce the extent of mitral regurgitation.

主权项

1. An implantable cardiac pacing device, comprising:
pulse generation circuitry for connecting to one or more electrodes and configured to deliver pacing pulses to a cardiac chamber; sensing circuitry for connecting to one or more electrodes and configured to detect electrical activity from a cardiac chamber, a controller coupled to the pulse generating and sensing circuitry and configured to control the delivery of pacing pulses; a switching network operated by the controller for connecting the pulse generation circuitry to one or more selected electrodes; wherein, in a first pacing mode, the controller is programmed to connect the pulse generation circuitry to one or more electrodes that are disposed near a ventricular region in proximity to a regurgitant atrio-ventricular valve in the same ventricle as the regurgitant valve and deliver pacing therapy in a manner which pre-excites the ventricular region in proximity to the regurgitant valve relative to the rest of the ventricle during ventricular systole; wherein the controller is programmed to measure an intrinsic atrio-ventricular (AV) interval and deliver pacing pulses in the first pacing mode at a first AV delay interval subsequent to an atrial sense or pace, wherein the first AV delay interval is selected to be shorter than the measured intrinsic AV interval; wherein, in a second pacing mode, the controller is programmed to connect the pulse generation circuitry to one or more electrodes that are disposed at different locations than the one or more electrodes used in the first pacing mode; and, an impedance sensor configurable for sensing transthoracic impedance and measuring cardiac stroke volume; and, wherein the controller is programmed to switch to the first pacing mode from the second pacing mode if the stroke volume measurement indicates volume overloading due to the regurgitant atrio-ventricular valve.