Method and apparatus for preventing cardiac arrhythmias with endovascular stimulation

摘要

Certain cardiac arrhythmias can be prevented by appropriate electrical stimulation of autonomic nerves innervating the heart. An implantable cardiac rhythm management device is configured to deliver such stimulation when an autonomic imbalance is predicted to be present via an endovascular electrode. Autonomic imbalance may be predicted to be present based upon circadian rhythms, detected heart rates, or detected heart rate variability.

主权项

1. An implantable device, comprising:
a pulse generator configurable into a parasympathetic channel for delivering stimulation to parasympathetic nerves; a sensing amplifier configurable into a cardiac sensing channel for measuring the patient's heart rate; a controller programmed to detect an autonomic imbalance due to increased sympathetic activity when a calculated ratio of low frequency to high frequency variation in the measured heart rate is above a specified threshold; and, wherein the controller is programmed to deliver parasympathetic stimulation when an autonomic imbalance due to increased sympathetic activity is detected.