141results about How to "Promote contraction" patented technology

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and / or to reverse the remodeling that produces an enlarged heart.

Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

An implantable stimulator and monitor measures a group of heart failure parameters indicative of the state of heart failure employing EGM signals, measures of blood pressure including absolute pressure P, developed pressure (DP=systolic P-diastolic P), and / or dP / dt, and measures of heart chamber volume (V) over one or more cardiac cycles. These parameters include: (1) relaxation or contraction time constant tau (.tau.); (2) mechanical restitution (MR), i.e., the mechanical response of a heart chamber to premature stimuli applied to the heart chamber; (3) recirculation fraction (RF), i.e., the rate of decay of PESP effects over a series of heart cycles; and (4) end systolic elastance (E.sub.ES), i.e., the ratios of end systolic blood pressure P to volume V. These heart failure parameters are determined periodically regardless of patient posture and activity level. The physician can determine whether a particular therapy is appropriate, prescribe the therapy for a period of time while again accumulating the stored patient data for a later review and assessment to determine whether the applied therapy is beneficial or not, thereby enabling periodic changes in therapy, if appropriate. Drug therapies and electrical stimulation therapies, including PESP stimulation, and pacing therapies including single chamber, dual chamber and multi-chamber (bi-atrial and / or bi-ventricular) pacing can be delivered. In patient's prone to malignant tachyarrhythmias, the assessment of heart failure state can be taken into account in setting parameters of detection or classification of tachyarrhythmias and the therapies that are delivered.

Apparatus is provided that is configured to be implanted in a body of a subject, comprising an implant structure having first and second portions thereof, a spool coupled to the implant structure in a vicinity of the first portion thereof, and a flexible member coupled at a first end thereof to the spool, and not attached at a second end thereof to the spool. The flexible member, in response to rotation of the spool in a first direction thereof, is configured to be wound around the spool, and, responsively, to pull the second end of the flexible member toward the first end of the implant structure, and responsively to draw the first and second portions of the implant structure toward each other. Other embodiments are also described.

Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and / or to reverse the remodeling that produces an enlarged heart.

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and / or to reverse the remodeling that produces an enlarged heart.

Systems and methods are provided for performing electrosurgical interventions, such as selectively contracting soft collagen tissue and other body structures, while limiting thermal damage or molecular dissociation of such tissue and limiting the thermal damage to tissue adjacent to and underlying the treatment site. The systems and methods of the present invention are particularly useful for surgical procedures in electrically conducting environments, such as arthroscopic procedures in the joints, e.g., shoulder, knee, hip, hand, foot, elbow or the like. The present invention is also useful in relatively dry environments, such as treating and shaping the cornea, and dermatological procedures involving surface tissue contraction of tissue underlying the surface of the skin for tissue rejuvenation, wrinkle removal and the like.

The present invention provides systems, apparatus and methods for selective applying energy to a patient's dermis tissue to generate the growth of new collagen in this tissue, while minimizing the effect on the outer epidermis layer, thereby minimizing or suppressing the wound healing phase of the procedure. In one aspect of the invention, a method includes positioning a first electrode adjacent to, or in contact with, a region on or within a patient's skin, and applying a sufficient high frequency voltage between the first electrode and a second electrode to create a heat injury to a target tissue within the patient's dermis layer without ablating the epidermis layer overlying the target tissue. Typically, the voltage applied to the first and second electrodes is sufficient to induce heating of the dermis layer to about 60.degree.-80.degree. C., preferably about 65.degree.-75.degree. C. This induced heating causes the patient's body to undergo a wound healing response in the slightly inflamed tissue of the dermis. The wound healing process involves the generation of neo-collagen in the dermis layer, which fills in the wrinkle in the patient's skin.

Apparatus is provided including an implant structure (22, 122, 1122), a rotatable structure (2900) coupled to the implant structure (22, 122, 1122) in a vicinity of a first portion thereof, and a flexible member (30). At least a first portion of the 5 flexible member (30) is disposed in contact with the rotatable structure (2900), and at least one end portion of the flexible member (30) is not disposed in contact with the rotatable structure (30). In response to rotation of the rotatable structure (2900) in a first direction thereof, successive portions of the flexible member (30) contact the rotatable structure (2900) to pull the at least one end portion of the flexible member 0 (30) toward the first portion of the implant structure (22, 122, 1122), and responsively to draw the first and second portions of the implant structure (22, 122, 1122) toward each other. Other applications are also described.

Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Apparatus is provided that is configured to be implanted in a body of a subject, comprising an implant structure having first and second portions thereof, a spool coupled to the implant structure in a vicinity of the first portion thereof, and a flexible member coupled at a first end thereof to the spool, and not attached at a second end thereof to the spool. The flexible member, in response to rotation of the spool in a first direction thereof, is configured to be wound around the spool, and, responsively, to pull the second end of the flexible member toward the first end of the implant structure, and responsively to draw the first and second portions of the implant structure toward each other. Other embodiments are also described.

A splint assembly for placement transverse a heart chamber to reduce the heart chamber radius and improve cardiac function has a tension member formed of a braided cable with a covering. A fixed anchor assembly is attached to one end of the tension member and a leader for penetrating a heart wall and guiding the tension member through the heart is attached to the other end. An adjustable anchor assembly can be secured onto the tension member opposite to the side on which the fixed pad assembly is attached. The adjustable anchor assembly can be positioned along the tension member so as to adjust the length of the tension member extending between the fixed and adjustable anchor assemblies. The pad assemblies engage with the outside of the heart wall to hold the tension member in place transverse the heart chamber. A probe and marker delivery device is used to identify locations on the heart wall to place the splint assembly such that it will not interfere with internal heart structures. The device delivers a marker to these locations on the heart wall for both visual and tactile identification during implantation of the splint assembly in the heart.

The patterns of contraction and relaxation of the heart before and during left ventricular or biventricular pacing are analyzed and displayed in real time mode to assist physicians to screen patients for cardiac resynchronization therapy, to set the optimal A-V or right ventricle to left ventricle interval delay, and to select the site(s) of pacing that result in optimal cardiac performance. The system includes an accelerometer sensor; a programmable pace maker, a computer data analysis module, and may also include a 2D and 3D visual graphic display of analytic results, i.e. a Ventricular Contraction Map. A feedback network provides direction for optimal pacing leads placement. The method includes selecting a location to place the leads of a cardiac pacing device, collecting seismocardiographic (SCG) data corresponding to heart motion during paced beats of a patient's heart, determining hemodynamic and electrophysiological parameters based on the SCG data, repeating the preceding steps for another lead placement location, and selecting a lead placement location that provides the best cardiac performance by comparing the calculated hemodynamic and electrophysiological parameters for each different lead placement location.

Diet evaluation gastric apparatus (18) is provided, which detects when a patient (10) swallows, and detects the type and amount of matter ingested. The apparatus includes electrodes (74, 100) adapted to be coupled to the fundus and antrum of the patient and to measure electrical and mechanical activity therein, and a control unit (90) to analyze such electrical and mechanical activity and optionally apply electrical energy to modify the activity of tissue of the patient.

Laser and non-laser means for selective thermal shrinkage of ocular tissue (including cornea, sclera, choroids and ciliary-body) for the treatment of hyperopia, presbyopia and glaucoma are disclosed. The preferred system includes lasers in visible (0.48 to 0.78 micron) and IR (1.4 to 2.2 micron), and non-laser device of radio frequency wave including electrode device, bipolar device and plasma-assisted device. Two predetermined treated area having a circle diameter of about (6 to 8) mm and about (10 to 14) mm are defined. A revised Beer's law is introduced, Bexp(−dA), to relate the focusing factor (B), penetration depth (d) and the absorption coefficient (A) at a given laser spectra. An optimal focal length about 0.8 to 1.4 times of (InB*) / A is formulated for lens design. The effective thermal penetration depth, d*=(0.3−1.0) mm, may be achieved by choosing an optimal focal length laser, or by the length of the conductor tip (about 0.45 to 1.2 mm) of the radio frequency device.

Gastric apparatus (18) is provided, including one or more sensors (70, 72, 74), adapted to generate respective sensor signals responsively to a gastrointestinal (GI) tract physiological parameter of a GI tract of a subject, and an implantable control unit (90), comprising a rechargeable battery and a first set of one or more transducers. The implantable control unit (90) is adapted to receive the sensor signals, using one or more of the transducers of the first set, and transmit data responsively to the sensor signals, using one or more of the transducers of the first set. An external control unit (200), including a power source and a second set of one or more transducers, is adapted to drive the power source to inductively transfer energy via one or more transducers of the second set, so as to recharge the battery, and receive the transmitted data, using one or more transducers of the second set.

An electrical lead equipped with cathode and anode active succession electrodes for positioning in the vicinity of the His bundle tissue. The lead includes a lead body for carrying conductors coupled between electrodes located at or near the distal lead end and a connector assembly located at the proximal lead end for connecting to an implantable pacemaker. The electrode is shaped, at the distal end, for positioning and attachment in the His bundle and branches thereof, cathode and anode electrodes co-extensive with the lead body. The cathode and anode electrodes may be helical screw-in type or equivalent electrodes adapted for secure fixation deep within the His bundle tissue or the tissue in the vicinity of the His bundle.

A method is provided, including physically contacting a gastric implantation site of a stomach via a transluminal approach, physically contacting the site via a transabdominal approach, stabilizing the site, and implanting an electrode at the site based on the physical contact provided by the transluminal and transabdominal approach. Other embodiments are also described.

Apparatus is provided, including a control unit (310), adapted to be implanted within a patient (324), and a corkscrew-shaped electrode mount (400), adapted to be implanted in a wall of a stomach of the patient. The corkscrew-shaped electrode mount includes first (404) and second (424) electrodes, at respective sites of the electrode mount, and a controller (420), wirelessly coupled to the control unit. Other embodiments are also described.

Apparatus is provided, including a control unit (310), adapted to be implanted within a patient (324), and a corkscrew-shaped electrode mount (400), adapted to be implanted in a wall of a stomach of the patient. The corkscrew-shaped electrode mount includes first (404) and second (424) electrodes, at respective sites of the electrode mount, and a controller (420), wirelessly coupled to the control unit. Other embodiments are also described.

The subject disclosure relates to pre-installed software and services, such as online services, and markets for pre-installed software and online services. In one aspect, the disclosed subject matter facilitates contracting between software vendors and device manufacturers or redistributors for placement and / or conversion of software applications or services in devices. As further advantages, embodiments of the disclosed subject matter can provide transparency into markets for device placement and can facilitate detailed contract performance tracking. Further non-limiting embodiments are provided that illustrate the advantages and flexibility of the disclosed subject matter.

Apparatus (20) is provided for compressing at least one ventricle of a heart (40). The apparatus includes a plurality of inflatable elements (64) and a pump (24) in fluid communication with the inflatable elements. At least one band (68) is in mechanical communication with the inflatable elements. A portion of the band is adapted to be placed around at least a portion of the heart in mechanical communication with the portion of the heart. The inflatable elements are arranged such that when the inflatable elements are inflated by the pump, the inflatable elements apply more force to the heart via shortening of the portion of the band than via expansion of the inflatable elements against the heart.

Techniques are provided for use with an implantable cardiac stimulation device equipped with a multi-pole left ventricular (LV) lead having a proximal electrode implanted near an atrioventricular (AV) groove of the heart of the patient. A left atrial (LA) cardioelectrical event is sensed using the proximal electrode of the LV lead and a corresponding LA cardiomechanical event is also detected, either using an implantable sensor or an external detection system. The electromechanical activation delay between the LA cardioelectrical event and the corresponding LA cardiomechanical event is determined and then pacing delays are set based on the electromechanical activation delay for use in controlling pacing. The pacing delays can include, e.g., AV delays for use with biventricular cardiac resynchronization therapy (CRT) pacing. Other techniques described herein are directed to exploiting right atrial (RA) cardioelectrical events detected via an RA lead for the purposes of setting pacing delays.

A method includes positioning an anchor deployment manipulator at least partially within a lumen of a sleeve of an annuloplasty ring, the sleeve having a lateral wall shaped to define the lumen, and the lumen extending longitudinally along a length of the sleeve. A portion of the sleeve that contains a distal end of the deployment manipulator is placed into an atrium in a vicinity of an annulus of an atrioventricular valve. An anchor is deployed from the distal end of the deployment manipulator through the lateral wall of the sleeve into cardiac tissue, while the distal end of the deployment manipulator is positioned such that a central longitudinal axis of the deployment manipulator through the distal end of the deployment manipulator forms an angle of between 45 and 90 degrees with the lateral wall of the sleeve at a point at which the anchor penetrates the lateral wall.

A method for treatment of congestive heart failure from the right side of the heart, by stimulating at numerous points along the right-ventricular septum to produce a fused line of stimulation upon breakthrough of wave fronts into the left ventricular septum and an LV action potential that simultaneously propagates toward the apex, base, and left free wall. Five electrodes, all in contact with the septum and spaced approximately 1.5 cm apart, produce a fused action potential in an average adult human within 10 ms of delivering simultaneous pacing pulses. Breakthrough of this fused region of stimulation will occur within 20 ms of delivering the pacing pulses. The most proximal electrode may be located in or near the right-ventricular apex. The most distal electrode may be located somewhere near the right-ventricular outflow tract, generally somewhere near the moderator band.