Methods for improving heart function

Abstract

The invention provides methods related to improving heart function.

1 . A device for treating heart failure, comprising:
 a power source;   an atrial stimulation electrode;   a ventricular stimulation electrode; and   a controller that is:
 operably connected to the power source and to the stimulation electrodes; 
 configured to receive a signal indicative of atrial activity; and 
 programmed to:
 monitor the signal to detect an atrial heart rate; and 
 operate the device in a normal pacing mode, for which the controller is programmed to cause the atrial stimulation electrode to depolarize atrial tissue if the atrial heart rate is below a predetermined limit; and 
 periodically transiently operate the device in a dyssynchrony-inducing mode, for which the controller is programmed to cause the ventricular stimulation electrode to depolarize ventricular tissue at a rate sufficient to induce cardiac dyssynchrony; and
 alternate between the normal pacing mode and the dyssynchrony-inducing mode in a cycle, and repeat that cycle multiple times for at least one month. 
 
 
   
     
     
         2 . (canceled) 
     
     
         3 . (canceled) 
     
     
         4 . (canceled) 
     
     
         5 . (canceled) 
     
     
         6 . The device of  claim 1 , wherein for a single cycle the controller is programmed to apply the dyssynchrony-inducing mode for a period of time, and then to apply the normal pacing mode for a period of time equal to or longer than the period of the dyssynchrony-inducing mode. 
     
     
         7 . The device of  claim 6 , wherein the dyssynchrony-inducing mode is applied to a left ventricular site. 
     
     
         8 . (canceled) 
     
     
         9 . The device of  claim 1 , wherein the controller is programmed to apply the dyssynchrony-induced mode during a period of sleep and to apply the normal pacing mode during non-sleeping hours of each day. 
     
     
         10 - 96 . (canceled) 
     
     
         97 . A device for treating heart failure, comprising:
 a power source;   an atrial stimulation electrode;   a ventricular stimulation electrode; and   a controller that is:   operably connected to the power source and to the stimulation electrodes;   configured to receive a signal indicative of atrial activity; and   programmed to:
 monitor the signal to detect an atrial heart rate;
 operate the device in a normal pacing mode, for which the controller is programmed to cause the atrial stimulation electrode to depolarize atrial tissue if the atrial heart rate is below a predetermined limit; 
 operate the device in a dyssynchrony-inducing mode, for which the controller is programmed to cause the ventricular stimulation electrode to depolarize ventricular tissue at a rate sufficient to induce cardiac dyssynchrony; and 
 alternate between the dyssynchrony-inducing mode and the normal pacing mode for a period of time spanning at least a few hours to several weeks and is sufficient to stimulate molecular and cellular changes in a failing heart to improve its function. 
 
   
     
     
         98 . The device of  claim 97 , wherein the controller is programmed to apply the dyssynchrony-inducing mode for a period of time, and then to apply normal the pacing mode for a period of time equal to or longer than the period of the dyssynchrony-inducing mode. 
     
     
         99 . The device of  claim 98 , wherein the dyssynchrony-inducing mode is applied to a left ventricular site. 
     
     
         100 . The device of  claim 99 , wherein the controller is programmed to apply the dyssynchrony-inducing mode during a period of sleep and to apply the normal pacing mode during non-sleeping hours of each day. 
     
     
         101 . A device for treating heart failure, comprising:
 a power source;   an atrial stimulation electrode;   a ventricular stimulation electrode; and   a controller that is:   operably connected to the power source and to the stimulation electrodes;   configured to receive a signal indicative of atrial activity; and   programmed to:
 monitor the signal to detect atrial heart rate; 
 operate the device in a normal pacing mode, for which the controller is programmed to cause the atrial stimulation electrode to depolarize atrial tissue if the atrial heart rate is below a predetermined limit; 
 periodically transiently operate the device in a dyssynchrony-inducing mode, for which the controller is programmed to cause the ventricular stimulation electrode to depolarize ventricular tissue by pre-excitation pacing via a shortened time interval between sensing atrial stimulation and pacing the ventricular tissue to induce cardiac dyssynchrony; and
 alternate between the normal pacing mode and the dyssynchrony-inducing mode in a cycle, and repeat that cycle multiple times for at least one month. 
 
   
     
     
         102 . The device of  claim 101 , wherein for a single cycle the controller is programmed to apply the dyssynchrony-inducing mode for a period of time, and then to apply the normal pacing mode for a period of time equal to or longer than the period of the dyssynchrony-inducing mode. 
     
     
         103 . The device of  claim 102 , wherein the dyssynchrony-inducing mode is applied to a left ventricular site. 
     
     
         104 . The device of  claim 101 , wherein the controller is programmed to apply the dyssynchrony-induced mode during a period of sleep and to apply the normal pacing mode during non-sleeping hours of each day. 
     
     
         105 . The device of  claim 101 , wherein a single cycle of alternating between the normal pacing mode and the dyssynchrony-inducing mode is sufficient to stimulate molecular and cellular changes in a failing heart to improve its function.