A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the por
A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.
대표청구항▼
1. Apparatus for non-excitatory modulation of activity of a heart, comprising: an implantable housing;a power supply within the housing;at least one electrode coupled to said power supply and adapted to apply an electric field to a portion of a heart;memory storing therein at least a first activatio
1. Apparatus for non-excitatory modulation of activity of a heart, comprising: an implantable housing;a power supply within the housing;at least one electrode coupled to said power supply and adapted to apply an electric field to a portion of a heart;memory storing therein at least a first activation state indication of an activation state of a heart or portion thereof and an associated first timing parameter value and at least a second activation state indication of an activation state of a heart or a portion thereof and an associated second timing parameter value; andcircuitry which determines a delay using said timing parameter values in said memory and a present activation state of the heart and which controls said power supply to electrify said at least one electrode according to said delay to be within a refractory period of tissue at said portion. 2. Apparatus according to claim 1, wherein said electric field has a timing, shape, frequency and amplitude suitable for increasing a contractility of tissue to which it is applied. 3. Apparatus according to claim 1, wherein said delay is less than 70 msec from an expected activation time at said portion. 4. Apparatus according to claim 1, wherein said delay is less than 150 msec from an expected activation time at said portion. 5. Apparatus according to claim 1, wherein said circuitry determines said delay based on a time of pacing of the heart. 6. Apparatus according to claim 5, wherein said pacing is in a different chamber of the heart than said portion. 7. Apparatus according to claim 1, wherein said circuitry determines said delay based on a sensed activation time. 8. Apparatus according to claim 1, wherein said circuitry determines said activation state by sensing. 9. Apparatus according to claim 1, wherein said first activation state indication comprises an arrhythmia state indication. 10. Apparatus according to claim 1, wherein said activation state indication distinguishes between the pacing source for the heart being natural or artificial. 11. Apparatus according to claim 1, comprising at least one sensing circuit configured to detect a local activation. 12. Apparatus according to claim 11, wherein said circuitry controls said power source in response to sensing of local activation at said at least one electrode. 13. Apparatus according to claim 11, wherein said circuitry controls said power source in response to sensing of local activation at at least two temporally spaced apart electrodes. 14. Apparatus according to claim 13, wherein said local activation is determined in a first chamber and in a second chamber in which said portion is. 15. Apparatus according to claim 1, wherein said circuitry controls said power source in response to sensing of local activation at said at least one electrode in a same chamber as said portion. 16. Apparatus according to claim 11, wherein said circuitry controls said power source in response to sensing of local activation, which local activation is caused by pacing of said heart. 17. A method of controlling a heart, comprising: determining an activation profile of the heart, including if the heart is naturally or artificially paced; andapplying an electric field to a portion of said heart, during a refractory period of said portion, at a timing determined at least in part based on the identity of a pacing source of the heart. 18. A method according to claim 17, comprising increasing a contractility of said heart by said applying. 19. A method according to claim 17, comprising pacing said heart using a separate pacemaker and said determining is based on indication of pacing of the a present heart beat. 20. A method according to claim 17, wherein said applying comprises using at least two of four electrodes which are positioned to apply said field to a same said portion. 21. A method according to claim 17, wherein said timing is determined at a learning state of a controller used for said applying.
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