Acute myocardial infarction treatment by electrical stimulation of the thoracic aorta
Apparatus and methods are described including identifying a subject as suffering from a condition selected from the group consisting of congestive heart failure, diastolic heart failure, acute myocardial infarction, and hypertension. In response to the identifying, an electrode is placed on the subject's aorta at an aortic site that is between a bifurcation of the aorta with the subject's left subclavian artery and a bifurcation of the aorta with the subject's fifth intercostal artery. The subject is treated by electrically stimulating the aortic site by driving a current into the aortic site, via the electrode. Other applications are also described.
1. A method, comprising:
identifying a subject as suffering from a condition selected from the group consisting of congestive heart failure, diastolic heart failure, acute myocardial infarction, and hypertension; and
in response to the identifying:
placing an electrode on an aorta of the subject at an aortic site that is downstream of a bifurcation of the aorta with a left subclavian artery, between the bifurcation of the aorta with the left subclavian artery of the subject and a bifurcation of the aorta with a fifth intercostal artery of the subject; and
treating the subject by electrically stimulating the aortic site by driving a current into the aortic site, via the electrode.
2. The method according to claim 1 , wherein treating the subject comprises reducing ventricular pressure of the subject.
3. The method according to claim 1 , wherein treating the subject comprises reducing aortic pressure of the subject.
4. The method according to claim 1 , wherein treating the subject comprises reducing sympathetic tone of the subject.
5. The method according to claim 1 , wherein treating the subject comprises increasing parasympathetic tone of the subject.
6. The method according to claim 1 , wherein placing the electrode at the aortic site comprises implanting the electrode at the aortic site.
7. The method according to claim 1 , wherein identifying the subject as suffering from the condition comprises identifying the subject as suffering from a condition selected from the group consisting of congestive heart failure, diastolic heart failure, and hypertension, and wherein placing the electrode at the aortic site comprises placing the electrode at the aortic site that is between the first and fifth intercostal arteries.
8. The method according to claim 1 , wherein placing the electrode at the aortic site comprises placing the electrode at an aortic site that is between the bifurcation of the aorta with the left subclavian artery and a bifurcation of the aorta with a fourth intercostal artery of the subject.
9. The method according to claim 8 , wherein placing the electrode at the aortic site comprises placing the electrode at an aortic site that is between the bifurcation of the aorta with the left subclavian artery and a bifurcation of the aorta with a first intercostal artery of the subject.
10. The method according to claim 1 , further comprising detecting an electrical signal at the aortic site, and deriving from the electrical signal a physiological parameter of the subject selected from the group consisting of: blood pressure of the subject and an ECG signal of the subject.
11. The method according to claim 10 , wherein detecting the electrical signal at the aortic site comprises detecting the electrical signal using at least two electrodes that are disposed around a circumference of the aorta at the aortic site at a distance of more than 10 mm from one another.
12. The method according to claim 10 , wherein driving the current into the aortic site comprises driving the current into the aortic site responsively to the detected electrical signal.
13. The method according to claim 12 , wherein deriving the physiological parameter comprises deriving the subject's ECG signal, and wherein driving the current into the aortic site comprises driving the current into the aortic site in coordination with a QRS complex of the subject's ECG signal.
14. The method according to claim 1 , wherein placing the electrode at the aortic site comprises placing the electrode in contact with the aortic site of the subject's aorta by percutaneously inserting the electrode into the subject's body via a catheter, the method further comprising, subsequent to termination of the electrical stimulation, removing the electrode and the catheter from the subject's body.
15. The method according to claim 14 , wherein identifying the subject as suffering from the condition comprises identifying the subject as suffering from acute myocardial infarction.
16. The method according to claim 15 , further comprising, in response to identifying the subject, performing a percutaneous coronary intervention, wherein electrically stimulating the aortic site comprises driving the current into the aortic site, at least periodically, during the percutaneous coronary intervention, and for a period of time following the percutaneous coronary intervention.
17. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing afterload of the subject by driving the current into the aortic site via the electrode.
18. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing ventricular pressure of the subject by driving the current into the aortic site via the electrode.
19. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing aortic pressure of the subject by driving the current into the aortic site via the electrode.
20. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing sympathetic tone of the subject by driving the current into the aortic site via the electrode.
21. The method according to claim 15 , wherein driving the current into the aortic site comprises increasing parasympathetic tone of the subject by driving the current into the aortic site via the electrode.
22. The method according to claim 15 , wherein placing the electrode in contact with the aortic site comprises assessing a response of the subject to placement of the electrode at a plurality of sites, and selecting one of the plurality of sites as the aortic site in response to the assessing.
23. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing ventricular work and oxygen consumption of the subject by driving the current into the aortic site via the electrode.
24. The method according to claim 15 , wherein driving the current into the aortic site comprises increasing myocardial perfusion of the subject by driving the current into the aortic site via the electrode.
25. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing a likelihood of the myocardium being damaged due to ischemia by driving the current into the aortic site via the electrode.
26. The method according to claim 15 , wherein driving the current into the aortic site comprises reducing a likelihood of the myocardium being damaged due to reperfusion injury by driving the current into the aortic site via the electrode.
27. The method according to claim 1 , wherein placing the electrode on the subject's aorta at the aortic site comprises placing the electrode inside the aorta at the aortic site.
28. The method according to claim 1 , wherein placing the electrode on the subject's aorta at the aortic site comprises placing the electrode outside the aorta at the aortic site.