Protein activity modification
View Patent ↗A method of modifying tissue behavior, comprising: determining a desired modification of tissue behavior for at least one of treatment of a disease, short or long term modification of tissue behavior, assessing tissue state and assessing tissue response to stimulation; selecting an electric field having an expected effect of modifying protein activity of at least one protein as an immediate response of a tissue to the field, said expected effect correlated with said desired modification; and applying said field to said tissue.
1. A method of treating a patient for chronic heart failure, comprising:
a. selecting a patient having (i) a narrow QRS and (ii) a New York Heart Association (NYHA) class of at least II; and
b. applying a cardiac contractility modifying electrical therapy to a heart of said patient for at least 3 months.
2. A method according to claim 1 , wherein said QRS has a duration of less than 105 ms.
3. A method according to claim 1 , wherein said QRS has a duration of less than 90 ms.
4. A method according to claim 1 , wherein said selecting comprises selecting patients with an EF (ejection fraction) <40%.
5. A method according to claim 1 , wherein said selecting comprises selecting patients with an EF (ejection fraction) <35%.
6. A method according to claim 1 , wherein said selecting comprises selecting patients with a NYHA class of at least III.
7. A method according to claim 1 , wherein said selecting comprises selecting patients with a NYHA class of II or III.
8. A method according to claim 1 , wherein said selecting comprises selecting patients with a NYHA class of IV.
9. A method according to claim 1 , wherein said selecting comprises selecting patients with ischemic heart failure.
10. A method according to claim 1 , wherein said selecting comprises selecting patients with idiopathic heart failure.
11. A method according to claim 1 , wherein said selecting comprises selecting a patient being treated for heart failure using medication.
12. A method according to claim 1 , wherein said selecting comprises selecting with a goal to improve six minute walk by at least 15 meters.
13. A method according to claim 1 , wherein said applying comprises applying at least until a six minute walk of the patient improves by at least 15 meters.
14. A method according to claim 1 , wherein said selecting comprises selecting with a goal to improve peak oxygen consumption (VO 2 ) by at least 1 ml O 2 /kg/min.
15. A method according to claim 1 , wherein said selecting comprises selecting with a peak oxygen consumption (VO 2 ) <14.4 ml O 2 /kg/min.
16. A method according to claim 1 , wherein said selecting comprises selecting with a peak oxygen consumption (VO 2 ) of about 14.3±2.8 ml O 2 /kg/min.
17. A method according to claim 1 , wherein said applying comprises applying at least until peak oxygen consumption (VO 2 ) improves by at least 1 ml O 2 /kg/min.
18. A method according to claim 1 , wherein said selecting comprises selecting with a goal to improve NYHA class by at least one class.
19. A method according to claim 1 , wherein said applying comprises applying at least until NYHA class improves by at least one class.
20. A method according to claim 1 , wherein said selecting comprises selecting with a Minnesota Living With Heart Failure Questionnaire (MLWHFQ) of about 41±20.
21. A method according to claim 1 , wherein said selecting comprises selecting with a goal to improve Minnesota Living With Heart Failure Questionnaire (MLWHFQ) by at least 18.3.
22. A method according to claim 1 , wherein said applying comprises applying at least until Minnesota Living With Heart Failure Questionnaire (MLWHFQ) improves by at least 18.3.
23. A method according to claim 1 , comprising continuing treating with beta blockers.
24. A method according to claim 1 , wherein said applying comprises applying for at least 6 months.
25. A method according to claim 1 , wherein said applying comprises stopping applying while allowing therapeutic effect of said applying to continue for at least 3 months.
26. A method according to claim 1 , wherein said applying comprises applying using an implantable device and implantable electrodes.
27. A method according to claim 1 , wherein said cardiac contractility modifying therapy is applied at a time when the therapy is non-excitatory to said heart.
28. A method according to claim 1 , wherein said applying comprises applying intermittently for at least 5 hours a day.