PROTEIN ACTIVITY MODIFICATION
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 manufacturing a therapeutic device for reversing a cardiac fetal gene, comprising:
selecting an electrical pulse sequence according to its effect on gene expression in the heart; and
programming a controller of said therapeutic device to apply a pulse sequence on a tissue of the heart for reversing the fetal gene program of said tissue.
2 . A method according to claim 1 , wherein said sequence is selected to treat heart failure.
3 . A method according to claim 1 , wherein said sequence is non-excitatory.
4 . A method according to claim 1 , comprising modifying said pulse sequence in response to an effect of said pulse sequence on the cardiac gene activity.
5 . A method according to claim 1 , comprising determining said pulse sequence in response to a patient classification.
6 . A method according to claim 1 , wherein said programming is to apply a pulse sequence synchronized to the refractory period.
7 . A method according to claim 1 , wherein said pulse sequence is applied within the right ventricle.
8 . A method according to claim 7 , wherein said pulse sequence affects the left ventricle.
9 . A method of treating cardiac dysfunction, comprising applying an electric field to said heart which is sufficient to cause a reversal of a fetal gene program without significant effect on contractility.
10 . A method according to claim 9 , wherein said electrical field is non-excitatory to said heart.
11 . A method according to claim 9 , comprising stopping said application for a length of time which is a function of an expected washout time of an effect of said field.
12 . A method according to claim 9 , wherein said applying comprises applying for a duration of at least 1 hour.
13 . A method according to claim 9 , wherein said applying comprises repeating said applying and at least 20 times.
14 . A method according to claim 13 , comprising stopping said application for a length of time which varies between repetitions.
15 . A method according to claim 9 , wherein said applying comprises applying electrical field within the right ventricle.
16 . A method according to claim 9 , wherein said applying affects the left ventricle.
17 . A method according to claim 9 , wherein said applied field does not acutely increase contractility by more than 3%.
18 . A method according to claim 9 , wherein said applying comprises applying using an implantable device and implantable electrodes.
19 . A cardiac therapeutic device manufactured by the method of claim 1 .
20 . A cardiac therapeutic device according to claim 19 , comprising:
at least one electrode adapted to apply an electric field to in-vivo cardiac tissue;
a controller including a memory having stored therein at least one pulse sequence which modifies cardiac gene expression in said tissue, said controller being configured to determine that a modification of said gene expression causes a reversal of a fetal gene program, and apply said sequence in response said determination.