Methods and systems for controlling blood pressure by controlling atrial pressure
Systems and methods for controlling blood pressure by controlling atrial pressure and atrial stretch are disclosed. In some embodiments, a stimulation circuit may be configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of a patient, and at least one controller may be configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber, wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced.
1. A system for reducing blood pressure in a hypertensive patient, the system comprising:
a stimulation circuit configured to deliver a stimulation pulse to at least one cardiac chamber of a heart of the patient; and
at least one controller configured to execute delivery of one or more stimulation patterns of stimulation pulses to the at least one cardiac chamber,
wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced, and
wherein the stimulation has an immediate effect on reduction of blood pressure.
2. The system of claim 1 , wherein the one or more stimulation patterns comprise stimulating the heart such that atrial kick is reduced or prevented.
3. The system of claim 2 , wherein stimulation pulses of the one or more stimulation patterns are configured to reduce or prevent atrial kick and are delivered based upon need.
4. The system of claim 3 , wherein the stimulation pulses configured to reduce or prevent atrial kick are provided only during part of a 24-hour period.
5. The system of claim 4 , wherein said part of a 24-hour period is a night or part thereof.
6. The system of claim 4 , wherein said part of a 24-hour period is a day or part thereof.
7. The system of claim 3 , wherein the stimulation pulses configured to reduce or prevent atrial kick are provided only when heart rate is below a predefined threshold.
8. The system of claim 7 , wherein the predefined threshold is an absolute value.
9. The system of claim 7 , wherein the predefined threshold is set at a value relative to the patient's average heart rate.
10. The system of claim 3 , wherein the stimulation pulses configured to reduce or prevent atrial kick are provided only when the patient is at rest and/or at a low activity level.
11. The system of claim 10 , wherein the at least one controller determines whether the patient is at rest and/or at a low activity level based on data from a sensor sensing motion, posture, respiration rate, and/or heart rate.
12. The system of claim 3 , wherein the one or more stimulation patterns are selected based on a measured blood pressure parameter.
13. The system of claim 12 , wherein the at least one controller changes the one or more stimulation patterns when baroreflex is sensed.
14. The system of claim 1 , wherein the one or more stimulation patterns comprise stimulating the heart at a plurality of heartbeats, and
wherein at least some of the stimulation pulses are configured to reduce or prevent atrial kick.
15. The system of claim 14 , wherein the stimulation pulses configured to reduce or prevent atrial kick are delivered based upon need.
16. The system of claim 1 , wherein a stimulation pulse is provided such that in a single heartbeat both atrial kick is reduced or prevented and an atrial pressure resulting from atrial contraction of an atrium overlaps in time the passive pressure build-up of the atrium such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation.
17. The system of claim 16 , wherein the stimulation pulse is delivered based upon need.
18. A method, carried out with an implanted heart muscle stimulator associated with a heart of a patient, for reducing blood pressure of the patient, the method comprising:
delivering one or more stimulation patterns of stimulation pulses to at least one cardiac chamber of the heart of the patient,
wherein at least one of the stimulation pulses stimulates the heart such that an atrial pressure resulting from atrial contraction of an atrium overlaps in time a passive pressure build-up of the atrium, such that an atrial pressure of the atrium resulting from the stimulation is a combination of the atrial pressure resulting from atrial contraction and the passive pressure build-up and is higher than an atrial pressure of the atrium would be without the stimulation, and such that the blood pressure of the patient is reduced, and
wherein the stimulation has an immediate effect on reduction of blood pressure.
19. The method of claim 18 , wherein the one or more stimulation patterns comprise stimulating the heart such that atrial kick is reduced or prevented.
20. The method of claim 19 , wherein stimulation pulses of the one or more stimulation patterns are configured to reduce or prevent atrial kick and are delivered based upon need.