Devices, systems, and methods for cardiac resynchronization therapy
The present technology generally includes devices, systems, and methods for providing electrical stimulation to the left ventricle of a human heart in a patient suffering from Left Bundle Branch Block (LBBB). In particular, the present technology includes an implantable receiver-stimulator and an implantable controller-transmitter for leadless electrical stimulation of the heart. The receiver-stimulator can include one or more sensors capable of detecting the electrical conduction of the heart and the receiver-stimulator can be configured to pace the stimulation of the left ventricle based off the sensed electrical conduction to achieve synchronization of the left and right ventricles.
1 . A wireless controller-transmitter for controlling stimulation of a left ventricle of a heart, the controller-transmitter comprising:
one or more sensors configured to receive an indication of electrical conduction of the heart;
a controller operably coupled to the one or more sensors and configured to determine, in substantially real-time, an occurrence of an onset of a QRS segment in the electrical conduction of the heart; and
a transducer operably coupled to the controller and configured to emit an acoustic signal in response to the controller determining the occurrence of the onset of the QRS segment in the electrical conduction of the heart,
wherein the transducer is configured to emit the acoustic signal toward a receiver-stimulator implanted within or adjacent the left ventricle to cause the receiver-stimulator to deliver electrical stimulation to the left ventricle within a predefined duration beginning at the onset of the QRS segment, and
wherein emission of the acoustic signal is configured to improve contraction synchronization of the left ventricle and a right ventricle of the heart.
2 . The controller-transmitter of claim 1 , wherein the one or more sensors are configured to detect the electrical conduction of the heart in substantially real-time.
3 . The controller-transmitter of claim 1 , wherein the one or more sensors are configured to detect the electrical conduction of the heart with a delay of less than about 5 milliseconds, less than about 4 milliseconds, less than about 3 milliseconds, less than about 2 milliseconds, or less than about 1 millisecond.
4 . The controller-transmitter of claim 1 , wherein the predefined duration is less than about 10 milliseconds.
5 . The controller-transmitter of claim 1 , wherein the predefined duration is about 5 milliseconds.
6 . The controller-transmitter of claim 1 , further comprising a battery and a battery housing, and wherein at least one of the one or more sensors is attached to the battery housing.
7 . The controller-transmitter of claim 1 , further comprising a housing, and wherein at least one of the one or more sensors is attached to the housing.
8 . The controller-transmitter of claim 1 , wherein the one or more sensors include a first sensor and a second sensor, and wherein the controller-transmitter further comprises:
a controller-transmitter housing carrying the controller and the transducer;
a battery; and
a battery housing carrying the battery,
wherein the first sensor is attached to the controller-transmitter housing and the second sensor is attached to the battery housing.
9 . The controller-transmitter of claim 1 , further comprising a communication module configured to provide a data path to an external programmer unit.
10 . The controller-transmitter of claim 1 , further comprising a housing carrying the controller and the transducer, wherein the housing is configured to be implanted inside a human subject.
11 . The controller-transmitter of claim 1 , wherein the transducer is a first transducer, and wherein the controller-transmitter is a part of a system, the system further comprising:
the receiver-stimulator comprising—
a second transducer configured to convert the acoustic signal received from the controller-transmitter into electrical energy, and
one or more stimulation electrodes electrically coupled to the second transducer.