Intra-cardiac left atrial and dual support systems
A system for treating atrial dysfunction, including heart failure and/or atrial fibrillation, that includes one or more pressurizing elements and control circuitry. The one or more pressurizing elements can comprise one or more balloons and can be configured to be positioned in the left atrium, and optionally the pulmonary artery, of a patient's heart. The one or more pressurizing elements can be coupled to one or more positioning structures that can be configured to position the one or more pressurizing elements in the left atrium, and optionally the pulmonary artery. The control circuitry can be configured to operate the one or more pressurizing elements to decrease or increase pressure and/or volume in the left atrium, and optionally the pulmonary artery, in accordance with different phases of the cardiac cycle. The control circuitry can be further configured to operate the one or more pressurizing elements to generate coordinated pressure modifications in the left atrium, and optionally the pulmonary artery.
1. A system for treating atrial dysfunction, the system comprising:
a pressurizing element configured to be positioned in a left atrium of a heart of a patient; and
control circuitry configured to:
operate the pressurizing element to decrease a pressure in the left atrium and timed to coincide with atrial diastole to draw oxygenated blood out of the lungs of the patient by increasing a relative volume of the left atrium to reduce a filling pressure in the left atrium; and
operate the pressurizing element to increase the pressure in the left atrium and timed to coincide with atrial systole by reducing the relative volume of the left atrium to increase a left atrial pressure during atrial systole, wherein the increase in the left atrial pressure during atrial systole increases a pressure differential between the left atrium and a left ventricle that improves diastolic filling of the left ventricle.
2. The system of claim 1 , further comprising an atrial positioning structure coupled to the pressurizing element and configured to position the pressurizing element in the left atrium.
3. The system of claim 2 , wherein the atrial positioning structure comprises a septal anchor or a left atrial appendage anchor.
4. The system of claim 2 , wherein the atrial positioning structure comprises a shaft configured to extend transseptally between a right atrium and the left atrium of the heart of the patient.
5. The system of claim 4 , wherein the shaft is pre-shaped with a curve or bend to facilitate positioning of the pressurizing element in the left atrium.
6. The system of claim 4 , wherein the system further comprises a shaped stylet configured to be delivered through the shaft to facilitate positioning of the pressurizing element in the left atrium.
7. The system of claim 1 , wherein the pressurizing element comprises a balloon, wherein operating the pressurizing element to increase the pressure in the left atrium comprises filling the balloon with a liquid or a gas, and wherein operating the pressurizing element to decrease the pressure in the left atrium comprises removing the liquid or the gas from the balloon.
8. The system of claim 7 , wherein a distal end of the balloon is recessed within the balloon such that the distal end of the balloon is atraumatic.
9. The system of claim 7 , wherein the balloon comprises an open central lumen.
10. The system of claim 7 , further comprising pressurizing components that include a pressure chamber and at least one pump disposed between the balloon and the pressure chamber.
11. The system of claim 10 , wherein the pressurizing components are configured to be external fixed, external ambulatory, or implantable components.
12. The system of claim 2 , wherein the atrial positioning structure comprises a septal anchor, wherein the septal anchor comprises first and second expandable members configured to expand respectively against left and right sides of an atrial septum of the heart of the patient, and wherein the pressurizing element is attached to the first expandable member.
13. The system of claim 1 , wherein the pressurizing element configured to be positioned in the left atrium is a first pressurizing element, and further comprising a second pressurizing element configured to be positioned in a pulmonary artery of the patient.
14. The system of claim 13 , further comprising a pulmonary artery positioning structure, wherein the second pressurizing element is coupled to the pulmonary artery positioning structure, the pulmonary artery positioning structure configured to position the second pressurizing element in the pulmonary artery of the patient.
15. The system of claim 13 , wherein the control circuitry is further configured to operate the first and second pressurizing elements to generate coordinated pressure modifications in the left atrium and the pulmonary artery.
16. The system of claim 13 , wherein the first pressurizing element comprises a first balloon, and the second pressurizing element comprises a second balloon.
17. A method for treating atrial dysfunction, comprising:
delivering a pressurizing element into a left atrium of a patient;
operating the pressurizing element to decrease a pressure in the left atrium timed to coincide with atrial diastole to draw oxygenated blood out of the lungs of the patient by increasing a relative volume of the left atrium to reduce a filling pressure in the left atrium; and
operating the pressurizing element to increase the pressure in the left atrium timed to coincide with atrial systole by reducing the relative volume of the left atrium to increase a left atrial pressure during atrial systole, wherein the increase in the left atrial pressure during atrial systole increases a pressure differential between the left atrium and left ventricle that improves diastolic filling of the left ventricle.
18. The method of claim 17 , wherein the pressurizing element is a balloon.
19. The method of claim 17 , further comprising:
receiving, at control circuitry from a sensor communicatively coupled to the patient, a signal corresponding to a cardiac cycle for the heart of the patient;
operating the pressurizing element to decrease a pressure in the left atrium responsive to a portion of the signal; and
operating the pressurizing element to increase a pressure in the left atrium responsive to an additional portion of the signal.
20. The method of claim 19 , wherein the sensor comprises an electrical sensor or a pressure sensor.
21. The method of claim 17 , further comprising anchoring the pressurizing element within the left atrium.
22. The method of claim 17 , wherein the pressurizing element delivered into the left atrium is a first pressurizing element, and further comprising:
delivering a second pressurizing element into a pulmonary artery of the patient;
operating the second pressurizing element to decrease a pressure in the pulmonary artery during pulmonary artery systole to reduce pulmonary artery systolic pressures and reduce a work load of a right ventricle of the heart of the patient; and
operating the second pressurizing element to increase a pressure in the pulmonary artery during pulmonary artery diastole after a pulmonary valve is closed to increase pulmonary artery diastolic pressure to overcome pulmonary vascular resistance and increase cardiac output.