Electrical muscle controller
A method of modifying the force of contraction of at least a portion of a heart chamber, including providing a subject having a heart, comprising at least a portion having an activation, and applying a non-excitatory electric field having a given duration, at a delay after the activation, to the portion, which causes the force of contraction to be increased by a least 5%.
1. A method of treating a heart of a patient using electrical therapy, comprising:
(a) setting a target of a change in at least one physiological parameter of the heart;
(b) applying electrical therapy to the heart for a period of time of at least a day, said therapy selected to at least approach said target;
(c) detecting or assuming a change in said at least one physiological parameter over time due to said applying, wherein said change represents a change in physiology of said heart; and
(d) modifying said applying in response to said detected or assumed change.
2. A method according to claim 1 , wherein said applying includes applying an electrical field to tissue of said heart, at least a portion of which field is applied during a refractory period of said tissue.
3. A method according to claim 1 , wherein said modifying comprises modifying to compensate for an adaptation of said heart to an effect of said applying.
4. A method according to claim 1 , wherein said modifying comprises modifying in response to an increase in strength of said heart.
5. A method according to claim 1 , wherein said modifying comprises modifying in response to an increase in efficiency of said heart.
6. A method according to claim 1 , wherein said modifying comprises changing a target of said therapy and changing said applying to match said new target.
7. A method according to claim 1 , wherein said setting a target comprises setting a plurality of targets.
8. A method according to claim 1 , wherein said modifying comprises modifying in response to a reduction of an immediate response of said heart to said therapy.
9. A method according to claim 1 , wherein said period of time comprises at least two weeks.
10. A method according to claim 1 , wherein said period of time comprises a time for an infarct to heal.
11. A method according to claim 1 , wherein said target comprises an increase in cardiac output.
12. A method according to claim 1 , wherein said applying comprises applying using a first control sequence and wherein said modifying comprises changing at least one parameter of said first control sequence.
13. A method according to claim 12 , wherein said modifying comprises changing a frequency of beat skipping.
14. A method according to claim 12 , wherein said modifying comprises changing a frequency of application.
15. A method according to claim 12 , wherein said modifying comprises changing a strength of application.
16. A method according to claim 12 , wherein said modifying comprises changing a duration of application.
17. A method according to claim 12 , wherein said modifying comprises changing a time delay associated with application.
18. A method according to claim 12 , wherein said modifying comprises changing a waveform of application.
19. A method according to claim 1 , wherein said modifying comprises applying during an arrhythmia.
20. A method according to claim 1 , comprising identifying an activation profile state of the heart wherein said applying comprises applying according to said activation profile state.
21. A method according to claim 1 , wherein said applying and said modifying are gradual enough to avoid an acute problem with the heart.
22. A method according to claim 1 , wherein said modifying comprises learning a response of the heart and modifying said target and/or said applying in response thereto.
23. A method of controlling the heart comprising:
determining a desired range of values for at least one parameter of cardiac activity; and
controlling at least a local force of contraction in the heart to maintain the parameter within the desired range.
24. A method according to claim 23 , wherein said controlling comprises applying an electrical field to cardiac tissue whose local force of contraction is being controlled.