Methods and implantable devices for treating supraventricular arrhythmias

Abstract

A medication, method and device for cardiac treatment are provided, in particular, for treating supraventricular arrhythmias. Specifically, a method is provided for treating supraventricular arrhythmias, using a therapeutically effective amount of a cholinergic receptor agonist, for example, acetylcholine. This device may be part of universal device which provides pacing and defibrillation. In particular, the present invention can be used to treat atrial fibrillation, atrial flutter and atrial tachycardia by a bolus injection of a rapidly hydrolysable cholinergic receptor agonist such as acetylcholine.

1 - 53 . (canceled) 
     
     
         54 . A device comprising a device body adapted for implantation into a body and a sensor for sensing an electrical or mechanical activity of a heart being in contact with said device body when implanted into the body, said device body housing a reservoir for holding a cholinergic receptor agonist suitable for intracardiac or and/or intravascular administration via a vein, or an artery or a heart chamber. 
     
     
         55 . The device of  claim 54 , wherein said vein is selected from the group consisting of a peripheral vein, a superior vena cava and/or an inferior vena cava and/or a coronary sinus, or said artery is selected from the group consisting of a coronary artery and/or a pulmonary artery or said heart chamber, is selected from the group consisting of a right atrium, a left atrium, a right ventricle or a left ventricle. 
     
     
         56 . The device of  claim 54 , wherein said administration is effected using a catheter, said catheter comprising any of a lumen for drug delivery, a pacing lead with a lumen for drug delivery, a cannula, a needle, syringe or a pump. 
     
     
         57 . The device of  claim 54 , wherein a housing of said device is sealed with a puncturable material so as to allow replenishing of said cholinergic receptor agonist in said reservoir by needle puncture. 
     
     
         58 . The device of  claim 54 , further comprising a controller within said device body for controlling release of said cholinergic receptor agonist and a power source for powering said controller, said power source being in electrical communication with said controller. 
     
     
         59 . The device of  claim 56 , said catheter having a proximal end at said housing and a distal end positionable in proximity with said tissue, said catheter defining a lumen, said lumen running substantially the length of said catheter and opening into an orifice, wherein said electrically controlled valve controls a release of said cholinergic receptor agonist into said lumen. 
     
     
         60 . The device of  claim 59 , further comprising an electrical lead, said electrical lead running along a part of the length of said catheter, the entire length of said catheter or beyond the length of said catheter, and having a proximal end in electrical communication with said controller, and a distal end associated with said tissue. 
     
     
         61 . The device of  claim 54 , wherein said device is operative as a pacemaker or as an ICD. 
     
     
         62 . The device of  claim 59 , wherein said orifice is in a right side of said heart or is in a vein leading to a right side of said heart or wherein said orifice is in a left side of said heart or is in a vessel leading to a left side of said heart. 
     
     
         63 . The device of  claim 54 , wherein said cholinergic receptor agonist is acetylcholine or an acetylcholine salt selected from the group consisting of acetylcholine chloride, acetylcholine bromide and acetylcholine iodide. 
     
     
         64 . The device of  claim 54 , wherein said release of said cholinergic receptor agonist is effected by a bolus injection further wherein said cholinergic receptor agonist is selected capable of modulating at least one electrical property of at least a portion of atrial cells. 
     
     
         65 . A device comprising a device body adapted for implantation into a body, said device body housing a reservoir for holding a cholinergic receptor agonist for administering into or close to a heart tissue. 
     
     
         66 . The device of  claim 65 , wherein a housing of said device is provided with a seal formed of a puncturable material enabling replenishing of said cholinergic receptor agonist in said reservoir. 
     
     
         67 . The device of  claim 66 , further comprising an electrically controlled valve associated with said reservoir, said electrically controlled valve is suitable for controlling a release of said cholinergic receptor agonist. 
     
     
         68 . The device of  claim 67 , further comprising a controller selected capable of controlling said electrically controlled valve, said controller being located within said device body further wherein said device comprises a power source being in electrical communication with said controller. 
     
     
         69 . The device of  claim 68 , further comprising a catheter, said catheter having a proximal end at said housing and a distal end positionable in proximity to said tissue, said catheter defining a lumen, said lumen running substantially the length of said catheter and opening into an orifice, wherein said electrically controlled valve controls a release of said cholinergic receptor agonist into said lumen further comprising an electrical lead, said electrical lead running at least the length of said catheter and having a proximal end in electrical communication with said controller, and a distal end associated with said tissue further wherein the electrical lead is combined with the drug delivery catheter in one lead-catheter body or said electrical lead and said drug delivery catheter are separate, further wherein said sensor is on the atrial lead. 
     
     
         70 . The device of  claim 69 , wherein said catheter is a part of a pacing lead-catheter. 
     
     
         71 . The device of  claim 69 , wherein said orifice is in a right side of said heart or in a vein leading to a right side or wherein said orifice is in a left side of said heart or is in a vessel leading to a left side of said heart 
     
     
         72 . The device of  claim 65 , wherein said cholinergic receptor agonist is acetylcholine or an acetylcholine salt, said salt selected from the group consisting of acetylcholine chloride, acetylcholine bromide and acetylcholine iodide. 
     
     
         73 . The device of  claim 65 , wherein said release of said cholinergic receptor agonist is effected by a bolus injection further wherein said cholinergic receptor agonist is selected capable of modulating at least one electrical property of at least a portion of atrial cells. 
     
     
         74 . An implantable cardiac treatment device, comprising a reservoir containing a cholinergic receptor agonist and a releasing mechanism for releasing a predetermined dose of said cholinergic receptor agonist in, on or in proximity to a heart further comprising a sensor for sensing supraventricular arrhythmia of said heart further wherein said sensor communicates with said releasing mechanism for releasing said predetermined dose of said cholinergic receptor agonist in, on or in proximity to said heart when said supraventricular arrhythmia of said heart is sensed by said sensor further wherein decision to release said predetermined dose of said cholinergic receptor agonist is determined by application of an algorithm residing on a micro chip associated with said device.