Protein activity modification

Abstract

A method of modifying tissue behavior, comprising: determining a desired modification of tissue behavior for at least one of treatment of a disease, short or long term modification of tissue behavior, assessing tissue state and assessing tissue response to stimulation; selecting an electric field having an expected effect of modifying protein activity of at least one protein as an immediate response of a tissue to the field, said expected effect correlated with said desired modification; and applying said field to said tissue.

What is claimed is: 
     
         1 . A method of manufacturing a therapeutic device for reversing a cardiac fetal gene, comprising:
 selecting an electrical pulse sequence according to its effect on gene expression in the heart; and   programming a controller of said therapeutic device to apply a pulse sequence on a tissue of the heart for reversing the fetal gene program of said tissue.   
     
     
         2 . A method according to  claim 1 , wherein said sequence is selected to treat heart failure. 
     
     
         3 . A method according to  claim 1 , wherein said sequence is non-excitatory. 
     
     
         4 . A method according to  claim 1 , comprising modifying said pulse sequence in response to an effect of said pulse sequence on the cardiac gene activity. 
     
     
         5 . A method according to  claim 1 , comprising determining said pulse sequence in response to a patient classification. 
     
     
         6 . A method according to  claim 1 , wherein said programming is to apply a pulse sequence synchronized to the refractory period. 
     
     
         7 . A method according to  claim 1 , wherein said pulse sequence is applied within the right ventricle. 
     
     
         8 . A method according to  claim 7 , wherein said pulse sequence affects the left ventricle. 
     
     
         9 . A method of treating cardiac dysfunction, comprising applying an electric field to said heart which is sufficient to cause a reversal of a fetal gene program without significant effect on contractility. 
     
     
         10 . A method according to  claim 9 , wherein said electrical field is non-excitatory to said heart. 
     
     
         11 . A method according to  claim 9 , comprising stopping said application for a length of time which is a function of an expected washout time of an effect of said field. 
     
     
         12 . A method according to  claim 9 , wherein said applying comprises applying for a duration of at least 1 hour. 
     
     
         13 . A method according to  claim 9 , wherein said applying comprises repeating said applying and at least 20 times. 
     
     
         14 . A method according to  claim 13 , comprising stopping said application for a length of time which varies between repetitions. 
     
     
         15 . A method according to  claim 9 , wherein said applying comprises applying electrical field within the right ventricle. 
     
     
         16 . A method according to  claim 9 , wherein said applying affects the left ventricle. 
     
     
         17 . A method according to  claim 9 , wherein said applied field does not acutely increase contractility by more than 3%. 
     
     
         18 . A method according to  claim 9 , wherein said applying comprises applying using an implantable device and implantable electrodes. 
     
     
         19 . A cardiac therapeutic device manufactured by the method of  claim 1 . 
     
     
         20 . A cardiac therapeutic device according to  claim 19 , comprising:
 at least one electrode adapted to apply an electric field to in-vivo cardiac tissue;   a controller including a memory having stored therein at least one pulse sequence which modifies cardiac gene expression in said tissue, said controller being configured to determine that a modification of said gene expression causes a reversal of a fetal gene program, and apply said sequence in response said determination.