Systems, methods, and devices for treating bradyarrhythmias, tachyarrhythmias and heart failure

Abstract

A method, system and device for monitoring and treating conditions of a mammalian heart, among which may include bradyarrhythmias, tachyarrhythmias and heart failure, the device being configured as a pacemaker that harvests energy as it implements the pacemaker functions to treat and monitor conditions of the heart. The pacemaker has a case, electrical circuitry sealed within the case, an electrode that is electrically coupled to the electrical circuitry, and embodiments may include a microelectromechanical system (MEMS) for harvesting and converting the kinematic energy of the heart into electrical energy. Embodiments provide receivers at locations of the heart which sense heart activity and are controlled with pacing circuitry to deliver electrical impulses at locations and time intervals to replicate the contractions of a normal functioning heart. Further embodiments provide a multi-part pacemaker where case-connectable electrode part may be implanted separately from the case part.

What is claimed is: 
     
         1 . A multi-part pacemaker for treating conditions of a mammalian heart, said pacemaker comprising: a power source; control circuitry; at least one first part and at least one second part, said first part including an electrode that is implantable in a mammalian heart separate from said second part, said second part including a case and circuitry sealed within said case, wherein said second part is separately implantable to connect with said first part when said first part is implanted in said mammalian heart. 
     
     
         2 . The multi-part pacemaker of  claim 1 , wherein said power source and said control circuitry are provided in at least one of said first part and said second part. 
     
     
         3 . The multi-part pacemaker of  claim 2 , wherein said power source and said control circuitry are provided in said second part. 
     
     
         4 . The multi-part pacemaker of  claim 1 , wherein said first part is releasably connectable to said second part, and wherein a connecting mechanism connects the first part with the second part. 
     
     
         5 . The multi-part pacemaker of  claim 4 , wherein said connecting mechanism includes a connector electrically connecting the electrode with the case circuitry of the second part, wherein said first part includes a top surface that acts as an anode, wherein said electrode acts as a cathode, wherein an insulator is provided, and wherein said electrode is electrically insulated from said top surface by said insulator. 
     
     
         6 . The multi-part pacemaker of  claim 5 , wherein said connecting mechanism comprises a threaded stem provided on one of said first part and said second part, and a threaded socket provided on the other of said first part and said second part. 
     
     
         7 . The multi-part pacemaker of  claim 4 , wherein said first part has a flange, and wherein said first part flange includes threads, and wherein said second part has a side wall, and wherein said side wall has threads thereon, wherein said first part threads comprise male or female threads, and wherein said second part threads comprise the other of said male or female threads, said first part being releasably connectable to said second part via said respective male and female threads. 
     
     
         8 . The multi-part pacemaker of  claim 4 , wherein said second part comprises a socket sized to receive the end of said electrode therein when said second part is connected to said first part, said socket comprising at least one electrical contact that electrically contacts said electrode end, and wherein said at least one electrical contact is electrically connected to said circuitry. 
     
     
         9 . The multi-part pacemaker of  claim 8 , wherein said second part includes a seal that seals said socket, said case circuitry, and the electrical connection between said electrode and said case circuitry. 
     
     
         10 . The multi-part pacemaker of  claim 4 , including mounting eyes disposed on the first part. 
     
     
         11 . The multi-part pacemaker of  claim 1 , wherein said electrode makes an electrical connection with circuitry housed within one of the first part and second part, and wherein said electrode is electrically insulated from the first part. 
     
     
         12 . The multi-part pacemaker of  claim 1 , wherein said pacemaker includes circuitry for wirelessly communicating with one or more receivers that are configured to deliver an electrical impulse to the heart. 
     
     
         13 . The multi-part pacemaker of  claim 1 , including a mounting socket disposed in the second part rear wall, and being configured having a shape to receive a matingly configured tool therein. 
     
     
         14 . The multi-part pacemaker of  claim 13 , wherein said first part is sealed and wherein said second part is sealed, and wherein at least one connector is provided on said first part and said second part to make an electrical connection that connects the electrode with said circuitry, wherein said circuitry is contained in said second part and said electrode passes through said first part. 
     
     
         15 . The multi-part pacemaker of  claim 13 , wherein said second part includes a battery, and wherein said circuitry connects with said battery, and wherein said battery powers said circuitry, and wherein said battery is removable along with said second part. 
     
     
         16 . The multi-part pacemaker of  claim 15 , further including a tool having a tool end with a shape that is matingly configured to fit within said mounting socket. 
     
     
         17 . The multi-part pacemaker of  claim 1 , wherein said circuitry includes wireless circuitry that wirelessly communicates with one or more epicardial electrodes. 
     
     
         18 . A method for treating one or more conditions of a mammalian heart, comprising:
 a) configuring the multi-part pacemaker of  claim 1  to deliver electrical impulses to a heart by connecting said first part with said second part; and   b) implanting the multi-part pacemaker epicardially at a location of the heart, and delivering electrical impulses from said multi-part pacemaker.   
     
     
         19 . The method of  claim 18 , including connecting said first part and said second part together. 
     
     
         20 . The method of  claim 18 , wherein said first part and said second part are connected together, and wherein said first part and said second part are implantable when connected together. 
     
     
         21 . The method of  claim 19 , wherein said first part is implanted epicardially at the location prior to said second part being connected with said first part, and wherein said second part is connected to said first part while said first part remains implanted. 
     
     
         22 . The method of  claim 19 , wherein (i) said first part and said second part are implantable after they are connected together, or (ii) wherein said first part is implanted epicardially at the location prior to said second part being connected with said first part, and wherein said second part is connected to said first part while said first part remains implanted. 
     
     
         23 . The method of  claim 18 , including replacing said second part with a replacement second part, including removing said second part from said first part while said first part remains implanted, and connecting said replacement second part with said first part while said first part remains implanted. 
     
     
         24 . The method of  claim 23 , wherein said replacement second part contains a battery. 
     
     
         25 . The method of  claim 18 , further comprising:
 implanting a plurality of receivers at a respective plurality of locations on the heart to be monitored and regulated via the delivery of electrical impulses to those respective plurality of locations;   monitoring the heart activity at the respective locations via said receivers;   communicating activity signals from said receivers to said pacemaker control circuitry, wherein said activity signals correspond to the heart activity monitored at said respective locations;   monitoring the respective activity signals communicated from each said receiver that corresponds to the heart activity at the said respective receiver location;   processing with said pacemaker pacing circuitry, said activity signals communicated from each said receiver,   communicating an actuation signal from said pacemaker to one or more of the said receivers of the said plurality of receivers, and   delivering an electrical impulse at one or more respective locations of the heart where the said respective receiver is located.   
     
     
         26 . The method of  claim 18 , further comprising a plurality of receivers, and communicating activity signals from said plurality of receivers to said control circuitry, and wherein communicating an actuation signal from said pacemaker to one or more of the said receivers of the said plurality of receivers, comprise wireless communications;
 wherein said receivers include at least one first receiver R 1  configured for operation at a first location at the left ventricle to electrically stimulate the oblique fibers of the left ventricle, and at least one second receiver R 2  configured for operation at a second location at the right ventricle to electrically stimulate the oblique fibers of the right ventricle, and a third receiver R 3  configured for operation at a third location at the left ventricle to electrically stimulate the oblique fibers of the left ventricle, and at least one additional receiver R 5  configured for operation at the interventricular septum, and at least one other additional receiver R 6  configured for operation at the right atrial appendage; and   wherein the circuitry is configured to operate each receiver to deliver electronic impulses from each respective receiver, in a sequence that delivers electronic impulses from the respective receivers to produce spiral contraction of the oblique fibers so that at an initial time t 0 , the receiver R 6  at the right atrial appendage provides the initial stimulation of the right atrial appendage, which continues to the left atrium, and so that thereafter at time t 1 , the pacemaker provides stimulation at the apex, and so that thereafter, at time t 2  the respective receivers nearest to the apex of the heart, R 1  and R 2 , provide electronic stimulation to both the right ventricle and left ventricle prior to time t 3  when the receivers farther from the apex, R 3  and R 5 , provide stimulation to both the left ventricle and the interventricular septum.