An intelligent cardio-synchronous myostimulator

A system consisting of implantable cardio-synchronous myostimulation (CSM) device, intramuscular leads and programmer is presented. The device is capable of delivering relatively high-energy pulse trains to the muscle. The frequency of pulses, energy delivered for each pulse (voltage amplitude and width), and total number of pulses (or duration of the burst) is configurable. Ventricular demand or asynchronous pacing is provided. The delay time from the sensed QRS-complex or pacing pulse is programmable. The device is capable of a range of heart beat to myostimulation burst ratios, form 1:1 to 10:1. It is usual for the muscle stimulation to occur during every second cardiac cycle. The burst duration and frequency and the heart beat to burst ratio may be independently configured over three heart rate ranges. Additionally, the interval between burst pulses may be incremented or decremented during burst delivery