Method and apparatus for pacing during revascularization

• US 10,549,101 B2
• Filed: 04/04/2017
• Issued: 02/04/2020
• Est. Priority Date: 04/25/2005
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Shuros, Allan Charles, Baynham, Tamara Colette, Qu, Jihong, Pastore, Joseph M., Kramer, Andrew P., Prinzen, Frits W., Vanagt, Ward Y. R., Cornelussen, Richard N.
• Primary Examiner(s): Dietrich, Joseph M
• Application Number:
  US15/479,082
• Publication Number:
  US 20170266439A1
• Time in Patent Office: 1,036 Days
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0041 Removal of thrombosis
• CPC Class Codes: A61B 2018/00422 Angioplasty
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3625 External stimulators
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes
• CPC Class Codes: A61N 5/1001 using radiation sources introduced into or applied onto the body; brachytherapy

Abstract

A system for use during revascularization includes a catheter having an adjustable balloon for delivery a stent, one or more pacing electrodes for delivering one or more pacing pulses to a patient'"'"'s heart, and a pacemaker configured to generate the one or more pacing pulses to be delivered to the heart via the one or more pacing electrodes. The one or more pacing pulses are delivered at a rate substantially higher than the patient'"'"'s intrinsic heart rate without being synchronized to the patient'"'"'s intrinsic cardiac contractions, and are delivered before, during, or after an ischemic event to prevent or reduce cardiac injury.

Claims

1. A method for delivering cardiac pacing to a patient, comprising:

delivering cardiac pacing pulses to the patient through a first electrode incorporated onto a distal end portion of a percutaneous transluminal vascular intervention (PTVI) device, the distal end portion placed in a coronary artery of the patient, the PTVI device including a coronary guide wire or a coronary guide catheter, the first electrode incorporated onto the distal end portion of the coronary guide wire or the coronary guide catheter; and

controlling the delivery of the pacing pulses to prevent arrhythmia.

2. The method of claim 1, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto the coronary guide wire.

3. The method of claim 1, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto the coronary guiding catheter.

4. The method of claim 1, wherein delivering the cardiac pacing pulses comprises delivering the pacing pulses from an external pacemaker.

5. A method for delivering cardiac pacing to a patient, comprising:

delivering cardiac pacing pulses to the patient through a first electrode incorporated onto a distal end portion of a percutaneous transluminal vascular intervention (PTVI) device, the distal end portion placed in a coronary artery of the patient; and

controlling the delivery of the pacing pulses to prevent arrhythmia,

wherein the PTVI device comprises a tip, an elongate body, and an angioplasty device coupled between the tip and the elongate body, and delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto one or more of the tip, the elongate body, or the angioplasty device of the PTVI device.

6. The method of claim 5, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto the tip.

7. The method of claim 6, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode and a second electrode incorporated onto the elongate body adjacent to the angioplasty device.

8. The method of claim 5, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto the angioplasty device.

9. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode and a second electrode incorporated onto the angioplasty device.

10. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode and a second electrode incorporated onto the tip.

11. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto a balloon.

12. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto a brachytherapy device.

13. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto an atherectomy device.

14. The method of claim 8, wherein delivering the cardiac pacing pulses comprises delivering the cardiac pacing pulses through the first electrode incorporated onto an embolization protection device.

15. A system for delivering cardiac pacing to a patient having a coronary artery, comprising:

means for delivering cardiac pacing pulses to the coronary artery by percutaneous transluminal vascular intervention, including;

means for performing angioplasty including an angioplasty device and one or more electrodes on or adjacent to the angioplasty device;

a pacemaker; and

means for providing for mechanical and electrical connections between the means for performing angioplasty and the pacemaker; and

means for controlling the delivery of the cardiac pacing pulses to prevent arrhythmia.

16. The system of claim 15, wherein the one or more electrodes are on the angioplasty device.

17. The system of claim 15, wherein the one or more electrodes are adjacent to the angioplasty device.

18. The system of claim 15, wherein the one or more electrodes comprise a plurality of electrodes on the angioplasty device and adjacent to the angioplasty device.