System and Method for Promoting Coronary Angiogenesis

• US 20070249558A1
• Filed: 04/25/2006
• Published: 10/25/2007
• Est. Priority Date: 04/25/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Picano, Eugenio
• Granted Patent: US 7,751,883 B2
• Time in Patent Office: Days
• US Class Current: 514/56
• CPC Class Codes: A61K 31/519 ortho- or peri-condensed with heterocyclic rings
• CPC Class Codes: A61K 31/727 Heparin; Heparan
• CPC Class Codes: A61N 1/3629 in combination with non-electric therapy

Abstract

Systems and methods for promoting coronary angiogenesis employ a combination of mechanical, metabolic and biochemical stimuli.

Claims

1. A medical system promoting coronary angiogenesis, comprising:

an implantable medical electrical lead including at least one electrode;

a first fluid reservoir containing heparin and a second fluid reservoir containing an adenosine-modulating drug, each reservoir coupled to a pump;

a delivery tube coupled to the first reservoir and the second reservoir; and

a microcomputer unit coupled to the lead and the pump, and programmed to control the lead and the pump, such that a bolus of heparin is delivered, via the delivery tube, into a venous system of a patient, cardiac pacing stimuli is delivered, via the at least one lead electrode, to the patient after the delivery of the bolus of heparin, the pacing stimuli being delivered for a predetermined period of time at a rate that generally provokes ischemia in the patient, and a bolus of the adenosine-modulating drug is delivered, via the delivery tube, into the venous system of the patient after the period of the pacing stimuli.

2. The system of claim 1, further comprising:

an implantable housing containing the pump, the first and second fluid reservoirs, and the microcomputer unit;

at least one feedthrough, extending through a sidewall of the housing, for electrical coupling of the lead to the microcomputer unit; and

at least one passageway, extending through the housing sidewall, for coupling the delivery tube to the pump.

3. The system of claim 2, further comprising a fill port mounted in the housing sidewall and coupled to each of the first and second fluid reservoirs, the fill port being accessible transcutaneously.

4. The system of claim 1, wherein the delivery tube is implantable.

5. The system of claim 1, wherein the bolus of heparin is approximately 5,000 units and is delivered approximately five minutes prior to the period of the pacing stimuli.

6. The system of claim 1, wherein the adenosine-modulating drug is dipyridamole and the bolus of dipyridamole is approximately 10 milligrams and is delivered approximately one minute after the period of the pacing stimuli.

7. The system of claim 1, wherein the period of the pacing stimuli is between approximately 5 minutes and approximately 30 minutes.

8. The system of claim 1, wherein the microcomputer unit is further programmed such that a cycle of the heparin delivery, followed by the pacing stimuli, followed by the adenosine-modulating drug delivery, is repeated twice a day.

9. The system of claim 1, wherein the microcomputer unit is further programmed such that a cycle of the heparin delivery, followed by the pacing stimuli, followed by the adenosine-modulating drug delivery, is repeated at least once a day for between approximately ten and approximately fifteen days.

10. A medical system including computer-readable program instructions for a method of promoting coronary angiogenesis, the method comprising:

delivering a bolus of heparin to a venous system of a patient;

delivering pacing stimuli to the patient for a predetermined period of time at a rate generally causing ischemia, the pacing stimuli delivered after the heparin delivery; and

delivering a bolus of an adenosine-modulating drug to the venous system of the patient after the pacing stimuli.

11. The system of claim 10, wherein the bolus of heparin is approximately 5,000 units and is delivered approximately five minutes prior to the period of the pacing stimuli.

12. The system of claim 10, wherein the adenosine-modulating drug is dipyridamole and the bolus of dipyridamole is approximately 10 milligrams and is delivered approximately one minute after the period of the pacing stimuli.

13. The system of claim 10, wherein the period of the pacing stimuli is between approximately 5 minutes and approximately 30 minutes.

14. The system of claim 10, wherein a cycle of the heparin delivery followed by the pacing stimuli, followed by the adenosine-modulating drug delivery, is repeated twice a day.

15. The system of claim 10, wherein a cycle of the heparin delivery followed by the pacing stimuli, followed by the adenosine-modulating drug delivery, is repeated at least once a day for between approximately ten and approximately fifteen days.

16. A method for promoting coronary angiogenesis in a patient, the method comprising:

determining an ischemia-inducing heart rate for the patient;

programming a pacing device implanted within the patient to deliver pacing stimuli at the ischemia-inducing heart rate, at a predetermined time, and for a predetermined period of time;

releasing a bolus of heparin into a venous system of the patient prior to the predetermined time of the pacing stimuli; and

releasing a bolus of an adenosine-modulating drug into the venous system after the period of the pacing stimuli.

17. The method of claim 16, wherein the bolus of heparin is approximately 5,000 units and is delivered approximately five minutes prior to the period of the pacing stimuli.

18. The method of claim 16, wherein the adenosine-modulating drug is dipyridamole and the bolus of dipyridamole is approximately 10 milligrams and is delivered approximately one minute after the period of the pacing stimuli.

19. The method of claim 16, wherein the time period of the pacing stimuli is between approximately 5 minutes and approximately 30 minutes.

20. The method of claim 16, wherein a cycle of the heparin delivery followed by the pacing stimuli, followed by the adenosine-modulating delivery drug, is repeated at least once a day for between approximately ten and approximately fifteen days.