TRANSVASCULAR BALLOON CATHETER WITH PACING ELECTRODES ON SHAFT

• US 20090318994A1
• Filed: 06/15/2009
• Published: 12/24/2009
• Est. Priority Date: 06/19/2008
• Status: Abandoned Application

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Eidenschink, Tracee, Olson, Richard J.
• Application Number:
  US12/484,778
• Publication Number:
  US 20090318994A1
• Time in Patent Office: Days
• US Class Current: 607/10
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/320716 comprising means for preventing embolism by dislodged material
• CPC Class Codes: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0096 being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 2025/09183 having tools at the distal tip
• CPC Class Codes: A61M 2025/1086 having a special balloon surface topography, e.g. pores, protuberances, spikes or grooves
• CPC Class Codes: A61M 2025/1093 having particular tip characteristics
• CPC Class Codes: A61M 25/005 with embedded materials for reinforcement, e.g. wires, coils, braids
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/104 used for angioplasty
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Cardioprotective pacing is applied to prevent and/or reduce cardiac injury associated with myocardial infarction (MI) and revascularization procedure. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure. In one embodiment, at least one pacing electrode is incorporated onto the shaft of a PTVI device to allow the pacing pulses to be delivered to a site remote from an infarcted region where the distal end portion of the PTVI device is placed.

Claims

1. A percutaneous transluminal vascular intervention (PTVI) device for use during revascularization of a blood vessel, the device comprising:

a proximal end portion;

a distal end portion configured to be placed in the blood vessel, the distal end including an angioplasty device;

an elongate shaft coupled between the proximal end portion and the distal end portion; and

one or more pacing electrodes over the shaft, the one or more pacing electrodes displaceable along a portion of the shaft.

2. The device of claim 1, wherein the angioplasty device comprises a balloon.

3. The device of claim 1, comprising a sleeve over the shaft, the sleeve configured to be displaceable along the portion of the shaft, and wherein the one or more electrodes are incorporated onto the sleeve.

4. The device of claim 3, wherein the sleeve comprises a slit positioned to allow the sleeve to be pushed onto the shaft and peeled away from the shaft.

5. The device of claim 3, wherein the sleeve comprises:

a first lumen configured to accommodate the portion of the shaft; and

a second lumen configured to receive a push wire allowing the sleeve to be pushed to slide over the portion of the shaft.

6. The device of claim 1, wherein the one or more pacing electrodes are each configured to be a flexible stent over the shaft.

7. A percutaneous transluminal vascular intervention (PTVI) device for use during revascularization of a blood vessel, the device comprising:

a proximal end portion;

a distal end portion configured to be placed in the blood vessel, the distal end including an angioplasty device;

an elongate shaft coupled between the proximal end portion and the distal end portion, the shaft including an outer shell including a conductive portion; and

a first pacing electrode including the conductive portion.

8. The device of claim 7, wherein the angioplasty device comprises a balloon.

9. The device of claim 7, wherein the outer shell comprises a flexible metal tube.

10. The device of claim 9, wherein the outer shell is covered by an insulation layer including one or more exposed areas functioning as the first pacing electrode.

11. The device of claim 7, comprising an elongate conductive inner portion extending within the shaft and including an exposed portion in the distal end portion of the PTVI device, the exposed portion functioning as a second pacing electrode.

12. The device of claim 11, wherein the elongate conductive inner portion comprises a flexible metal wire or tube.

13. A method for cardioprotective pacing during revascularization of a blood vessel, the method comprising:

delivering pacing pulses through one or more pacing electrodes incorporated onto a percutaneous transluminal vascular intervention (PTVI) device including a proximal end portion, a distal end portion configured to be placed in the blood vessel and including an expandable angioplasty device, and an elongate shaft coupled between the proximal end portion and the distal end portion, the one or more pacing electrodes displaceable along a portion of the shaft.

14. The method of claim 13, wherein delivering the pacing pulses comprises executing a cardioprotective pacing protocol specifying one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of the pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which none of the pacing pulses is delivered.

15. The method of claim 14, comprising:

expanding the expandable angioplasty device; and

positioning the one or more pacing electrodes by sliding the one or more pacing electrodes along the shaft after the expandable angioplasty device is expanded.

16. The method of claim 15, wherein expanding the expandable angioplasty device comprises inflating a balloon.

17. The method of claim 16, wherein delivering the pacing pulses comprises delivering the pacing pulses through one or more pacing electrodes incorporated onto a sleeve placed over the portion of the shaft.

18. The method of claim 17, wherein sliding the one or more pacing electrodes along the shaft comprises:

inserting a push wire into a lumen of the sleeve; and

pushing the sleeve to slide over the shaft.

19. The method of claim 16, wherein delivering the pacing pulses comprises delivering the pacing pulses through one or more pacing electrodes each configured to be a flexible stent over the shaft.

20. A method for cardioprotective pacing during revascularization of a blood vessel, the method comprising:

delivering pacing pulses through a first pacing electrode incorporated onto a percutaneous transluminal vascular intervention (PTVI) device including a proximal end portion, a distal end portion configured to be placed in the blood vessel and including an expandable angioplasty device, and an elongate shaft coupled between the proximal end portion and the distal end portion and including an outer shell, the first pacing electrode including a conductive portion of the outer shell.

21. The method of claim 20, wherein delivering the pacing pulses comprises executing a cardioprotective pacing protocol specifying one or more cardiac protection pacing sequences each including alternating pacing and non-pacing periods, the pacing periods each having a pacing duration during which a plurality of the pacing pulses is delivered, the non-pacing periods each having a non-pacing duration during which none of the pacing pulses is delivered.

22. The method of claim 21, wherein delivering the pacing pulses comprises delivering the pacing pulses through a second pacing electrode in the distal end portion of the PTVI device, the second pacing electrode including an exposed portion of an elongate conductive inner portion extending within the shaft of the PTVI device.

23. The method of claim 22, comprising:

expanding the expandable angioplasty device; and

delivering the pacing pulses after the expandable angioplasty device are expanded.

24. The method of claim 23, wherein expanding the expandable angioplasty device comprises inflating a balloon.