Method and apparatus for pacing during revascularization

• US 8,452,400 B2
• Filed: 05/23/2011
• Issued: 05/28/2013
• Est. Priority Date: 04/25/2005
• Status: Expired due to Fees

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Shuros, Allan C., 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:
  US13/113,706
• Publication Number:
  US 20110230928A1
• Time in Patent Office: 736 Days
• Field of Search: 607/2, 607/3, 607/119
• US Class Current: 607/9
• 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

Cardiac protection pacing is applied to prevent or reduce cardiac injury and/or occurrences of arrhythmia associated with an ischemic event including the occlusion of a blood vessel during a revascularization procedure. Pacing pulses are generated from a pacemaker and delivered through one or more pacing electrodes incorporated onto a percutaneous transluminal vascular intervention (PTVI) device used in the revascularization procedure. The pacemaker generates the pacing pulses according to a predetermined cardiac protection pacing sequence before, during, and/or after the ischemic event.

Claims

1. A method for pacing during a revascularization procedure, comprising:

timing a predetermined first pacing sequence configured to prevent cardiac injury caused by occlusion of a coronary artery during the revascularization procedure, the predetermined first pacing sequence including alternating first pacing periods and first non-pacing periods, the first pacing periods each having a predetermined first pacing duration during which a first plurality of pacing pulses are delivered in a predetermined first pacing mode, the first non-pacing periods each having a predetermined first non-pacing duration during which no pacing pulse is delivered; and

delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto a percutaneous transluminal vascular intervention (PTVI) device.

2. The method of claim 1, wherein timing the predetermined first pacing sequence comprises timing the first pacing periods each in a range of approximately 10 seconds to 20 minutes and timing the first non-pacing periods each in a range of approximately 10 seconds to 20 minutes.

3. The method of claim 2, wherein delivering the first plurality of pacing pulses comprises programming a pacing rate to a rate that is substantially higher than an intrinsic heart rate.

4. The method of claim 1, wherein delivering the first plurality of pacing pulses comprises delivering the first plurality of pacing pulses before an ischemic event during the revascularization procedure using the PTVI device, the ischemic event caused by the occlusion of the coronary artery during the revascularization procedure.

5. The method of claim 1, wherein delivering the first plurality of pacing pulses comprises delivering the first plurality of pacing pulses during an ischemic event during the revascularization procedure using the PTVI device, the ischemic event caused by the occlusion of the coronary artery during the revascularization procedure.

6. The method of claim 1, wherein delivering the first plurality of pacing pulses comprises delivering the first plurality of pacing pulses after an ischemic event during the revascularization procedure using the PTVI device, the ischemic event caused by the occlusion of the coronary artery during the revascularization procedure.

7. The method of claim 1, further comprising delivering a second plurality of pacing pulses to one or more pacing electrodes incorporated onto an implantable pacing lead.

8. The method of claim 7, wherein delivering the second plurality of pacing pulses comprises delivering a predetermined second pacing sequence including alternating second pacing periods and second non-pacing periods, the second pacing periods each having a predetermined second pacing duration during which a second plurality of pacing pulses are delivered in a predetermined second pacing mode, the second non-pacing periods each having a predetermined second non-pacing duration during which no pacing pulse is delivered.

9. The method of claim 1, wherein delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto the PTVI device comprises delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto a guide wire.

10. The method of claim 1, wherein delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto the PTVI device comprises delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto a guide catheter.

11. The method of claim 1, wherein delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto the PTVI device comprises delivering the first plurality of pacing pulses to one or more pacing electrodes incorporated onto a PTVI device including an angioplasty device.

20. The method of claim 11, wherein delivering the first plurality of pacing pulses to one or more pacing electrodes comprises delivering the first plurality of pacing pulses to pacing electrodes attached onto the angioplasty device.

12. A system for use during revascularization of a coronary artery, comprising:

a pacemaker including;

a pacing output circuit; and

a control circuit coupled to the pacing output circuit, the control circuit including a cardiac protection pacing sequence timer configured to time a predetermined cardiac protection pacing sequence configured to prevent cardiac injury caused by occlusion of the coronary artery during the revascularization, the cardiac protection pacing sequence including alternating pacing and non-pacing periods, the pacing periods each having a predetermined pacing duration during which a plurality of pacing pulses are delivered from the pacing output circuit in a predetermined pacing mode, the non-pacing periods each having a predetermined non-pacing duration during which no pacing pulse is delivered; and

a percutaneous transluminal vascular intervention (PTVI) device including one or more pacing electrodes, the PTVI device configured to be coupled to the pacemaker to allow the plurality of pacing pulses to be delivered from the pacing output circuit to the one or more pacing electrodes during the revascularization.

13. The system of claim 12, wherein the PTVI device comprises a guide wire.

14. The system of claim 12, wherein the PTVI device comprises a guiding catheter.

15. The system of claim 12, wherein the PTVI device comprises an angioplasty device.

16. The system of claim 15, wherein the angioplasty device comprises a dilation balloon.

17. The system of claim 15, wherein the angioplasty device comprises a stent delivery platform.

18. The system of claim 15, wherein the angioplasty device comprises an atherectomy device.

19. The system of claim 15, wherein the angioplasty device comprises an embolization protection device.