Compositions, apparatus and methods for facilitating surgical procedures
First Claim
1. A method of inducing transient reversible ventricular asystole in a human patient in which same is desired, comprising administering carbachol to the heart of the patient, while maintaining the ability of the heart to be electrically paced.
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Accused Products
Abstract
Methods are provided for conducting surgical procedures in a patient wherein, during the surgical procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the surgical procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an AV node blocker. In one embodiment, compositions including an atrioventricular (AV) node blocker and a β-blocker are provided, wherein the β-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of surgical techniques, including minimally invasive microsurgical techniques. Methods for performing a surgical procedure on a human patient are provided wherein a composition capable of inducing transient reversible ventricular asystole is administered to the heart, for example by intracoronary injection. The heart then is electrically paced using an electrical pacing system, thereby to maintain the patient'"'"'s blood circulation. The electrical pacing then is selectively intermittently stopped to allow ventricular asystole to occur, and the steps of the surgical or therapeutic procedure, such as suturing, are conducted during the time that the electrical pacing is intermittently stopped. The methods and compositions advantageously may be used in a range of different surgical procedures including cardiac, vascular and neurosurgical procedures.
167 Citations
15 Claims
- 1. A method of inducing transient reversible ventricular asystole in a human patient in which same is desired, comprising administering carbachol to the heart of the patient, while maintaining the ability of the heart to be electrically paced.
- 7. A method of inducing transient reversible ventricular asystole in the heart of a human patient in which same is desired, comprising administering carbachol to the patient at a dosage of about 1 to 15 mg, while maintaining the ability of the heart to be electrically paced.
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9. A method of inducing transient reversible ventricular asystole in the heart of a human patient in which same is desired, the method comprising administering carbachol to the patient at a rate of about 0.1 to 4.8 μ
- g/kg body weight/min, while maintaining the ability of the heart to be electrically paced.
- View Dependent Claims (10, 11)
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12. A method of inducing transient reversible ventricular asystole in the heart of a human patient, in which same is desired, the method comprising:
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administering an initial intracoronary bolus of carbachol of about 0.1 to 10 μ
g/kg body weight of the patient; andadministering a continuous intracoronary infusion of carbachol at a rate of about 0.1-4.8 μ
g/kg body weight/min, while maintaining the ability of the heart to be electrically paced. - View Dependent Claims (13, 14)
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15. A method of inducing transient reversible ventricular asystole in a human patient in which same is desired, comprising:
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administering an intracoronary bolus injection of about 0.01 to 0.5 mg of carbachol over about 0.5 to 3 minutes; and administering an intracoronary infusion of carbachol at a rate of about 0.01 to 0.3 mg/min over about 30 to 90 minutes, while maintaining the ability of the heart to be electrically paced.
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Specification