Method and apparatus for pacing during revascularization

• US 9,415,225 B2
• Filed: 03/15/2013
• Issued: 08/16/2016
• 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 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:
  US13/838,599
• Publication Number:
  US 20130268014A1
• Time in Patent Office: 1,250 Days
• Field of Search: 607/2, 607/3, 607/9, 607/119
• US Class Current: 1/1
• 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 system for placing a stent in a patient having a heart, the system comprising:

a catheter including a proximal end portion, a distal end portion, and an elongate body extending therebetween, wherein the distal end portion includes an adjustable balloon fbr delivering the stent;

one or more pacing electrodes configured to deliver pacing pulses to the heart; and

a pacemaker configured to generate the pacing pulses to be delivered to the heart via the one or more pacing electrodes, wherein the 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.

2. The system of claim 1 wherein the ischemic event is the occlusion of the blood vessel in which the stent is to be delivered.

3. The system of claim 1 wherein the pacemaker is an external pacemaker.

4. The system of claim 1, wherein the pacemaker is configured to cause the pacing pulses to be delivered at the rate substantially higher than the patient'"'"'s intrinsic heart rate without being synchronized to the patient'"'"'s intrinsic cardiac contractions during a pacing period programmable in a range of approximately 10 seconds to 20 minutes.

5. The system of claim 1, wherein a sequence of the pacing pulses are initiated during or after the ischemic event.

6. The system of claim 1, wherein a sequence of the pacing pulses are initiated after the ischemic event.

7. The system of claim 1, wherein the pacing pulses are delivered at the rate substantially higher than the patient'"'"'s intrinsic heart rate during alternating pacing and non-pacing periods.

8. The system of claim 1, wherein the pacemaker is configured to cause the pacing pulses to be delivered at the rate substantially higher than the patient'"'"'s intrinsic heart rate without being synchronized to the patient'"'"'s intrinsic cardiac contractions during a pacing period programmable in a range of approximately 30 seconds to 20 minutes.

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

delivering a stent using a catheter including a stent delivery system causing an ischemic event in a patient; and

pacing the heart of the patient before, during, or after the ischemic event in a manner such that 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.

10. The method of claim 9 wherein the pacing pulses are delivered before, during, or after an ischemic event to prevent or reduce cardiac injury.

11. The method of claim 9 wherein an external pacemaker is provided to pace the heart of the patient before, during, or after the ischemic event.

12. The method of claim 9 wherein the pacing pulses are delivered during a pacing period programmable in a range of approximately 10 seconds to 20 minutes.

13. The method of claim 9, wherein pacing the heart of the patient before, during, or after the ischemic event includes initiating a sequence of the pacing pulses during or after the ischemic event.

14. The method of claim 9, wherein pacing the heart includes delivering bipolar pacing of the heart using a bipolar configuration.

15. The method of claim 9, wherein pacing the heart includes delivering unipolar pacing of the heart using a unipolar configuration.

16. A system comprising:

a stent;

a catheter including a proximal end portion, a distal end portion, and an elongate body extending therebetween, wherein the distal end portion includes an adjustable balloon for delivering the stent;

one or more pacing electrodes configured to deliver pacing pulses to a heart of a patient; and

a pacemaker configured to generate the pacing pulses to be delivered to the heart via the one or more pacing electrodes, wherein the 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.

17. The system of claim 16, wherein the pacing pulses are delivered before, during, or after an ischemic event to prevent or reduce cardiac injury.

18. The system of claim 16 wherein the ischemic event is the occlusion of the blood vessel in which the stent is to be delivered.

19. The system of claim 16 wherein the pacemaker is an external pacemaker.

20. The system of claim 16 wherein the pacemaker is configured to cause the pacing pulses to be delivered at the rate substantially higher than the patient'"'"'s intrinsic heart rate without being synchronized to the patient'"'"'s intrinsic cardiac contractions during a pacing period programmable in a range of approximately 10 seconds to 20 minutes.