Pacing catheter with expandable distal end

摘要

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, a PTVI device includes an expandable distal end to provide a stable electrical contact between a pacing electrode and the vascular wall of a blood vessel when the distal end is placed in the blood vessel.

主权项

1. A percutaneous transluminal vascular intervention (PTVI) device assembly for use by a user during revascularization of a blood vessel, the PTVI device assembly comprising:
a sheath including a sheath proximal end portion, a sheath distal end portion configured for intravascular placement, an elongate sheath shaft coupled between the sheath proximal end portion and the sheath distal end portion, and a sheath lumen extending within the sheath shaft from the sheath proximal end portion to the sheath distal end portion, the sheath lumen including a proximal opening at the sheath proximal end portion and a distal opening at the sheath distal end portion; a pacing lead including a lead proximal end portion, a lead distal end portion, and an elongate lead shaft coupled between the lead proximal end portion and the lead distal end portion, the pacing lead configured to allow the lead distal end portion to enter the sheath lumen through the proximal opening and exit from the sheath lumen through the distal opening by pushing the pacing lead into the sheath lumen, the lead distal end portion configured to self-expand after exiting from the sheath lumen and including one or more pacing electrodes; and an external pacemaker connected to the lead proximal end portion, the pacemaker including:
a pacing output circuit delivering pacing pulses through the one or more pacing electrodes;a control circuit coupled to the pacing output circuit and configured to execute 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 timed to be delivered according to a stress augmentation pacing mode to augment myocardial mechanical stress to a level effecting cardioprotection against myocardial injury, the non-pacing periods each having a non-pacing duration during which none of the pacing pulses is timed to be delivered;a chassis housing the pacing output circuit and the control circuit;a user interface incorporated onto the chassis, the user interface configured to allow control of the delivery of the pacing pulses by the user; and a pacing protocol module detachably connected to the external pacemaker, wherein the cardioprotective pacing protocol is stored in the pacing protocol module and specifies the stress augmentation pacing mode with pacing parameters including an atrioventricular delay selected to augment the myocardial mechanical stress to the level effecting cardioprotection against myocardial injury.