Pacemaker integrated with vascular intervention catheter
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 flexible pacemaker circuit integrated with a percutaneous transluminal vascular intervention (PTVI) device and delivered through pacing electrodes incorporated onto the PTVI device during the revascularization procedure.
1. A cardiac pacing system for use during revascularization of a blood vessel, the system comprising:
a percutaneous transluminal vascular intervention (PTVI) device including:
a proximal end portion;
a distal end portion configured to be placed in the blood vessel;
an elongate shaft coupled between the proximal end portion and the distal end portion; and
a plurality of pacing electrodes; and
a pacemaker including:
a flexible circuit substrate affixed to the PTVI device; and
a flexible pacemaker circuit including an electronic circuit built on the flexible circuit substrate, the flexible pacemaker circuit configured to deliver cardiac pacing pulses through the plurality of pacing electrodes.
2. The system of claim 1 , wherein the pacemaker comprises one or more pacing electrodes connected to the electronic circuit and built on the flexible circuit substrate.
3. The system of claim 1 , wherein the flexible pacemaker circuit is affixed to at least the distal end portion of the PTVI device.
4. The system of claim 1 , wherein the plurality of pacing electrodes comprises one or more pacing electrodes incorporated on to one or more locations on the PTVI device that are remote from the flexible pacemaker circuit.
5. The system of claim 4 , wherein the flexible pacemaker circuit is affixed to at least the shaft of the PTVI device.
6. The system of claim 4 , wherein the flexible pacemaker circuit is affixed to at least the proximal end portion of the PTVI device.
7. The system of claim 1 , wherein the pacemaker comprises a solid state battery deposited onto the flexible circuit substrate.
8. The system of claim 7 , wherein the solid state battery comprises a lithium battery.
9. The system of claim 7 , wherein the flexible pacemaker circuit comprises:
a pacing output circuit configured to deliver pacing pulses through the plurality of pacing electrodes; and
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 delivered, the non-pacing periods each having a non-pacing duration during which none of the pacing pulses is delivered.
10. The system of claim 9 , wherein the solid state battery has an energy capacity allowing execution of the cardioprotective pacing protocol for at least about 10 minutes.
11. The system of claim 9 , wherein the PTVI device comprises a guide wire.
12. The system of claim 9 , wherein the PTVI device comprises a guide catheter.
13. The system of claim 9 , wherein the PTVI device comprises an angioplasty catheter including an angioplasty device at the distal end portion.
14. A method for cardioprotective pacing during revascularization of a blood vessel, the method comprising:
delivering pacing pulses from a flexible pacemaker circuit integrated into a percutaneous transluminal vascular intervention (PTVI) device, the flexible pacemaker circuit including an electronic circuit built on a flexible circuit substrate affixed to the PTVI device.
15. The method of claim 14 , 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.
16. The method of claim 15 , wherein delivering the cardiac pacing pulses comprises delivering cardiac pacing pulses from the flexible pacemaker circuit integrated into one of a guide wire, a guide catheter, and an angioplasty device.
17. The method of claim 16 , wherein delivering the cardiac pacing pulses comprises delivering cardiac pacing pulses through one or more pacing electrodes built on the flexible circuit substrate.
18. The method of claim 16 , wherein delivering the cardiac pacing pulses comprises delivering cardiac pacing pulses through one or more pacing electrodes incorporated onto one or more locations on the PTVI device that are remote from the flexible pacemaker circuit.
19. The method of claim 16 , comprising energizing the flexible pacemaker circuit using a solid state battery deposited on the flexible circuit substrate.
20. The method of claim 19 , wherein using the solid state battery comprises using a lithium battery capable of energizing the flexible pacemaker circuit for executing the cardioprotective pacing protocol for at least about 10 minutes.
21. The method of claim 16 , comprising controlling the delivery of the pacing pulses using a control circuit of the flexible pacemaker circuit.