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Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space
- Source :
- Circulation: Arrhythmia and Electrophysiology. 11
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Background: Permanent cardiac pacemakers require invasive procedures with complications often related to long pacemaker leads. We are developing a percutaneous pacemaker for implantation of an entire pacing system into the pericardial space. Methods: Percutaneous micropacemaker implantations were performed in 6 pigs (27.4–34.1 kg) using subxyphoid access to the pericardial space. Modifications in the implantation methods and hardware were made after each experiment as the insertion method was optimized. In the first 5 animals, nonfunctional pacemaker devices were studied. In the final animal, a functional pacemaker was implanted. Results: Successful placement of the entire nonfunctional pacing system into the pericardial space was demonstrated in 2 of the first 5 animals, and successful implantation and capture was achieved using a functional system in the last animal. A sheath was developed that allows retractable features to secure positioning within the pericardial space. In addition, a miniaturized camera with fiberoptic illumination allowed visualization of the implantation site before electrode insertion into myocardium. All animals studied during follow-up survived without symptoms after the initial postoperative period. Conclusions: A novel micropacemaker system allows cardiac pacing without entering the vascular space or surgical exposure of the heart. This pericardial pacemaker system may be an option for a large number of patients currently requiring transvenous pacemakers but is particularly relevant for patients with restricted vascular access, young children, or those with congenital heart disease who require epicardial access.
- Subjects :
- Pacemaker, Artificial
medicine.medical_specialty
Percutaneous
Heart block
Sus scrofa
0206 medical engineering
02 engineering and technology
030204 cardiovascular system & hematology
Article
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
medicine
Animals
Minimally Invasive Surgical Procedures
Pericardium
Miniaturization
business.industry
Cardiac Pacing, Artificial
Equipment Design
Pericardial space
medicine.disease
020601 biomedical engineering
Pacemaker leads
Surgery
medicine.anatomical_structure
Models, Animal
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19413084 and 19413149
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Circulation: Arrhythmia and Electrophysiology
- Accession number :
- edsair.doi.dedup.....b47323770c213d1f822c86a173910cb1