Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space.
Circ Arrhythm Electrophysiol
; 11(7): e006307, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29945929
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Marca-Passo Artificial
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Pericárdio
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Estimulação Cardíaca Artificial
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Procedimentos Cirúrgicos Minimamente Invasivos
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Miniaturização
Limite:
Animals
Idioma:
En
Revista:
Circ Arrhythm Electrophysiol
Ano de publicação:
2018
Tipo de documento:
Article