Compositions, apparatus and methods for facilitating surgical procedures

Abstract

Methods are provided for conducting diagnostic or therapeutic medical or surgical procedures in a patient wherein, during the procedure, autonomous ventricular electrical conductivity and escape beats are reversibly and transiently suppressed to facilitate the procedure. Also provided are compositions which are capable of inducing ventricular asystole in a patient. The compositions may include an atrioventricular (AV) node blocker. In one embodiment, compositions including an AV node blocker and a &bgr;-blocker are provided, wherein the &bgr;-blocker is present in an amount sufficient to substantially reduce the amount of AV node blocker required to induce ventricular asystole in the patient. The compositions and methods may be used for inducing temporary ventricular asystole in a beating heart, and to facilitate the performance of a variety of techniques, including minimally invasive microsurgical techniques. Methods for performing a diagnostic or therapeutic procedure on a human patient are provided wherein a composition capable of inducing transient reversible ventricular asystole is administered to the heart, for example by intracoronary injection. In one embodiment, the heart then is electrically paced using an electrical pacing system, thereby to maintain the patient's blood circulation. The electrical pacing then is selectively intermittently stopped to allow ventricular asystole to occur, and the steps of the diagnostic or therapeutic procedure, such as suturing, are conducted during the time that the electrical pacing is intermittently stopped. In one embodiment, pacing is not required, and at least one step of a procedure is conducted during a period of ventricular asystole. The methods and compositions advantageously may be used in a range of different diagnostic or therapeutic procedures including imaging procedures, placement of stents, grafts, and embolic devices, and cardiac, vascular and neurosurgical procedures.