Cardiovascular devices pacemakers/implantible defibrillators

Hauser RG et al (2010) Deaths and cardiovascular injuries due to device-assisted implantable cardioverter-defibrillator and pacemaker lead extraction. Europace 12(3) 395 01... 

Biomaterials have played a vital role in the treatment of cardiovascular diseases, examples of applications including heart valve prostheses, vascular grafts, stents, indwelling catheters, ventricular assist devices, total implantable artificial heart, pacemakers, automatic internal cardioverter defibrillator, intraaortic balloon pump, and more. A key requirement for materials in cardiovascular applications, particularly blood-contacting devices, is blood compatibility, that is, nonthrombogenic. Additional requirements include mechanical and surface properties that are application specific. Surveying the field of polymers used in cardiovascular applications reveals that PUs, polyethylene terephthalate (PET), and expanded PTFE (ePTFE) are the most commonly used. This section will review each of the three polymers followed by a brief introduction of other emerging polymers for use in the cardiovascular area. 

Vascular grafts and patches, as well as heart valves, are among the oldest of cardiovascular implants. More recently, permanent internal devices include pacemakers, defibrillators, stents, left ventricular assist devices, and artificial hearts. 

Intra-arterial catheters have been used for different objectives, such as the placement of other devices like stents, the delivery of drugs to various targets in the cardiovascular system and the delivery of embolic materials to close arterial-venous fistulas. Drug therapy has also been combined with catheter ablation, pacemakers and cardioverter defibrillators in order to treat arrhythmias. On the other hand, implants for the reconstruction or functional replacement of cardiovascular components have been combined with drugs to prevent thrombosis. Finally, drugs to avoid restenosis have been widely employed in different devices such as drug-eluting stents. 

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