# PeriPath: A Single Incision Delivery Tool for Epicardial Pacing and Defibrillation: Phase 2

> **NIH NIH R44** · PERICOR, LLC · 2022 · $914,055

## Abstract

Project Summary
 Each year, nearly 7,200 infants in the United States are born with a complex congenital
heart disease that requires surgical intervention within the first year of life. For infants and young
children with heart rhythm abnormalities, interventional treatment can be especially difficult, as
the size of their vasculature and/or congenital anomalies typically preclude a transvenous
approach for implanting a cardiac device such as a pacemaker or defibrillator. As a result, infants
must undergo a sternotomy or thoracotomy to access the epicardial surface of the heart. We have
developed a novel minimally-invasive pericardial access tool to deliver pacing and defibrillation
leads to the epicardial surface of the heart under direct visualization from an endoscope. Utilizing
this tool, we hypothesize that we can safely and effectively deliver pacing and defibrillation therapy
through a single small port. By using a percutaneous approach, this should reduce pain and risk
of infection, decrease procedure times, and minimize operative complications from an open
surgical approach. In addition, direct visualization of the procedure makes it safer than blind
pericardial punctures. Our team has utilized an immature porcine model implantation of cardiac
devices, and demonstrated the percutaneous approach was as safe and effective as an open
surgical technique.
The specific goal of this Phase II SBIR project is to demonstrate superior pericardial
access and epicardial pacing compared to a commercial trocar using a preclinical animal model
with infant growth rate, followed by first in human (FIH) clinical trials to accelerate regulatory
approval and commercialization of the PeriPath tool. In this work, we will complete the following
3 specific aims:
 Aim 1: Demonstrate superior performance and usability to a commercial trocar as
measured by device performance and handling in tissue plates. We will conduct a pilot verification
build of the PeriPath device in compliance with FDA regulation. Devices will be subjected to
usability, verification, and validation testing and results compared to an EndoPath trocar using a
two-one-sided test. Success is defined as PeriPath achieving superior performance and
pericardial access compared to the commercially available trocar in all tests.
 Aim 2: Demonstrate stable pacing parameters in a chronic pacing study. We will compare
the chronic pacing performance of leads implanted with the PeriPath tool to leads implanted with
the EndoPath trocar. The 12-week study will use a porcine animal model with a growth rate
equivalent to a newborn. We will measure pacing outcomes as well as device usability and tissue
healing. We will combine the results from Aim 1 to request an investigational device exemption
(IDE). Success is defined as superior usability, stable pacing parameters, and better tissue
healing scores for the PeriPath tool compared with EndoPath.
 Aim 3: Perform a first in human feasibility clinical study using ...

## Key facts

- **NIH application ID:** 10547070
- **Project number:** 1R44HL166048-01
- **Recipient organization:** PERICOR, LLC
- **Principal Investigator:** CHARLES I BERUL
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $914,055
- **Award type:** 1
- **Project period:** 2022-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10547070

## Citation

> US National Institutes of Health, RePORTER application 10547070, PeriPath: A Single Incision Delivery Tool for Epicardial Pacing and Defibrillation: Phase 2 (1R44HL166048-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10547070. Licensed CC0.

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