CN102686178A - Electrode catheter - Google Patents

Electrode catheter Download PDF

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Publication number
CN102686178A
CN102686178A CN2010800593416A CN201080059341A CN102686178A CN 102686178 A CN102686178 A CN 102686178A CN 2010800593416 A CN2010800593416 A CN 2010800593416A CN 201080059341 A CN201080059341 A CN 201080059341A CN 102686178 A CN102686178 A CN 102686178A
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CN
China
Prior art keywords
electrode
catheter
proximal end
end portion
catheter proximal
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Granted
Application number
CN2010800593416A
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Chinese (zh)
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CN102686178B (en
Inventor
坂野泰夫
大川靖洋
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Japan Lifeline Co Ltd
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Japan Lifeline Co Ltd
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Priority claimed from JP2010012642A external-priority patent/JP5201636B2/en
Priority claimed from JP2010012643A external-priority patent/JP5265589B2/en
Application filed by Japan Lifeline Co Ltd filed Critical Japan Lifeline Co Ltd
Publication of CN102686178A publication Critical patent/CN102686178A/en
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Publication of CN102686178B publication Critical patent/CN102686178B/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape

Abstract

The disclosed electrode catheter includes: a catheter body (10); a control handle (20); catheter tip-end sections (31, 32, 33, 34); and ring-shaped electrodes, a plurality of which being attached to each catheter tip-end section. One ring-shaped electrode (41B) attached to the first catheter tip-end section (31) and one ring-shaped electrode (42C) attached to the second catheter tip-end section (32) are broader in width than the other ring-shaped electrodes (41c, 42b, 43b, 43c, 44b, 44c). The ring-shaped electrodes (41B and 42C), which are broader in width, are arranged at different positions on the respective catheter tip-end sections to which the same are attached. With the disclosed electrode catheter, it is possible to easily find out which catheter tip-end section and which position thereon the electrode specified on an X-ray image is attached to.

Description

Electrode catheter
Technical field
The present invention relates to have the electrode catheter of a plurality of catheter proximal end portion.
Background technology
Survey the electroactive conduit in (mapping) heart as being used for mark, known have to have from the front end of catheter main body be radial extended a plurality of catheter proximal end portion, particularly have a conduit (with reference to patent documentation 1 and patent documentation 2) of 5 catheter proximal end portions (jut 14).
Termination electrode and ring electrode before each catheter proximal end portion of this conduit is equipped with can be measured the length of the catheter proximal end portion current potential as the round inner region of radius with 1 this conduit simultaneously.
Patent documentation 1: TOHKEMY 2003-235821 communique
Patent documentation 2: TOHKEMY 2004-130114 communique
Summary of the invention
The problem that invention will solve
The described conduit of above-mentioned patent documentation except be used for mark survey electroactive, also be used for various diagnosis, treatment behavior.
Whether what for example, be used for behind ablation confirming expecting reliably burns.Particularly, 2 electrodes (preceding termination electrode or ring electrode) that are installed on each different catheter proximal end portions are kept somewhere the transmission speed of measuring current potential in the symmetric position that with the ablation line is axis.At this, under the situation of burning reliably, the bang path of 2 interelectrode current potentials is cut off by ablation line, and current potential transmits round, thereby its transmission speed postpones.Relative therewith, under the situation of reliably not burning, the delay of transmission speed with the beeline transmission, therefore can not take place in current potential between 2 electrodes.
(1) behind the ablation, while the operation of confirming whether to burn reliably etc., use various diagnosis, the treatment behavior of conduit to observe X ray image usually to carry out with a plurality of catheter proximal end portion.
In addition, measured potential data to employed electrode () be presented on the monitor of electrocardiograph, therefore, need to be grasped the potential data (waveform) that is shown in this monitor by which electrode () measure.
Therefore, each electrode that requires the operator to grasp to be reflected in the X ray image is mounted in the electrode (for example, being the ring electrode that is installed on from which catheter proximal end portion of front end) of which position of which catheter proximal end portion.
But the electrode that grasp specific electrodes on X ray image is mounted in which position of which catheter proximal end portion is extremely difficult.
At this; Be reflected under the situation on the X ray image at all electrodes (being installed on the electrode of all catheter proximal end portions); About certain specific on X ray image electrode; Though can grasp allocation position at catheter proximal end portion place (being the electrode that is installed on from which catheter proximal end portion of front end); But because the configuration of the electrode at catheter proximal end portion place is identical, therefore, instantaneous grasp is that the electrode that is installed in which catheter proximal end portion is practically impossible in specific electrodes on the X ray image.
In addition, be reflected under the situation on the X ray image at all electrodes, a plurality of catheter proximal end portion that also can make a mistake the electrode on the image sometimes and these electrodes are installed be see from the front of conduit or see from the base end side of conduit.
Whether (2) be desirably in affirmation utilizes under the situation that conduit with a plurality of catheter proximal end portion burns reliably; To all keep somewhere in position the electrode that is installed on same position between a plurality of catheter proximal end portion (below, will be also referred to as " corresponding electrode " or " counter electrode ") at the electrode that a plurality of catheter proximal end portion is installed on same position apart from the ablation line equidistance.
But, the conduit that above-mentioned patent documentation is put down in writing, it is impossible all keeping somewhere corresponding 5 electrodes in the position apart from the ablation line equidistance.
For example; Shown in figure 12; Keeping somewhere under the situation of symmetric position that with ablation line AL is axle being installed on 2 the preceding termination electrodes 91,92 (corresponding electrode) that are in the catheter proximal end portion 81 and 82 radial extended 5 catheter proximal end portions 81,82,83,84,85, adjacent from the front end of catheter main body 80 respectively; Apart from the separating distance of ablation line AL, in addition, remaining preceding termination electrode 94 was positioned on the ablation line AL termination electrode 91 and 92 separately before preceding termination electrode 95 and 93 was longer than apart from the separating distance of ablation line AL separately; Under these circumstances, can not termination electrode 94 before being somebody's turn to do be used for the measurement of current potential.
(3) in the conduit that above-mentioned patent documentation is put down in writing; After the electrode that will be used for potential measurement positions with respect to ablation line; Fore-end through making catheter main body is crooked to move catheter proximal end portion, thereby the electrode that will be used for potential measurement is close (contact) with the inwall of heart or moves along ablation line.
For example; Through 2 adjacent catheter proximal end portions are disposed with the mode of crossing over ablation line; It is the symmetric position of axle that the preceding termination electrode that is installed on these catheter proximal end portions respectively (corresponding electrode) is positioned with the ablation line; Make catheter main body crooked afterwards, make above-mentioned before termination electrode and the inwall of heart be close (contact).
But, in the conduit that above-mentioned patent documentation is put down in writing, owing to make the fore-end of catheter main body crooked, therefore exist the position relation of having adjusted between catheter proximal end portion (electrode that will be used for potential measurement) and the ablation line that the such problem of dislocation takes place.For example, owing to make the fore-end of catheter main body crooked, therefore can not keep the state (the position relation before crooked) that ablation line are crossed over by 2 catheter proximal end portions, the preceding termination electrode and the ablation line that are close with the inwall of heart depart from significantly.
(4) in the conduit that above-mentioned patent documentation is put down in writing; Under the bending direction of the fore-end of the catheter main body situation consistent with certain extended direction of catheter proximal end portion; When the fore-end that makes catheter main body is crooked, be installed on to pushing the inwall of (puncture) heart and damage inwall with the preceding termination electrode of extended this catheter proximal end portion of the same direction of bending direction.
The present invention is based on that the situation of above that kind makes.
The 1st purpose of the present invention is to be provided at the electrode catheter that a plurality of catheter proximal end portion is equipped with a plurality of electrodes respectively, and this electrode catheter can grasp easily that specific electrodes is the electrode that is installed on which position of which catheter proximal end portion on X ray image.
The 2nd purpose of the present invention is to be provided at the electrode catheter that electrode is installed respectively from the extended a plurality of catheter proximal end of the front end of catheter main body portion, and this electrode catheter can all be retained in corresponding electrode apart from the position of ablation line equidistance.
Even the 3rd purpose of the present invention is to provide the fore-end of catheter main body crooked, also can maintain adjust before this bending, catheter proximal end portion is with respect to the configuration status (for example the state of ablation line is crossed over by 2 catheter proximal end portions) of ablation line, the electrode electrode catheter with respect to the position relation of ablation line (for example 2 counter electrodes are in the ablation line relation of the symmetric position that is axle).
Even the 4th purpose of the present invention is to provide the fore-end that makes catheter main body crooked, the preceding termination electrode that is installed on catheter proximal end portion can not damage the electrode catheter of wall of the heart yet.
Be used to solve the scheme of problem
(1) the present invention's (the 1st technical scheme) electrode catheter is characterised in that this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles from the front end of above-mentioned catheter main body at interval; Ring electrode, it is equipped with a plurality of in each above-mentioned catheter proximal end portion,
The electrode width of 1 ring electrode that is installed on the 1st catheter proximal end portion is different with the electrode width (" electrode widths of other ring electrodes " are mutually the same) of other ring electrodes with the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door
Electrode width above-mentioned 2 ring electrodes different with other ring electrodes differ from one another at the allocation position that is equipped with in the catheter proximal end portion of these 2 ring electrodes.
Employing has the electrode catheter of the 1st technical scheme of such structure; Through on X ray image, finding electrode width 2 ring electrodes different, can identify the catheter proximal end portion that these 2 ring electrodes are installed and be respectively the 1st catheter proximal end portion and the 2nd catheter proximal end portion with other ring electrodes.
In addition; Electrode width 2 ring electrodes different with other ring electrodes differ from one another at the allocation position that is equipped with in the catheter proximal end portion of these 2 ring electrodes (the 1st catheter proximal end portion or the 2nd catheter proximal end portion); Therefore, also can easily identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion.
If can on X ray image, identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion, other catheter proximal end portions that then can identify on the X ray image are which catheter proximal end portion (for example the number of catheter proximal end portion is the 3rd catheter proximal end portion, the 4th catheter proximal end portion under 4 the situation).
In addition, can the allocation position of easily grasping the ring electrode be installed on each catheter proximal end portion on the X ray image (be installed on from front end which on electrode).
As a result, all ring electrodes that can easily grasp on the X ray image are the electrodes that are installed on which allocation position of which catheter proximal end portion.
(2) in the electrode catheter of above-mentioned such the 1st technical scheme that constitutes, the electrode width from the ring electrode of the 2nd of front in the electrode width of the ring electrode of the 1st of front and the 2nd catheter proximal end portion in preferred the 1st catheter proximal end portion is wideer than the electrode width of other ring electrodes.
Employing has the electrode catheter of the 1st technical scheme of such formation, is the 1st catheter proximal end portion through on X ray image, finding the ring electrode that is positioned at the 1st electrode width broad from front, can identify the catheter proximal end portion that this ring electrode is installed.In addition, be the 2nd catheter proximal end portion through finding the ring electrode that is positioned at the 2nd electrode width broad from front, can identify the catheter proximal end portion that this ring electrode is installed.
(3) electrode catheter of above-mentioned such the 1st technical scheme that constitutes preferably has 4 catheter proximal end portions.
4 ring electrodes (corresponding ring electrode) that are installed on same position (for example being configured to the 1st from front) in 4 catheter proximal end portions lay respectively at foursquare summit.
Adopt corresponding ring electrode to lay respectively at the electrode catheter (electrode catheter) of the 1st technical scheme on foursquare summit with 4 catheter proximal end portions; For example under the situation of whether burning reliably behind the affirmation ablation, can easily corresponding 4 ring electrodes be disposed at apart from the position of ablation line equidistance.
For example if 2 ring electrodes in corresponding 4 ring electrodes, that be installed on adjacent catheter proximal end portion are kept somewhere with the mode that ablation line is positioned at their intermediate point, then can all the other 2 ring electrodes also be kept somewhere with the mode that ablation line is positioned at their intermediate point.
(4) in addition, the electrode catheter of the 1st technical scheme is characterised in that this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles from the front end of above-mentioned catheter main body at interval; Before termination electrode, it is installed on each above-mentioned catheter proximal end portion; Ring electrode, it installs 1 at least in each above-mentioned catheter proximal end portion,
The electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other preceding termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door is different with the electrode width of other ring electrodes.
Employing has the electrode catheter of the 1st technical scheme of such structure, and through on X ray image, finding the different preceding termination electrode of the preceding termination electrode of electrode width and other, can identify the catheter proximal end portion that this preceding termination electrode is installed is the 1st catheter proximal end portion.
In addition, through on X ray image, finding the electrode width ring electrode different with other ring electrodes, can identify the catheter proximal end portion that this ring electrode is installed is the 2nd catheter proximal end portion.
If can on X ray image, identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion, which catheter proximal end portion other catheter proximal end portions that then can identify on the X ray image are.
In addition, can on X ray image, grasp easily be installed on the preceding termination electrode of each catheter proximal end portion and the allocation position of ring electrode.
As a result, can easily grasp which allocation position which catheter proximal end portion all electrodes (preceding termination electrode and ring electrode) on the X ray image are installed on.
(5) in the electrode catheter of the 1st technical scheme of above-mentioned such structure, be preferably, the electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is wideer than the electrode width of other preceding termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wideer than the electrode width of other ring electrodes.
Employing has the electrode catheter of the 1st technical scheme of such structure, is the 1st catheter proximal end portion through on X ray image, finding the electrode width preceding termination electrode wideer than other preceding termination electrodes, can identifying the catheter proximal end portion that this preceding termination electrode is installed.In addition, through finding the electrode width ring electrode wideer than other ring electrodes, can identify the catheter proximal end portion that this ring electrode is installed is the 2nd catheter proximal end portion.
(6) electrode catheter of above-mentioned such the 1st technical scheme that constitutes preferably has 4 catheter proximal end portions.
Lay respectively at foursquare summit at 4 corresponding 4 electrodes of catheter proximal end portion (termination electrode for example).
Adopt corresponding electrode to lay respectively at the electrode catheter (electrode catheter) of the 1st technical scheme on foursquare summit with 4 catheter proximal end portions; For example under the situation of confirming behind the ablation whether to burn reliably, can easily corresponding 4 electrodes be configured in apart from the position of ablation line equidistance.
For example, then also can remaining 2 preceding termination electrode be kept somewhere with the mode that ablation line is positioned at their intermediate point if 2 preceding termination electrodes in 4 preceding termination electrodes, that be installed on adjacent catheter proximal end portion are kept somewhere with the mode that ablation line is positioned at their intermediate point.
(7) in the electrode catheter of the 1st technical scheme, be preferably that to have the fore-end that can make above-mentioned catheter main body be (Bidirectional Control) deflection mechanism's (oscillating mechanism) of middle mind-set both direction crooked (deflection) with the axis of this catheter main body.
Around the inwall of heart, particularly valve, have a more filum that is known as tendon, be wound in this tendon for fear of catheter proximal end portion etc., the catheter main body that preferably inserts in the chambers of the heart does not rotate around axis as far as possible.
So; Employing has the electrode catheter of the 1st technical scheme of the deflection mechanism of above-mentioned that kind; For example under the situation of 180 ° of the fore-end deflections that makes catheter main body, catheter main body is rotated, therefore around axis; Have with (catheter main body is rotated around axis) catheter main body is compared to the electrode catheter of the mechanism of deflection to folk prescription, very favourable.
(8) the present invention's (the 2nd technical scheme) electrode catheter is characterised in that this electrode catheter has:
Catheter main body, it has at least 1 endoporus;
Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body;
4 catheter proximal end portions, they circumferentially extend with equal angles from the axis of this catheter main body of front end edge of above-mentioned catheter main body at interval;
Electrode, it is installed on each above-mentioned catheter proximal end portion;
Deflection mechanism, it makes the fore-end of above-mentioned catheter main body crooked to the binary direction in the angle that 2 adjacent catheter proximal end portions are become.
In the electrode catheter of the 2nd technical scheme with such structure, 4 counter electrodes (termination electrode for example) that are installed on 4 catheter proximal end portions lay respectively at the position on foursquare summit.
Adopt 4 counter electrodes to lay respectively at the electrode catheter (electrode catheter) of the 2nd technical scheme on foursquare summit, can 4 counter electrodes be kept somewhere in the position apart from the ablation line equidistance with 4 catheter proximal end portions.
For example, also can remaining 2 preceding termination electrode be kept somewhere in the symmetric position that with the ablation line is axis through keeping somewhere in the symmetric position that with the ablation line is axis as 2 preceding termination electrodes in 4 preceding termination electrodes of counter electrode, that be installed on adjacent catheter proximal end portion.As a result, can easily 4 preceding termination electrodes be kept somewhere in the position apart from the ablation line equidistance.
The deflection mechanism that constitutes the electrode catheter of the 2nd technical scheme makes the fore-end of catheter main body crooked to the binary direction in the angle that 2 adjacent catheter proximal end portions are become.
That is direction (plane that comprises the track of this bisecting line) unanimity of, utilizing deflection mechanism that the bisecting line at the angle that the crooked direction (plane that comprises the track of crooked fore-end) of fore-end of catheter main body become with 2 adjacent catheter proximal end portions is moved.
Adopting should deflection mechanism, can keep adjacent catheter proximal end portion and cross over the state (counter electrode that is installed on each catheter proximal end portion is the relation that axis is in symmetric position with the ablation line) of ablation line and the electrode that will be used for potential measurement is close with wall of the heart (contact) or moves along ablation line.
(9) in the electrode catheter of the 2nd technical scheme, it is middle mind-set both direction crooked (Bidirectional Control) with the axis of this catheter main body that above-mentioned deflection mechanism is preferably the fore-end that makes above-mentioned catheter main body.
Around the inwall of heart, particularly valve, there is a more tissue that is known as tendon, is wound in this tendon, the catheter main body that inserts in the chambers of the heart is not rotated around axis as far as possible for fear of catheter proximal end portion etc.
So; Employing has the electrode catheter of the 2nd technical scheme of the deflection mechanism of above-mentioned that kind; For example under the situation that makes 180 ° of catheter proximal end portion deflections, catheter main body is rotated, therefore around axis; (catheter main body is rotated around axis) only can make catheter main body compare to the electrode catheter of the mechanism of deflection to folk prescription with having, and is difficult for being wound on the tendon this point very favourable in catheter proximal end portion.
(10) in the electrode catheter of the 2nd technical scheme, preferably termination electrode and at least 1, particularly 2 ~ 3 ring electrodes before each above-mentioned catheter proximal end portion is equipped with.
(11) in addition; Be preferably, the electrode width from the ring electrode of the 2nd of front in the electrode width of the ring electrode of the 1st of front and the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door in the 1st catheter proximal end portion is wideer than the electrode width of other ring electrodes.
Employing has the electrode catheter of the 2nd technical scheme of such structure; Through on X ray image, finding the ring electrode that is positioned at the 1st electrode width broad from front, can identify the catheter proximal end portion that this ring electrode is installed is the 1st catheter proximal end portion.In addition, be the 2nd catheter proximal end portion through finding the ring electrode that is positioned at the 2nd electrode width broad from front, can identify the catheter proximal end portion that this ring electrode is installed.And; If can identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion; Then can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion next door is the 3rd catheter proximal end portion, and the catheter proximal end portion that can identify by the 3rd catheter proximal end portion that is positioned at is the 4th catheter proximal end portion.In addition, can on X ray image, easily grasp the allocation position (being to be installed on which individual electrode) of the ring electrode that is installed on each catheter proximal end portion from front end.Thus, all ring electrodes that can easily grasp on the X ray image are the electrodes that is installed on which allocation position of which catheter proximal end portion.
(12) in addition, be preferably, the electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is wideer than the electrode width of other preceding termination electrodes, and the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wideer than the electrode width of other ring electrodes.
Employing has the electrode catheter of the 2nd technical scheme of such structure, is the 1st catheter proximal end portion through on X ray image, finding the electrode width preceding termination electrode wideer than other preceding termination electrodes, can identifying the catheter proximal end portion that this preceding termination electrode is installed.In addition, through finding the electrode width ring electrode wideer than other ring electrodes, can identify the catheter proximal end portion that this ring electrode is installed is the 2nd catheter proximal end portion.And; If can identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion; Then can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion next door is the 3rd catheter proximal end portion, and the catheter proximal end portion that can identify by the 3rd catheter proximal end portion that is positioned at is the 4th catheter proximal end portion.In addition, can on X ray image, grasp easily be installed on the preceding termination electrode of each catheter proximal end portion and the allocation position of ring electrode.Thus, all electrodes (preceding termination electrode and ring electrode) that can easily grasp on the X ray image are the electrodes that is installed on which allocation position of which catheter proximal end portion.
The invention effect
Adopt the electrode catheter of the 1st technical scheme, can grasp easily that specific electrodes is the electrode that is installed on which position of which catheter proximal end portion on X ray image.
Adopt the electrode catheter of the 2nd technical scheme, can 4 counter electrodes that be installed on 4 catheter proximal end portions respectively be kept somewhere in the position apart from the ablation line equidistance.
In addition; Even make the fore-end of catheter main body crooked, also can keep adjust before this bending, catheter proximal end portion with respect to the configuration status (for example the state of ablation line is crossed over by 2 catheter proximal end portions) of ablation line, electrode with respect to the position relation of ablation line (for example 2 counter electrodes be in be the relation of the symmetric position of axis) with the ablation line.Therefore, keep catheter proximal end portion with respect to the configuration of ablation line, electrode with respect to the position relation of ablation line and the electrode that is installed on each catheter proximal end portion is close (contact) with the inwall of heart or moves along ablation line.
And when the fore-end that makes catheter main body was crooked, the preceding termination electrode that is installed on catheter proximal end portion can not damage the inwall of heart.
Description of drawings
Fig. 1 is the general principal view of the electrode catheter of an embodiment of the present invention.
Fig. 2 is the side view (I-I of Fig. 1 is to view) of electrode catheter shown in Figure 1.
Fig. 3 is the profile (the II-II profile of Fig. 2) of the leading section office of electrode catheter shown in Figure 1.
Fig. 4 is the profile (the III-III profile of Fig. 2) of the leading section office of electrode catheter shown in Figure 1.
Fig. 5 is the profile (the IV-IV profile of Fig. 1) of the leading section office of electrode catheter shown in Figure 1.
Fig. 6 is the skeleton diagram of the user mode of expression electrode catheter shown in Figure 1.
Fig. 7 is the vertical view and the side view of the user mode (the unbent state of the fore-end of catheter main body) of expression electrode catheter shown in Figure 1.
Fig. 8 is the vertical view and the side view of the user mode (state that the fore-end of catheter main body is crooked) of expression electrode catheter shown in Figure 1.
Fig. 9 is the side view of the electrode catheter of another embodiment of the present invention.
Figure 10 is the side view of the variation of expression electrode catheter of the present invention.
Figure 11 is the summary side elevation of user mode of the electrode catheter of expression comparative example.
Figure 12 is an approximate vertical view of representing the user mode of electrode catheter in the past.
The specific embodiment
＜the 1 embodiment＞
The electrode catheter 1 of this embodiment for example is used for the ARR diagnosis or the treatment of heart.
Electrode catheter 1 has catheter main body 10; Joystick 20; 4 (the 1st catheter proximal end portions 31 of catheter proximal end portion; The 2nd catheter proximal end portion 32; The 3rd catheter proximal end portion 33; The 4th catheter proximal end portion 34); Be installed on the preceding termination electrode 41a of each catheter proximal end portion; 42a; 43a; 44a; 8 ring electrode 41B41c of 2 are installed respectively in each catheter proximal end portion; 42b42C; 43b43c; 44b44c; The fore-end that makes catheter main body 10 is to the crooked deflection mechanism (oscillating mechanism) of the binary direction in angle (arrow A direction/arrow B direction) that 2 catheter proximal end portions (catheter proximal end portion 32 and 33/ catheter proximal end portion 34 of catheter proximal end portion and catheter proximal end portion 31) are become.
Catheter main body 10 is made up of pipe component 11 and front end components 12.
In addition, in Fig. 1, illustrate the length of catheter main body 10 shorter, but in fact the length of catheter main body 10 than long about several times ~ tens times of the Z-direction length of joystick 20.
The pipe component 11 that constitutes catheter main body 10 has 1 endoporus (inner chamber) at least.In the inner chamber of pipe component 11, be through with the lead (omitting diagram) that is connected with preceding termination electrode and ring electrode, the pulling line (in Fig. 4, representing) that constitutes the deflection mechanism (oscillating mechanism) of catheter proximal end portion with Reference numeral 51,52.
Pipe component 11 also can be made up of the material of identical characteristics vertically, and rigidity (hardness) material different forms but preferably use vertically.Particularly, the preferred distolateral constituent material of peri position has high relatively rigidity, and the distolateral constituent material of amphi position has low relatively rigidity.
Pipe component 11 for example is made up of polyolefin, polyamide, polyethers polyamide, polyurethane, nylon, PEBAX synthetic resin such as (polyether block amides).In addition, the peri position of pipe component 11 is distolateral also can be the braided tube that the effective stainless steel wire marshalling that is made up of these synthetic resin is formed.
The external diameter of pipe component 11 is 1.0 ~ 3.0mm preferably, is more preferably 1.6 ~ 2.7mm.
The length of pipe component 11 is 600 ~ 1500mm preferably, is more preferably 900 ~ 1200mm.
As shown in Figure 3, the front end components 12 that constitutes catheter main body 10 forms the cylindric part 121 and the retaining part 122 with 4 pores that each cardinal extremity of supplying 4 catheter proximal end portions (31,32,33,34) partly inserts in the inner chamber that is inserted into pipe component 11.
Front end components 12 can be by constituting with pipe component 11 identical materials, for example PEBAX.
Preferably the external diameter with pipe component 11 is identical for the external diameter of front end components 12 (retaining part 122).
The length of front end components 12 (retaining part 122) is 2 ~ 60mm preferably, is more preferably 5 ~ 10mm.
Joystick 20 is connected with the cardinal extremity of catheter main body 10 (pipe component 11).In Fig. 1, Reference numeral 21 is handle parts, and Reference numeral 22 is the swivel plates that constitute the deflection mechanism of the fore-end bending that makes catheter main body.
The electrode catheter 1 of this embodiment has 4 catheter proximal end portions (the 33, the 4th catheter proximal end portion 34 of the 32, the 3rd catheter proximal end portion of the 31, the 2nd catheter proximal end portion of the 1st catheter proximal end portion).
As shown in Figure 2,4 catheter proximal end portions from the axis of the front end edge catheter main body 10 of catheter main body 10 (front end components 12) circumferentially with actual equal angles at interval (seeing it is about 90 ° of intervals in the side shown in this figure) be radial and extend.
4 catheter proximal end portions respectively the axle of conductive pipe main body 10 radially foreign side bendingly the forward end direction extend.
The external diameter of catheter proximal end portion (from front end components 12 extended parts) is preferably 0.3 ~ 1.4mm, more preferably 0.5 ~ 1.0mm.
The external diameter of catheter proximal end portion is preferably 0.15 ~ 0.4 times of external diameter of pipe component 11.
The length of catheter proximal end portion (from front end components 12 extended parts) is preferably 5 ~ 50mm, more preferably 10 ~ 30mm.
Like Fig. 3 and shown in Figure 5, catheter proximal end portion 31,32,33,34 is made up of elongated tabular core component 311,321,331,341 and cage walls 312,322,332,342.
As shown in Figure 3, constitute of the endoporus extension of the core component 311 of the 1st catheter proximal end portion 31 along cage walls 312, its leading section is fixed with the state of termination electrode 41a before imbedding.
In addition, constitute the endoporus extension of the core component 331 of the 3rd catheter proximal end portion 33 along cage walls 332, its leading section is fixed with the state of termination electrode 43a before imbedding.
In addition, the internal structure of the 2nd catheter proximal end portion 32 and the 4th catheter proximal end portion 34 is also identical with the internal structure of the 1st catheter proximal end portion 31 and the 3rd catheter proximal end portion 33.
The shape of core component memory catheter proximal end portion is out of shape (for example being deformed into linearity) through applying power, but will revert to institute's memorized shape (expansion shape of Fig. 1 ~ that kind shown in Figure 4) during the power of removal.
As the constituent material of core component, can enumerate the Ni-Ti alloy.Ni in the Ni-Ti alloy and the ratio of Ti are preferably 54:46 ~ 57:43.As preferred Ni-Ti alloy, can enumerate Nitinol.
As the constituent material of cage walls, can enumerate the resin material of the such live body toleration of polyurethane or PEBAX.
The cardinal extremity part of 4 catheter proximal end portions 31,32,33,34 is inserted into respectively in the pore that is formed on the front end components 12 (retaining part 122); The cage walls 312,322,332,342 and retaining part 122 thermal weldings of cardinal extremity part; Thus, catheter proximal end portion 31,32,33,34 is fixed in catheter main body 10 (front end components 12) respectively.
Termination electrode 41a before in catheter proximal end portion (the 33, the 4th catheter proximal end portion 34 of the 32, the 3rd catheter proximal end portion of the 31, the 2nd catheter proximal end portion of the 1st catheter proximal end portion), being separately installed with, 42a, 43a, 44a and 2 ring electrode 41B41c, 42b42C, 43b43c, 44b44c respectively.
The lead that is connected with preceding termination electrode and ring electrode (omitting diagram) runs through the endoporus of catheter proximal end portion (cage walls) and the inner chamber of catheter main body 10 with insulating state respectively.
Preceding termination electrode and ring electrode are made up of aluminum, copper, rustless steel, gold, platinum, iridium or their alloy etc., electric conductivity good metal.The external diameter of preceding termination electrode and ring electrode is not special to be limited, but preferred identical with the external diameter of catheter proximal end portion.
As shown in Figure 2; Constituting electrode width (length of tube axial direction) among 8 the ring electrode 41B41c, 42b42C, 43b43c, 44b44c of electrode catheter 1, that be installed on the ring electrode 41B of the 1st catheter proximal end portion 31 and be installed on the ring electrode 42C of the 2nd catheter proximal end portion 32 and be longer than the electrode width of other ring electrode, particularly is 1.5 ~ 2.0 times.
At this, the electrode width of the ring electrode beyond ring electrode 41B and the ring electrode 42C is mutually the same, is preferably 0.5 ~ 4.0mm, more preferably 0.6 ~ 1.2mm.
Adopt the electrode catheter 1 of such formation; Through find on the X ray image, be arranged in the 1st ring electrode 41B, 42b, 43b, ring electrode 41B 44b, the electrode width broad from front, can identify the catheter proximal end portion that this ring electrode 41B is installed is the 1st catheter proximal end portion 31.
And if can on X ray image, identify the 1st catheter proximal end portion 31, then can identify the preceding termination electrode and the ring electrode that are installed on the 1st catheter proximal end portion 31 is respectively preceding termination electrode 41a and ring electrode 41B41c.
In addition; Be arranged in the 2nd ring electrode 41c, 42C, 43c, ring electrode 42C 44c, the electrode width broad from front through on X ray image, finding, can identify the catheter proximal end portion that this ring electrode 42C is installed is the 2nd catheter proximal end portion 32.
And if can on X ray image, identify the 2nd catheter proximal end portion 32, then can identify the preceding termination electrode and the ring electrode that are installed on the 2nd catheter proximal end portion 32 is respectively preceding termination electrode 42a and ring electrode 42b42C.
In addition, if can on X ray image, identify the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32, then can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion 32 next doors (side opposite with the 1st catheter proximal end portion 31) is the 3rd catheter proximal end portion 33.
And, if can on X ray image, identify the 3rd catheter proximal end portion 33, then can identify the preceding termination electrode and the ring electrode that are installed on the 3rd catheter proximal end portion 33 and be respectively preceding termination electrode 43a and ring electrode 43b43c.
In addition; If can on X ray image, identify the 31, the 2nd catheter proximal end portion 32 of the 1st catheter proximal end portion and the 3rd catheter proximal end portion 33, then can identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end portion 33 next doors (between the 3rd catheter proximal end portion 33 and the 1st catheter proximal end portion 31) is the 4th catheter proximal end portion 34.
And, if can on X ray image, identify the 4th catheter proximal end portion 34, then can identify the preceding termination electrode and the ring electrode that are installed on the 4th catheter proximal end portion 34 and be respectively preceding termination electrode 44a and ring electrode 44b44c.
Which catheter proximal end portion all preceding termination electrode 41a, 42a, 43a, the 44a that can easily grasp on the X ray image as a result, are installed in.
In addition, also can easily grasp which allocation position which catheter proximal end portion all ring electrode 41B 41c, 42b42C, 43b43c, 44b44c on the X ray image is mounted in.
The electrode catheter 1 of this embodiment has such characteristic: electrode width 2 ring electrodes (ring electrode 41B and ring electrode 42C) wideer than other ring electrodes are installed on the position that differs from one another of adjacent catheter proximal end portion (the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32).
Be under 1 the situation at the ring electrode of electrode width broad; For example only under the situation of the electrode width broad of ring electrode 41B; Can not on X ray image, identify the 2nd catheter proximal end portion 32 and the 4th catheter proximal end portion 34 at once, for example possibly think the preceding termination electrode 42a that is reflected on the X image by mistake preceding termination electrode 44a.
Under these circumstances; For example when preceding termination electrode 43a that is installed on the 3rd catheter proximal end portion 33 and the preceding termination electrode 42a that is installed on the 2nd catheter proximal end portion 32 cross over the indwelling of ablation line ground; Termination electrode 44a before preceding termination electrode 42a on the X image thought by mistake is " that expects burns " based on potential data mistaken diagnosis ablation line, between preceding termination electrode 43a and the preceding termination electrode 44a of not crossing over that is shown on the monitor.
Relative therewith; In the electrode catheter 1 of this embodiment, except the electrode width broad of ring electrode 41B, be installed on the also broad of electrode width of the ring electrode 42C of the 2nd catheter proximal end portion 32; Therefore; Can identify the 2nd catheter proximal end portion 32 and the 4th catheter proximal end portion 34 at once, the preceding termination electrode 42a that can not will be reflected on the X ray image thinks preceding termination electrode 44a by mistake, can avoid taking place the mistaken diagnosis of above-mentioned that kind reliably.
In addition; Be installed at electrode width 2 ring electrodes wideer under the situation of identical separately position of adjacent catheter proximal end portion than other ring electrodes; On X ray image, 2 catheter proximal end portions that can not identify the ring electrode that the electrode width broad is installed are respectively the 1st catheter proximal end portion or the 2nd catheter proximal end portion.
Under these circumstances, can not identify at once 4 catheter proximal end portions on the X ray image be see from the front of conduit or see from the base end side of conduit.
Relative therewith; In the electrode catheter 1 of this embodiment; Because the installation site (as ring electrode from the 2nd of front) that is installed on the allocation position (as ring electrode from the 1st of front) of the ring electrode 41B of the 1st catheter proximal end portion 31 and is installed on the ring electrode 42C of the 2nd catheter proximal end portion 32 differs from one another; Therefore, can discern the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32 reliably.Thus, can discern at once 4 catheter proximal end portions on the X ray image be see from the front of conduit or see from the base end side of conduit.
It is the deflection mechanism (oscillating mechanism) of middle mind-set both direction deflection with the axis of catheter main body 10 that the electrode catheter 1 of this embodiment has the fore-end that makes catheter main body 10.
This deflection mechanism makes the fore-end of catheter main body 10 to the crooked mechanism of the binary direction in the angle that 2 adjacent catheter proximal end portions are become.
That is, utilize this deflection mechanism to make the crooked direction (plane that comprises the track of crooked fore-end) of the fore-end of catheter main body 10 with the fore-end bending of following catheter main body 10 and direction (plane that comprises the track of this bisecting line) unanimity that the bisecting line at the angle that 2 catheter proximal end portions are become moves.
Utilize such deflection mechanism, the fore-end that can make catheter main body 10 is to binary direction in angle that catheter proximal end portion 32 is become with catheter proximal end portion 33 (direction shown in the arrow A in Fig. 1 and Fig. 2) and the binary direction in angle (direction shown in the arrow B in Fig. 1 and Fig. 2) bending that catheter proximal end portion 34 is become with catheter proximal end portion 31.
And crooked to the direction shown in arrow A or the arrow B through the fore-end that makes catheter main body 10,4 catheter proximal end portions 31,32,33,34 move to the direction shown in arrow A or the arrow B integratedly.
Do not limit the mechanisms of 2 swivel plates 22 that pull lines (in Fig. 4, representing) and be connected that can enumerate the leaf spring (omitting diagram) that for example has the amphi position end part that is housed in pipe component 11, run through the inner chamber of pipe component 11 in the table rear side of this leaf spring with 2 pulling lines peri position end separately with Reference numeral 51,52 as deflection mechanism is special.
At this, 2 each amphi position ends that pulls lines can clip the relative fixed-site of leaf spring in the inwall of pipe component 11, also can be fixed in the table back side of flat part at the amphi position end place of leaf spring.
On the other hand, the peri position end that pulls line 51,52 is connected with the position that is separated from each other of the swivel plate 22 of joystick 20, swivel plate 22 can with the vertical rotating shaft of Z axle shown in Figure 1 be that the center rotates freely.
The operator is with a handle part 21 of holding joystick 20 in hand, with the finger manipulation swivel plate 22 (to the direction rotation of regulation) of another hands.Thus, pull the tension variation of line 51,52, arrow A or direction arrow B shown in of the fore-end of catheter main body 10 in Fig. 1 and Fig. 2 is crooked.
That is, when swivel plate 22 usual practices A1 direction as shown in Figure 1 is rotated, pull line 52 and be stretched, it is lax to pull line 51.As a result, the fore-end of catheter main body 10 is to the binary direction in angle (arrow A direction) bending that catheter proximal end portion 32 is become with catheter proximal end portion 33, and thus, 4 catheter proximal end portions move integratedly and are partial to the arrow A direction.
Likewise, when swivel plate 22 usual practices B1 direction as shown in Figure 1 is rotated, pull line 51 and be stretched, it is lax to pull line 52.As a result, the fore-end of catheter main body 10 is to the binary direction in angle (arrow B direction) bending that catheter proximal end portion 34 is become with catheter proximal end portion 31, and thus, 4 catheter proximal end portions move integratedly and are partial to the arrow B direction.
And, if make joystick 20 around Z axle shown in Figure 1 rotation, then can the state in being inserted into the chambers of the heart under, freely set A direction or B direction with respect to joystick 20 towards.
An example of method for using of representing the electrode catheter 1 of this embodiment; At first; Under the state in the sheath that electrode catheter 1 is inserted into tubular (4 catheter proximal end portions are deformed into the state of linearity); Make electrode catheter 1 move to target site in the chambers of the heart near, near target site, from sheath, release 4 catheter proximal end portions, make catheter proximal end portion refresh memory shape (expansion shape of Fig. 1 ~ that kind shown in Figure 4).
Then; Shown in Fig. 6 (1); Make fore-end (the amphi position end part of the pipe component 11) bending of catheter main body 10, keep somewhere this preceding termination electrode 42a and be somebody's turn to do preceding termination electrode 43a with the mode of the intermediate point of the preceding termination electrode 43a that is installed on the 3rd catheter proximal end portion 33 so that ablation line AL is positioned at the preceding termination electrode 42a of the 2nd catheter proximal end portion 32 that is installed on.
Like this; Be installed on 2 ring electrodes of adjacent catheter proximal end portion through indwelling, also can so that ablation line AL is positioned at all the other 2 ring electrodes, the mode of intermediate point that promptly is installed on the preceding termination electrode 41a of the 1st catheter proximal end portion 31 and is installed on the preceding termination electrode 44a of the 4th catheter proximal end portion 34 is kept somewhere this preceding termination electrode 41a and should before termination electrode 44a.As a result, can 4 preceding termination electrode 41a, 42a, 43a, 44a be disposed at apart from the position of ablation line AL equidistance.
After such configuration, termination electrode gives electricity irritation (constant speed (pacing)) before any, and carries out potential measurement at other preceding termination electrode, its transmission speed (detecting the time of current potential) relatively, thus can estimate ablation line AL.
In addition, also can around catheter main body 10, dispose other electrode catheters, give electricity irritation (constant speed) from these other electrode catheters, and termination electrode carry out potential measurement before each, relatively its transmission speed.
Through 4 preceding termination electrodes are disposed at apart from the position of ablation line AL equidistance; As if burning along what ablation line AL expected, the transmission speed (crossing over the transmission speed of the interelectrode current potential of ablation line AL) of the current potential before reaching between then preceding termination electrode 42a and the preceding termination electrode 43a between termination electrode 41a and the preceding termination electrode 44a than the transmission speed (not crossing over the transmission speed of the interelectrode current potential of ablation line AL) that reaches the current potential between preceding termination electrode 43a and the preceding termination electrode 44a between preceding termination electrode 42a and the preceding termination electrode 41a slowly.
And, if burn uniformly along ablation line AL, then before the transmission speed of current potential between transmission speed and the preceding termination electrode 41a and the preceding termination electrode 44a of current potential between termination electrode 42a and the preceding termination electrode 43a equate.
In addition, the ablation line AL shown in Fig. 6 (1) is not presented on the X ray image, is grasped by the operator usually.
As above-mentioned, adopting the number of catheter proximal end portion is the electrode catheter 1 of this embodiment of 4, can easily corresponding 4 electrodes (termination electrode for example) be disposed at apart from the position of ablation line AL equidistance.
Adopt the electrode catheter 1 of this embodiment, the catheter proximal end portion that can discern the electrode of X ray image at once and this electrode is installed be see from the front of conduit or see from the base end side of conduit.
On the X ray image of Fig. 6 (1) such state; Through finding the ring electrode 41B that is positioned at the 1st electrode width broad from front, can identify the catheter proximal end portion that this ring electrode left downside 41B, that be positioned at drawing is installed is the 1st catheter proximal end portion 31.
In addition, be the 2nd catheter proximal end portion 32 through finding the ring electrode 42C that is positioned at the 2nd electrode width broad from front, can identify the catheter proximal end portion that this ring electrode upper left side 42C, that be positioned at drawing is installed.
And; In (1) of Fig. 6; Because the 33, the 4th catheter proximal end portion 34 of the 32, the 3rd catheter proximal end portion of the 31, the 2nd catheter proximal end portion of the 1st catheter proximal end portion " around clockwise " configuration, therefore, can identify this X ray image at once is to look catheter proximal end portion sideways from the cardinal extremity of conduit.
On the other hand; On the X ray image of Fig. 6 (2) such state; Know identical at a glance with Fig. 6 (1); Be conceived to the electrode width of ring electrode, find the ring electrode 41B that is positioned at the 1st electrode width broad from front, can identify the catheter proximal end portion that this ring electrode lower right side 41B, that be positioned at drawing is installed is the 1st catheter proximal end portion 31.
In addition, be the 2nd catheter proximal end portion 32 through finding the ring electrode 42C that is positioned at the 2nd electrode width broad from front, can identify the catheter proximal end portion that this ring electrode upper right side 42C, that be positioned at drawing is installed.
And; In (2) of Fig. 6; Because the 33, the 4th catheter proximal end portion 34 of the 32, the 3rd catheter proximal end portion of the 31, the 2nd catheter proximal end portion of the 1st catheter proximal end portion " around counterclockwise " configuration, therefore, can identify this X ray image at once is to look catheter proximal end portion sideways from the front end of conduit.
Below, more specifically explain in the example of method for using of electrode catheter 1 of this embodiment, 4 preceding termination electrode 41a, 42a, 43a, 44a are configured in apart from the method for the position of ablation line AL equidistance.
At first; Electrode catheter 1 is inserted in the sheath of tubular; Under 4 catheter proximal end portions are deformed into the state (closing state) of linearity, make electrode catheter 1 move to target site (the for example formation position of ablation line) in the chambers of the heart near; Near target site, 4 catheter proximal end portions are released from sheath, thereby make catheter proximal end portion refresh memory shape (expansion shape of Fig. 1 ~ that kind shown in Figure 4).
Below, Yi Bian observe X ray image one edge ablation line (abreast) deployment catheter main body 10, this catheter main body 10 is rotated around axis, the angle that 2 catheter proximal end portions became adjacent on X ray image stops for maximum position.
(1) of Fig. 7, (2) are the vertical view and the side views of expression state at this moment, are the states that on X ray image, can grasp.Under the vertical view shown in (1) of Fig. 7, ablation line AL extends along the binary direction in angle (on the bisecting line) that catheter proximal end portion 32 is become with catheter proximal end portion 33.
Promptly; In the vertical view shown in (1) of Fig. 7; Catheter proximal end portion 32 and catheter proximal end portion 33 are axis shaft symmetry (these catheter proximal end portions are across the state of ablation line) with ablation line AL, and it is the symmetric position of axis that preceding termination electrode 42a and preceding termination electrode 43a are positioned at ablation line AL.
In addition, shown in Fig. 7 (2), catheter proximal end portion 31 and catheter proximal end portion 34 are in the state of crossing over ablation line AL, and it is the symmetric position of axis that preceding termination electrode 41a and preceding termination electrode 44a are positioned at ablation line AL.
Then, the fore-end that utilization deflection mechanism makes catheter main body 10 is along ablation line AL (the inwall side of heart) bending.Thus, can keep catheter proximal end portion 32 (31) and catheter proximal end portion 33 (34) crosses over the state of ablation line AL and the preceding termination electrode that is installed on these catheter proximal end portions is respectively contacted with the inwall of heart.
For example, make swivel plate 22, pull line 51, thereby the fore-end that makes catheter main body 10 is to 90 ° of the binary arrow B direction bendings in the angle that catheter proximal end portion 34 is become with catheter proximal end portion 31 to arrow B shown in Figure 11 direction rotation.
Thus, 4 catheter proximal end portions 31,32,33,34 move to the arrow B direction integratedly, shown in Fig. 8 (1), (2), the preceding termination electrode 41a, 42a, 43a, the 44a that are installed on 4 catheter proximal end portions are respectively contacted with the inwall of heart.
Adopt the electrode catheter 1 of this embodiment; The bending direction (moving direction of catheter proximal end portion) that makes the fore-end of catheter main body 10 is that arrow A direction and arrow B direction are consistent with the formed direction of ablation line; Under this state; Make crooked 90 ° of the fore-end of catheter main body 10; Thereby the state that ablation line AL cross in catheter proximal end portion 32 (31) and the catheter proximal end portion 33 (34) that can keep (it is the position relation of the symmetric position of axis that preceding termination electrode 42a (41a) and preceding termination electrode 43a (44a) are in ablation line AL) also makes 4 catheter proximal end portions 31,32,33,34 mobile integratedly, 4 the preceding termination electrode 41a, 42a, 43a, the 44a that are installed on these catheter proximal end portions are respectively contacted with the inwall of heart or moves along ablation line.
In addition, Fig. 7 and ablation line AL shown in Figure 8 are not presented on the X ray image usually, are grasped by the operator usually.
Shown in Fig. 8 (1), after the fore-end bending of catheter main body 10,4 preceding termination electrode 41a, 42a, 43a, 44a are configured in apart from the position of ablation line AL equidistance.
Give electricity irritation (constant speed) from wherein wantonly 1 of preceding termination electrode of configuration in this wise, and carry out potential measurement at other preceding termination electrode, its transmission speed (detecting the time of current potential) relatively, thus can estimate ablation line AL.
In addition, also can around catheter main body 10, dispose other electrode catheters, give electricity irritation (constant speed) from these other electrode catheters, and termination electrode carry out potential measurement before each, relatively its transmission speed.
Through 4 preceding termination electrodes are configured in apart from the position of ablation line AL equidistance; As if burning along what ablation line AL expected, the transmission speed (crossing over the transmission speed of the interelectrode current potential of ablation line AL) of the current potential before reaching between then preceding termination electrode 42a and the preceding termination electrode 43a between termination electrode 41a and the preceding termination electrode 44a than the transmission speed (not crossing over the transmission speed of the interelectrode current potential of ablation line AL) that reaches the current potential between preceding termination electrode 43a and the preceding termination electrode 44a between preceding termination electrode 42a and the preceding termination electrode 41a slowly.
And, if burn uniformly along ablation line AL, then before the transmission speed of current potential between transmission speed and the preceding termination electrode 41a and the preceding termination electrode 44a of current potential between termination electrode 42a and the preceding termination electrode 43a equate.
Shown in figure 11; Adopt in the deflection mechanism of the electrode catheter that replace to constitute the present invention's (the 2nd technical scheme) under the situation of the crooked deflection mechanism of the bearing of trend (direction shown in arrow a and the arrow b) of the fore-end conductive pipe leading section 633 that makes catheter main body 610 and catheter proximal end portion 631; Even shown in this Figure 11 (1), being configured to catheter proximal end portion 632 (631) and catheter proximal end portion 633 (634) with ablation line AL is axis shaft symmetry (states of ablation line are crossed over by these catheter proximal end portions); Fore-end through making catheter main body 610 is crooked to for example b direction; Shown in this Figure 11 (2); The state that ablation line are crossed over by catheter proximal end portion 632 (631) and the catheter proximal end portion 633 (634) that can not keep (the position relation before crooked), the preceding termination electrode 641a, 642a, 643a, the 644a that are close with the inwall of heart depart from from ablation line AL significantly.
In addition; The fore-end that makes catheter main body 610 in the deflection mechanism that utilizes above-mentioned that kind is along ablation line AL when crooked; Catheter proximal end portion 633 and 631 moves along ablation line AL; The preceding termination electrode 643a and the 641a that are installed on these catheter proximal end portions move on ablation line AL, therefore, can not these preceding termination electrodes be used for potential measurement.
In addition, in above-mentioned, as corresponding electrode, former termination electrode 41a, 42a, 43a, 44a are that example is illustrated, and corresponding ring electrode (8 ring electrodes shown in Figure 2) is also identical.
Promptly; Adopt the electrode catheter 1 of this embodiment, can keep ring electrode 42b (41B) and ring electrode 43b (44b) be in ablation line AL be axis symmetric position the position relation and these ring electrodes 41B, 42b, 43b, 44b be close with wall of the heart (contact) or move along ablation line.
And, after the fore-end bending that makes catheter main body 10, can will be configured in apart from the position of ablation line AL equidistance as 4 ring electrode 41B, 42b, 43b, 44b of counter electrode.
In addition; Adopt the electrode catheter 1 of this embodiment, can keep ring electrode 42C (41c) and ring electrode 43c (44c) be in ablation line AL be axis symmetric position the position relation and these ring electrodes 41c, 42C, 43c, 44c be close with wall of the heart (contact) or move along ablation line.
And, after the fore-end bending that makes catheter main body 10, can will be configured in apart from the position of ablation line AL equidistance as 4 ring electrode 41c, 42C, 43c, 44c of counter electrode.
And; Adopt the electrode catheter 1 of this embodiment, it is binary directions in angle that 2 catheter proximal end portions are become that deflection mechanism makes the crooked bending direction of fore-end of catheter main body 10, therefore; Power when making the fore-end of catheter main body 10 crooked is not concentrated in wherein 1 catheter proximal end portion; Because it is minimum that the preceding termination electrode that is installed on catheter proximal end portion is pushed the power of inwall of heart, therefore, can not damage inwall.
＜the 2 embodiment＞
Electrode catheter 2 shown in Figure 9 have from the front end of catheter main body 10 (front end components 12) with equal angles (being about 90 ° when the side-looking) be at interval radial extended 4 catheter proximal end portions (36,37,38,39), respectively be installed on the preceding termination electrode (46A, 47a, 48a, 49a) of these catheter proximal end portions, 8 ring electrodes (46b46c, 47B47c, 48b48c, 49b49c) of 2 are installed respectively in each catheter proximal end portion.
As shown in Figure 9, the electrode width of preceding termination electrode 46A in 4 preceding termination electrodes (46A, 47a, 48a, 49a) of formation electrode catheter 2, that be installed on the 1st catheter proximal end portion 36 is longer than the electrode width of other preceding termination electrodes, particularly is 1.5 times.
In addition; The electrode width of ring electrode 47B in 8 ring electrodes (46b46c, 47B47c, 48b48c, 49b49c) of formation electrode catheter 2, that be installed on the 2nd catheter proximal end portion 37 is longer than the electrode width of other ring electrodes, particularly is 1.5 ~ 2.0 times.
Adopt the electrode catheter 2 that constitutes like this, through on X ray image, finding the preceding termination electrode 46A of electrode width broad, can identify the catheter proximal end portion that this preceding termination electrode 46A is installed is the 1st catheter proximal end portion 36.
And, if can on X ray image, identify the 1st catheter proximal end portion 36, then can identify the ring electrode that is installed on the 1st catheter proximal end portion 36 and be respectively ring electrode 46b, ring electrode 46c.
In addition, be the 2nd catheter proximal end portion 37 through on X ray image, finding the ring electrode 47B of electrode width broad, can identify the catheter proximal end portion that this ring electrode 47B is installed.
And, if can on X ray image, identify the 2nd catheter proximal end portion 37, then can identify the preceding termination electrode and the ring electrode that are installed on the 2nd catheter proximal end portion 37 and be respectively preceding termination electrode 47a and ring electrode 47B47c.
In addition, if can on X ray image, identify the 1st catheter proximal end portion 36 and the 2nd catheter proximal end portion 37, then can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion 37 next doors (side opposite with the 1st catheter proximal end portion 36) is the 3rd catheter proximal end portion 38.
And, if can on X ray image, identify the 3rd catheter proximal end portion 38, then can identify the preceding termination electrode and the ring electrode that are installed on the 3rd catheter proximal end portion 38 and be respectively preceding termination electrode 48a and ring electrode 48b48c.
In addition; If can on X ray image, identify the 36, the 2nd catheter proximal end portion 37 of the 1st catheter proximal end portion and the 3rd catheter proximal end portion 38, then can identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end portion 38 next doors (between the 3rd catheter proximal end portion 38 and the 1st catheter proximal end portion 36) is the 4th catheter proximal end portion 39.
And, if can on X ray image, identify the 4th catheter proximal end portion 39, then can identify the preceding termination electrode and the ring electrode that are installed on the 4th catheter proximal end portion 39 and be respectively preceding termination electrode 49a and ring electrode 49b49c.
As a result, which catheter proximal end portion all preceding termination electrodes (46A, 47a, 48a, 49a) that can easily grasp on the X ray image are installed on.
In addition, also can easily grasp which allocation position which catheter proximal end portion all ring electrodes (46b46c, 47B47c, 48b48c, 49b49c) on the X ray image are installed on.
More than, embodiment of the present invention has been described, but the present invention is not limited to this, can shown in following, carry out various changes.
For example, in the present invention's (the 1st technical scheme), the quantity that is installed on the ring electrode of each catheter proximal end portion is not limited to 2, also can be for more than 3.In addition, the electrode width of such preceding termination electrode that is installed on the 1st catheter proximal end portion shown in the 2nd embodiment than the wide situation of the electrode width of other preceding termination electrodes under, the quantity that is installed on the ring electrode of each catheter proximal end portion also can be 1.
In addition, in the present invention's (the 1st technical scheme), be not defined as 4, can be 3 from the quantity of the extended catheter proximal end of the front end of catheter main body portion, also can be for more than 5.
At this; Electrode catheter shown in Figure 10 (1) have from the front end of catheter main body 10 (front end components 12) with equal angles (being about 120 ° when the side-looking) be at interval radial extended 3 catheter proximal end portions (131,132,133), respectively be installed on these catheter proximal end portions preceding termination electrode (141a, 142a, 143a), in each catheter proximal end portion 6 ring electrodes (141B141c, 142b142C, 143b143c) of 2 are installed respectively, the ring electrode 141B that is installed on the 1st catheter proximal end portion 131 and the ring electrode 142C that is installed on the 2nd catheter proximal end portion 132 are the present invention's (1st technical scheme) wideer than the electrode width of other ring electrodes electrode catheters.
In addition; Electrode catheter shown in Figure 10 (2) have from the front end of catheter main body 10 (front end components 12) with equal angles (being about 72 ° when the side-looking) be at interval radial extended 5 catheter proximal end portions (231,232,233,234,235), respectively be installed on these catheter proximal end portions preceding termination electrode (241a, 242a, 243a, 244a, 245a), in each catheter proximal end portion 10 ring electrodes (241B241c, 242b242C, 243b243c, 244b244c, 245b245c) of 2 are installed respectively, the ring electrode 241B that is installed on the 1st catheter proximal end portion 231 and the ring electrode 242C that is installed on the 2nd catheter proximal end portion 232 are the present invention's (1st technical scheme) wideer than the electrode width of other ring electrodes electrode catheters.
In the electrode catheter shown in (1) ~ (2) of Figure 10, which catheter proximal end portion all electrodes (preceding termination electrode and ring electrode) that also can easily grasp on the X ray image are installed on.
In addition, in the present invention's (the 2nd technical scheme), the quantity that is installed on the ring electrode of each catheter proximal end portion is not limited to 2, also can be for more than 3.In addition, the electrode width of all ring electrodes also can be identical.
After electrode catheter of the present invention can not only be confirmed ablation, can also be used for various diagnosis or treatment.For example, the length that can measure simultaneously with catheter proximal end portion is the current potential of the round inner region of radius, therefore, can preferably be used for mark and survey conduit (mapping catheter).
Symbol description
1 electrode catheter, 10 catheter main bodies, 11 pipe components, 12 front end components, 121 cylindric parts; 122 retaining parts, 20 joysticks, 21 handle parts, 22 swivel plates, 31 the 1st catheter proximal end portions; 32 the 2nd catheter proximal end portions, 33 the 3rd catheter proximal end portions, 34 the 4th catheter proximal end portions, 311,321,331,341 core components, 312,322,332,342 cage walls; Termination electrode before the 41a, termination electrode before the 41B41c ring electrode, 42a, 42b42C ring electrode; Termination electrode before the 43a, termination electrode before the 43b43c ring electrode, 44a, 44b44c ring electrode.

Claims (12)

1. an electrode catheter is characterized in that, this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles from the front end of above-mentioned catheter main body at interval; Ring electrode, it is equipped with a plurality of in each above-mentioned catheter proximal end portion;
The electrode width of 1 ring electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other ring electrodes with the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door,
Electrode width above-mentioned 2 ring electrodes different with other ring electrodes differ from one another at the allocation position that is equipped with in the catheter proximal end portion of these 2 ring electrodes.
2. electrode catheter according to claim 1 is characterized in that,
The electrode width from the ring electrode of the 2nd of front in the electrode width of the ring electrode of the 1st of front and the 2nd catheter proximal end portion in the 1st catheter proximal end portion is wideer than the electrode width of other ring electrodes.
3. electrode catheter according to claim 2 is characterized in that,
This electrode catheter has 4 catheter proximal end portions.
4. an electrode catheter is characterized in that, this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles from the front end of above-mentioned catheter main body at interval; Before termination electrode, it is installed on each above-mentioned catheter proximal end portion; Ring electrode, it installs 1 at least in each above-mentioned catheter proximal end portion;
The electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other preceding termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door is different with the electrode width of other ring electrodes.
5. electrode catheter according to claim 4 is characterized in that,
The electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is wideer than the electrode width of other preceding termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wideer than the electrode width of other ring electrodes.
6. electrode catheter according to claim 5 is characterized in that,
This electrode catheter has 4 catheter proximal end portions.
7. according to each described electrode catheter in the claim 1 ~ 6, it is characterized in that,
It is the crooked deflection mechanism of middle mind-set both direction with the axis of this catheter main body that this electrode catheter has the fore-end that can make above-mentioned catheter main body.
8. an electrode catheter is characterized in that, this electrode catheter has:
Catheter main body, it has at least 1 endoporus;
Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body;
4 catheter proximal end portions, they circumferentially extend with equal angles from the axis of this catheter main body of front end edge of above-mentioned catheter main body at interval;
Electrode, it is installed on each above-mentioned catheter proximal end portion;
Deflection mechanism, it makes the fore-end of above-mentioned catheter main body crooked to the binary direction in the angle that 2 adjacent catheter proximal end portions are become.
9. electrode catheter according to claim 8 is characterized in that,
The fore-end that above-mentioned deflection mechanism makes above-mentioned catheter main body is that middle mind-set both direction is crooked with the axis of this catheter main body.
10. according to Claim 8 or 9 described electrode catheters, it is characterized in that,
Termination electrode and at least 1 ring electrode before each above-mentioned catheter proximal end portion is equipped with.
11. according to Claim 8 or 9 described electrode catheters, it is characterized in that,
The electrode width from the ring electrode of the 2nd of front in the electrode width of the ring electrode of the 1st of front and the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door in the 1st catheter proximal end portion is wideer than the electrode width of other ring electrodes.
12. according to Claim 8 or 9 described electrode catheters, it is characterized in that,
The electrode width of preceding termination electrode that is installed on the 1st catheter proximal end portion is wideer than the electrode width of other preceding termination electrodes, and the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end portion next door is wideer than the electrode width of other ring electrodes.
CN201080059341.6A 2010-01-23 2010-08-19 Electrode catheter Expired - Fee Related CN102686178B (en)

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JP2010012642A JP5201636B2 (en) 2010-01-23 2010-01-23 Electrode catheter
JP2010-012642 2010-01-23
JP2010012643A JP5265589B2 (en) 2010-01-23 2010-01-23 Electrode catheter
JP2010-012643 2010-01-23
PCT/JP2010/064028 WO2011089750A1 (en) 2010-01-23 2010-08-19 Electrode catheter

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KR101402543B1 (en) 2014-05-30
TW201125601A (en) 2011-08-01

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