CN102814000A - Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber - Google Patents
Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber Download PDFInfo
- Publication number
- CN102814000A CN102814000A CN2012102803157A CN201210280315A CN102814000A CN 102814000 A CN102814000 A CN 102814000A CN 2012102803157 A CN2012102803157 A CN 2012102803157A CN 201210280315 A CN201210280315 A CN 201210280315A CN 102814000 A CN102814000 A CN 102814000A
- Authority
- CN
- China
- Prior art keywords
- electrode
- catheter
- chambers
- heart
- low
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Images
Abstract
The invention relates to an electrical cardioversion electrode catheter in a single-catheter low-energy cardiac chamber. The electrode catheter is composed of an electrode part, a catheter body, an operating handle and electrode buttcock lines; one end of the catheter body is connected with the electrode part; the electrode part is branched into two electrode catheters; the two electrode catheters are respectively provided with an electrode; the other end of the catheter body is connected with the operating handle; each electrode in the two electrode catheters is connected with one of the electrode buttcock lines; and the electrode buttcock lines are penetrated from the operating handle and the catheter body and stretched out of the tail end of the operating handle and then connected with a low-energy implantable cardioverter defibrillator. The electrical cardioversion electrode catheter in the single-catheter low-energy cardiac chamber, related by the invention, has the advantages that the structure of one catheter is low in cost and good in maneuverability; the electrode catheters are put in the cardiac chamber and arranged near a right atrium crista terminalis and a left ventricular free wall and are simple and convenient to operate; the electrode catheters are covered on the left and the right atriums and can be applied to electrophysiological examination and diagnosis of arrhythmogenic mechanisms and temporary cardiac pacing; and an electric field is formed between two electrodes and covered on the left and the right atriums in a biggest range so as to further reduce energy needed by cardioversion and bring a stable cardioversion effect.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments, specifically, is electrical conversion electrode catheter in the low-yield chambers of the heart of a kind of single conduit.
Background technology
Electrical conversion is meant with the high-energy electric pulse and carries out synchronous discharge, and tachyarrhythmia is stopped, and changes multiple sinus rhythm (as being asynchronous discharge, being called electric defibrillation).Its ultimate principle is to give cardiac muscle through high energy electric pulse moment, forces cardiac muscle depolarization and get into refractory stage simultaneously, and the sinuatrial node that self-disciplining is the highest then is Wen Xing at first, controls the activity of whole heart again and recovers sinus rhythm.
Lown reported first in 1961 is with the success of direct current electrical conversion ventricular tachycardia, and electrical conversion is widely used, and is the effective ways that stop tachyarrhythmia.China's Ministry of Public Health register report showed in 2011, and the case that tachyarrhythmia carries out the treatment of catheter ablation art is 60,000 examples, wherein about 20,000 examples of atrial fibrillation catheter ablation art.It is estimated that nearly 10,000 examples are pounced on/room speed, chamber speed etc. for persistence/persistency atrial fibrillation, the room that is not true to type, the catheter ablation art can not directly stop these arrhythmia, need carry out electrical conversion and change and answer sinus rhythm.The indication of electrical conversion is that atrial fibrillation, room are pounced on, room speed, supraventricular tachycardia, chamber speed etc., and all effective to the tachyarrhythmia that various mechanism cause, especially tachyarrhythmia is the most effective due to the foldback mechanism, be divided in external, the body with the chambers of the heart in three kinds of modes.
Want successful conversion defibrillation, act on during electric shock cardiac muscle energy (with the electric current density that acts on same cardiac muscle square or square being directly proportional of electric potential gradient) must reach certain threshold value.When external electrical conversion defibrillation, the conversion defibrillation pulse will just can act on heart through the thoracic cavity, and the actual energy that arrives heart has only about 4 ﹪ of gross energy, and the distribution of electric potential gradient is also inhomogeneous, and maximum and minimum place differs about 4 ~ 5 times.In vivo during the conversion defibrillation, be 30 times away from the electrode electric potential gradient, that is to say that the distributed pole of conversion defibrillation energy on cardiac muscle is inhomogeneous near the electric potential gradient at conversion defibrillation electrode place.
External electrical conversion is that pair of electrical pole plate/sheet is placed on the apex of the heart on the thoracic wall-heart bottom/left front breast-back respectively, covers whole heart scope between two battery lead plates/sheet, carries out synchronous discharge, the higher 100J-360J of institute's energy requirement.External electrical conversion is simple and easy to do, can repeatedly repeat, and is the most commonly used.Its weak point 1. need to be general anesthesia, suppresses to breathe, and is very painful; 2. electric burn, electrical burn of skin are often arranged; 3. shirtfront and limbs pain have pulmonary edema by chance; 4. heating, blood pressure drops, myocardium enzyme raises; 5. bring out new arrhythmia, peripheral artery ambolism; If 6. the patient is fat, thoracic wall is thick or emphysema, conversion defibrillation threshold value is high, and institute's energy requirement increases, and external electrical conversion often is difficult for successfully.
When electrical conversion only was used for department of cardiac surgery direct-view operation in the body, after the cardiac operation under direct vision extracorporeal circulation was ended, heart was not jumped yet again when body temperature had reached 33 ℃, gave conversion defibrillation in the unidirectional current body.One of defibrillation electrode plate places right ventricle's face, and another places apex, burns for avoiding cardiac muscle, and heart surface should be filled with normal saline.Because of battery lead plate directly contacts cardiac muscle, so required electric energy is less, and can use repeatedly, electric energy often is 20-30J, generally is no more than 70J, advocates that recently 94% case can be succeedd below 20J from lower energy (3-5J) beginning.Weak point is that the scope of application is very limited, when only being used for department of cardiac surgery direct-view operation.
Electrical conversion then is in intravenous route inserts two electrode catheter to chambers of the heart, to discharge electric pulse by the direct current countershock device tachy-arrhythmia is changeed multiple in the chambers of the heart, institute's energy requirement less (< 20J, 5J usually), success rate higher (70-92%).Only be used at first that those patients are fat, thoracic wall is thick or emphysema, conversion defibrillation threshold value is high, the situation of external conversion failure.
Electrical conversion is compared preceding dual mode in the chambers of the heart, has the following advantages: 1. the electric current heart that all can avoid high impedance is organized outward, only needs extremely low-yieldly, and the effective energy of synchronized cardioversion is reduced to 2J-25J, and general maximum is no more than 40J; 2. little to myocardial damage, even not damaged; 3. there are not skin burn and muscle injury; 4. do not have obvious pain, only need calmness, do not need general anesthesia; 5. catheter electrode still can be used for intracardiac electrophysiology inspection and temporary heart pace-making; 6. Wicresoft, the venipuncture approach need not be opened breast.But its weak point is: 1. this technology waits to improve, and makes the electrode catheter configuration more reasonable with placement; 2. be applicable to mainly that atrial fibrillation, room pounce on.Also there is example report electrical conversion in the vein chambers of the heart to be used for chamber speed person at present, but still do not have sophisticated experience; 3. external at present a small amount of clinical practice, domestic report is less, does not promote as yet; 4. need conversion defibrillation electrode conduit in two radical centers, price is comparatively expensive.
Summary of the invention
The objective of the invention is provides electrical conversion electrode catheter in the low-yield chambers of the heart of a kind of single conduit to deficiency of the prior art.
For realizing above-mentioned purpose; The technical scheme that the present invention takes is: electrical conversion electrode catheter in the low-yield chambers of the heart of a kind of single conduit; The electrical conversion electrode catheter is made up of electrode part, conduit pipe shaft, control crank and electrode buttock line four parts in the described chambers of the heart, described conduit pipe shaft one end connection electrode part, and described electrode partly is branched into two strip electrode conduits; Difference installing electrodes on the two strip electrode conduits; The described conduit pipe shaft other end connects control crank, and each electrode of described two strip electrode catheter interior connects an electrode buttock line, and described electrode buttock line passes conduit pipe shaft and control crank; End by control crank stretches out, and links to each other with low-yield endocardiac defibrillation device.
On the described two strip electrode conduits 10 electrodes are installed respectively respectively.
Described electrode is the platinum electrode ring, and wide 5mm, interelectrode distance are 5mm.
Described catheter tube height 50cm.
Described each long 12cm of two strip electrode conduits.
The invention has the advantages that:
1, single catheter, cost-effective, maneuverability is good;
2, electrode catheter is placed in the chambers of the heart, abuts in the free wall of crista terminalis atrii dextri-left atrium, and is easy and simple to handle;
3, electrode catheter covers the bilateral atrium, can be used for electrophysiologic study diagnose arrhythmia mechanism, can be used for the temporary heart pace-making;
4, form electric field between two electrodes and cover the bilateral atrium, scope is maximum, further reduces conversion institute energy requirement, the conversion effect stability.
Description of drawings
Accompanying drawing 1 is the structural representation of electrical conversion electrode catheter in the low-yield chambers of the heart of a kind of single conduit of the present invention.
Accompanying drawing 2 is electrical conversion electrode catheter rest in the chambers of the heart in the chambers of the heart.
Accompanying drawing 3 is 10J electrical conversions in the chambers of the heart, and the A. atrial fibrillation stops changeing multiple sinus rhythm; B.10J discharge pulse voltage, square wave; C. the rest of electrode catheter in the chambers of the heart.
The specific embodiment
Below in conjunction with accompanying drawing the specific embodiment provided by the invention is elaborated.
The Reference numeral and the ingredient that relate in the accompanying drawing are as follows:
1. electrode part 2. conduit pipe shafts
3. control crank 4. electrode buttock lines
11. electrode
Embodiment 1
Please with reference to accompanying drawing 1, accompanying drawing 1 is the structural representation of electrical conversion electrode catheter in the low-yield chambers of the heart of a kind of single conduit of the present invention.The electrical conversion electrode catheter is made up of electrode part 1, conduit pipe shaft 2, control crank 3 and electrode buttock line 4 four parts in the described chambers of the heart; Described conduit pipe shaft 2 long 50cm; One end connection electrode part 1, described electrode part 1 is branched into two strip electrode conduits, each long 12cm of two strip electrode conduits.On the described two strip electrode conduits 10 electrodes 11 are installed respectively respectively.Described electrode 11 is platinum electrode rings, and wide 5mm, interelectrode distance are 5mm.Described conduit pipe shaft 2 other ends connect control crank 3, and control crank 3 can bend through the electrode catheter that two bifurcateds are controlled in push-and-pull, places respectively and abuts in the free wall of crista terminalis atrii dextri-left atrium.Each electrode 11 of described two strip electrode catheter interior connects an electrode buttock line 4; Described electrode buttock line 4 compiles in conduit pipe shaft 2; Pass conduit pipe shaft 2 and control crank 3; End by control crank 3 stretches out, totally two groups of each 10 electrode buttock lines 4, and described electrode buttock line 4 links to each other with low-yield endocardiac defibrillation device.
Embodiment 2
Electrical conversion then is in intravenous route inserts two electrode catheter to chambers of the heart, to discharge electric pulse by the direct current countershock device tachy-arrhythmia is changeed multiple in the chambers of the heart, institute's energy requirement less (< 20J, 5J usually), success rate higher (70-92%).Only be used at first that those patients are fat, thoracic wall is thick or emphysema, conversion defibrillation threshold value is high, the situation of external conversion failure.The rest of two electrode catheters in the chambers of the heart has two kinds, is respectively: superior vena cava/>high right atrium-Coronary vein (Fig. 2 .A); Superior vena cava/high right atrium-pulmonary artery and left and right sides branch (Fig. 2 .B).
Electrical conversion case data in table 1 chambers of the heart
Electrical conversion electrode catheter in the low-yield chambers of the heart of single conduit of the present invention,
Number of poles: 20 utmost points
Deflectable/fixed bend
External diameter: 6 F/7F
Electrode width: 5mm, interelectrode distance are 5mm
Length: 120cm
Curved: Curves:Large
Place in the art and require: control crank 3 can be controlled two fens interdigitated electrodes through push-and-pull and bend, and 10 electrodes 11 abut in the right atrium TA, and it is annulus of mitral valve-left atrium top that other 10 electrodes 11 abut in the free wall of left atrium.Please with reference to accompanying drawing 3, accompanying drawing 3 is 10J electrical conversions in the chambers of the heart, and the A. atrial fibrillation stops changeing multiple sinus rhythm; B.10J discharge pulse voltage, square wave; C. the rest of electrode catheter in the chambers of the heart.
The electrical conversion electrode catheter uses single catheter in the low-yield chambers of the heart of single conduit of the present invention, cost-effective, and maneuverability is good; Electrode catheter is placed in the chambers of the heart, abuts in the free wall of crista terminalis atrii dextri-left atrium, and is easy and simple to handle; Electrode catheter covers the bilateral atrium, can be used for electrophysiologic study diagnose arrhythmia mechanism, can be used for the temporary heart pace-making; Form electric field between two electrodes and cover the bilateral atrium, scope is maximum, further reduces conversion institute energy requirement, the conversion effect stability.
The above only is a preferred implementation of the present invention; Should be pointed out that for those skilled in the art, under the prerequisite that does not break away from the inventive method; Can also make some improvement and replenish, these improvement and replenish and also should be regarded as protection scope of the present invention.
Claims (5)
1. the interior electrical conversion electrode catheter of the low-yield chambers of the heart of single conduit is characterized in that the electrical conversion electrode catheter is made up of electrode part, conduit pipe shaft, control crank and electrode buttock line four parts in the described chambers of the heart; Described conduit pipe shaft one end connection electrode part; Described electrode partly is branched into two strip electrode conduits, difference installing electrodes on the two strip electrode conduits, and the described conduit pipe shaft other end connects control crank; Each electrode of described two strip electrode catheter interior connects an electrode buttock line; Described electrode buttock line passes conduit pipe shaft and control crank, is stretched out by the end of control crank, links to each other with low-yield endocardiac defibrillation device.
2. electrical conversion electrode catheter in the chambers of the heart according to claim 1 is characterized in that, on the described two strip electrode conduits 10 electrodes is installed respectively respectively.
3. electrical conversion electrode catheter in the chambers of the heart according to claim 2 is characterized in that described electrode is the platinum electrode ring, and wide 5mm, interelectrode distance are 5mm.
4. electrical conversion electrode catheter in the chambers of the heart according to claim 1 is characterized in that described catheter tube height 50cm.
5. electrical conversion electrode catheter in the chambers of the heart according to claim 1 is characterized in that described each long 12cm of two strip electrode conduits.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2012102803157A CN102814000A (en) | 2012-08-08 | 2012-08-08 | Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2012102803157A CN102814000A (en) | 2012-08-08 | 2012-08-08 | Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN102814000A true CN102814000A (en) | 2012-12-12 |
Family
ID=47298672
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2012102803157A Pending CN102814000A (en) | 2012-08-08 | 2012-08-08 | Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN102814000A (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1147964A (en) * | 1995-10-17 | 1997-04-23 | 郭伟 | Composition electrode connecting conduct |
| US20040193240A1 (en) * | 1996-03-01 | 2004-09-30 | Cardiac Pacemakers, Inc. | Device for the transvenous cardioversion of atrial fibrillation or atrial flutter |
| CN101190146A (en) * | 2006-11-21 | 2008-06-04 | 李楚森 | Cardiac intervention ablation catheter |
| CN202740633U (en) * | 2012-08-08 | 2013-02-20 | 上海交通大学医学院附属新华医院 | Cardiac intracavity electrical conversion electrode catheter |
-
2012
- 2012-08-08 CN CN2012102803157A patent/CN102814000A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1147964A (en) * | 1995-10-17 | 1997-04-23 | 郭伟 | Composition electrode connecting conduct |
| US20040193240A1 (en) * | 1996-03-01 | 2004-09-30 | Cardiac Pacemakers, Inc. | Device for the transvenous cardioversion of atrial fibrillation or atrial flutter |
| CN101190146A (en) * | 2006-11-21 | 2008-06-04 | 李楚森 | Cardiac intervention ablation catheter |
| CN202740633U (en) * | 2012-08-08 | 2013-02-20 | 上海交通大学医学院附属新华医院 | Cardiac intracavity electrical conversion electrode catheter |
Non-Patent Citations (1)
| Title |
|---|
| OUYANG, FEIFAN, ET AL.: "Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique", 《CIRCULATION》 * |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| Ratliff et al. | Persistent left superior vena cava: case reports and clinical implications | |
| Deshmukh et al. | Direct His‐bundle pacing: present and future | |
| Biffi et al. | Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience | |
| Spielman et al. | Ventricular fibrillation during programmed ventricular stimulation: incidence and clinical implications | |
| Barold et al. | Significance of right bundle-branch block patterns during pervenous ventricular pacing. | |
| Yang et al. | Treatment of pulmonary sinus cusp‐derived ventricular arrhythmia with reversed U‐curve catheter ablation | |
| John et al. | Localization of the origin of the atrioventricular junctional rhythm induced during selective ablation of slow-pathway conduction in patients with atrioventricular node reentrant tachycardia | |
| Huang et al. | Improvement of defibrillation efficacy and quantification of activation patterns during ventricular fibrillation in a canine heart failure model | |
| CN202740633U (en) | Cardiac intracavity electrical conversion electrode catheter | |
| Greene et al. | Mechanism of the repetitive ventricular response in man | |
| Overbay et al. | Mastering temporary invasive cardiac pacing | |
| CN102814000A (en) | Electrical cardioversion electrode catheter in single-catheter low-energy cardiac chamber | |
| ANDRESS et al. | Bidirectional bundle branch reentry tachycardia associated with Ebstein's anomaly: cured by extensive cryoablation of the right bundle branch | |
| Bodegas et al. | Brugada syndrome in a patient with accessory pathway | |
| Kumar et al. | Use of a closed loop irrigated catheter in epicardial ablation of ventricular tachycardia | |
| CN204890964U (en) | Double -purpose pipe is surveyed, is defibrillated to intracardiac mark | |
| CN201366174Y (en) | Novel multifunctional pacing electrode catheter | |
| Pang et al. | High-energy defibrillation increases the dispersion of regional ventricular repolarization | |
| Yokoyama et al. | A case of successful radiofrequency catheter ablation of ventricular tachycardia from the noncoronary cusp | |
| de Voogt et al. | Electrocardiographic characteristics in low atrial septum pacing | |
| Perkins et al. | Cardioversion and defibrillation using a catheter electrode: myocardial damage assessed at autopsy | |
| Ciesielski et al. | Prąd uszkodzenia pęczka Hisa i czynny rytm węzłowy—rozważania kliniczne i techniczne | |
| Ferrari et al. | Ventricular tachycardia originating from the crux of the heart treated with ablation within the cardiac venous system in a 12-year-old patient | |
| Kong et al. | Atrial tachycardia ablation at the pulmonary outflow tract in a patient with congenitally corrected transposition of the great arteries | |
| Rotondi et al. | Atypical response of class IC atrial flutter to adenosine |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C02 | Deemed withdrawal of patent application after publication (patent law 2001) | ||
| WD01 | Invention patent application deemed withdrawn after publication |
Application publication date: 20121212 |