CN102686178B - Electrode catheter - Google Patents

Electrode catheter Download PDF

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Publication number
CN102686178B
CN102686178B CN201080059341.6A CN201080059341A CN102686178B CN 102686178 B CN102686178 B CN 102686178B CN 201080059341 A CN201080059341 A CN 201080059341A CN 102686178 B CN102686178 B CN 102686178B
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CN
China
Prior art keywords
electrode
catheter
proximal end
end portion
catheter proximal
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Expired - Fee Related
Application number
CN201080059341.6A
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Chinese (zh)
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CN102686178A (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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Filing date
Publication date
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
Application granted granted Critical
Publication of CN102686178B publication Critical patent/CN102686178B/en
Expired - Fee Related legal-status Critical Current
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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 multiple catheter proximal end portion.
Background technology
As the electroactive conduit in mapping (mapping) heart, be known to have the multiple catheter proximal end portion that is from the front end of catheter main body that radiated entends goes out, the conduit (with reference to patent documentation 1 and patent documentation 2) particularly with 5 catheter proximal end portions (jut 14).
Termination electrode and ring electrode before the each catheter proximal end portion of this conduit is provided with can be measured with 1 this conduit the current potential of the round inner region using the length of catheter proximal end portion as radius 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
Conduit described in above-mentioned patent documentation is except electroactive for mapping, also for various diagnosis, treatment behavior.
For example,, for burning of being confirmed whether to expect reliably after ablation.Particularly, 2 electrodes (front termination electrode or the ring electrode) indwelling that is installed on different each catheter proximal end portion is measured to the transmission speed of current potential in the symmetrical position taking ablation line as axis.At this, in the situation that 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.On the other hand, in the situation that not burning reliably, with beeline transmission, therefore can not there is the delay of transmission speed in current potential between 2 electrodes.
(1) various diagnosis, the treatment behavior that after ablation, be confirmed whether the operation of burning reliably etc., uses the conduit with multiple catheter proximal end portion conventionally observed X ray image while carried out.
In addition, measured potential data for used 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, require operator to grasp to be reflected in each electrode in X ray image to be mounted in the electrode (being for example, to be installed on the ring electrode which catheter proximal end portion from front end) of which position of which catheter proximal end portion.
But it is extremely difficult resting in the electrode that on X ray image, specific electrode is mounted in which position of which catheter proximal end portion.
At this, in the case of all electrodes (being installed on the electrode of all catheter proximal end portions) are reflected on X ray image, about specific certain electrode on X ray image, although can rest in the allocation position (being to be installed on the electrode which catheter proximal end portion from front end) at place of catheter proximal end portion, but because the configuration of the electrode at catheter proximal end portion place is identical, it is therefore, instantaneous that to rest on X ray image specific electrode be that the electrode being installed in which catheter proximal end portion is practically impossible.
In addition, in the case of all electrodes are reflected on X ray image, the multiple catheter proximal end portion that sometimes also can mistake the electrode on image and these electrodes are installed be see from the front of conduit or see from the base end side of conduit.
(2) be desirably in and be confirmed whether to utilize in the situation that the conduit with multiple catheter proximal end portion burns reliably, by the electrode (following, by the electrode that is installed on same position in multiple catheter proximal end portion also referred to as " corresponding electrode " or " counter electrode ") that is installed on same position between multiple catheter proximal end portion all indwelling in the position apart from ablation line equidistance.
But, the conduit that above-mentioned patent documentation is recorded, by 5 corresponding electrodes all indwelling in being impossible apart from the position of ablation line equidistance.
For example, as shown in figure 12, be by being installed on respectively from the front end of catheter main body 80 5 catheter proximal end portions 81 that radiated entends goes out, 82, 83, 84, in 85, 2 front termination electrodes 91 in adjacent catheter proximal end portion 81 and 82, the electrode that 92(is corresponding) indwelling is in the situation of the symmetrical position taking ablation line AL as axle, front termination electrode 95 and 93 is longer than front termination electrode 91 and 92 separately apart from the separating distance of ablation line AL apart from the separating distance of ablation line AL separately, in addition, remaining front termination electrode 94 is positioned on ablation line AL, under these circumstances, can not the measurement for current potential by this front termination electrode 94.
(3) in the conduit of recording at above-mentioned patent documentation, after the electrode that will be used for potential measurement positions with respect to ablation line, by making, the fore-end of catheter main body is bending moves catheter proximal end portion, thereby makes to be used for the electrode of potential measurement and the inwall of heart is close (contact) or moves along ablation line.
For example, by 2 adjacent catheter proximal end portions are configured in the mode of crossing over ablation line, the front termination electrode (corresponding electrode) that is installed on respectively these catheter proximal end portions is positioned to the symmetric position taking ablation line as axle, make afterwards catheter main body bending, make above-mentioned front termination electrode and the inwall of heart be close (contact).
But, in the conduit of recording at above-mentioned patent documentation, owing to making the fore-end bending of catheter main body, therefore exist the position relationship of having adjusted between catheter proximal end portion (will be used for the electrode of potential measurement) and ablation line that the such problem of dislocation occurs.For example, owing to making the fore-end bending of catheter main body, therefore can not maintain 2 catheter proximal end portions and cross over the state (position relationship before bending) of ablation line, the front termination electrode and the ablation line that are close with the inwall of heart depart from significantly.
(4) in the conduit of recording at above-mentioned patent documentation, in the case of the bending direction of the fore-end of catheter main body is consistent with certain extended direction of catheter proximal end portion, in the time that the fore-end that makes catheter main body is bending, be installed on to pressing the inwall of (puncture) heart and damage inwall with the front termination electrode of extended this catheter proximal end portion of the same direction of bending direction.
The present invention makes based on above such situation.
The 1st object of the present invention is to provide the electrode catheter that is separately installed with multiple electrodes in multiple catheter proximal end portion, and it is the electrode that is installed on which position of which catheter proximal end portion that this electrode catheter can easily rest in specific electrode on X ray image.
The 2nd object of the present invention is to provide the electrode catheter that is separately installed with electrode in the extended multiple catheter proximal end of the front end from catheter main body portion, and this electrode catheter can all be retained in corresponding electrode apart from the position of ablation line equidistance.
Even if the 3rd object of the present invention is to provide the fore-end bending of catheter main body, also can maintain adjust before this bending, catheter proximal end portion for example, with respect to the configuration status (state of ablation line is crossed over by 2 catheter proximal end portions) of ablation line, electrode for example, electrode catheter with respect to the position relationship of ablation line (2 counter electrodes relation in the symmetric position taking ablation line as axle).
Even if the 4th object of the present invention is to provide the fore-end bending that makes catheter main body, the front termination electrode that is installed on catheter proximal end portion also can not damage the electrode catheter of wall of the heart.
For solving 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 interval from the front end of above-mentioned catheter main body; Ring electrode, it is provided with multiple in each above-mentioned catheter proximal end portion,
Be installed on the 1st catheter proximal end portion 1 ring electrode electrode width and to be installed on the electrode width of 1 ring electrode of the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end radical limit different with the electrode width of other ring electrodes (" electrode widths of other ring electrodes " are mutually the same)
The allocation position of electrode width above-mentioned 2 ring electrodes different from other ring electrodes in the catheter proximal end portion that these 2 ring electrodes are installed differs from one another.
Employing has the electrode catheter of the 1st technical scheme of such structure, by finding electrode width 2 ring electrodes different from other ring electrodes on X ray image, can identify the catheter proximal end portion that these 2 ring electrodes are installed to be respectively the 1st catheter proximal end portion and the 2nd catheter proximal end portion.
In addition, electrode width 2 ring electrodes different from other ring electrodes differ from one another at the allocation position being provided 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 identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion on X ray image, other catheter proximal end portions on X ray image of identifying for example, for which catheter proximal end portion (number of catheter proximal end portion is the 3rd catheter proximal end portion, the 4th catheter proximal end portion in the situation of 4).
In addition, can be on X ray image easily grasp the ring electrode that is installed on each catheter proximal end portion allocation position (be installed on from front end which electrode).
As a result, all ring electrodes that can easily grasp on 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 forming, preferably the electrode width of ring electrode of the 2nd from front electrode width and the 2nd catheter proximal end portion of ring electrode of the 1st from front in the 1st catheter proximal end portion is wider 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 by finding the wider ring electrode of electrode width that is positioned at the 1st from front on X ray image, can identify the catheter proximal end portion that this ring electrode is installed.In addition, be the 2nd catheter proximal end portion by finding the wider ring electrode of electrode width that is positioned at the 2nd 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 forming preferably has 4 catheter proximal end portions.
4 ring electrodes (corresponding ring electrode) that are installed on same position (being for example 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 (thering is the electrode catheter of 4 catheter proximal end portions) of the 1st technical scheme on foursquare summit, for example, the in the situation that of whether burning reliably after confirmation ablation, can easily 4 corresponding ring electrodes be disposed at apart from the position of ablation line equidistance.
If for example 2 ring electrodes in 4 corresponding ring electrodes, that be installed on adjacent catheter proximal end portion are positioned to the mode indwelling of their intermediate point with ablation line, all the other 2 ring electrodes also can be positioned to the mode indwelling of their intermediate point with ablation line.
(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 interval from the front end of above-mentioned catheter main body; Front termination electrode, it is installed on each above-mentioned catheter proximal end portion; Ring electrode, it at least installs 1 in each above-mentioned catheter proximal end portion,
The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other front 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 radical limit is different with 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 by finding the different front termination electrode of the front termination electrode of electrode width and other on X ray image, can identify the catheter proximal end portion that this front termination electrode is installed.
In addition, be the 2nd catheter proximal end portion by finding the electrode width ring electrode different from other ring electrodes on X ray image, can identify the catheter proximal end portion that this ring electrode is installed.
If can identify the 1st catheter proximal end portion and the 2nd catheter proximal end portion on X ray image, which catheter proximal end portion other catheter proximal end portions that can identify on X ray image are.
In addition, can be on X ray image easily grasp and be installed on the front termination electrode of each catheter proximal end portion and the allocation position of ring electrode.
As a result, can easily grasp all electrodes (front termination electrode and ring electrode) on X ray image and be installed on which allocation position of which catheter proximal end portion.
(5) in the electrode catheter of the 1st technical scheme of above-mentioned such structure, be preferably, the electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wider 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 by finding the electrode width front termination electrode wider than other front termination electrodes on X ray image, can identify the catheter proximal end portion that this front termination electrode is installed.In addition, be the 2nd catheter proximal end portion by finding the electrode width ring electrode wider than other ring electrodes, can identify the catheter proximal end portion that this ring electrode is installed.
(6) electrode catheter of above-mentioned such the 1st technical scheme forming preferably has 4 catheter proximal end portions.
For example, lay respectively at foursquare summit at 4 corresponding 4 electrodes (termination electrode before) of catheter proximal end portion.
Adopt corresponding electrode to lay respectively at the electrode catheter (thering is the electrode catheter of 4 catheter proximal end portions) of the 1st technical scheme on foursquare summit, for example, the in the situation that of being confirmed whether to burn reliably after ablation, can easily 4 corresponding electrodes be configured in apart from the position of ablation line equidistance.
If for example 2 front termination electrodes in 4 front termination electrodes, that be installed on adjacent catheter proximal end portion are positioned to the mode indwelling of their intermediate point with ablation line, also remaining 2 front termination electrode can be positioned to the mode indwelling of their intermediate point with ablation line.
(7), in the electrode catheter of the 1st technical scheme, be preferably and there is the fore-end that can make above-mentioned catheter main body (Bidirectional Control) deflection mechanism (oscillating mechanism) to both direction bending (deflection) centered by the axis of this catheter main body.
Around the inwall of heart, particularly valve, have the more filum that is known as tendon, be wound in this tendon for fear of catheter proximal end portion etc., the catheter main body preferably inserting 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 being partial to mechanism as described above, for example, in the case of 180 ° of fore-end deflections that make catheter main body, do not need catheter main body is rotated around axis yet, therefore, have and only can make catheter main body to compared with the electrode catheter of the mechanism of one direction deflection with (needing in these cases catheter main body is rotated around axis), 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 interval from the axis of this catheter main body of front end edge of above-mentioned catheter main body;
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 to the binary direction bending in 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 (for example, before termination electrode) 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 (thering is the electrode catheter of 4 catheter proximal end portions) of the 2nd technical scheme on foursquare summit, can be by 4 counter electrode indwellings in the position apart from ablation line equidistance.
For example, by using 2 front termination electrode indwellings in 4 front termination electrodes of counter electrode, that be installed on adjacent catheter proximal end portion in the symmetrical position taking ablation line as axis, also can be by remaining 2 front termination electrode indwellings in the symmetrical position taking ablation line as axis.As a result, can be easily by 4 front termination electrode indwellings in the position apart from ablation line equidistance.
The deflection mechanism that forms the electrode catheter of the 2nd technical scheme makes the fore-end of catheter main body to the binary direction bending in angle that 2 adjacent catheter proximal end portions are become.
, utilize deflection mechanism to make direction (plane of the track that comprises this bisecting line) that the bisecting line at the angle that the direction (plane of the track that comprises bending fore-end) of the fore-end bending of catheter main body becomes with 2 adjacent catheter proximal end portions moves unanimously.
Adopt this deflection mechanism, can maintain adjacent catheter proximal end portion and cross over the state of ablation line (counter electrode that is installed on each catheter proximal end portion is the relation in symmetric position taking ablation line as axis) and make the electrode that will be used for potential measurement be close with wall of the heart (contact) or move along ablation line.
(9) in the electrode catheter of the 2nd technical scheme, above-mentioned deflection mechanism be preferably the fore-end that makes above-mentioned catheter main body centered by the axis of this catheter main body to both direction bending (Bidirectional Control).
Around the inwall of heart, particularly valve, have the more tissue that is known as tendon, be wound in this tendon for fear of catheter proximal end portion etc., the catheter main body that preferably makes to insert in the chambers of the heart does not rotate around axis as far as possible.
So, employing has the electrode catheter of the 2nd technical scheme of being partial to mechanism as described above, for example, in the situation that making catheter proximal end portion be partial to 180 °, do not need catheter main body is rotated around axis, therefore, (needing in these cases catheter main body is rotated around axis) only can make catheter main body to compared with the electrode catheter of the mechanism of one direction deflection with having, and is difficult for being wound in 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 provided with.
(11) in addition, be preferably, in the 1st catheter proximal end portion from front the 1st ring electrode electrode width and to be positioned at the electrode width of ring electrode of the 2nd from front the 2nd catheter proximal end portion on the 1st catheter proximal end radical limit wider than the electrode width of other ring electrodes.
Employing has the electrode catheter of the 2nd technical scheme of such structure, be the 1st catheter proximal end portion by finding the wider ring electrode of electrode width that is positioned at the 1st from front on X ray image, can identify the catheter proximal end portion that this ring electrode is installed.In addition, be the 2nd catheter proximal end portion by finding the wider ring electrode of electrode width that is positioned at the 2nd 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, can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end radical limit is the 3rd catheter proximal end portion, and to identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end radical limit be the 4th catheter proximal end portion.In addition, can be on X ray image easily grasp the ring electrode that is installed on each catheter proximal end portion allocation position (be from front end, be installed on which electrode).Thus, all ring electrodes that can easily grasp on 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 front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front termination electrodes, and the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wider 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 by finding the electrode width front termination electrode wider than other front termination electrodes on X ray image, can identify the catheter proximal end portion that this front termination electrode is installed.In addition, be the 2nd catheter proximal end portion by finding the electrode width ring electrode wider than other ring electrodes, 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, can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end radical limit is the 3rd catheter proximal end portion, and to identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end radical limit be the 4th catheter proximal end portion.In addition, can be on X ray image easily grasp and be installed on the front termination electrode of each catheter proximal end portion and the allocation position of ring electrode.Thus, all electrodes (front termination electrode and ring electrode) that can easily grasp on X ray image are the electrodes that is installed on which allocation position of which catheter proximal end portion.
Invention effect
Adopt the electrode catheter of the 1st technical scheme, can easily rest in specific electrode on X ray image is the electrode that is installed on which position of which catheter proximal end portion.
Adopt the electrode catheter of the 2nd technical scheme, can be by 4 counter electrode indwellings that are installed on respectively 4 catheter proximal end portions in the position apart from ablation line equidistance.
In addition, even if make the fore-end bending of catheter main body, also can maintain adjust before this bending, catheter proximal end portion for example, with respect to the configuration status (state of ablation line is crossed over by 2 catheter proximal end portions) of ablation line, electrode for example, with respect to the position relationship of ablation line (2 counter electrodes relation in the symmetric position taking ablation line as axis).Therefore, maintain catheter proximal end portion with respect to the configuration of ablation line, electrode with respect to the position relationship of ablation line and the electrode that makes to be installed on each catheter proximal end portion be close (contact) or move along ablation line with the inwall of heart.
And in the time that the fore-end that makes catheter main body is bending, the front termination electrode that is installed on catheter proximal end portion can not damage the inwall of heart.
Brief description of the drawings
Fig. 1 is the general principal view of the electrode catheter of one embodiment of the present invention.
Fig. 2 is the side view (I-I of Fig. 1 is to view) of the electrode catheter shown in Fig. 1.
Fig. 3 is the profile (the II-II profile of Fig. 2) of the leading section office of the electrode catheter shown in Fig. 1.
Fig. 4 is the profile (the III-III profile of Fig. 2) of the leading section office of the electrode catheter shown in Fig. 1.
Fig. 5 is the profile (the IV-IV profile of Fig. 1) of the leading section office of the electrode catheter shown in Fig. 1.
Fig. 6 is the skeleton diagram of the using state of the electrode catheter shown in presentation graphs 1.
Fig. 7 is top view and the side view of the using state (the unbent state of fore-end of catheter main body) of the electrode catheter shown in presentation graphs 1.
Fig. 8 is top view and the side view of the using state (state of the fore-end bending of catheter main body) of the electrode catheter shown in presentation graphs 1.
Fig. 9 is the side view of the electrode catheter of another embodiment of the present invention.
Figure 10 is the side view that represents the variation of electrode catheter of the present invention.
Figure 11 is the summary side elevation that represents the using state of the electrode catheter of comparative example.
Figure 12 is the approximate vertical view that represents the using state of electrode catheter in the past.
Detailed description of the invention
< the 1st embodiment >
The electrode catheter 1 of this embodiment is for example for 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 front termination electrode 41a of each catheter proximal end portion, 42a, 43a, 44a, in each catheter proximal end portion, 8 ring electrode 41B41c of 2 are installed respectively, 42b42C, 43b43c, 44b44c, make the fore-end of catheter main body 10 to the bending 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, the length of catheter main body 10 is illustrated shortlyer, but in fact the Z-direction length of the Length Ratio joystick 20 of catheter main body 10 is grown several times ~ tens times left and right.
The pipe component 11 that forms catheter main body 10 at least has 1 endoporus (inner chamber).In the inner chamber of pipe component 11, be through with the wire (omitting diagram) being connected with front termination electrode and ring electrode, the pulling line (representing with Reference numeral 51,52) that forms the deflection mechanism (oscillating mechanism) of catheter proximal end portion in Fig. 4.
Pipe component 11 also can be made up of the material of identical characteristics vertically, but preferably uses the different material of rigidity (hardness) vertically to form.Particularly, preferably the distolateral constituent material of peri position has relatively high rigidity, and the distolateral constituent material of amphi position has relatively low rigidity.
Pipe component 11 is for example by polyolefin, polyamide, polyethers polyamide, polyurethane, nylon, PEBAX(polyether block amide) etc. synthetic resin form.In addition, the peri position of pipe component 11 is distolateral can be also that the effective stainless steel wire being made up of these synthetic resin is organized into groups to the braided tube forming.
Preferably 1.0 ~ 3.0mm of the external diameter of pipe component 11, is more preferably 1.6 ~ 2.7mm.
Preferably 600 ~ 1500mm of the length of pipe component 11, is more preferably 900 ~ 1200mm.
As shown in Figure 3, forming the front end components 12 of catheter main body 10 forms the cylindric part 121 in the inner chamber that is inserted into pipe component 11 and has the retaining part 122 for 4 pores of each cardinal extremity partial insertion of 4 catheter proximal end portions (31,32,33,34).
Front end components 12 can be made up of the material identical with pipe component 11, for example PEBAX.
Front end components 12(retaining part 122) external diameter preferably identical with the external diameter of pipe component 11.
Front end components 12(retaining part 122) preferably 2 ~ 60mm of length, be more preferably 5 ~ 10mm.
Joystick 20 and catheter main body 10(pipe component 11) cardinal extremity be connected.In Fig. 1, Reference numeral 21 is handle parts, and Reference numeral 22 is the swivel plates that form 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 1st the 31, the 2nd the 32, the 3rd the 33, the 4th catheter proximal end portion 34 of catheter proximal end portion of catheter proximal end portion of catheter proximal end portion).
As shown in Figure 2,4 catheter proximal end portions are from catheter main body 10(front end components 12) being circumferentially radiated entends with actual equal angles interval (seeing it is approximately 90 ° of intervals in the side shown in this figure) and going out of axis of front end edge catheter main body 10.
4 catheter proximal end portions respectively the axle of conductive pipe main body 10 radially foreign side bendingly forward end direction extend.
The external diameter of catheter proximal end portion (from the extended part of front end components 12) 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 the extended part of front end components 12) is preferably 5 ~ 50mm, more preferably 10 ~ 30mm.
As shown in Fig. 3 and Fig. 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, the core component 311 that forms the 1st catheter proximal end portion 31 extends along the endoporus of cage walls 312, and its leading section is fixed with the state of imbedding front termination electrode 41a.
In addition, the core component 331 that forms the 3rd catheter proximal end portion 33 extends along the endoporus of cage walls 332, and its leading section is fixed with the state of imbedding front termination electrode 43a.
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 (being for example deformed into linearity) by applying power, but will revert to remembered shape (Fig. 1 ~ expansion shape) as shown in Figure 4 when the power of removal.
As the constituent material of core component, can enumerate Ni-Ti alloy.Ni in 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 and is formed on front end components 12(retaining part 122) on pore in, 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 respectively catheter main body 10(front end components 12).
In catheter proximal end portion (the 1st the 31, the 2nd the 32, the 3rd the 33, the 4th catheter proximal end portion 34 of catheter proximal end portion of catheter proximal end portion of catheter proximal end portion), be separately installed with front termination electrode 41a, 42a, 43a, 44a and distinguish ring electrode 41B41c, 42b42C, 43b43c, the 44b44c of 2.
The wire (omitting diagram) being connected with front termination electrode and ring electrode runs through the endoporus of catheter proximal end portion (cage walls) and the inner chamber of catheter main body 10 with the state of insulation respectively.
Front termination electrode and ring electrode are made up of aluminum, copper, rustless steel, gold, platinum, iridium or their alloy etc., the good metal of electric conductivity.The external diameter of front termination electrode and ring electrode is not particularly limited, but preferably identical with the external diameter of catheter proximal end portion.
As shown in Figure 2, form electrode width (length of tube axial direction) in 8 ring electrode 41B41c, 42b42C, 43b43c, the 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, specifically 1.5 ~ 2.0 times.
At this, the electrode width of the ring electrode beyond ring electrode 41B and 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, by find on X ray image, from front, be arranged in ring electrode 41B, the 42b of the 1st, ring electrode 41B 43b, 44b, that electrode width is wider, 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 identify the 1st catheter proximal end portion 31 on X ray image, front termination electrode and the ring electrode that can identify the 1st catheter proximal end portion 31 that is installed on are respectively front termination electrode 41a and ring electrode 41B41c.
In addition, from front, be arranged in ring electrode 41c, the 42C of the 2nd, ring electrode 42C 43c, 44c, that electrode width is wider by finding on X ray image, 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 identify the 2nd catheter proximal end portion 32 on X ray image, front termination electrode and the ring electrode that can identify the 2nd catheter proximal end portion 32 that is installed on are respectively front termination electrode 42a and ring electrode 42b42C.
In addition, if can identify the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32 on X ray image, can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion 32 sides (side contrary with the 1st catheter proximal end portion 31) is the 3rd catheter proximal end portion 33.
And if can identify the 3rd catheter proximal end portion 33 on X ray image, front termination electrode and the ring electrode that can identify the 3rd catheter proximal end portion 33 that is installed on are respectively front termination electrode 43a and ring electrode 43b43c.
In addition, if can identify the 1st the 31, the 2nd catheter proximal end portion 32 of catheter proximal end portion and the 3rd catheter proximal end portion 33 on X ray image, can identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end portion 33 sides (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 identify the 4th catheter proximal end portion 34 on X ray image, front termination electrode and the ring electrode that can identify the 4th catheter proximal end portion 34 that is installed on are respectively front termination electrode 44a and ring electrode 44b44c.
Which catheter proximal end portion all front termination electrode 41a, 42a, 43a, the 44a that can easily grasp on X ray image as a result, are installed in.
In addition, also can easily grasp all ring electrode 41B 41c, 42b42C, 43b43c, 44b44c on X ray image and be mounted in which allocation position of which catheter proximal end portion.
The electrode catheter 1 of this embodiment has such feature: electrode width 2 ring electrodes (ring electrode 41B and ring electrode 42C) wider than other ring electrodes are installed on the position differing from one another of adjacent catheter proximal end portion (the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32).
1 at the wider ring electrode of electrode width, for example, only in the wider situation of the electrode width of ring electrode 41B, can not on X ray image, identify at once the 2nd catheter proximal end portion 32 and the 4th catheter proximal end portion 34, for example, may think the front termination electrode 42a being reflected on X image by mistake front termination electrode 44a.
Under these circumstances, for example, in the time that the front termination electrode 43a that is installed on the 3rd catheter proximal end portion 33 crosses over the indwelling of ablation line ground with the front termination electrode 42a that is installed on the 2nd catheter proximal end portion 32, think the front termination electrode 42a on X image by mistake front termination electrode 44a, based on be shown on monitor not cross over potential data mistaken diagnosis ablation line, between front termination electrode 43a and front termination electrode 44a be " that expects burns ".
On the other hand, in the electrode catheter 1 of this embodiment, except the electrode width of ring electrode 41B is wider, the electrode width of ring electrode 42C that is installed on the 2nd catheter proximal end portion 32 is also wider, therefore, can identify at once the 2nd catheter proximal end portion 32 and the 4th catheter proximal end portion 34, can not think the front termination electrode 42a being reflected on X ray image by mistake front termination electrode 44a, can avoid reliably occurring mistaken diagnosis as described above.
In addition, the identical position separately that is installed on adjacent catheter proximal end portion at electrode width 2 ring electrodes wider than other ring electrodes, on X ray image, can not identify 2 catheter proximal end portions that the wider ring electrode of electrode width is installed is 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 X ray image be see from the front of conduit or see from the base end side of conduit.
On the other hand, in the electrode catheter 1 of this embodiment, due to be installed on the 1st catheter proximal end portion 31 ring electrode 41B allocation position (as ring electrode from front the 1st) and be installed on the ring electrode 42C of the 2nd catheter proximal end portion 32 installation site (as ring electrode from front the 2nd) differ from one another, therefore, can identify reliably the 1st catheter proximal end portion 31 and the 2nd catheter proximal end portion 32.Thus, can identify at once 4 catheter proximal end portions on X ray image be see from the front of conduit or see from the base end side of conduit.
The electrode catheter 1 of this embodiment has the fore-end that makes catheter main body 10 deflection mechanism (oscillating mechanism) to both direction deflection centered by the axis of catheter main body 10.
This deflection mechanism is the fore-end that makes catheter main body 10 mechanism to the binary direction bending in angle that 2 adjacent catheter proximal end portions are become.
The direction (plane of the track that comprises bending fore-end) of, utilizing this deflection mechanism to make the fore-end bending of catheter main body 10 is bending with the fore-end of following catheter main body 10 and direction (plane of the track that comprises this bisecting line) that the bisecting line at the angle that 2 catheter proximal end portions become moves is consistent.
Utilize such deflection mechanism, the fore-end that can make catheter main body 10 is to by the binary direction in angle of catheter proximal end portion 32 and 33 one-tenth, catheter proximal end portion (direction shown in arrow A in Fig. 1 and Fig. 2) and by the binary direction in angle of catheter proximal end portion 34 and 31 one-tenth, catheter proximal end portion (direction shown in arrow B in Fig. 1 and Fig. 2) bending.
And by making the fore-end of catheter main body 10 to the direction bending shown in arrow A or arrow B, 4 catheter proximal end portions 31,32,33,34 move integratedly to the direction shown in arrow A or arrow B.
As deflection, mechanism is not particularly limited, the mechanism that can enumerate the leaf spring for example with the amphi position end part that is housed in pipe component 11 (omitting diagram), run through 2 swivel plates 22 that pull lines (representing with Reference numeral 51,52) and be connected with 2 pulling lines peri position end separately in Fig. 4 of the inner chamber of pipe component 11 in the table rear side of this leaf spring.
At this, 2 each amphi position ends that pull lines can clip position that leaf spring is relative and be fixed on the inwall of pipe component 11, also can be fixed on the table back side of the flat part at the amphi position end place of leaf spring.
On the other hand, the position being separated from each other that pulls the peri position end of line 51,52 and the swivel plate 22 of joystick 20 is connected, and swivel plate 22 can rotate freely centered by the rotating shaft vertical with the Z axis shown in Fig. 1.
Operator catches the handle part 21 of joystick 20 with a hands, use the finger manipulation swivel plate 22(of another hands to the direction rotation of regulation).Thus, pull the tension variation of line 51,52, the fore-end of catheter main body 10 is to the arrow A in Fig. 1 and Fig. 2 or the direction bending shown in arrow B.
That is, in the time making A1 direction rotation as shown in Figure 1 of swivel plate 22 usual practices, pull line 52 and be stretched, pull line 51 lax.As a result, the fore-end of catheter main body 10 is to by the binary direction in angle (arrow A direction) bending of catheter proximal end portion 32 and 33 one-tenth, catheter proximal end portion, and thus, 4 catheter proximal end portions move integratedly and are partial to arrow A direction.
Similarly, in the time making B1 direction rotation as shown in Figure 1 of swivel plate 22 usual practices, pull line 51 and be stretched, pull line 52 lax.As a result, the fore-end of catheter main body 10 is to by the binary direction in angle (arrow B direction) bending of catheter proximal end portion 34 and 31 one-tenth, catheter proximal end portion, and thus, 4 catheter proximal end portions move integratedly and are partial to arrow B direction.
And, if make joystick 20 around the Z axis rotation shown in Fig. 1, can be under the state being inserted in the chambers of the heart, freely set A direction or B direction with respect to joystick 20 towards.
Represent an example of the using method of the electrode catheter 1 of this embodiment, first, under state (4 catheter proximal end portions are deformed into the state of linearity) in the sheath that electrode catheter 1 is inserted into tubular, make electrode catheter 1 move near of the target site in the chambers of the heart, from sheath, release 4 catheter proximal end portions near of target site, make catheter proximal end portion refresh memory shape (Fig. 1 ~ expansion shape) as shown in Figure 4.
Then, as shown in Fig. 6 (1), make fore-end (the amphi position end part of the pipe component 11) bending of catheter main body 10, so that ablation line AL is positioned at the front termination electrode 42a of the 2nd catheter proximal end portion 32 that is installed on and is installed on this front termination electrode 42a of mode indwelling of intermediate point and this front termination electrode 43a of the front termination electrode 43a of the 3rd catheter proximal end portion 33.
Like this, be installed on 2 ring electrodes of adjacent catheter proximal end portion by indwelling, also can so that ablation line AL be positioned at all the other 2 ring electrodes, be installed on the front termination electrode 41a of the 1st catheter proximal end portion 31 and be installed on this front termination electrode 41a of mode indwelling and this front termination electrode 44a of the intermediate point of the front termination electrode 44a of the 4th catheter proximal end portion 34.As a result, 4 front termination electrode 41a, 42a, 43a, 44a can be disposed at apart from the position of ablation line AL equidistance.
After configuring like this, from any, termination electrode gives electricity irritation (constant speed (pacing)), and carries out potential measurement at other front termination electrode, relatively its transmission speed (detecting the time of current potential), thus can evaluate ablation line AL.
In addition, also can be around catheter main body 10 other electrode catheters of configuration, give electricity irritation (constant speed) from these other electrode catheters, and carry out potential measurement at each front termination electrode, relatively its transmission speed.
By 4 front termination electrodes are disposed at apart from the position of ablation line AL equidistance, if that expects along ablation line AL burns, the transmission speed of the current potential between front termination electrode 42a and front termination electrode 43a and between front termination electrode 41a and front termination electrode 44a (crossing over the transmission speed of the interelectrode current potential of ablation line AL) is slower than the transmission speed (not crossing over the transmission speed of the interelectrode current potential of ablation line AL) of the current potential between front termination electrode 42a and front termination electrode 41a and between front termination electrode 43a and front termination electrode 44a.
And, if burn uniformly along ablation line AL, before the transmission speed of current potential between transmission speed and front termination electrode 41a and the front termination electrode 44a of current potential between termination electrode 42a and front termination electrode 43a equate.
In addition, the ablation line AL shown in Fig. 6 (1) is not presented on X ray image, is conventionally grasped by operator.
As described above, adopting the number of catheter proximal end portion is the electrode catheter 1 of this embodiment of 4, can easily 4 corresponding electrodes (for example, before termination electrode) 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 identify at once the electrode of X ray image 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, be the 1st catheter proximal end portion 31 by finding the wider ring electrode 41B of electrode width that is positioned at the 1st from front, can identify the catheter proximal end portion that this ring electrode lower-left 41B, that be positioned at drawing side is installed.
In addition, be the 2nd catheter proximal end portion 32 by finding the wider ring electrode 42C of electrode width that is positioned at the 2nd 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 Fig. 6 (1), due to the 1st the 31, the 2nd the 32, the 3rd the 33, the 4th catheter proximal end portion 34 of catheter proximal end portion of catheter proximal end portion of catheter proximal end portion " around clockwise " configuration, therefore, can identify at once this X ray image is to see catheter proximal end portion from the base end side of conduit.
On the other hand, on the X ray image of Fig. 6 (2) such state, know at a glance identical with Fig. 6 (1), be conceived to the electrode width of ring electrode, find the wider ring electrode 41B of electrode width that is positioned at the 1st 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 by finding the wider ring electrode 42C of electrode width that is positioned at the 2nd 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 Fig. 6 (2), due to the 1st the 31, the 2nd the 32, the 3rd the 33, the 4th catheter proximal end portion 34 of catheter proximal end portion of catheter proximal end portion of catheter proximal end portion " around counterclockwise " configuration, therefore, can identify at once this X ray image is to see catheter proximal end portion from the front of conduit.
Below, be described more specifically in the example of using method of the electrode catheter 1 of this embodiment, 4 front termination electrode 41a, 42a, 43a, 44a are configured in apart from the method for the position of ablation line AL equidistance.
First, electrode catheter 1 is inserted in the sheath of tubular, under being deformed into the state (state of closing) of linearity, 4 catheter proximal end portions make electrode catheter 1 move near of the target site (forming part of for example ablation line) in the chambers of the heart, near at target site is released 4 catheter proximal end portions from sheath, thereby makes catheter proximal end portion refresh memory shape (Fig. 1 ~ expansion shape) as shown in Figure 4.
, observe X ray image one edge ablation line (abreast) deployment catheter main body 10 on one side below, this catheter main body 10 is rotated around axis, the angle that 2 adjacent catheter proximal end portions become on X ray image is that maximum position stops.
Fig. 7 (1), (2) are top view and the side views that represents state now, are the states that can grasp on X ray image.Under the top view shown in (1) of Fig. 7, ablation line AL is along the binary direction in angle (in bisecting line) of catheter proximal end portion 32 and 33 one-tenth, catheter proximal end portion is extended.
; in the top view shown in (1) of Fig. 7; catheter proximal end portion 32 and catheter proximal end portion 33 be (these catheter proximal end portions are across the state of ablation line) taking ablation line AL as axis shaft symmetry, and front termination electrode 42a and front termination electrode 43a are positioned at the symmetrical position taking ablation line AL as axis.
In addition, as shown in Fig. 7 (2), catheter proximal end portion 31 and catheter proximal end portion 34 are in crossing over the state of ablation line AL, and front termination electrode 41a and front termination electrode 44a are positioned at the symmetrical position taking ablation line AL as axis.
Then, utilize fore-end that deflection mechanism the makes catheter main body 10 inwall side along ablation line AL(to heart) bending.Thus, can maintain the 32(31 of catheter proximal end portion) and the 33(34 of catheter proximal end portion) cross over the state of ablation line AL and the front termination electrode that is installed on respectively these catheter proximal end portions is contacted with the inwall of heart.
For example, make swivel plate 22 to arrow B 1 direction rotation shown in Fig. 1, pull line 51, thereby the fore-end that makes catheter main body 10 is to by the angle binary arrow B direction 90-degree bent of catheter proximal end portion 34 and 31 one-tenth, catheter proximal end portion.
Thus, 4 catheter proximal end portions 31,32,33,34 move to arrow B direction integratedly, as shown in Fig. 8 (1), (2), can make to be installed on respectively front termination electrode 41a, 42a, 43a, the 44a of 4 catheter proximal end portions to contact 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 the direction that forms with ablation line of arrow A direction and arrow B direction is consistent, under this state, make the fore-end 90-degree bent of catheter main body 10, thereby can maintain the 32(31 of catheter proximal end portion) and the 33(34 of catheter proximal end portion) cross over state (front termination electrode 42a(41a) and the front termination electrode 43a(44a of ablation line AL) position relationship in the symmetric position taking ablation line AL as axis) and make 4 catheter proximal end portions 31, 32, 33, 34 move integratedly, make to be installed on respectively 4 front termination electrode 41a of these catheter proximal end portions, 42a, 43a, 44a contacts or moves along ablation line with the inwall of heart.
In addition, the ablation line AL shown in Fig. 7 and Fig. 8 is not presented on X ray image conventionally, is conventionally grasped by operator.
As shown in Fig. 8 (1), after the fore-end bending of catheter main body 10,4 front termination electrode 41a, 42a, 43a, 44a are configured in apart from the position of ablation line AL equidistance.
From configuration in this wise termination electrode wherein wantonly 1 give electricity irritation (constant speed), and carry out potential measurement at other front termination electrode, relatively its transmission speed (detecting the time of current potential), thereby can evaluate ablation line AL.
In addition, also can be around catheter main body 10 other electrode catheters of configuration, give electricity irritation (constant speed) from these other electrode catheters, and carry out potential measurement at each front termination electrode, relatively its transmission speed.
By 4 front termination electrodes are configured in apart from the position of ablation line AL equidistance, if that can expect along ablation line AL burns, the transmission speed of the current potential between front termination electrode 42a and front termination electrode 43a and between front termination electrode 41a and front termination electrode 44a (crossing over the transmission speed of the interelectrode current potential of ablation line AL) is slower than the transmission speed (not crossing over the transmission speed of the interelectrode current potential of ablation line AL) of the current potential between front termination electrode 42a and front termination electrode 41a and between front termination electrode 43a and front termination electrode 44a.
And, if burn uniformly along ablation line AL, before the transmission speed of current potential between transmission speed and front termination electrode 41a and the front termination electrode 44a of current potential between termination electrode 42a and front termination electrode 43a equate.
As shown in figure 11, adopt in the case of replacing the deflection mechanism of the electrode catheter that forms the present invention's (the 2nd technical scheme) the deflection mechanism that makes the fore-end conductive pipe leading section 633 of catheter main body 610 and the bearing of trend of catheter proximal end portion 631 (direction shown in arrow a and arrow b) bending, even as shown in this Figure 11 (1) by the 632(631 of catheter proximal end portion) and the 633(634 of catheter proximal end portion) be configured to taking ablation line AL as axis shaft symmetry (states that ablation line are crossed over by these catheter proximal end portions), by making the fore-end of catheter main body 610 to for example b direction bending, as shown in this Figure 11 (2), can not maintain the 632(631 of catheter proximal end portion) and the 633(634 of catheter proximal end portion) state (position relationship before bending) of ablation line crossed over, the front termination electrode 641a being close with the inwall of heart, 642a, 643a, 644a departs from significantly from ablation line AL.
In addition, in the time utilizing deflection as described above mechanism to make the fore-end of catheter main body 610 bending along ablation line AL, catheter proximal end portion 633 and 631 moves along ablation line AL, the front termination electrode 643a and the 641a that are installed on these catheter proximal end portions move on ablation line AL, therefore, can not be by these front termination electrodes 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 Fig. 2) is also identical.
; the electrode catheter 1 that adopts this embodiment, can maintain ring electrode 42b(41B) with ring electrode 43b(44b) position relationship in the symmetric position taking ablation line AL as axis make 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 10,4 ring electrode 41B, 42b, 43b, 44b as counter electrode can be configured in apart from the position of ablation line AL equidistance.
In addition, the electrode catheter 1 that adopts this embodiment, can maintain ring electrode 42C(41c) with ring electrode 43c(44c) position relationship in the symmetric position taking ablation line AL as axis make 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 10,4 ring electrode 41c, 42C, 43c, 44c as counter electrode can be configured in apart from the position of ablation line AL equidistance.
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 bending direction of the fore-end bending of catheter main body 10, therefore, power while making the fore-end of catheter main body 10 bending is not concentrated in wherein 1 catheter proximal end portion, owing to being installed on the front termination electrode of catheter proximal end portion, to press the power of inwall of heart minimum, therefore, can not damage inwall.
< the 2nd embodiment >
Electrode catheter 2 shown in Fig. 9 has from catheter main body 10(front end components 12) front end taking equal angles (when the side-looking as approximately 90 °) interval be 4 catheter proximal end portions (36,37,38,39) that radiated entends goes out, be respectively installed on these catheter proximal end portions termination electrode (46A, 47a, 48a, 49a), in each catheter proximal end portion, 8 ring electrodes (46b46c, 47B47c, 48b48c, 49b49c) of 2 are installed respectively.
As shown in Figure 9, the electrode width of front termination electrode 46A in 4 front 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 front termination electrodes, is particularly 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, is particularly 1.5 ~ 2.0 times.
Adopting the electrode catheter 2 forming like this, is the 1st catheter proximal end portion 36 by finding the wider front termination electrode 46A of electrode width on X ray image, can identify the catheter proximal end portion that this front termination electrode 46A is installed.
And if can identify the 1st catheter proximal end portion 36 on X ray image, the ring electrode that can identify the 1st catheter proximal end portion 36 that is installed on is respectively ring electrode 46b, ring electrode 46c.
In addition, be the 2nd catheter proximal end portion 37 by finding the wider ring electrode 47B of electrode width on X ray image, can identify the catheter proximal end portion that this ring electrode 47B is installed.
And if can identify the 2nd catheter proximal end portion 37 on X ray image, front termination electrode and the ring electrode that can identify the 2nd catheter proximal end portion 37 that is installed on are respectively front termination electrode 47a and ring electrode 47B47c.
In addition, if can identify the 1st catheter proximal end portion 36 and the 2nd catheter proximal end portion 37 on X ray image, can identify the catheter proximal end portion that is positioned at the 2nd catheter proximal end portion 37 sides (side contrary with the 1st catheter proximal end portion 36) is the 3rd catheter proximal end portion 38.
And if can identify the 3rd catheter proximal end portion 38 on X ray image, front termination electrode and the ring electrode that can identify the 3rd catheter proximal end portion 38 that is installed on are respectively front termination electrode 48a and ring electrode 48b48c.
In addition, if can identify the 1st the 36, the 2nd catheter proximal end portion 37 of catheter proximal end portion and the 3rd catheter proximal end portion 38 on X ray image, can identify the catheter proximal end portion that is positioned at the 3rd catheter proximal end portion 38 sides (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 identify the 4th catheter proximal end portion 39 on X ray image, front termination electrode and the ring electrode that can identify the 4th catheter proximal end portion 39 that is installed on are respectively front termination electrode 49a and ring electrode 49b49c.
As a result, which catheter proximal end portion all front termination electrodes (46A, 47a, 48a, 49a) that can easily grasp on X ray image are installed on.
In addition, also can easily grasp all ring electrodes (46b46c, 47B47c, 48b48c, 49b49c) on X ray image and be installed on which allocation position of which catheter proximal end portion.
Above, embodiments of the present invention have been described, but the present invention is not limited to this, can carries out as shown below 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, can be also more than 3.In addition, in the case of as shown in the 2nd embodiment, be installed on the electrode width of front termination electrode of the 1st catheter proximal end portion wider than the electrode width of other front termination electrodes, 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), not being defined as 4 from the quantity of the extended catheter proximal end of the front end portion of catheter main body, can being 3, can be also more than 5.
At this, electrode catheter shown in Figure 10 (1) has from catheter main body 10(front end components 12) front end be taking equal angles (when the side-looking as approximately 120 °) interval 3 catheter proximal end portions (131 that radiated entends goes out, 132, 133), be installed on respectively the front termination electrode (141a of these catheter proximal end portions, 142a, 143a), in each catheter proximal end portion, 6 ring electrode (141B141c of 2 are installed respectively, 142b142C, 143b143c), the ring electrode 142C that is installed on the ring electrode 141B of the 1st catheter proximal end portion 131 and be installed on the 2nd catheter proximal end portion 132 is the present invention's (1st technical scheme) wider than the electrode width of other ring electrodes electrode catheter.
In addition, electrode catheter shown in Figure 10 (2) has from catheter main body 10(front end components 12) front end be taking equal angles (when the side-looking as approximately 72 °) interval 5 catheter proximal end portions (231 that radiated entends goes out, 232, 233, 234, 235), be installed on respectively the front termination electrode (241a of these catheter proximal end portions, 242a, 243a, 244a, 245a), in each catheter proximal end portion, 10 ring electrode (241B241c of 2 are installed respectively, 242b242C, 243b243c, 244b244c, 245b245c), the ring electrode 242C that is installed on the ring electrode 241B of the 1st catheter proximal end portion 231 and be installed on the 2nd catheter proximal end portion 232 is the present invention's (1st technical scheme) wider than the electrode width of other ring electrodes electrode catheter.
In the electrode catheter shown in (1) ~ (2) of Figure 10, which catheter proximal end portion all electrodes (front termination electrode and ring electrode) that also can easily grasp on 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, can be also more than 3.In addition, the electrode width of all ring electrodes also can be identical.
Electrode catheter of the present invention can not only be confirmed, after ablation, can also be used for various diagnosis or treatment.For example, can measure the current potential taking the length of catheter proximal end portion as the round inner region of radius simultaneously, therefore, can be preferably for mapping catheter (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 41a, 41B41c ring electrode, termination electrode before 42a, 42b42C ring electrode, termination electrode before 43a, 43b43c ring electrode, termination electrode before 44a, 44b44c ring electrode.

Claims (13)

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 interval from the front end of above-mentioned catheter main body; Ring electrode, it is provided with multiple 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 radical limit,
The allocation position of electrode width above-mentioned 2 ring electrodes different from other ring electrodes in the catheter proximal end portion that these 2 ring electrodes are installed differs from one another.
2. electrode catheter according to claim 1, is characterized in that,
The electrode width of ring electrode of the 2nd from front electrode width and the 2nd catheter proximal end portion of ring electrode of the 1st from front in the 1st catheter proximal end portion is wider 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. according to the electrode catheter described in any one in claim 1～3, it is characterized in that,
This electrode catheter has the fore-end that can make above-mentioned catheter main body deflection mechanism to both direction bending centered by the axis of this catheter main body.
5. 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 interval from the front end of above-mentioned catheter main body; Front termination electrode, it is installed on each above-mentioned catheter proximal end portion; Ring electrode, it at least installs 1 in each above-mentioned catheter proximal end portion;
The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other front 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 radical limit is different with the electrode width of other ring electrodes.
6. electrode catheter according to claim 5, is characterized in that,
The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front termination electrodes,
The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wider than the electrode width of other ring electrodes.
7. electrode catheter according to claim 6, is characterized in that,
This electrode catheter has 4 catheter proximal end portions.
8. according to the electrode catheter described in any one in claim 5～7, it is characterized in that,
This electrode catheter has the fore-end that can make above-mentioned catheter main body deflection mechanism to both direction bending centered by the axis of this catheter main body.
9. 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 interval from the axis of this catheter main body of front end edge of above-mentioned catheter main body;
Deflection mechanism, it makes the fore-end of above-mentioned catheter main body to the binary direction bending in angle that 2 adjacent catheter proximal end portions are become;
Ring electrode, it is provided with multiple 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 radical limit,
The allocation position of electrode width above-mentioned 2 ring electrodes different from other ring electrodes in the catheter proximal end portion that these 2 ring electrodes are installed differs from one another.
10. electrode catheter according to claim 9, is characterized in that,
The fore-end that above-mentioned deflection mechanism makes above-mentioned catheter main body centered by the axis of this catheter main body to both direction bending.
11. according to the electrode catheter described in claim 9 or 10, it is characterized in that,
Termination electrode before each above-mentioned catheter proximal end portion is provided with.
12. according to the electrode catheter described in claim 9 or 10, it is characterized in that, in the 1st catheter proximal end portion from front the 1st ring electrode electrode width and to be positioned at the electrode width of ring electrode of the 2nd from front the 2nd catheter proximal end portion on the 1st catheter proximal end radical limit wider than the electrode width of other ring electrodes.
13. electrode catheters according to claim 11, is characterized in that,
The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front 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 radical limit is wider 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
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JP2010012643A JP5265589B2 (en) 2010-01-23 2010-01-23 Electrode catheter
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US10624554B2 (en) * 2016-01-14 2020-04-21 Biosense Webster (Israel) Ltd. Non-overlapping loop-type or spline-type catheter to determine activation source direction and activation source type

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