CN106362292A - Dual-purpose catheter used for intracardial mapping and defibrillation - Google Patents
Dual-purpose catheter used for intracardial mapping and defibrillation Download PDFInfo
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- CN106362292A CN106362292A CN201510520833.5A CN201510520833A CN106362292A CN 106362292 A CN106362292 A CN 106362292A CN 201510520833 A CN201510520833 A CN 201510520833A CN 106362292 A CN106362292 A CN 106362292A
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Abstract
The invention provides a dual-purpose catheter used for intracardial mapping and defibrillation. The dual-purpose catheter comprises a hollow insulated conduit, first electrode groups, second electrodes, a group of leads, insulated safety wires and wire splitting connectors, wherein terminal electrode groups are arranged at one end of the hollow insulated conduit; the terminal electrode groups are composed of terminal electrodes and ring electrodes arranged at intervals; the first electrode groups and the terminal electrode groups are arranged at intervals, and the first electrode groups are composed of one group of ring electrodes arranged at intervals; the second electrode groups and the first electrode groups are arranged at intervals, and the second electrode groups are composed of another group of ring electrodes arranged at intervals; the group of leads is arranged in the hollow insulated conduit, the leads are respectively connected with the corresponding terminal electrodes or ring electrodes in the terminal electrode groups, the first electrode groups and the second electrode groups; the leads are insulated; the insulated safety wires are detachably arranged in the insulated conduit; the safety wires are arranged in the insulated conduit; the group of leads and the safety wires are branched through the wire splitting connectors, and connectors are formed; and the safety wires are branched by the wire splitting connectors, and the connectors of the safety wires are formed.
Description
Technical field
The invention belongs to intracardiac catheter field, espespecially a kind of chambers of the heart internal standard for endocardiac defibrillation, ablation detection
Survey, defibrillation double-purpose conduit.
Background technology
In all of tachycardia Radiofrequency catheter ablation, greatly exist atrial fibrillation (room
Quiver) the scene turn demand for normal sinus rhythm again.And in ablation of atrial fibrillation, this demand is not just portion
Point, but most even 100% all has this demand.And current, realize this purpose in conduit room
Conventional method is through thorax external defibrillation.This kind of mode needs first to paste defibrillation electrode outside patient's thorax
Plate, because electric current need to through the different histoorgan of other density, the impedance such as thorax, chest rib, lung tissue,
Thus generally needing very high energy (200-360j), this stimulates injury very big it is necessary to first allow patient town to human body
Quiet anesthesia could be implemented when entering deep sleep state, is therefore also necessary for having enforcement tracheal intubation and cardiopulmonary extensive
The conduit room of reactivation power is carried out.Even if so, due to by defibrillation electrode sites, sufferer body weight, thorax
Size, the impact of breast pulmonary disease, electrode slice and skin exposure level, defibrillation energy etc., a defibrillation
Success rate is not relatively still high, and repeatedly external high power defibrillation is very big to the damage of sufferer.For this reason, more closely
The method that year introduces intracardiac defibrillation.Intracavity defibrillation is close to cardiac muscle because of conduit and can be significantly reduced defibrillation energy, only
Need the biphase current of 5-10j, be therefore not usually required to sedation anesthesia.This not only largely overcomes to removing
The restriction quivered, the crucial repeatedly painless defibrillation that can achieve same patient, this is to the following one-tenth improving atrial fibrillation ablation
The power ablation of atrial fibrillation formula new with discovery is significant.
And current intracardiac defibrillation technology needs two defibrillation catheters respectively from superior vena cava and postcava
It is respectively fed to coronary sinus vein and high right atrium.Both can be greatly as realized intracardiac defibrillation with two electrodes
Increase the financial burden of sufferer, also can limit popularizing of this technology.Need through internal jugular vein simultaneously and
At femoral vein two, vascular puncture sends into these defibrillation catheters, and not only the veins that take also easily increase vascular complication more
Probability.
For overcoming disadvantages mentioned above, in prior art, provide a kind of single intracavity defibrillation catheter, Chinese patent Shen
Please number be " 200980134297.8 ", but it has the critical defect of the cardiac muscular tissue that cannot recline well.
This is due to single defibrillation catheter, has both needed it to have certain hardness, to facilitate feeding coronary sinus vein,
And play certain supporting role.Need conduit to have suitable pliability could be fine with cardiac muscular tissue simultaneously again
Recline, otherwise conduit can hovering do not realize low-power defibrillation in the chambers of the heart.But existing both this
Can not meet under design simultaneously.So formerly in patent, its hardness is from its front towards base end side periodically
Gradual change is high, and leads to its front end hardness relatively low and cannot efficiently send into coronary sinus vein, needs doctor repeatedly to grasp
Make just to be sent to coronary sinus vein, cause the growth of operating time, operation inconvenience, and its rear end hardness
Again higher lead to it cannot recline well in right atrium, lead to conduit vacantly to remove it is impossible to realize low-power
Quiver and mapping.
For this reason, present inventor designs and a can meet supporting degree and the intracavity defibrillation list of pliability is led simultaneously
Pipe.
Content of the invention
It is an object of the invention to provide one kind is applied to endocardiac defibrillation conduit, it enters the right heart by postcava
Room and coronary sinus vein, it enables endocardiac defibrillation by the mapping that a conduit can meet intracardiac current potential again
Treatment.
For achieving the above object, the present invention employs the following technical solutions:
Mapping, defibrillation double-purpose conduit in a kind of chambers of the heart, it comprises:
The insulated conduit of hollow, one end of this insulated conduit is provided with termination electrode group；This termination electrode group is by termination electrode
With ring electrode interval setting composition；
First electrode group, with this termination electrode group's interval setting, is made up of one group of ring electrode interval setting；
Second electrode group, with this first electrode group's interval setting, is made up of another group of ring electrode interval setting；
One group of wire, is arranged in this insulated conduit of hollow, and respectively this wire connects this end electricity corresponding respectively
Pole group, first electrode group, the termination electrode in second electrode group or ring electrode；Respectively this wire insulation；
Safety line, this safety line is arranged in this insulated conduit, is connected with the front end of this insulated conduit；
Branch joint, this group wire and this safety line tap out union joint by this branch joint；This safety line by
This branch joint taps out safe wire terminal；
Wherein, described first electrode group and the described insulated conduit of described second electrode group's compartment are to support
Section, in the described chambers of the heart, mapping, defibrillation double-purpose catheter tube are in described first electrode group, described termination electrode group institute
The hardness in place region and mapping, defibrillation double-purpose catheter tube in the described chambers of the heart are in area residing for described second electrode group
The hardness in domain is less than the hardness of this supporting section.The length of described supporting section is 40～60mm；Described separated time connects
It is provided with, in head, the deviation mechanism deflecting this insulated conduit front end by safety line.
In a preferred embodiment, in the described chambers of the heart mapping, defibrillation double-purpose catheter tube in described first electrode
Group, the hardness in region residing for described termination electrode group are 40 ± 2d, and in the described chambers of the heart, mapping, defibrillation double-purpose are led
The hardness in region residing for described second electrode group for the pipe pipe shaft is 55 ± 2d, and the hardness of described supporting section is 72
±2d.
In a preferred embodiment, it is provided with wire netting in the tube wall of insulated conduit of described support fragment position.
In a preferred embodiment, described first electrode group comprises 5 to 9 ring electrodes, described second electrode
Group comprises 4 to 9 ring electrodes, and described termination electrode group comprises a ring electrode.
In a preferred embodiment, the width of described termination electrode is 1～4mm, the ring in described termination electrode group
The width of electrode is 0.5mm～2mm, the ring electrode in described first electrode group and described second electrode group
Width is 2～5mm, and respectively this ring electrode and respectively this termination electrode are made up of platinumiridio.
In a preferred embodiment, the ring electrode in described termination electrode group and the spacing of termination electrode are 1～5mm,
The spacing of respectively this ring electrode in described first electrode group is 1～5mm, respectively should in described second electrode group
The spacing of ring electrode is 1～5mm, and described termination electrode group is 5～10mm with the spacing of described first electrode group,
Described first electrode group is 30～50mm with the spacing of described second electrode group.
In a preferred embodiment, described safety line is made up of the outer sheathed nylon of multiply stainless steel silk.
In a preferred embodiment, described branch joint be in handle form, described deviation mechanism by locking nut,
Fixed column, handle inner core, handle push rod forms, and this is fixed makes this safety line be fixed in handle inner core,
Pass from this handle push rod, this safety line is wound around around flexible member in this handle push rod.
The medicine have the advantages that the present invention, when using, has preferable soft durometer it is ensured that it has relatively
Good degree of reclining and support, and quickly and easily can enter heart by implantable intravascular.And only need list when using
Root can meet mapping and defibrillation therapy, cost-effective, reduces the pressure of patient.And in defibrillation therapy,
Because it directly acts on heart, therefore only need to can complete defibrillation therapy less than 20j, it is to avoid remove in vitro
The power that quivers is big, may hurt patient, and the relatively low risk of success rate.And can be real without general anesthesia/calmness
Existing defibrillation therapy, injures little to sufferer.
Brief description
Fig. 1 is the structural representation of the present invention.
Fig. 2 is the a-a generalized section of Fig. 1.
Fig. 3 is the b portion partial enlargement change schematic diagram of Fig. 1.
Fig. 4 is the cross-sectional schematic of the deviation mechanism of a preferred embodiment.
Specific embodiment
Hereinafter only the possible enforcement aspect of the present invention is illustrated with embodiment, but and be not used to limit institute of the present invention
The category to be protected, first give chat bright.
As shown in Figure 1 to Figure 3, the present invention provides mapping, defibrillation double-purpose conduit in a kind of chambers of the heart, by cavity of resorption
Vein enters right atrium and coronary sinus vein (because coronary sinus vein is close to left atrium, that is, in coronary sinus vein
Interior can carry out electric potential and defibrillation to left atrium), with and left and right atrium carried out potentiometric detection or
Endocardiac defibrillation treatment is carried out to patient.It is by the insulated conduit 6 of hollow, termination electrode group 12, first electrode group
4, second electrode group 5, wire 8, safety line 7, branch joint 9 forms.
Wherein, one end of this insulated conduit 6 is provided with termination electrode group 12；This termination electrode group 12 is by termination electrode 1
With ring electrode 2 interval setting composition.
First electrode group 4 and this termination electrode group 12 interval setting, by one group of (at least one) ring electrode 3
Interval setting forms；
Second electrode group 5, and this first electrode group 4 interval setting, by another group of (at least one) ring electricity
Pole 3 interval setting composition；
One group of (at least one) wire 8 is arranged in this insulated conduit 6 of hollow, the respectively quantity of this wire
With the termination electrode 1 in this termination electrode group 12, first electrode group 4, second electrode group 5 or this ring electricity of ring electrode
The quantity summation of pole 2,3 corresponds to, and each termination electrode 1 or ring electrode 2,3 are all connected with a wire 8
Connect, and respectively this wire 8 is insulated from each other；
This safety line 7 is arranged in this insulated conduit 6, is connected with the front end of this insulated conduit 5；
This group wire 8 taps out union joint 10 with this safety line 7 by this branch joint 9.
Wherein, for ensureing the soft durometer when using for the present invention, described first electrode group 4 and described second electricity
The described insulated conduit 6 of pole group 5 compartment is supporting section, and it is described exhausted that described first electrode group 4 is located
The hardness of the described insulated conduit 6 at the hardness of edge conduit 6 and described second electrode group 5 place is respectively less than this
The hardness of support section.Enter heart for convenience of it, being provided with described branch joint 9 should by safety line 7 deflection
The deviation mechanism 91 of insulated conduit front end.
When so in use, the present invention first passes through postcava and enters right atrium, enters back into Coronary vein,
Enter coronary sinus vein.When postcava is from the Vascular implantation present invention, by described first electrode group 4 institute
Described insulated conduit 6 the hardness of described insulated conduit 6 that is located with described second electrode group 5 of hardness
Hardness less than this supporting section.So that first electrode group 4, termination electrode group 12 are in coronary sinus vein, second
Electrode group 5 is respectively provided with preferable laminating degree in right atrium, simultaneously because the hardness of its supporting section is more than both sides
Hardness, and form loop shape outside coronary sinus vein, this supporting section plays the effect of support, be suspended in blood
In, so that its first electrode group 4, termination electrode group 12 are in coronary sinus vein, second electrode group 5 is in the right heart
In room, to meet the purpose to left atrium defibrillation therapy and mapping current potential simultaneously.And can be by this support
The support of section prevents the present invention from producing displacement with beating of heart.And its union joint 8 is connected with controller
Connect (in figure does not regard), to provide electricity when mapping or endocardiac defibrillation treatment, and can be to carry out mapping intracardiac
The current potential of mapping gained is shown in the display during current potential.In treatment endocardiac defibrillation or the intracardiac current potential of mapping
When, termination electrode group 12, first electrode group 4 and second electrode group 5 one same-action with the intracardiac current potential of mapping or
Discharge into, control the electricity of each ring electrode or termination electrode by controller, and endocardiac defibrillation and mapping intracardiac
Voltage switching during electrode.In defibrillation therapy, because it directly acts on heart, therefore only need to be less than 20j
Defibrillation therapy can be completed, it is to avoid external defibrillation power is big, may hurt patient, and success rate is relatively low
Risk.And can achieve defibrillation therapy without general anesthesia/calmness, sufferer is injured little.
In a preferred embodiment, the hardness of described supporting section relies in the tube wall of insulated conduit 6 and interior sets metal
Net and realize.And the softness of the pipe shaft of insulated conduit 6 relies on it to adopt pebax (manufacture of arema company)
Make etc. nylon elastomer, to ensure that it has preferable softness and anticorrosive to a certain extent.Preferably
Ground, this wire netting is stainless steel cloth, and its parameter is that 0.002 " stainless steel silk, 16,1 takes 1,55ppi
Braiding.So, the present invention had both taken into account softness and hardness, and solve in prior art cannot be both this simultaneously
The problem taken into account.
In a preferred embodiment, as its b-b enlarged diagram for Fig. 1 of Fig. 3 (is not drawn in Fig. 1 in detail
Go out electrode group), in figure dotted line is pipe shaft linear state of the present invention, is located due to its termination electrode group 12
Blood vessel in coronary sinus vein is thinner, and insulated conduit 5 diameter that described termination electrode group 12 is located is little later
Described insulated conduit 5 diameter.The more convenient entrance of mapping in the chambers of the heart, defibrillation double-purpose conduit can be made crown
Hole, and the less header terminal design of caliber also can to a certain degree reduce the damage to coronary sinus.The insulation of the present invention
The diameter range of conduit is 5f～7f (1f approximates 0.33mm), and this diameter is crossed to be more than and then be cannot be introduced into blood vessel,
This diameter is excessively little, cannot meet its laminating degree.
It is preferred that in actual use, described first electrode group 4 comprises 5 to 9 ring electrodes 3, described
Two electrode groups 5 comprise 4 to 9 ring electrodes 3, and described termination electrode group 12 comprises a ring electrode 2.Pass through
This kind of setting can meet required electricity when the most of detection to intracardiac current potential and endocardiac defibrillation treatment
Number of poles.
It is preferred that width (axial length) l1 of described termination electrode 1 is 1～4mm, described termination electrode group 12
In ring electrode 2 width l3 be 0.5mm～2mm it is ensured that the measurement accuracy of its termination electrode group, and prevent
It releases larger geothermal flow in applied voltage, burns out heart.More preferably, in described termination electrode group 12
Ring electrode 2 is 1～5mm with spacing l2 of termination electrode 1.
It is preferred that spacing l6 of respectively this ring electrode 3 in described first electrode group 4 is 1～5mm, described
The spacing of respectively this ring electrode 3 in second electrode group is 1～5mm.Described first electrode group 4 and described the
The width l5 of the ring electrode 3 in two electrode groups 5 be 2～5mm it is ensured that its certainty of measurement, and ensure described
The softness of the insulated conduit 6 that first electrode group 4 is located with described second electrode group 5, to have preferable patch
By degree.
Wherein, respectively this ring electrode and each this termination electrode are made it is ensured that its nonreactive in intravascular for platinumiridio
Former, do not corroded, impedance is homogeneous, stable.
Described termination electrode group 12 is 5～10mm with spacing l4 of described first electrode group 4, described first electricity
Pole group 4 is 40～60mm with spacing l7 of described second electrode group 5.By being so designed that, that is, in molding
During pipeline, in advance bending forming is carried out to this insulated conduit 6, being allowed to can be when reaching predetermined Atrial situs
It is bent into loop shape outside coronary sinus vein.
Reclined for realizing it there is preferable pliability, and its supporting section is had certain hardness with complete
Become to support, it is preferred that mapping in the described chambers of the heart, defibrillation double-purpose catheter tube in described first electrode group 4,
The hardness in region residing for described termination electrode group 12 is 55 ± 2d, mapping, defibrillation double-purpose conduit in the described chambers of the heart
The hardness in region residing for described second electrode group 5 for the pipe shaft is 40 ± 2d, and the hardness of described supporting section is 72
±2d.Remaining hardness is 72 ± 2d.
Therefore compared to known technology, the hardness of its pipe shaft increases successively, and the present invention, can be by when using
The present invention is easily sent into coronary sinus vein by deviation mechanism 91, so that first electrode group, termination electrode group
It is introduced into right atrium, is finally placed in the coronary sinus vein being close to left atrium, and by the length of l7 be
It is (approximate that the design of 40～60mm forms a loop shape in the blood vessel at coronary sinus vein by this supporting section
Hook-shaped, coordinated with the shape of blood vessel with heart), because hardness l7 of its supporting section is 72 ± 2d, permissible
Play a supporting role well, so that this section of pipe shaft is suspended in intravascular, by its second electrode group location
For 40 ± 2d, the hardness of the pipe shaft of the present invention in domain ensures that it can preferably abut in blood vessel wall, with convenient
Carry out mapping and defibrillation therapy.
It is preferred that described safety line is made up of the outer sheathed nylon 13 of multiply stainless steel silk 14.It is preferably 7 strands
0.005mm stainless steel silk, tensile strength is more than 20n, prevents the present invention to be pulled off when using, Yi Jiwei
The insulated conduit part of the present invention provides certain intensity.
In a preferred embodiment, described deviation mechanism 91 is arranged in this branch joint 9, and this separated time connects
9 is in handle form, described deviation mechanism 91 by locking nut 911, fixed column 912, handle inner core 913,
Handle push rod 914 forms, and this fixes 912 makes this safety line 7 be fixed in handle inner core 913, from handss
Pass in handle push rod 914, safety line 7 is wound around so that pushing away around flexible member in this handle push rod 914
The rotating part 915 of fixed handle push rod 914 can make the front end of safety line 7 enter when driving handle push rod rotation 914
Row bending, makes this safety push-rod and the shell of branch joint 9 fix by this locking nut 911.Using
When, unclamp this locking nut 911, be pushed outwardly this handle push rod 914, then promote rotating part 915
Make safety line 7 deviation, drive conduit to enter horizontal deflection.
In sum, the present invention, when using, has preferable soft durometer it is ensured that it has preferably reclines
Degree and support.And only need when using single can meet mapping and defibrillation therapy, cost-effective, fall
The pressure of low patient.And in defibrillation therapy, because it directly acts on heart, therefore only need to be less than 20j
Defibrillation therapy can be completed, it is to avoid external defibrillation power is big, may hurt patient, and success rate is relatively low
Risk.And can achieve defibrillation therapy without general anesthesia/calmness, sufferer is injured little.
Claims (9)
1. mapping, defibrillation double-purpose conduit in a kind of chambers of the heart, it comprises:
The insulated conduit of hollow, one end of this insulated conduit is provided with termination electrode group；This termination electrode group is by termination electrode
With ring electrode interval setting composition；
First electrode group, with this termination electrode group's interval setting, is made up of one group of ring electrode interval setting；
Second electrode group, with this first electrode group's interval setting, is made up of another group of ring electrode interval setting；
One group of wire, is arranged in this insulated conduit of hollow, and respectively this wire connects this end electricity corresponding respectively
Pole group, first electrode group, the termination electrode in second electrode group or ring electrode；Respectively this wire is insulated from each other；
Safety line, this safety line is arranged in this insulated conduit；
Branch joint, this group wire and this safety line tap out union joint by this branch joint；This safety line by
This branch joint taps out safe wire terminal；
It is characterized in that, the described insulated conduit of described first electrode group and described second electrode group's compartment
For supporting section, the length of this supporting section is 40～60mm；
In the described chambers of the heart, mapping, defibrillation double-purpose catheter tube are in described first electrode group, described termination electrode group institute
In the hardness in place region and the described chambers of the heart, mapping, defibrillation double-purpose catheter tube are in area residing for described second electrode group
The hardness in domain is respectively less than the hardness of this supporting section；
It is provided with the deviation mechanism deflecting this insulated conduit front end by safety line in described branch joint.
2. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
In the chambers of the heart, mapping, defibrillation double-purpose catheter tube are in described first electrode group, region residing for described termination electrode group
Hardness is 40 ± 2d, and in the described chambers of the heart, mapping, defibrillation double-purpose catheter tube are in residing for described second electrode group
The hardness in region is 55 ± 2d, and the hardness of described supporting section is 72 ± 2d.
3. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
First electrode group comprises 5 to 9 ring electrodes, and described second electrode group comprises 4 to 9 ring electrodes, described
Termination electrode group comprises a ring electrode.
4. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
The width of termination electrode is 1～4mm, and the width of the ring electrode in described termination electrode group is 0.5mm～2mm, institute
The width stating ring electrode in first electrode group and described second electrode group is 2～5mm, respectively this ring electrode with
Respectively this termination electrode is made up of platinumiridio.
5. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
Ring electrode in termination electrode group is 1～5mm with the spacing of termination electrode, respectively this ring in described first electrode group
The spacing of electrode is 1～5mm, and the spacing of respectively this ring electrode in described second electrode group is 1～5mm, institute
The spacing stating termination electrode group with described first electrode group is 5～10mm.
6. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
Safety line is made up of the outer sheathed nylon of multiply stainless steel silk.
7. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
It is provided with wire netting in the tube wall of insulated conduit supporting fragment position.
8. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that described
Branch joint is in handle form, and by locking nut, fixed column, handle inner core, handle pushes away for described deviation mechanism
Bar forms, and this is fixed makes this safety line be fixed in handle inner core, passes, this peace from this handle push rod
Completely it is wound around around flexible member in this handle push rod.
9. mapping in the chambers of the heart according to claim 1, defibrillation double-purpose conduit are it is characterised in that institute
State the little described insulated conduit diameter later of insulated conduit diameter at termination electrode group place.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510520833.5A CN106362292A (en) | 2015-08-21 | 2015-08-21 | Dual-purpose catheter used for intracardial mapping and defibrillation |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510520833.5A CN106362292A (en) | 2015-08-21 | 2015-08-21 | Dual-purpose catheter used for intracardial mapping and defibrillation |
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| Publication Number | Publication Date |
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| CN106362292A true CN106362292A (en) | 2017-02-01 |
Family
ID=57881054
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201510520833.5A Pending CN106362292A (en) | 2015-08-21 | 2015-08-21 | Dual-purpose catheter used for intracardial mapping and defibrillation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| TWI726351B (en) * | 2018-12-27 | 2021-05-01 | 日商日本來富恩有限公司 | Intraventricular defibrillation catheter system |
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| US20050004556A1 (en) * | 2003-06-25 | 2005-01-06 | Pursley Matt D. | Catheter having polymer stiffener rings and method of making the same |
| US20060100492A1 (en) * | 2004-10-29 | 2006-05-11 | Medtronic, Inc. | Intra-esophageal catheter |
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| TWI726351B (en) * | 2018-12-27 | 2021-05-01 | 日商日本來富恩有限公司 | Intraventricular defibrillation catheter system |
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Application publication date: 20170201 |