Summary of the invention
The purpose of this invention is to provide a kind of rapid linear radio-frequency ablation electrode, the technical problem that solve is fast continuous ablation.
The present invention is by the following technical solutions: a kind of rapid linear radio-frequency ablation electrode, is made up of the joystick of near-end, the sleeve pipe that connects joystick, the electrode tube that is connected boot proximal end, the manipulation section that the section of melting that described electrode tube is made of the triangle base and two hypotenuses constitute is formed; The described spacer segment that melts is equipped with a ring electrode, and each electrode length is 1-10mm, and temperature sensor is housed on the electrode; Described ring electrode connects radiofrequency generator through lead, and temperature sensor connects radiofrequency generator through temperature sensor lead; The bandlet that elastomeric material is made is equipped with at the center of the described section of melting, bandlet outwards supports the archwise shape with the section of melting that the triangle base constitutes, the length of bandlet extends to the intersection of two hypotenuses of triangle, and both ends are connected with backguy, and the other end of two backguys is fixed on the joystick.
Ring electrode of the present invention is shaped as the diplopore tubulose, has a big through hole with the downward off-centre of tube hub axis, and upwards off-centre has a small blind hole.
Stainless steel ring or platinum ring are housed, sleeve pipe in the boot proximal end of the present invention) offer four through holes vertically, be 90 ° of distributions, one group of aperture of 180 ° of symmetrical distributions is bigger, and another group aperture is less relatively.
The outer wall of stainless steel ring of the present invention or platinum ring is connected in the joystick through the deflection steel wire.
Joystick of the present invention is closed by two symmetric handle casings, forms an axial hole therein, and the near-end of handle casing,, 180 ° symmetries parallel with its axis have chute, are separately installed with slide bar, between slide bar and the chute spring leaf are set; Described two handle casing axial hole are equipped with sleeve pipe and push rod, the flange of slide bar is higher than the periphery of joystick, and slide bar is shaped as cuboid, has a flange on it, far-end at the upper surface of cuboid has the zigzag tooth for one section, be used for handle casing in the engagement of saw shape tooth.
Spring leaf free state of the present invention is arc.
Slide bar far-end of the present invention has the hole, and an end of deflection steel wire is fixed on the hole of slide bar far-end.
Joystick of the present invention middle part has the hole with the axis normal of handle casing, and fixed leg is housed in the hole.
The other end of a backguy of the present invention is fixed on the push rod of joystick, and the other end of another root is fixed on the fixed leg of joystick.
Ring electrode of the present invention is made with platinumiridio; Described bandlet adopts Nitinol, rustless steel or elastoplast; Stainless steel silk or nitinol alloy wire are adopted in described backguy; Described deflection steel wire) makes by nitinol alloy wire or stainless steel silk.
The present invention compared with prior art, the section of melting that electrode tube is made of the triangle base, article two, the manipulation section of hypotenuse formation is formed, ring electrode is set at interval, the bandlet that elastomeric material is made is equipped with at the center of the section of melting, bandlet outwards supports the archwise shape with the section of melting that the triangle base constitutes, reliably carry out pulmonary vein isolation continuously, reduce the relapse rate of atrial fibrillation therapy, the seriality that melts the cicatrix line increases during than single electrode ablation, has isolated ablation areas fully, and it is complete to melt circle, easy to operate, operation is finished rapidly.
Description of drawings
Fig. 1 a is the structural representation of the embodiment of the invention.
Fig. 1 b is the vertical view of Fig. 1 a.
Fig. 1 c is the linear ablation electrode catheter deflection sketch map of the embodiment of the invention.
Fig. 1 d is the vertical view of Fig. 1 c.
Fig. 2 a is the sleeve pipe sketch map of the embodiment of the invention.
The A-A cutaway view of Fig. 2 b Fig. 2 a.
Fig. 3 is the electrode tube section of the melting sketch map of the embodiment of the invention.
Fig. 4 is the electrode tube sketch map of the embodiment of the invention.
Fig. 5 is the electrode tube cut-away view of the embodiment of the invention.
Fig. 6 is the electrode tube delivery configuration figure () of the embodiment of the invention.
Fig. 7 is the electrode tube delivery configuration figure (two) of the embodiment of the invention.
Fig. 8 is the joystick structure chart of the embodiment of the invention.
Fig. 9 is the arrangement of temperature sensor figure of the embodiment of the invention.
Figure 10 is the ring electrode and the temperature sensing receiver installation diagram of the embodiment of the invention.
Figure 11 is the B-B cutaway view of Fig. 4.
Figure 12 a is the ring electrode cutaway view of the embodiment of the invention.
Figure 12 b is the C-C view of Figure 12 a.
Figure 13 a is that the handle push rod of the embodiment of the invention is to near-end pushing direction sketch map.
Figure 13 b is that the handle push rod of the embodiment of the invention is to far-end pushing direction sketch map.
Figure 14 a is the handle end cap front view of the embodiment of the invention.
Figure 14 b is Figure 14 a left view.
Figure 15 a is the cutaway view of the handle casing of the embodiment of the invention.
Figure 15 b is Figure 15 a left view.
Figure 16 is the pusher structure sketch map of the embodiment of the invention.
Figure 17 is the handle Slide bar structure sketch map of the embodiment of the invention.
Figure 18 a is the spring leaf master diagrammatic sketch of the embodiment of the invention.
Figure 18 b is the spring leaf vertical view of the embodiment of the invention.
The specific embodiment
Below in conjunction with drawings and Examples the present invention is described in further detail.Shown in Fig. 1 a and Fig. 1 b, rapid linear radio-frequency ablation electrode of the present invention is made up of the joystick 1 of near-end, the sleeve pipe 2 that connects joystick 1, the electrode tube 3 that is connected sleeve pipe 2 far-ends, and the distal portion of electrode tube 3 is the section of melting 4.Electrode tube 3 bodys and sleeve pipe 2 are made by medical plastic macromolecular material nylon elastomer Pebax.Shown in Fig. 1 c and Fig. 1 d, operating control handle 1 can make electrode tube 3 that lateral bending takes place, and bends backward along sleeve pipe 2 near-ends.
Shown in Fig. 2 a and Fig. 2 b, a stainless steel ring or platinum ring 16 are housed in sleeve pipe 2 far-ends, sleeve pipe 2 offers four through holes vertically, be 90 ° of distributions, one group of aperture of 180 ° of symmetrical distributions is bigger, be respectively electrode pore and backguy hole 5, be used for electrode tube and electrode backguy from its middle passing, another group aperture is less relatively, be deflection backguy hole 6, be used for deflection steel wire 19 from its middle passing, deflection steel wire 19 is by deflection backguy hole 6, be connected to the fixing point of sleeve pipe 2 far-ends, be used to make boot proximal end portion and electrode tube generation lateral bending.As shown in Figure 8, deflection steel wire 19 is made by nitinol alloy wire or stainless steel silk, and deflection steel wire 19 1 ends are fixed in the joystick 1, and other end welding is fixed on the outer wall of interior stainless steel ring of sleeve pipe 2 distal end walls or platinum ring 16, handle joystick, pulling deflection steel wire makes sleeve pipe 2 lateral bendings.
As shown in Figure 3, electrode tube 3 shapes are triangular in shape arciform, are made up of triangle base section of melting that constitutes and the manipulation section that two hypotenuses constitute.Melt spacer segment 1-10 ring electrode 7 is housed, ring electrode 7 usefulness platinumiridios are made, and each electrode length is 1-10mm, external diameter 2.33mm (7F), and two ring electrodes, 7 spacings are 3mm.On each ring electrode 7 temperature sensor 8 is housed all.Lead 9 is welded to connect the adapter on ring electrode 7 and the joystick 1, and ring electrode 7 is gathered intracardiac electrical activity signal, transmits intracardiac electrical activity signal to radiofrequency generator by lead 9.Be provided with temperature sensor lead 10 in the electrode tube 3, adopt copper cash, connect temperature sensor 8 and radiofrequency generator, the temperature signal that melts of temperature sensor collection is delivered to radiofrequency generator.Each electrode all can carry out radio-frequency (RF) ablation separately.
Shown in Figure 12 a and Figure 12 b, ring electrode 7 is shaped as the diplopore tubulose, is made by the platinum material, have a big through hole with the downward off-centre of ring electrode 7 tube hub axis, upwards off-centre has a small blind hole, and the section of melting of electrode tube is set in the macropore, mounting temperature sensor 8 in the aperture.As shown in Figure 9, critesistor or thermocouple are adopted in temperature sensor 8, have two leads 10 to draw in critesistor or the thermocouple, are used to transmit temperature signal.As shown in figure 11, temperature sensor 8 is inserted in the aperture of inside of ring electrodes 7, the outer wall that two leads 10 pass the electrode tube section of melting be inserted into the ring electrode 7 below sections of melting with myocardium contact macropore 6 in.As shown in figure 10, with two liquid mixed hardening glue AB glue fixed temperature sensors 8 in the aperture of ring electrode 7.Critesistor or T type thermocouple are adopted in temperature sensor 8.
As shown in Figure 4, the bandlet 11 that an elastic material is made is equipped with at the center of electrode tube 3 sections of melting, and elastic material adopts Nitinol, rustless steel or elastoplast.Bandlet 11 is inserted in the electrode tube 3 after arc by being heat-treated to, and the section of melting that bandlet 11 constitutes the triangle base of electrode tube 3 is support archwise shape outwards, is convenient to ablating electrode and closely contacts with myocardium.The length of bandlet 11 extends to the intersection of two hypotenuses of triangle, and both ends are connected with backguy 12, and stainless steel silk or nitinol alloy wire are adopted in backguy 12.As shown in Figure 5, the other end of a backguy 12 is fixed on the push rod 13 of joystick 1 of electrode tube 3 far-ends, the other end of another root is fixed on the fixed leg 14 of joystick, control backguy 12, thus the section of melting that the triangle base is constituted outwards supports the archwise shape.Shown in Figure 13 a, to near-end pulling push rod 13, electrode tube 3 can be drawn in the sleeve pipe 2 to joystick 1, shown in Figure 13 b, promote push rod 13 to joystick 1 far-end, electrode tube 3 can be released sleeve pipe 2, the section of the melting archwise shape of electrode tube 3 is stretched out outside sleeve pipe.
As shown in Figure 6,3 fens sections of melting of electrode tube and handle section, the manipulation section of electrode tube 3 is sections that electrode tube 3 is connected with joystick 1, the section of melting is meant and the myocardium bow-shaped section that contacts, melts.The manipulation section of electrode tube 3 is inserted in one of them hole in two bigger holes of sleeve pipe 2, the backguy 12 of insertion end connects push rods 13, and the backguy 12 of the section of the melting other end is inserted in sleeve pipe 2 another bigger holes, is connected with fixed leg 14 on the joystick 1.Shown in Figure 13 a, the operator grasps handle, and to the flange 131 of near-end promotion push rod 13, the manipulation section 3 of pulling electrode tube all draws in electrode tube 3 in the sleeve pipe 2.The section of melting is linearly to be drawn in the sleeve pipe 2, is convenient to by sleeve pipe 2 section of melting of electrode tube 3 be sent in the heart.Shown in Figure 13 b, the operator grasps handle, and to the flange 131 of far-end promotion push rod 13, the manipulation section that promotes electrode tube 3 is all released sleeve pipe 2 far-ends with the section of melting of electrode tube 3, as shown in Figure 7, makes the section of the melting arciform sleeve pipe 3 that stretches out triangular in shape.
As shown in Figure 8, joystick 1 is made up of two symmetric handle casings 20, two slide bars 15, push rod 13, a fixation with steel wire post 14 and two spring leafs 17.Two symmetric handle casings 20 are closed, in joystick 1, form an axial hole.Shown in Figure 15 a and Figure 15 b, the near-end of handle casing 20,, 180 ° symmetries parallel with its axis have chute, are used for installing respectively slide bar 15, and spring leaf 17 is set between slide bar 15 and the chute.Two handle casings 20 are lumped together the garden shape through hole of far-end intermediate formation afterwards, be used for mounting sleeve 2 and push rod 13.The flange of slide bar 15 is higher than the periphery of joystick 1, and slide bar 15 far-ends have the hole, and an end of deflection steel wire 19 is fixed on the hole of slide bar 15 far-ends, and the other end is fixed on the becket 16 of sleeve pipe 2.Fixed leg 14 be installed in joystick 1 middle part, with the hole of the handle casing 20 of its axis normal in.
As shown in figure 17, slide bar 15 is shaped as cuboid, has a flange on it, has the zigzag tooth for one section at the far-end of the upper surface of cuboid, be used for handle casing 20 in the engagement of saw shape tooth, cuboid can slide in the chute of handle casing.Shown in Figure 18 a and 18b, spring leaf 17 free states are arc.Operator grasps joystick 1, with the flange of depress slide bar 15, can spur deflection steel wire 19 to near-end to near-end sliding bar 15, make electrode tube 3 relative sleeve pipes 2 that lateral bendings take place.Unclamp thumb, under the elastic force effect of spring leaf 17, the saw shape tooth tight engagement of the chute in the saw shape tooth on the slide bar 15 and the handle casing 20, can resist electrode tube 3 and sleeve pipe 2 lateral bending power, electrode tube 3 and sleeve pipe 2 are fixed on the lateral bending state.Electrode tube 3 with respect to the state of sleeve pipe 2 lateral bendings under to far-end sliding bar 15, can make electrode tube 3 be returned to the state that lateral bending does not before take place.Shown in Figure 15 a and 15b, push rod 13 is inserted in the handle casing axial hole, promotes flange on the push rod 13 to near-end, and the push rod 13 of joystick slides to near-end, can be with in the electrode tube 3 income sleeve pipes 2, or on the contrary electrode tube 3 is released sleeve pipes 2 and triangularity is arc.Pass electrode tube 3 in 2 two macropores of sleeve pipe, be installed with backguy 12 in the electrode tube 3.On the bandlet 11 in the one end welding electrode pipe of a backguy 12, the other end is connected on the push rod 13; One end of another root backguy 12 is connected on the other end of the bandlet 11 in the electrode tube, and the other end is connected on the fixed leg 14 on the handle.One in two slide bars 15 direction toward far-end is slided, another slide bar slides toward proximal direction, the side that the far-end of sleeve pipe 2 and electrode tube 3 is yearned for the slide bar of near-end slip deflects, if the direction of motion of two slide bars is reverse, the head end of sleeve pipe 2 and electrode tube 3 deflects round about.
Shown in Figure 14 a, 14b, handle end cap 18 is subtriangular cones of a hollow, and the big end of cone inserts the far-end of handle casing, and two handle casings 20 are fixed together, and sleeve pipe and two deflection steel wires pass from the hole, garden of cone small end.
As shown in figure 16, push rod 13 is a hollow garden columnar object, and the near-end of garden post has a flange, is convenient to promote push rod and seesaws, and the far-end of push rod 13 has an aperture, is used for fixing backguy 12, and the hollow hole of garden post is used for fixing the manipulatable end of electrode tube.
The present invention begins assembling after each part preparation is finished: the bandlet heat treatment is shaped inserts in the section of melting of electrode tube for the arc back of triangle, every lead is welded on the ring electrode respectively.The ring electrode that has welded lead is contained on the electrode tube section of melting.Lead is passed the electrode tube section of melting body, in the section of melting body hole, pull out, temperature sensor is packed in the aperture on the electrode retaining collar, temperature sensor lead is passed the section of melting tube wall, pull out the section of melting from the section of melting near an aperture of temperature sensing receiver and manage.The backguy of burn-oning at the two ends of bandlet.The manipulatable end backguy is wrapped polytetrafluoroethylene PTFE together with melting the manipulation section that lead and temperature sensing lead insert electrode tube, to melt (section of melting of electrode tube and the end of handling the section connection) of holding with the special plastic bulb-tubulating machine and link into an integrated entity, electrode tube manipulation section will be passed from a telescopic macropore with manipulatable end; To melt the end backguy wraps polytetrafluoroethylene PTFE and passes from telescopic another macropore.Sleeve pipe is fixed on the shell of control crank far-end, the manipulatable end of electrode tube is fixed on the push rod of control crank together with the manipulatable end backguy.To melt the backguy that brings out from electrode tube and be fixed on the fixed leg of handle, two deflection wire will be fixed on the slide bar of control crank.To melt lead and temperature sensing wire bonds on the adapter on the control crank afterbody push rod, and finish conduit and make.
When the doctor performs the operation, at first one hold handle casing, another hands promotes push rod 13 to near-end, electrode tube 3 is drawn in the sleeve pipe 2, decontrol the hands of holding push rod then, only hold handle casing orifices of pulmonary veins in far-end is advanced into heart, one hold handle casing again, another holds push rod and advances push rod to far-end, electrode tube is arc shape releases sleeve pipe, under X-ray, observe electrode tube and be fully and decontrol the hands of holding push rod behind the arc shape, only hold handle casing the myocardial sites that Duan Yuxu melts that melts of electrode tube is closely contacted.Can not touch the position that to melt as electrode retaining collar, holding handle rotates to an angle, and the manipulation slide bar deflects the relative sleeve pipe of electrode tube, reach the electrode retaining collar position tight contact condition to be melted with cardiac muscle, decontrol the thumb of handling slide bar, saw shape tooth engagement at the saw shape tooth and the handle casing of the elastic force effect drop shot of spring leaf makes slide bar and handle casing generation self-locking, held stationary the arc shape of electrode tube.Opening radiofrequency generator melts.After having melted, handle slide bar electrode tube and sleeve pipe are deflected into normal straightened condition, pull back push rod again electrode tube is drawn in the sleeve pipe, extract the linear ablation combination of electrodes out, finish fast, connect ablative surgery in external.
Embodiment 1: isolated test, adopt one of fresh beef, size 200 * 200 * 100mm, one of rapid linear radio-frequency ablation electrode of the present invention, the ablating electrode ring diameter is 15mm, each ablating electrode length is 5mm, 3 of number of electrodes, and radiofrequency generator is Irvine Biomedical, the Inc.IBI-1500T type, the radiofrequency generator output parameter is set to: temperature 60 degree, 120 seconds time, power 30W.Test divides two processes, and first process is that 3 electrodes discharge one by one, and each electrode wheel was banished electricity 120 seconds, and 120 seconds at interval, power was 30W.After electrode tube inserts, promote the push rod of control crank, make the section of the melting archwise of electrode tube stretch out sleeve pipe, the ring electrode on the arc section of melting is closely contacted with beef.In the process of the test, each electrode discharge is normal, all in the radiofrequency generator set point.The lead of 3 electrodes is connected on the radiofrequency generator, set radiofrequency generator and be discharge one by one, power is made as 30W, be 120 seconds the discharge time of each electrode, in this discharge process, have 3 electrodes to melt, and common radio-frequency ablation electrode conduit have only an electricity to have ablation functionality, therefore, realized ablation procedure rapidly, continuously.Second process is that 3 electrodes are set at discharge simultaneously, 3 all discharges simultaneously of electrode in the test, each electrode power 30W, in the process of the test, each electrode discharge is normal, all in the radiofrequency generator set point, 3 electrodes melt simultaneously, and common radio-frequency ablation electrode conduit has only an electricity to have ablation functionality, therefore, has realized ablation procedure rapidly, continuously.
The test back is observed at the SONY TW-TL5M of Sony microscopically, as seen the clear cicatrix line that melts, the ablation line sliver is continuous, the cicatrix line that melts that is produced in these two processes is successive, be not interrupted, and be discontinuous with the cicatrix line that melts that common radio-frequency (RF) ablation conduit melts, the middle existence is interrupted.The used time ratio of operation shortens twice with the used time of common radio-frequency (RF) ablation operative catheter in these two processes.
Embodiment 2: the Canis familiaris L. live body, and healthy public Canis familiaris L., body weight is more than 20 kilograms, 2 years old age.One of rapid linear radio-frequency ablation electrode of the present invention, the diameter of arc electrode pipeloop is 12mm, each ablating electrode length is 5mm, 2 of number of electrodes, radiofrequency generator is Irvine Biomedical, the Inc.IBI-1500T type, and the radiofrequency generator output parameter is set to: temperature 60 degree, 120 seconds time, power 30W.To enter left room behind the fast linear ablation catheter transatrial septal puncture of the present utility model, under Siemens DSAX ray monitors, at first push the push rod of joystick, electrode tube is occured bending and deformation, far-end arrives orifices of pulmonary veins, promote push rod along handle to far-end again, the section of melting of electrode tube is released, and the section of melting is arc ring-type, the slide bar on the Sliding Control handle, the section of melting is deflected, arrive orifices of pulmonary veins.Hold joystick, joystick integral body is pushed ahead, make ring electrode on the arc circle of the section of the melting orifices of pulmonary veins that closely reclines.Adopt 2 electrodes to discharge one by one, each 120 seconds, power 30W.Finish the ring-type linear ablation.Employing multi-electrode discharge is shortened 2 times during the single electrode ablation of the time ratio that melts, and needs the number of times of traveling electrode to reduce when melting in the ablation areas of identical size, has realized ablation procedure rapidly, continuously.
The above two example experiments of experimental result were finished with interior in half an hour, and 100% has isolated the focus point of supposing on the beef among the embodiment 1, has isolated pulmonary vein among the embodiment 2 fully, does not find to have in the pulmonary vein electrical activity to be delivered to heart.Reached fully and melted, effectively prevented the recurrence of atrial fibrillation.
Adopt fast linear ablating electrode conduit of the present invention to carry out the ablation atrial fibrillation, can shorten operating time greatly, reliably carry out pulmonary vein isolation, reduce the relapse rate of atrial fibrillation therapy.The seriality that melts the cicatrix line increases during than single electrode ablation, has isolated ablation areas fully, and is easy to operate.
Adopt rapid linear radio-frequency ablation electrode of the present invention, the multi-electrode arc many discharge electrode structures that discharge make operation rapidly, and it is complete to melt circle.The electrode of linear ablation electrode catheter of the present invention can discharge successively one by one in operation process, but also all electrodes discharge simultaneously, and each electrode all has the temperature sensor monitors temperature simultaneously.Use fast linear ablating electrode conduit of the present invention can shorten operating time, guarantee operation process safety.Linear ablation electrode catheter of the present invention can be to two opposite direction deflections, and be used, can make electrode to contact with cardiac muscle with controlled sheath good, and the focus point of atrial fibrillation is effectively isolated fully fast, prevent that atrial fibrillation from recurring once more.The success rate height requires to reduce to doctor's level.