CN104822335A - Catheter system - Google Patents
Catheter system Download PDFInfo
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- CN104822335A CN104822335A CN201380062501.6A CN201380062501A CN104822335A CN 104822335 A CN104822335 A CN 104822335A CN 201380062501 A CN201380062501 A CN 201380062501A CN 104822335 A CN104822335 A CN 104822335A
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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
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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
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
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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
- 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
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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
- 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
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00744—Fluid flow
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00779—Power or energy
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
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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
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
Abstract
Provided is a catheter system that is capable of performing a suitable irrigation operation. The catheter system (5) comprises: an ablation catheter (1) having an irrigation mechanism; a power supply unit (32) that supplies electrical power to the ablation catheter (1) during ablation; a fluid supply unit (21) for supplying irrigation fluid to the ablation catheter (1); and a control unit (35). The control unit (35) controls so as to achieve high flowrate operation when the measured power (Pm) during ablation is in a high-power state at or above a threshold power (Pth), and controls so as to achieve low flowrate operation when the measured power (Pm) is in a low-power state below the threshold power (Pth). Furthermore, the control unit (35) quickly switches from low flowrate operation to high flowrate operation upon a transition from the low-power state to the high-power state and, upon a transition from the high-power state to the low-power state, if at the time of transition the low-power state has continued for a first standby time, the control unit (35) switches to low flowrate operation after maintaining high flowrate operation for the first standby time.
Description
Technical field
The present invention relates to a kind of possess such as be used for the treatment of arrhythmia and can when the affected part of this treatment melts (ablation) conduit system of the filling mechanism of the liquid such as saline injection.
Background technology
Electrode catheter passes through in blood vessel insertosome (such as endocardial), for checking and treatment arrhythmia.This electrode catheter in general, shape near front end (far-end) in insertosome is according to the operation of following operating portion, and on a direction or both direction, change (deflect, bend), this operating portion is arranged on and is configured at external cardinal extremity (near-end, rear end, on hand).In addition, except the type that the shape of this front end can change arbitrarily according to operation, also there is the type that the shape near front end is fixing.
But, following problem may be there is when affected part melts in the conduit (so-called ablation catheter) be used for the treatment of in this electrode catheter.That is, in the ablative surgery process of heart etc., may occur because the excessive temperature of disposal part rises and cause damage and adhere to the problems such as thrombosis in disposal part.
So, as the method addressed this is that, can use that have when melting can the conduit system (such as, patent documentation 1,2) of filling mechanism of the liquid such as saline injection.This conduit system, because the front end electrode when melting from ablation catheter flows out aforesaid liquid, so can cool affected part, prevents thrombosis.
Prior art document
Patent documentation
Patent documentation 1: Japanese Unexamined Patent Publication 2006-239414 publication;
Patent documentation 2: Japanese Unexamined Patent Publication 2012-176119 publication.
Summary of the invention
But in a general case, if the conduit system possessing above-mentioned filling mechanism is too much to the flow disposing the liquid that part is discharged, then the temperature disposing part reduces, and likely produces harmful effect to disposal during treatment.In addition, if liquid enters in body too much, the burden of patient may also be increased.On the other hand, if the flow of liquid is very few, the cooling of likely disposal part and the improvement effect of blood stasis become insufficient.For all these reasons, need the flow regulating (management) liquid according to behaviour in service, thus realize suitable perfusion action.
The present invention makes in view of the above problems, and its object is to provides a kind of conduit system can carrying out suitable perfusion action.
Conduit system of the present invention possess there is filling mechanism ablation catheter, the electric power when supply of this ablation catheter is melted power supply unit, to the liquid supply unit of ablation catheter supply perfusion liquid and the control part controlling the supply action of electric power of power supply unit and the supply action of the liquid of liquid supply unit respectively.When the actual measurement electric power of control part when melting is the high power state of more than threshold value electric power, control to become the relatively many large discharge actions (the large flow rate operation) of fluid flow; On the other hand, when actual measurement electric power is the low power state less than above-mentioned threshold value electric power, control to become the relatively less low discharge action of fluid flow (the small flow rate operation).In addition, when being converted to above-mentioned high power state from above-mentioned low power state, above-mentioned large discharge action is switched to rapidly from above-mentioned low discharge action; On the other hand, when being converted to above-mentioned low power state from above-mentioned high power state, when this conversion when low power state continue for the 1st stand-by time, above-mentioned large discharge action is switched to above-mentioned low discharge action after maintaining above-mentioned 1st stand-by time.
In conduit system of the present invention, above-mentioned control part controls as follows: when being converted to above-mentioned high power state from above-mentioned low power state, switch to above-mentioned large discharge action rapidly from above-mentioned low discharge action; On the other hand, when being converted to above-mentioned low power state from above-mentioned high power state, when this conversion when low power state continue for the 1st stand-by time, above-mentioned large discharge action is switched to above-mentioned low discharge action after maintaining above-mentioned 1st stand-by time.Therefore, the situation (situation of fluid low) that the flow of generation liquid is very few can be avoided when electric power is changed.
In conduit system of the present invention, above-mentioned control part preferably, only when being judged as after standby flow action that fluid flow is small starts, accepts the index signal making to melt beginning.Formation like this, before melting beginning, can make (such as, in the space of liquid flow) in ablation catheter to be full of liquid.Therefore, such as blood can be avoided to flow into inner from the fore-end (such as, the tap hole of liquid) of ablation catheter, the danger that inside (such as, in above-mentioned space) blocks by thrombosis.In addition, in the case, above-mentioned control part, more preferably when receiving above-mentioned index signal, after switching to above-mentioned low discharge action from above-mentioned standby flow action, makes the supply action of above-mentioned electric power start.Formation like this, because in general the supply (arrival) of liquid more expends time in than electric power supply, so can avoid the situation that fluid low occurs due to such service time difference, can realize more suitable perfusion action.
In conduit system of the present invention, above-mentioned control part, preferably when making the supply action of above-mentioned electric power stop, stopping rear in the supply action of electric power and after the 2nd stand-by time, making it be converted to above-mentioned standby flow action.Formation like this, can avoid, due to the condition of high temperature that also continues for some time and occur utilize the cooling of liquid not enough after the supply of electric power stops, can realizing more suitable perfusion action.
In conduit system of the present invention, preferred above-mentioned ablation catheter has temperature survey mechanism near its front end, and above-mentioned control part is by regulating the output power of power supply unit roughly to keep the temperature measured by this temperature survey mechanism.Formation like this, can regulate actual output power with the temperature of (near affected part when melting) near the front end roughly keeping ablation catheter.That is, after suitably regulating based on the setting electric power inputted in addition, supply output power.
In conduit system of the present invention, aforesaid liquid supply unit can be arranged in fluid Supplying apparatus, and to be arranged at above-mentioned power supply unit and above-mentioned control part with this fluid Supplying apparatus be respectively in the supply unit of not consubstantiality.Formation like this, because can configure separately each device (fluid Supplying apparatus and supply unit), so can improve the ease of use of whole system according to behaviour in service.Or, also aforesaid liquid supply unit, above-mentioned power supply unit and above-mentioned control part can be arranged in same device respectively.Formation like this, can simplify whole system.
According to conduit system of the present invention, because when being converted to above-mentioned low power state from above-mentioned high power state, when this conversion when low power state continue for the 1st stand-by time, the situation that fluid low occurs above-mentioned large discharge action switched to above-mentioned low discharge action after maintaining above-mentioned 1st stand-by time, so can be avoided when electric power is changed.Therefore, it is possible to carry out suitable perfusion action when melting.
Accompanying drawing explanation
Fig. 1 is the schematic block diagram of the overall configuration example of conduit system involved by one embodiment of the present invention.
Fig. 2 is the schematic diagram of the detailed configuration example of ablation catheter shown in Fig. 1.
Fig. 3 is the schematic diagram of an example of the relation through the power state of actual measurement and the flow action of liquid.
Fig. 4 is the flow chart of an example of the action representing conduit system shown in Fig. 1.
The schematic diagram of one example of control action when Fig. 5 is flow action conversion.
The schematic diagram of other examples of control action when Fig. 6 is flow action conversion.
Fig. 7 is the schematic block diagram of the overall configuration example of conduit system involved by variation of the present invention.
Detailed description of the invention
Embodiments of the present invention are described in detail referring to accompanying drawing.Further, explanation is undertaken by following order.
1, embodiment (fluid Supplying apparatus and supply unit with not consubstantiality and the example arranged)
2, variation (integrating the setting example of the single device of various function)
3, other variation
< embodiment >
[overall formation]
Fig. 1 is the schematic block diagram of the overall configuration example of conduit system (conduit system 5) involved by one embodiment of the present invention.The system that this conduit system 5 uses when being treatment patient's (this example for patient 9) arrhythmias etc., possesses ablation catheter 1, fluid Supplying apparatus 2, supply unit 3 and to pole plate 4.That is, in the conduit system 5 of present embodiment, fluid Supplying apparatus 2 and supply unit 3 are formed in the mode of not consubstantiality.
(ablation catheter 1)
Ablation catheter 1 is inserted by blood vessel to melt in patient 9 body, to affected part thus to treat the electrode catheter of arrhythmia etc.Ablation catheter 1 also has makes set perfusion liquid (such as, normal saline etc.) flow out the filling mechanism of (injection) from P1 side, front end when such melting.In other words, conduit system 5 is the conduit systems with this filling mechanism.
Fig. 2 is the schematic diagram of the configuration example of ablation catheter 1.This ablation catheter 1 have as catheter main body axle 11 (conduit axle) and be installed on the operating portion 12 of base portion of this axle 11.
Axle 11 is formed, in the shape that the axis direction (Z-direction) along himself extends by having flexible tubular structure (tubular part).In addition, the inside that axle 11 has along the axis direction extension of himself is formed with the what is called list pore structure in 1 space (lumen, through hole) or is formed with the many pore structures of what is called in plural number (such as, 4) space.Further, also can both arrange the region formed by single pore structure in the inside of axle 11, the region formed by many pore structures was set again.In such space, not shown various fine rules (wire and behaviour's position etc.) insert with the state of mutually insulated respectively.
In the inside of axle 11, except have above-mentioned various fine rule is inserted space except, be also formed with the space for injecting above-mentioned perfusion liquid L along Axis Extension direction.In addition, near the front end P1 of axle 11, be provided with the mechanism (temperature survey mechanism) of measuring (around affected part) temperature near the P1 of this front end.Specifically, in the space of axle 11 inside, be inserted with the thermocouple as the temperature sensor of measuring this temperature.Further, the temperature near the front end P1 so measured is as observed temperature information Tm, be supplied to supply unit 3 by ablation catheter 1.
This axle 11 is made up of such as polyolefin, polyamide, polyether-polyamide, polyurethane etc.In addition, the length of the axis direction of axle 11 is about 500 ~ 1200mm (such as 1170mm), and the external diameter (external diameter of X-Y section) of axle 11 is about 0.6 ~ 3mm (such as 2.0mm).
Near the front end P1 of axle 11, as shown in the enlarged drawing near the front end P1 in Fig. 2, be provided with plural electrode (being 3 ring electrodes 111a, 111b, 111c and 1 front termination electrode 112) herein.Specifically, near the P1 of front end, ring electrode 111a, 111b, 111c and front termination electrode 112 arranging with predetermined distance with this order foremost towards axle 11.In addition, ring electrode 111a, 111b, 111c are by fixed configurations is on the outer peripheral face of axle 11 respectively, and on the other hand, front termination electrode 112 is fixed and is configured at axle 11 foremost.These electrodes, by being inserted in the complex lead (not shown) in the space of above-mentioned axle 11, are electrically connected with operating portion 12.In addition, as denoted by the arrows in fig. 2, the front end of termination electrode 112 is neighbouring in the past flows out above-mentioned perfusion liquid L.
Such ring electrode 111a, 111b, 111c and front termination electrode 112 are made up of the metal material that such as aluminum (Al), copper (Cu), rustless steel (SUS), electric conductivity such as gold (Au), platinum (Pt) etc. are good respectively.Further, good to the developability of X-ray in order to make when using ablation catheter 1, above-mentioned electrode is preferably made up of platinum or its alloy.In addition, there is no particular limitation for the external diameter of these ring electrodes 111a, 111b, 111c and front termination electrode 112, preferably about equal with the external diameter of above-mentioned axle 11.
Operating portion 12 is installed on the base portion of axle 11, has handle (handle portion) 121 and swivel plate 122.
Handle 121 is the parts being caught (holding) when using ablation catheter 1 by operator (doctor).Have in the inside of this handle 121 and extend and next above-mentioned various fine rule from axle 11 inside.
Swivel plate 122 carries out making the deflection of deflection near the front end of axle 11 move the parts of operation (swinging operation).Specifically, herein as denoted by the arrows in fig. 2, operation swivel plate 122 being rotated along direction of rotation d1 can be carried out.
(fluid Supplying apparatus 2)
Fluid Supplying apparatus 2 is devices ablation catheter 1 being supplied to above-mentioned perfusion liquid L, as shown in Figure 1, has liquid supply unit 21.
Liquid supply unit 21 is the mechanisms liquid L of the flow by hereinafter described control signal CTL2 defined being supplied at any time ablation catheter 1.This liquid supply unit 21 is made up of parts such as comprising such as liquor pump.
(supply unit 3)
Supply unit 3 supplies electric power (such as by high frequency (RF when melting to ablation catheter 1 and to pole plate 4; Radio Frequency) the output power Pout that forms) and control the device of the supply action of the liquid L of fluid Supplying apparatus 2.This supply unit 3 as shown in Figure 1, has input part 31, power supply unit 32, voltage measurement portion 33, current measurement portion 34, control part 35 and display part 36.
Input part 31 is parts of the index signal for inputting various setting value and the hereinafter described set action of instruction.Various setting value will be described in detail later, include, for example: fluid flow Fst, various stand-by times etc. when fluid flow Fl when fluid flow Fh when setting electric power Ps (maximum power of=output power Pout), threshold value electric power Pth, target temperature Tt, " HIGH " flow action, " LOW " flow action, " Standby " flow action.These setting values are inputted by the operator (such as technician etc.) of supply unit 3.But such as threshold value electric power Pth also can can't help operator's input, and is set in supply unit 3 in advance when product turnout etc.In addition, the setting value inputted by input part 31 is supplied to control part 35.Further, in FIG, representatively represent with the setting electric power Ps in these various setting values.Such input part 31 such as can by set rotating disk and the formation such as button, touch panel.
Power supply unit 32 is according to hereinafter described control signal CTL1, and above-mentioned output power Pout is supplied to ablation catheter 1 and the part to pole plate 4.Such power supply unit 32 uses set electric power loop (such as switch voltage-stabilizing loop etc.) to form.If further, output power Pout is made up of high frequency, its frequency is such as about 450kHz ~ 550kHz (such as 500kHz).
Voltage measurement portion 33 is the parts of the voltage measuring the output power Pout that (detection) is exported by power supply unit 32 at any time, uses set voltage detection circuit to form.The voltage (actual measurement voltage Vm) so recorded by voltage measurement portion 33 is output to control part 35.
Current measurement portion 34 is the parts of the electric current measuring the output power Pout exported by power supply unit 32 at any time, uses set current detection circuit to form.The electric current (measured current Im) so recorded by current measurement portion 34 is output to control part 35.
Control part 35 is the parts controlling whole supply unit 3 and carry out set calculation process, such as, use the formations such as microcomputer.Specifically, first control part 35 has the function of the hereinafter described actual measurement electric power Pm (corresponding with the power value of output power Pout) of calculating.In addition, control part 35 has the function (electric power supply controlling functions) utilizing control signal CTL1 to control the supply action of the output power Pout of power supply unit 32, and utilizes control signal CTL2 to control the function (liquid supply controlling functions) of the supply action of the liquid L of liquid supply unit 21.
First, the computing function of surveying electric power Pm is as described below.That is, control part 35 calculates actual measurement electric power Pm at any time according to the actual measurement voltage Vm exported by voltage measurement the portion 33 and measured current Im that exported by current measurement portion 34.Specifically, control part 35 utilizes following formula (1) to calculate actual measurement electric power Pm.Used in the liquid supply controlling functions that the actual measurement electric power Pm so calculated by control part 35 is described later, and be output to display part 36 in this instance.
Pm＝(Vm×Im)......(1)
Next, above-mentioned electric power supply controlling functions is as described below.That is, control part 35 produces control signal CTL1 according to above-mentioned observed temperature information Tm, and by this control signal CTL1 being exported to the size that power supply unit 32 regulates (fine adjustment) output power Pout.Specifically, made the temperature near the front end P1 of the axle 11 represented by observed temperature information Tm roughly remain necessarily (preferably certain) by the size of regulation output electric power Pout, in other words, the target temperature Tt making this temperature approximate (preferably equaling) to preset.
In detail, when the temperature of control part 35 near the P1 of front end is lower than target temperature Tt, carries out control and output power Pout value is increased.On the other hand, when the temperature near the P1 of front end exceedes target temperature Tt, carry out control and output power Pout value is reduced.So suitably regulated based on the setting electric power Ps of input, actual output power Pout is provided.In other words, the value setting electric power Ps might not be consistent with the value of actual output power Pout (surveying electric power Pm).
In addition, aforesaid liquid supply controlling functions is as described below.That is, control part 35 produces control signal CTL2 according to the actual measurement electric power Pm obtained by said method, and by exporting to liquid supply unit 21 flow that this control signal CTL2 controls liquid L.
Specifically, control part 35, such as shown in Fig. 3, controls the flow (fluid flow F) of liquid L according to actual measurement electric power Pm.Namely, by comparing the size (according to comparative result) of actual measurement electric power Pm and the value of the given threshold electric power Pth preset (being such as 31W (watt)), the value (kind of the flow action of liquid supply unit 21) of the fluid flow F of setup control signal CTL2 defined.In detail, fluid flow F, when actual measurement electric power Pm is the high power state of threshold value more than electric power Pth (Pm >=Pth), is controlled to relatively many large discharge actions (" HIGH " flow action of F=Fh) by control part 35.On the other hand, when actual measurement electric power Pm is the low power state less than threshold value electric power Pth (Pm < Pth), fluid flow F is controlled to relatively few low discharge action (" LOW " flow action of F=Fl (< Fh)).In addition, under both stable condition described later, fluid flow F is controlled to small standby flow action (" Standby " flow action of F=Fst (0 < Fst < Fl)).Further, the object lesson of the value of above-mentioned Fh, Fl, Fst can enumerate Fh=30cc, Fl=17cc, Fst=2CC respectively.In addition, (Fig. 4 ~ 6) this liquid supply controlling functions (control action of fluid flow F) will hereinafter be described in detail.
Display part 36 is to the part (watch-dog) that outside exports after various information being represented.As the information representing object, include, for example: the above-mentioned various setting value (setting electric power Ps etc.) inputted by input part 31, the actual measurement electric power Pm provided by control part 35 and the observed temperature information Tm etc. provided by ablation catheter 1.But, as representing that the information of object is not limited to these information, also can replace by other information or add other information.Such display part 36 uses various display (such as liquid crystal display, CRT (Cathode Ray Tube) display and organic EL (Electro Luminescence) display etc.) to form.
(to pole plate 4)
As shown in Figure 1, to pole plate 4 be the body surface being installed on patient 9 when melting state under used.When melting, this is energized to high frequency between pole plate 4 and the electrode being inserted in the ablation catheter 1 in patient 9 body, hereinafter will describe in detail this.
[effect]
(A. basic acts)
When treating arrhythmia, the axle 11 of the ablation catheter 1 in this conduit system 5 is inserted in the body of patient 9 by blood vessel.Now, according to the operation of operator to operating portion 12, the shape near the front end P1 being inserted in the axle 11 in body such as changes on a direction or both direction.Specifically, if rotate swivel plate 122 by the finger of operator along direction of rotation d1 as denoted by the arrows in fig. 2, then the not shown behaviour's position in axle 11 is pulled to base portion side.Consequently, the front end P1 of axle 11 is neighbouring bends along direction d2 as illustrated by the arrows in fig. 1.
Now, the electric power (output power Pout) when melting is supplied by supply unit 3 (power supply unit 32) to such ablation catheter 1 and to pole plate 4.Therefore, when above-mentioned treatment arrhythmia, be installed on the body surface of patient 9 high frequency between pole plate 4 and the electrode (front termination electrode 112 and ring electrode 111a, 111b, 111c) being inserted in the ablation catheter 1 in patient 9 body is energized.By the energising of such high frequency, the position (disposal part) of the treatment target of patient 9 is optionally melted, and completes the transdermal therapeutic of arrhythmia etc.
When such melting, by fluid Supplying apparatus 2 (liquid supply unit 21), perfusion liquid L is supplied to ablation catheter 1.In addition, supply unit 3 (control part 35) utilizes control signal CTL2 to control the supply action of the liquid L of such fluid Supplying apparatus 2.Therefore, liquid L is used from ejection (arrow with reference to Fig. 2) perfusion near the front end of termination electrode 112 before ablation catheter 1.Consequently, the damage that the excessive temperature of disposal part when can avoid because melting rises and causes and adhere to thrombosis (improving blood stasis) in disposal part.
But if too much to the flow disposing the liquid L that part is discharged, then the temperature disposing part reduces, and likely produces harmful effect to disposal during treatment.In addition, if liquid L enters in body too much, the burden of patient may also be increased.On the other hand, if the flow of liquid is very few, the cooling of likely disposal part and the improvement effect of blood stasis become insufficient.During electric power height particularly when melting, because melt the damage that easily causes tissue due to excessive and produce thrombosis, so above-mentioned tendency will increase.Add in the ablation procedure of reality, as mentioned above, the temperature (observed temperature information Tm) near the value of output power Pout (actual measurement electric power Pm) and the front end P1 of axle 11 links and changes.Specifically, the value in order to make this temperature approximate target temperature Tt and regulation output electric power Pout.That is, change at any time according to the value for the treatment of situation actual measurement electric power Pm.For all these reasons, the flow according to behaviour in service regulates liquid is needed for the conduit system possessing filling mechanism, thus realizes suitable perfusion action.
(B. detailed melt action)
Therefore the conduit system 5 of present embodiment carries out melting action after regulating the flow of (control) perfusion liquid L in such a way.Hereafter be described in detail to such action of melting.Further, below with reference in the explanation of Fig. 4, the control action for convenience of explanation for the output power Pout utilizing above-mentioned observed temperature information Tm to carry out is omitted.
Fig. 4 is the flow chart melting an example of action representing present embodiment.Melt in action at this, start above-mentioned " Standby " flow action (step S101) first in the following manner.That is, utilize input part 31 by the operator of supply unit 3 and the index signal the action of " Standby " flow is made to control part 35 input, so the action that control part 35 controls liquid supply unit 21 makes this " Standby " flow action start.Therefore, near the front end of termination electrode 112 before ablation catheter 1 to the microperfusion liquid L disposing part drain flow F=Fst.
Then, setting electric power Ps when being melted input part 31 input by the operator of supply unit 3 and target temperature Tt, so these numerical value are provided to control part 35 to complete setting value (step S102).Then, input part 31 is utilized to set (step S103) (instruction) melts (melting action) by operator.That is, by input part 31, the index signal melting beginning is made to control part 35 input.
Now control part 35 is preferably only when judging after the action of " Standby " flow starts, and accepts to make this melt the index signal of beginning.Before being judged as that the action of " Standby " flow starts conversely speaking, even if input makes the index signal melting beginning, control part 35 also can not export power supply unit 32 and make the control signal CTL1 melting beginning.Therefore, before melting beginning, (in the space such as, for working fluid L) in ablation catheter 1 can be made to be full of liquid L.Consequently, such as blood can be avoided to flow into inner from the fore-end (such as, the tap hole of liquid L) of ablation catheter 1, the danger that inside (such as, in above-mentioned space) blocks by thrombosis.
(action of " LOW " flow)
After receiving such index signal, first control part 35 controls to start the relatively few low discharge action of fluid flow F (" LOW " flow action of F=Fl) (step S104) by carrying out as described above.Therefore, near the front end of termination electrode 112 before ablation catheter 1 to the liquid L disposing part drain flow F=Fl.
Then, from such " LOW " flow action and through set melt the stand-by time of beginning after, supply output power Pout (such as high frequency output) (step S105) to ablation catheter 1 and to pole plate 4 by power supply unit 32.Therefore principle as described above, starts melting of the disposal part of " LOW " flow action.Herein, stand-by time when melting beginning preferably about 1 ~ 10 second, is 5 seconds as enumerated a suitable example.
So, control part 35 is by with after making the action of " Standby " flow switch to the action of " LOW " flow, and the mode of the supply action of output power Pout when just starting the melting of power supply unit 32 controls, and can obtain following advantage.That is, because in general, the supply of liquid is more time-consuming than electric power supply compared with electric power, so can avoid the situation that fluid low occurs due to such service time difference, realizes more suitable perfusion action.
Then, by in voltage measurement portion 33, current measurement portion 34 and control part 35, carry out the measurement of above-mentioned actual measurement voltage Vm and measured current Im and utilize calculating of the actual measurement electric power Pm of above-mentioned formula (1), carrying out the measurement (step S106) of surveying electric power Pm.
Next, control part 35 is by the size of the value of the actual measurement electric power Pm that relatively so obtains and threshold value electric power Pth.Specifically, in this example, electric power Pm is judged to survey whether as the value (step S107) of threshold value more than electric power Pth (Pm >=Pth).
Now, if be judged to be Pm < Pth (when step S107:N, low power state), control part 35 controls to continue the relatively few low discharge action of fluid flow F (" LOW " flow action of F=Fl) (step S108) by carrying out as described above.
Then, control part 35 will judge whether the operator of supply unit 3 have input by input part 31 index signal (step S109) that the output of output power Pout is stopped.Now, the index signal (step S109:Y) exporting and stop is have input if judge, control part 35, by the control signal CTL1 by exporting this instruction to power supply unit 32, stops the supply (step S110) of output power Pout (high frequency output) thus.Then, from stopping the supply of output power Pout and after stand-by time (the 2nd stand-by time) when the supply of set electric power stops, control part 35 just carries out control makes the action of " LOW " flow be converted to " Standby " flow action (step S111), and to complete shown in Fig. 4 whole melts action.Herein, the stand-by time preferably about 1 ~ 5 second when electric power supply stops, being 2 seconds as enumerated a suitable example.
So, control part 35 make electric power when melting supply (supply of output power Pout) stop time, from stopping the supply action of output power Pout and be converted to the action of " Standby " flow again after the stand-by time that electric power supplies when stopping, following advantage can be obtained.That is, disposal part also continues for some time after the supply of output power Pout stops the condition of high temperature can be avoided resulting from and cooling that the perfusion liquid L that occurs carries out is not enough, more suitable perfusion action can be realized.
In addition, do not input the index signal (step S109:N) that above-mentioned output stops if judging, then turn back to step S106, again carry out the measurement of surveying electric power Pm.
(action of " HIGH " flow)
In addition, in above-mentioned steps S107, if be judged to be Pm >=Pth (when step S107:Y, high power state), control part 35 controls to change (step S112) from present " LOW " flow action to the large discharge action (" HIGH " flow action of F=Fh) that fluid flow F is relatively many by carrying out.Thus, by near the front end of termination electrode 112 before ablation catheter 1 to the liquid L disposing part drain flow F=Fh.Therefore, with principle mentioned above, high power state can be carried out and the melting of the disposal part of " HIGH " flow action.
Now as shown in Figure 5, when this actual measurement electric power Pm changes paramount power state from low power state, from hereinafter described be converted to low power state from high power state time different, control part 35 will make the action of " LOW " flow (not wait for stand-by time process when hereinafter described set flow action switches) rapidly and switch to the action of " HIGH " flow.So because the action of " HIGH " flow can be switched to immediately, so when changing paramount power state from low power state, the situation (situation of fluid low) that the flow of generation liquid is very few can be avoided.
Then, in voltage measurement portion 33, current measurement portion 34 and control part 35, the measurement (step S113) of surveying electric power Pm is again carried out.Then, control part 35 judges to survey electric power Pm again whether as the value (step S114) of threshold value more than electric power Pth (Pm >=Pth).
If be judged to be Pm >=Pth (when step S114:Y, high power state), control part 35 carries out control makes the action of " HIGH " flow continue (step S115).So then control part 35 in the same manner as above-mentioned steps S109, will judge whether to have input the index signal (step S116) making the output of output power Pout stop.Now, the index signal (step S116:Y) exporting and stop being have input if be judged as, control part 35, by exporting the control signal CTL1 of this instruction to power supply unit 32, stops the supply (step S117) of output power Pout (high frequency output).Then, after stand-by time when stopping the supply of output power Pout and have passed through above-mentioned electric power supply stopping, control part 35 carries out controlling to be converted to " Standby " flow action (step S118) from the action of " HIGH " flow, and to complete shown in Fig. 4 whole melts action.
Even if so under the situation of carrying out the action of " HIGH " flow, when control part 35 stops the supply of output power Pout, also from stopping the supply of output power Pout and be converted to the action of " Standby " flow again after the stand-by time that electric power supplies when stopping.Therefore, the advantage identical with during above-mentioned " LOW " flow action can be obtained.
In addition, do not input the index signal (step S116:N) that above-mentioned output stops if being judged as, then turn back to step S113, again carry out the measurement of surveying electric power Pm.
In addition, in above-mentioned steps S114, if be judged to be Pm < Pth (when step S114:N, low power state), then the given time (stand-by time, the 1st stand-by time when set flow action switches) (step S119) whether (Pm < Pth) state (low power state) continues to preset is somebody's turn to do in control part 35 judgement.Not yet continue the stand-by time (step S119:N) when flow action switches if be judged as, be then converted to above-mentioned steps S115, control part 35 carries out control makes the action of " HIGH " flow continue.Herein, the stand-by time preferably about 1 ~ 10 second when flow action switches, is 5 seconds as enumerated a suitable example.
On the other hand, continue the stand-by time (step S119:Y) when flow action switches if be judged as, then control part 35 carries out controlling to switch to " LOW " flow action (step S120) from present " HIGH " flow action.Therefore, by near the front end of termination electrode 112 before ablation catheter 1 to the liquid L disposing part drain flow F=Fl.Further, turn back to above-mentioned steps S106 later, again carry out the measurement of surveying electric power Pm.。
Herein as shown in Figure 6, when this actual measurement electric power Pm is converted to low power state from high power state, from above-mentioned change paramount power state from low power state time different, control part 35 will control the flow action of liquid L in the following manner.That is, control part 35 is when this conversion, when low power state continue for above-mentioned flow action switch time stand-by time, will the action of " HIGH " flow maintain this flow action switching time stand-by time after switch to the action of " LOW " flow.In other words, after waiting for the stand-by time when such flow action switches, the action of " LOW " flow is switched to from the action of " HIGH " flow.Therefore, when being converted to low power state from high power state, the situation (situation of fluid low) that the flow of generation liquid is very few can be avoided.
Specifically, because (temperature disposing part reduces risk time too much with aforesaid liquid flow F, harmful effect etc. is produced to disposal during treatment) compare, risk (cooling of disposal part and the improvement effect of blood stasis become insufficient) when fluid flow F is very few large (problem is more deep), so take above-mentioned control.Namely, in view of the magnitude relationship of risk like this, although keep one section of fluid flow F relatively many when the state of surveying electric power Pm is changed during, but in order to oversize during not making fluid flow F relatively many, after stand-by time when have passed through flow action and switching, just carry out switching and make fluid flow F become relatively few.
Have again, as shown in the dotted line waveform in Fig. 6 and "×" symbol, even when being converted to low power state from high power state, when this conversion when low power state not yet continues stand-by time when flow action switches (being equivalent to step S119:N), then become following situation.That is, in such a case, control part 35 will not carry out switching to " LOW " flow action (continuing the action of " HIGH " flow) from the action of " HIGH " flow.Therefore, as shown in the example in Fig. 6, even if the value of actual measurement electric power Pm changes in time change up and down near threshold value electric power Pth, also can realize suitable perfusion action.
In above-mentioned present embodiment, because control part 35 controls as follows: when actual measurement electric power Pm changes paramount power state from low power state, switch to the action of " HIGH " flow rapidly from the action of " LOW " flow; On the other hand, when being converted to low power state from high power state, when this conversion when low power state continue for stand-by time when flow action switches, the action of " LOW " flow is switched to, so the situation of generation fluid low can be avoided when electric power change after by the stand-by time of " HIGH " flow action when maintaining this flow action and switching.Therefore, it is possible to carry out suitable perfusion action when melting.
In addition, control part 35 is because make the temperature measured by the temperature survey mechanism in ablation catheter 1 roughly keep certain, so can obtain following effect by regulation output electric power Pout.That is, after suitably can regulating based on the setting electric power Ps of input in addition, the output power Pout that supply is actual.
Furtherly, because fluid Supplying apparatus 2 and supply unit 3 are formed in the mode of not consubstantiality, so each device can be configured separately according to behaviour in service, the ease of use of whole conduit system 5 is improved.Specifically, as shown in Figure 1, by fluid Supplying apparatus 2 is configured in relative patient 9 more nearby, such connecting fluid body feeding 2 can shorten with the liquid supply pipe of ablation catheter 1, and doctor also easily operates.In addition, meanwhile, by supply unit 3 is configured in relative patient 9 remotely, such technician easily operates.So can configure each device according to behaviour in service.
< variation >
Then, the variation of above-mentioned embodiment is described.Further, give identical symbol to the parts identical with the element in embodiment, and suitably omit the description.
Fig. 7 is the schematic block diagram of the overall configuration example of conduit system (conduit system 5A) involved by the variation of above-mentioned embodiment.The conduit system 5A of this variation is also the system used when treating patient 9 arrhythmia etc., possesses ablation catheter 1, control device 6 and to pole plate 4.
Control device 6 is the devices fluid Supplying apparatus 2 illustrated by above-mentioned embodiment and supply unit 3 integration formed as single equipment, has each parts square frame contained by fluid Supplying apparatus 2 and supply unit 3.That is, control device 6 has liquid supply unit 21, input part 31, power supply unit 32, voltage measurement portion 33, current measurement portion 34, control part 35 and display part 36.
So the conduit system 5A of this variation is different from the conduit system 5 of above-mentioned embodiment, and the various functions of fluid Supplying apparatus 2 and supply unit 3 are integrated in one and form as single device (control device 6).In other words, liquid supply unit 21, input part 31, power supply unit 32, voltage measurement portion 33, current measurement portion 34, control part 35 and display part 36 are respectively set in same device and control device 6.
This variation of formation like this can obtain the same effect produced by the effect identical with above-mentioned embodiment substantially.That is, the situation that fluid low occurs when electric power is changed can being avoided, suitable perfusion action can be carried out when melting.
In addition, particularly in this variation, the various functions of fluid Supplying apparatus 2 and supply unit 3 are integrated in one as single device (control device 6) formation, the formation of whole conduit system 5A can be simplified.
Other variation > of <
Although above by enumerating embodiment and variation describes the present invention, the present invention is not limited to these embodiments etc., can carry out various amendment.
Such as, each layer illustrated in the above-described embodiment and the material of each parts etc. do not limit, and also can use other materials.In addition, in the above-described embodiment, although specifically enumerate the formation of ablation catheter 1 (axle 11) and be illustrated, might not need that there are whole parts, also can have miscellaneous part further in addition.Specifically, such as, in the inside of axle 11, as tilting member, the leaf spring that can be out of shape on bending direction also can be set.In addition, the formation (configuration, shape, quantity etc. of ring electrode and front termination electrode) of the electrode on axle 11 is not limited to the example in above-mentioned embodiment etc.
In addition, in above-mentioned embodiment etc., although the ablation catheter type that can change in one direction according to the operation of operating portion 12 of the shape near the front end P1 enumerating axle 11 being illustrated, be not limited to this.That is, the present invention can the Application Example ablation catheter type that can change in both directions according to the operation of operating portion 12 as the shape near the front end P1 of axle 11, and complex root now will be used to grasp position.In addition, the ablation catheter type that the shape near the front end P1 that the present invention also can be suitable for axle 11 is fixed, does not now need behaviour's position and swivel plate 122.That is, handle 121 is only had to form operating portion.
Furtherly, in above-mentioned embodiment etc., although the square frame specifically enumerating fluid Supplying apparatus 2 and supply unit 3 forms and is illustrated, might not need that there is all parts square frame illustrated by whole above-mentioned embodiment, also can have miscellaneous part square frame further in addition.In addition, as whole conduit system, except each device that above-mentioned embodiment etc. is illustrated, also can have other devices further.Specifically, such as, on the liquid supply line between liquid supply unit 21 (fluid Supplying apparatus 2 or control device 6) and ablation catheter 1, also can have repeater during liquid supply further.
Further, in above-mentioned embodiment etc., although use flow chart to describe various process when melting action in detail, the illustrated various process such as above-mentioned embodiment might not be needed all to carry out, also can carry out other process in addition further.Specifically, the control action of " Standby " flow action illustrated for above-mentioned embodiment etc. and the output power Pout that utilizes observed temperature information Tm to carry out, according to circumstances at least can not carry out a kind of action wherein yet.
Claims (7)
1. a conduit system, wherein, possesses:
Ablation catheter, it has filling mechanism;
Power supply unit, electric power when described ablation catheter supply is melted;
Liquid supply unit, to described ablation catheter supply perfusion liquid; And
Control part, controls the supply action of the supply action of the described electric power of described power supply unit and the described liquid of described liquid supply unit respectively,
When the actual measurement electric power of described control part when described melting is the high power state of more than threshold value electric power, control to become the relatively many large discharge actions of described fluid flow;
On the other hand, when described actual measurement electric power is the low power state less than described threshold value electric power, control to become the relatively few low discharge action of described fluid flow,
And when being converted to described high power state from described low power state, switch to described large discharge action rapidly from described low discharge action;
On the other hand, when being converted to described low power state from described high power state, when this conversion when described low power state continue for the 1st stand-by time, described large discharge action is switched to described low discharge action after maintaining described 1st stand-by time.
2. conduit system according to claim 1, wherein, described control part only when judging after standby flow action that described fluid flow is small starts, accepts the index signal melting beginning described in making.
3. conduit system according to claim 2, wherein, described control part, when receiving described index signal, after switching to described low discharge action from described standby flow action, makes the supply action of described electric power start.
4. the conduit system described in any one in claims 1 to 3, wherein, described control part, when making the supply action of described electric power stop, stopping rear in the supply action of described electric power and after the 2nd stand-by time, makes it be converted to the small standby flow action of described fluid flow.
5. the conduit system described in any one in Claims 1-4, wherein,
Described ablation catheter has temperature survey mechanism near its front end,
Described control part regulates the output power from described power supply unit roughly to keep certain to make the temperature measured by described temperature survey mechanism.
6. the conduit system described in any one in claim 1 to 5, wherein,
Described liquid supply unit is arranged in fluid Supplying apparatus,
And it is in the supply unit of not consubstantiality that described power supply unit and described control part are arranged at respectively with described fluid Supplying apparatus.
7. the conduit system described in any one in claim 1 to 5, wherein, described liquid supply unit, described power supply unit and described control part are arranged in same device respectively.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2013-039600 | 2013-02-28 | ||
| JP2013039600A JP5757586B2 (en) | 2013-02-28 | 2013-02-28 | Catheter system |
| PCT/JP2013/075888 WO2014132476A1 (en) | 2013-02-28 | 2013-09-25 | Catheter system |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN104822335A true CN104822335A (en) | 2015-08-05 |
| CN104822335B CN104822335B (en) | 2017-12-19 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201380062501.6A Expired - Fee Related CN104822335B (en) | 2013-02-28 | 2013-09-25 | Conduit system |
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| Country | Link |
|---|---|
| JP (1) | JP5757586B2 (en) |
| KR (1) | KR101737253B1 (en) |
| CN (1) | CN104822335B (en) |
| TW (1) | TWI564042B (en) |
| WO (1) | WO2014132476A1 (en) |
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| WO2020174651A1 (en) * | 2019-02-28 | 2020-09-03 | 日本ライフライン株式会社 | Catheter system |
| WO2020174650A1 (en) * | 2019-02-28 | 2020-09-03 | 日本ライフライン株式会社 | Catheter system |
| US11589918B2 (en) * | 2019-04-08 | 2023-02-28 | Biosense Webster (Israel) Ltd. | System and method for temperature control in irrigated ablation |
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| CN1078377A (en) * | 1992-11-19 | 1993-11-17 | 中国人民解放军第二一三医院 | Program-controlled multi-function eletrocoagulation condensation therapeutic apparatus |
| US20050033278A1 (en) * | 2001-09-05 | 2005-02-10 | Mcclurken Michael | Fluid assisted medical devices, fluid delivery systems and controllers for such devices, and methods |
| US20100168736A1 (en) * | 2008-12-30 | 2010-07-01 | Huisun Wang | Controlled irrigated catheter ablation systems and methods thereof |
| US20100211070A1 (en) * | 2009-02-17 | 2010-08-19 | Raj Subramaniam | Apparatus and methods for supplying fluid to an electrophysiology apparatus |
| CN102238920A (en) * | 2008-10-06 | 2011-11-09 | 维兰德.K.沙马 | Method and apparatus for tissue ablation |
| CN102266245A (en) * | 2010-06-04 | 2011-12-07 | 心诺普医疗技术（北京）有限公司 | Perfusion-type radiofrequency ablation catheter |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
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| US6953461B2 (en) * | 2002-05-16 | 2005-10-11 | Tissuelink Medical, Inc. | Fluid-assisted medical devices, systems and methods |
| EP1385439A1 (en) * | 2001-05-10 | 2004-02-04 | Rita Medical Systems, Inc. | Rf tissue ablation apparatus and method |
| EP2523620B1 (en) * | 2010-01-15 | 2019-06-19 | Medtronic Advanced Energy LLC | Electrosurgical device |
| CN102309364B (en) * | 2010-07-01 | 2013-03-27 | 上海导向医疗系统有限公司 | Gas flow control device for assisting radiofrequency ablation and method for implementing cooling by same |
-
2013
- 2013-02-28 JP JP2013039600A patent/JP5757586B2/en active Active
- 2013-09-25 WO PCT/JP2013/075888 patent/WO2014132476A1/en active Application Filing
- 2013-09-25 KR KR1020157023084A patent/KR101737253B1/en active IP Right Grant
- 2013-09-25 CN CN201380062501.6A patent/CN104822335B/en not_active Expired - Fee Related
- 2013-11-19 TW TW102142026A patent/TWI564042B/en not_active IP Right Cessation
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1078377A (en) * | 1992-11-19 | 1993-11-17 | 中国人民解放军第二一三医院 | Program-controlled multi-function eletrocoagulation condensation therapeutic apparatus |
| US20050033278A1 (en) * | 2001-09-05 | 2005-02-10 | Mcclurken Michael | Fluid assisted medical devices, fluid delivery systems and controllers for such devices, and methods |
| CN102238920A (en) * | 2008-10-06 | 2011-11-09 | 维兰德.K.沙马 | Method and apparatus for tissue ablation |
| US20100168736A1 (en) * | 2008-12-30 | 2010-07-01 | Huisun Wang | Controlled irrigated catheter ablation systems and methods thereof |
| US20100211070A1 (en) * | 2009-02-17 | 2010-08-19 | Raj Subramaniam | Apparatus and methods for supplying fluid to an electrophysiology apparatus |
| CN102266245A (en) * | 2010-06-04 | 2011-12-07 | 心诺普医疗技术（北京）有限公司 | Perfusion-type radiofrequency ablation catheter |
Also Published As
| Publication number | Publication date |
|---|---|
| TWI564042B (en) | 2017-01-01 |
| JP5757586B2 (en) | 2015-07-29 |
| CN104822335B (en) | 2017-12-19 |
| WO2014132476A1 (en) | 2014-09-04 |
| KR101737253B1 (en) | 2017-05-17 |
| JP2014166237A (en) | 2014-09-11 |
| TW201433324A (en) | 2014-09-01 |
| KR20150113075A (en) | 2015-10-07 |
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