CN104941067A - Anti-dislocation left ventricle electrode wire - Google Patents
Anti-dislocation left ventricle electrode wire Download PDFInfo
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- CN104941067A CN104941067A CN201510431649.3A CN201510431649A CN104941067A CN 104941067 A CN104941067 A CN 104941067A CN 201510431649 A CN201510431649 A CN 201510431649A CN 104941067 A CN104941067 A CN 104941067A
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Abstract
The embodiment of the invention discloses an anti-dislocation left ventricle electrode wire which comprises a spindly catheter, wherein the catheter comprises a near end and a remote end; the near end is configured as a connector connected with a heart pacemaker; an end pacing electrode is arranged at the tip of the remote end; the remote end is bent twice to form a first oblique angle and a second oblique angle in sequence; lateral fixing wings are arranged on the side, approaching the near end, of the second oblique angle, and comprise folded elastomers which protrude in the normal direction of the catheter; when the folds of the elastomers extend or contract in the axial direction of the catheter, the lateral fixing wings contract or extend correspondingly in the normal direction of the catheter. The anti-dislocation left ventricle electrode wire provided by the embodiment of the invention adopts the design of double oblique angles, so that the position fixed effect of the anti-dislocation left ventricle electrode wire in a target vein can be greatly enhanced; moreover, the lateral fixing wings are arranged on the side, approaching the near end, of the second oblique angle, and the folds of the lateral fixing wings extend and are supported on the wall of a target vessel during use, so that the position fixed effect of the anti-dislocation left ventricle electrode wire can be further enhanced.
Description
Technical field
The present invention relates to technical field of medical instruments, particularly relate to a kind of anti-dislocation left ventricular electrode wire.
Background technology
Following cardiac resynchronization therapy (CRT) is treated the nonsynchronous heart failure patient of ventricular systole by the mode of ventricular pacemaking, is a revolution in heart failure treatment field.In following cardiac resynchronization therapy process, cardiac pacemaker is sent pace-making, cardioversion or defibrillation pulse by implantable lead and is provided therapeutic stimulation to heart.Pulse is delivered to heart via electrode, and this electrode is arranged on wire, such as, near the distal end being usually arranged on wire.In the case, electrode cable can make electrode locate relative to the various positions of heart, to enable pacemaker, pulse delivery is delivered to suitable position.If loosely cause loose electrode placement because electrode cable is fixing over the course for the treatment of, then there will be pace-making bad, cause CRT failure, occur diaphragm nerve stimulation, time serious, even can bring life danger to patient.Therefore, the fixed effect of electrode cable is the most essential steps determining CRT success or not.
In prior art, left ventricular electrode wire generally adopts a kind of level and smooth, straight electrode cable, and electrode cable is arranged on the intravenous appropriate location of target, relies on the electrode emission electric pulse pace-making of electrode cable head end.
But the left ventricular electrode wire used in prior art, usually due to its smooth, straight structure, causes in the fixation of target intravenous, finally to cause loose electrode placement and making CRT failure; In addition, existing left ventricular electrode wire only relies on the end pacing electrode of electrode head end to launch single-point electric pulse pace-making, and exhaustion cardiac muscle usually exists tiny scar tissue, if single-point pacing site by chance meets with cicatrix cardiac muscle, then occur that pace-making is bad, cause CRT failure.
Summary of the invention
Provide a kind of anti-dislocation left ventricular electrode wire in the embodiment of the present invention, fix loosely cause loose electrode placement and the problem making CRT failure to solve left ventricular electrode wire in prior art.
In order to solve the problems of the technologies described above, the embodiment of the invention discloses following technical scheme:
A kind of anti-dislocation left ventricular electrode wire, comprise elongated conduit, described conduit comprises near-end and far-end, and described near-end is configured to the interface be connected with cardiac pacemaker, and the end of described far-end is provided with end pacing electrode,
Described far-end is bent with the first oblique angle and the second oblique angle successively, and described second oblique angle is positioned at the proximal lateral at described first oblique angle;
The proximal lateral at described second oblique angle is also provided with side to fixed-wing, the conduit of described side direction fixed-wing both sides is connected by side direction fixed-wing, described side direction fixed-wing is the elastomer of the normal orientation protrusion fold along conduit, described fold is along the axial direction extension of conduit or when shrinking, and it is corresponding contraction or extension in the normal orientation of conduit.
Preferably, described first oblique angle is apart from the end 5-15mm of described far-end, and described second oblique angle is apart from the end 25-35mm of described far-end.
Preferably, the angle at described first oblique angle is 90-130 °, and the angle at described second oblique angle is 120-150 °.
Preferably, described side direction fixed-wing is apart from the end 40-60mm of described far-end.
Preferably, the telescopic extensions of described side direction fixed-wing in the normal orientation of described conduit is 5.7-24F.
Preferably, be also provided with ring-type pacing electrode between described first oblique angle and the second oblique angle, described ring-type pacing electrode ring set is on described conduit.
Preferably, the length of described conduit is 70-95cm.
Preferably, the length of described conduit is 78cm or 88cm.
Preferably, described side direction fixed-wing is with the one-body molded setting of described conduit or be connected by connector.
Preferably, the skin of described conduit is for having the medical silica gel tube of dielectric features, and the internal layer of described conduit is the net metal silk with conduction property.
From above technical scheme, the anti-dislocation left ventricular electrode wire that the embodiment of the present invention provides adopts double bevel design, double bevel structure makes conduit form the supporting construction be made up of multiple stress point at target intravenous, greatly strengthen electrode cable at the intravenous fixed effect of target; In addition, be also provided with side to fixed-wing in the proximal lateral at the second oblique angle, during use, the fold extension of side direction fixed-wing is supported on target vessel wall, and the fixed effect of electrode cable is strengthened further.
Accompanying drawing explanation
In order to be illustrated more clearly in the embodiment of the present invention or technical scheme of the prior art, be briefly described to the accompanying drawing used required in embodiment or description of the prior art below, apparently, for those of ordinary skills, under the prerequisite not paying creative work, other accompanying drawing can also be obtained according to these accompanying drawings.
Fig. 1 is one provided by the invention anti-dislocation left ventricular electrode conductor structure schematic diagram;
Fig. 2 is that the far-end of conduit is at the intravenous holding state schematic diagram of target;
Fig. 3 is the axial direction contraction state schematic diagram of side direction fixed-wing along conduit;
Fig. 4 is the axial direction extension state schematic diagram of side direction fixed-wing along conduit;
Fig. 5 is that side direction fixed-wing is at the intravenous holding state schematic diagram of target;
Symbol in Fig. 1-Fig. 5 is expressed as:
1-interface, 2-conduit, 3-side direction fixed-wing, 31-fold, 41-first oblique angle, 42-second oblique angle, 51-end pacing electrode, 52-ring-type pacing electrode, 61-first stress point, 62-second stress point, 63-the 3rd stress point, 64-the 4th stress point, 7-target vein.
Detailed description of the invention
Technical scheme in the present invention is understood better in order to make those skilled in the art person, below in conjunction with the accompanying drawing in the embodiment of the present invention, technical scheme in the embodiment of the present invention is clearly and completely described, obviously, described embodiment is only the present invention's part embodiment, instead of whole embodiments.Based on the embodiment in the present invention, those of ordinary skill in the art, not making the every other embodiment obtained under creative work prerequisite, should belong to the scope of protection of the invention.
The one anti-dislocation left ventricular electrode wire schematic diagram that Fig. 1 provides for the embodiment of the present invention, it is for connecting cardiac pacemaker, and the signal of telecommunication of cardiac pacemaker is delivered to position suitable in heart, to provide therapeutic stimulation to heart.Anti-dislocation left ventricular electrode wire shown in Fig. 1, as shown in Figure 1, anti-dislocation left ventricular electrode wire comprises the roughly rounded slender conduit in cross section 2, in order to ensure that anti-dislocation left ventricular electrode wire provided by the invention is at endovascular sanitary condition, avoid the physiological reaction that human body is bad, the skin of above-mentioned conduit 2 adopts the medical silica gel tube with insulation characterisitic, in order to realize the stable transfer of the signal of telecommunication in conduit 2, the internal layer of conduit 2 adopts the net metal silk with conduction property, and net metal silk is for connecting cardiac pacemaker and pacing electrode.Conduit 2 is divided into near-end and far-end according to the position of its relative heart pacemaker, is specially, and the one end be connected with cardiac pacemaker is near-end, and the other end is far-end, and wherein, in order to be connected with cardiac pacemaker, near-end is configured to the interface 1 be connected with cardiac pacemaker.
It should be noted that, above-mentioned interface 1 should be understood to all can mate applicable for existing cardiac pacemaker, the interface of cardiac pacemaker and electrode cable is prior art, herein in order to save length and protrude invention main points of the present invention, no longer its concrete principle and concrete structure are described in detail, but should not it can be used as the reason of insufficient disclosure of the present invention.
Because the height differences of child and adult is larger, then the length requirement of electrode cable is not quite similar, according to blood in human body in canal path length, the length of conduit 2 is arranged on 70-95cm, preferably, the length of conduit 2 is set to the different dimensions of 78cm and 88cm two kinds, implants with convenient for children or patient of short and small stature.
In the process of cardiac pacing, electrode cable and pacing electrode be fixed as one of most important link, if what loosely cause pacing electrode dislocation directly can affect pacemaker fixing is implanted to power, even brings life danger to patient time serious.The present invention, in order to the fixed effect of intensifier electrode wire, ensures electrical contact reliably between pacing electrode and target location, adopts double bevel design to anti-dislocation left ventricular electrode wire.Be specially, carry out moulding in advance to conduit 2, bend at the far-end of conduit 2 proximal lateral that first oblique angle 41 and the second oblique angle 42, oblique angle 42, second are positioned at the first oblique angle 41 successively, that is, relative first oblique angle 41, the second oblique angle 42 is closer to the near-end of conduit 2.
Fig. 2 be the far-end of conduit at the intravenous holding state schematic diagram of target, for the ease of the design principle that those skilled in the art understands double bevel in the present invention, contrast Fig. 1 and Fig. 2 below, the double bevel structure in the present invention be specifically described.
Under naturalness, as shown in Figure 1, be bent with the first oblique angle 41 and the second oblique angle 42 successively at the far-end of conduit 2, the oblique angle on conduit 2 keeps bending state to the shape of conduit 2 under the effect of conduit 2 its own resilient, the state namely shown in Fig. 1.In use, in order to target vein 7 implanted by auxiliary electrode wire, common way is in conduit 2, wear a steel wire, and the oblique angle on conduit 2 stretches under the supporting role of steel wire, facilitates the implantation of electrode cable.After electrode cable being placed on the correspondence position of target vein 7, steel wire in conduit 2 is drawn out of, without the support of steel wire in conduit 2, first oblique angle 41 and the second position, oblique angle 42 again bend distortion under the effect of conduit 2 its own resilient, form state as shown in Figure 2, under the restriction of blood vessel wall, between the far-end of conduit 2 and blood vessel wall, form multiple stress point.Wherein, the end of far-end is the first stress point 61; First oblique angle 41 is the second stress point 62; Second oblique angle 42 is the 3rd stress point 63; Conduit 2 and the blood vessel wall at the second proximal lateral, oblique angle 42 offset formation the 4th stress point 64.Be supported in blood vessel wall owing to having multiple stress point at the far-end of conduit 2, make to form stable supporting construction between the far-end of conduit 2 and blood vessel wall, therefore the stability of electrode cable in target vein 7 improves greatly.From the stress point of supporting construction, the crooked place of double bevel determines the shape of supporting construction, if the end of oblique angle and far-end is apart from too small, especially when the second oblique angle 42 is less than blood vessel diameter with the end distance of far-end, double bevel structure effectively can not be supported on the both sides of blood vessel wall; On the contrary, if the end of oblique angle and far-end is apart from excessive, then conduit 2 is comparatively mild at Ink vessel transfusing, and fixed effect is bad.In the present invention, be preferably the end 5-15mm of the first oblique angle 41 apart from far-end, the second oblique angle 42 is apart from the end 25-35mm of far-end.
In addition, the bending angle of double bevel determines the stressed size of stress point in supporting construction, in order to improve the fixed effect of electrode cable, it is contemplated that increase the pressure at stress point place, but along with the pressure increase at stress point place, the stimulation of conduit 2 pairs of blood vessel wall is larger.Therefore, ideal state drops to minimum by it to the stimulation of blood vessel wall meeting electrode cable fixed effect while, and the angle Selection 90-130 ° at the first oblique angle 41 in the present invention, the angle Selection 120-150 ° at the second oblique angle 42, to meet above-mentioned requirements.
In order to the fixed effect of further intensifier electrode wire, side is also provided with to fixed-wing 3 in the proximal lateral at the second oblique angle 42, the conduit 2 of side direction fixed-wing 3 both sides is connected by side direction fixed-wing 3, side direction fixed-wing 3 is with the one-body molded setting of conduit 2 or be connected by connector, during use, the fold extension of side direction fixed-wing 3 is supported in blood vessel wall, the fixed effect of electrode cable is strengthened further, below in conjunction with Fig. 3-Fig. 5, the concrete structure of side direction fixed-wing 3, operation principle and using state is described in detail.
Fig. 3 is the axial direction contraction state schematic diagram of side direction fixed-wing along conduit, as shown in Figure 3, side direction fixed-wing 3 is the elastomer of the normal orientation protrusion fold along conduit 2, under naturalness, fold on elastomer shrinks along the axial direction of conduit 2 under the effect of its own resilient, the state namely shown in Fig. 3.As previously mentioned, in use, in order to target vein 7 implanted by auxiliary electrode wire, usually in conduit 2, a steel wire is worn, fold on elastomer extends along the axis of conduit 2 under the support of steel wire, then the fold on elastomer is evened up gradually, and namely side direction fixed-wing 3 shrinks in the normal orientation (axial direction perpendicular to conduit) of conduit 2, reach state as shown in Figure 4, to facilitate the implantation of electrode cable.After electrode cable being placed on the correspondence position of target vein 7, steel wire in conduit 2 is drawn out of, after the support of steel wire, fold on elastomer shrinks along the axial direction of conduit 2 under the effect of its own resilient, fold on elastomer protrudes gradually in the normal orientation of conduit 2, until be supported in blood vessel wall, fixation is strengthened to electrode cable, as shown in Figure 5.
That is, side direction fixed-wing 3 can according to its extended distance in conduit 2 normal orientation of the different corresponding adjustment of the thickness of blood vessel, in order to adapt to the blood vessel of different thicknesses, in the present invention, side direction fixed-wing 3 telescopic extensions is between 5.7F-24F, the wherein corresponding 1mm of 3F, namely in the present invention, the telescopic extensions of side direction fixed-wing 3 is 1.8mm-8mm.In addition, the length of target vessel is no more than 80mm usually, side direction fixed-wing 3 needs to be fixed in target vessel, therefore side direction fixed-wing 3 is unsuitable long apart from the end of far-end, separately consider the restriction of double bevel position, avoid mutually interfering between side direction fixed-wing 3 and double bevel, within the end distance of side direction fixed-wing 3 opposite proximal end being limited to 40-60mm in the present invention.
Electrode cable is after target vein 7 internal fixtion completes, the signal of telecommunication that cardiac pacemaker produces transfers to the pacing electrode of conduit 2 far-end by the net metal silk of conduit 2 internal layer, to stimulate the correspondence position of target vein 7, reach the effect of by medical apparatus and instruments, heart being carried out to auxiliary pace-making.Existing left ventricular electrode wire generally only arranges end pacing electrode 51 in the end of far-end, but exhaustion cardiac muscle usually exists tiny scar tissue, if the pacing site of end pacing electrode 51 by chance meets with scar tissue, then there will be pace-making bad.For this problem, the present invention is except arranging end pacing electrode 51, also between the first oblique angle 41 and the second oblique angle 42, be provided with a ring-type pacing electrode 52, wherein ring-type pacing electrode 52 is set on conduit 2, adopts end pacing electrode 51 and ring-type pacing electrode 52 two point pace-making to greatly reduce the bad probability of pace-making.Wherein, end pacing electrode 51 is apart from ring-type pacing electrode 10-25mm.
Further, the position in the blood vessel of the pacing electrode in the present invention is more easily determined, during use, as required pacing electrode can be fixed on exactly the correspondence position in target vessel.Be specially, double bevel structure in the present invention makes the far-end of conduit 2 form stable supporting construction at Ink vessel transfusing, from the stress point of supporting construction, when the crooked place of double bevel is determined, the stress point of Ink vessel transfusing supporting construction is also determined relatively, then can determine pacing electrode position in the blood vessel by the position of the relative stress point of pacing electrode.Such as, end pacing electrode 51 is arranged on the first stress point 61 place, then end pacing electrode 51 is fixed on the first stress point 61 position all the time in the blood vessel; Ring-type pacing electrode 52 is arranged between the first oblique angle 41 and the second oblique angle 42, then ring-type pacing electrode 52 is fixed on the position between the second stress point 62 and the 3rd stress point 63 all the time in the blood vessel.That is, electrode cable provided by the present invention can control pacing electrode position in the blood vessel exactly, and then improves the success rate of ventricular pacemaking.
Understand the present invention better for the ease of those skilled in the art, below in conjunction with the implantation flow process of anti-dislocation left ventricular electrode wire provided by the present invention in target vein 7, it is further illustrated.
Because other work (setting of cardiac pacemaker, the dissection etc. of vein blood vessel) before anti-dislocation left ventricular electrode wire implantation belongs to the universal means of this area, therefore no longer describe in detail at this, in following operating process, only relate to the implantation flow process of anti-dislocation left ventricular electrode wire, it specifically comprises following steps:
Step 1: place sheath pipe to coronary sinus vein, determine the target vein 7 that anti-dislocation left ventricular electrode wire is implanted after radiography;
Step 2: place anti-dislocation left ventricular electrode wire in target vein 7 along sheath pipe;
Step 3: extract the steel wire in conduit 2 out, the double bevel stable support of conduit 2 far-end is in target vein 7, and side direction fixed-wing 3 shrinks at the axial direction of conduit 2, is supported in the blood vessel wall in target vein 7.
From the implantation flow process of above-mentioned anti-dislocation left ventricular electrode wire, in the present invention, anti-dislocation left ventricular electrode wire carries out dual fixing in conjunction with double bevel structure and side direction fixed-wing 3 pairs of electrode cables, after steel wire in conduit 2 is drawn out of, double bevel forms stable supporting construction under the effect of its own resilient, and the stability of electrode cable in target vein 7 is improved greatly; Fold on side direction fixed-wing 3 extends along the normal orientation of conduit 2 under the effect of its own resilient, is supported in blood vessel wall, improves the fixed effect of electrode cable further.And then realize cardiac pacemaker to human ecg signal detection senses and pulsed discharge stimulation therapy function, substantially increase the success rate of following cardiac resynchronization therapy.
It should be noted that, in this article, the such as relational terms of " first " and " second " etc. and so on is only used for an entity or operation to separate with another entity or operating space, and not necessarily requires or imply the relation that there is any this reality between these entities or operation or sequentially.And, term " comprises ", " comprising " or its any other variant are intended to contain comprising of nonexcludability, thus make to comprise the process of a series of key element, method, article or equipment and not only comprise those key elements, but also comprise other key elements clearly do not listed, or also comprise by the intrinsic key element of this process, method, article or equipment.When not more restrictions, the key element limited by statement " comprising ... ", and be not precluded within process, method, article or the equipment comprising described key element and also there is other identical element.
The above is only the specific embodiment of the present invention, those skilled in the art is understood or realizes the present invention.To be apparent to one skilled in the art to the multiple amendment of these embodiments, General Principle as defined herein can without departing from the spirit or scope of the present invention, realize in other embodiments.Therefore, the present invention can not be restricted to these embodiments shown in this article, but will meet the widest scope consistent with principle disclosed herein and features of novelty.
Claims (10)
1. an anti-dislocation left ventricular electrode wire, comprise elongated conduit (2), described conduit (2) comprises near-end and far-end, described near-end is configured to the interface (1) be connected with cardiac pacemaker, the end of described far-end is provided with end pacing electrode (51), it is characterized in that
Described far-end is bent with the first oblique angle (41) and the second oblique angle (42) successively, and described second oblique angle (42) is positioned at the proximal lateral of described first oblique angle (41);
The proximal lateral of described second oblique angle (42) is also provided with side to fixed-wing (3), the conduit of described side direction fixed-wing (3) both sides is connected by side direction fixed-wing (3), described side direction fixed-wing (3) is the elastomer of normal orientation protrusion fold (31) along conduit (2), described fold (31) is along the axial direction extension of conduit (2) or when shrinking, and it is corresponding contraction or extension in the normal orientation of conduit (2).
2. anti-dislocation left ventricular electrode wire according to claim 1, is characterized in that, described first oblique angle (41) is apart from the end 5-15mm of described far-end, and described second oblique angle (42) is apart from the end 25-35mm of described far-end.
3. anti-dislocation left ventricular electrode wire according to claim 1 and 2, is characterized in that, the angle of described first oblique angle (41) is 90-130 °, and the angle of described second oblique angle (42) is 120-150 °.
4. anti-dislocation left ventricular electrode wire according to claim 1, is characterized in that, described side direction fixed-wing (3) is apart from the end 40-60mm of described far-end.
5. the anti-dislocation left ventricular electrode wire according to claim 1 or 4, is characterized in that, the telescopic extensions of described side direction fixed-wing (3) in the normal orientation of described conduit (2) is 5.7-24F.
6. anti-dislocation left ventricular electrode wire according to claim 1, it is characterized in that, also be provided with ring-type pacing electrode (52) between described first oblique angle (41) and the second oblique angle (42), described ring-type pacing electrode (52) ring set is on described conduit (2).
7. anti-dislocation left ventricular electrode wire according to claim 1, is characterized in that, the length of described conduit (2) is 70-95cm.
8. anti-dislocation left ventricular electrode wire according to claim 7, is characterized in that, the length of described conduit (2) is 78cm or 88cm.
9. anti-dislocation left ventricular electrode wire according to claim 1, is characterized in that, described side direction fixed-wing (3) is with described conduit (2) one-body molded setting or be connected by connector.
10. anti-dislocation left ventricular electrode wire according to claim 1, it is characterized in that, the skin of described conduit (2) is for having the medical silica gel tube of dielectric features, and the internal layer of described conduit (2) is the net metal silk with conduction property.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201510431649.3A CN104941067A (en) | 2015-07-21 | 2015-07-21 | Anti-dislocation left ventricle electrode wire |
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| CN201510431649.3A CN104941067A (en) | 2015-07-21 | 2015-07-21 | Anti-dislocation left ventricle electrode wire |
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| CN105999550A (en) * | 2016-07-29 | 2016-10-12 | 乐普医学电子仪器股份有限公司 | Actively-fixed left ventricle pacing electrode lead |
| WO2019042454A1 (en) * | 2017-09-04 | 2019-03-07 | 首都医科大学附属北京胸科医院 | Coronary vein guide system and guide method thereof |
| CN111132725A (en) * | 2017-09-25 | 2020-05-08 | TauPNU医疗有限公司 | Device for positioning the end of a pacemaker lead traversing the coronary sinus in the his bundle |
| CN111184947A (en) * | 2018-11-15 | 2020-05-22 | TauPNU医疗有限公司 | Cerclage cardiac pacemaker lead wire |
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| CN111184947B (en) * | 2018-11-15 | 2024-02-20 | Tau医疗公司 | Cerclage cardiac pacemaker lead |
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Application publication date: 20150930 |