CN107693112A - Ablating electrode and the catheter with the ablating electrode - Google Patents

Ablating electrode and the catheter with the ablating electrode Download PDF

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Publication number
CN107693112A
CN107693112A CN201711019457.7A CN201711019457A CN107693112A CN 107693112 A CN107693112 A CN 107693112A CN 201711019457 A CN201711019457 A CN 201711019457A CN 107693112 A CN107693112 A CN 107693112A
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CN
China
Prior art keywords
cylinder
ablating electrode
catheter
receiving channel
electrode
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Pending
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CN201711019457.7A
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Chinese (zh)
Inventor
白忠爱
陈诚
胡昌
陈艳
高宾
孙飞飞
谭家宏
孙毅勇
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Shanghai Minimally Invasive Electrophysiology Medical Polytron Technologies Inc
Shanghai Microport EP MedTech Co Ltd
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Shanghai Minimally Invasive Electrophysiology Medical Polytron Technologies Inc
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Priority to CN201711019457.7A priority Critical patent/CN107693112A/en
Publication of CN107693112A publication Critical patent/CN107693112A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00059Material properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589Coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00714Temperature

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Plasma & Fusion (AREA)
  • General Health & Medical Sciences (AREA)
  • Otolaryngology (AREA)
  • Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Abstract

The present invention provides a kind of ablating electrode and the catheter with the ablating electrode, helps avoid forming coagulation on ablating electrode.The ablating electrode of the present invention includes:First cylinder, it is solid integrative-structure;Second cylinder, it is solid integrative-structure, it is coaxially connected and coaxial with first cylinder, and have a diameter larger than the diameter of first cylinder;One fluid receiving channel, from the bottom surface of first cylinder, second cylinder is extended to out of described first cylinder;One or more divided fluid stream passages, are intersected in the port of the fluid receiving channel in second cylinder and with the fluid receiving channel, and the port is located at the circle centre position perpendicular to the section of axial direction of second cylinder.

Description

Ablating electrode and the catheter with the ablating electrode
Technical field
The present invention relates to technical field of medical instruments, a kind of particularly ablating electrode and with the ablating electrode Catheter.
Background technology
Arrhythmia cordis, especially atrial fibrillation, it is always common and dangerous disease, it is particularly true in the elderly.Normal sinus Under the property rhythm of the heart, by the heart in atrium, ventricle and excitatory transmission organizational composition in the presence of electro photoluminescence can synchronously, medelling side Formula is beaten.And for the patient of arrhythmia cordis, the abnormal area of heart tissue will not follow related to normal conduction tissue same Walk beat cycles.
Electrode electrophysiology catheter uses RF energy ablation arrhythmia cordis as caused by abnormal electrical activity in heart tissue It is commonplace.In operation, radio frequency ablation catheter percutaneous puncture is transported to the target site that lesion occurs, and it is remote to be now placed in conduit The ablating electrode at end and the dispersing electrode at patient back form loop.The transmission of radio-frequency energy of transmitting is arrived by it by ablating electrode Neighbouring pathological tissues, it is dehydrated solidification and lose electrical conduction function, so as to realize the purpose for the treatment of tachyarrhythmia. During this, due to the conduction from heated tissue to electrode in itself, the heating to electrode also occurs.If electrode temperature is high In 60 DEG C, then the thin layer of dehydration blood protein can be formed on the surface of electrode.If temperature continues to raise, the dehydration layer It can become increasingly thicker, cause the coagulation for producing blood at the electrode surface, that is, cause to form a scab, so as to inhibit depth of ablation Development, cause electrical conduction not blocked thoroughly, in this case, conduit must be from withdrawing from and carried out to electrode clear in vivo Reason, have impact on the process of operation.
In order to reach deeper depth of ablation, the method generally used at present is while RF ablation, with stream Body such as saline infusions ablating electrode dilutes neighbouring blood to be actively cooled electrode-tissue interface, can so make Ablation catheter alleviates the temperature rise of radio-frequency ablation electrode while reaching deeper depth of ablation using higher power, so as to protect While demonstrate,proving effect, it is also prevented from target site surface and forms localized hyperthermia, reduces incrustation and the treatment of thrombosed probability, carry The security and validity of height operation.It can be seen that perfusion technique is significant to RF ablation.
Perfusion technique will solve the uniform effectively cooling to electrode surface (surface particularly with tissue contacting portions).It is right In the cold brine infusion type radiofrequency ablation catheter of routine, its catheter interior is provided with a coherent salt solution transfer passage, apex electrode For solid cylinder, and fluid passage is processed in it, form the fluid point with fluid receiving channel and through electrode surface The solid integral cylindrical-shaped structure of circulation road, after fluid is conveyed into the fluid receiving channel in electrode, then is further separated into multiple streams Body split channel, finally reach electrode surface and flow outwardly.To ensure that electrode surface can be uniformly cooled, divided fluid stream passage Uniformly arranged on the circumferencial direction of electrode surface in the hole formed at the electrode surface.
Figure 1A is the side view according to catheter of the prior art.As shown in Figure 1A, mainly include in catheter Apex electrode 1, ring electrode 2, sheath 3, handle 4, female Luer 5, Brine Pipe 6, wherein being deflectable close to the part of ring electrode Section 7.
Figure 1B is the schematic diagram according to the ablating electrode of the prior art with perfusing hole.Figure 1B is ablating electrode 10 Perspective view, interconnection and coaxial the first cylinder 11 and the second cylinder 12 being shown, the two is all solid integrative-structure, And the diameter of the first cylinder 11 is less than the diameter (D1 i.e. in figure of the second cylinder 12>D2).Fluid receiving channel 13 from First cylinder 11 extends to the second cylinder 12, is crossed in the end of fluid receiving channel 13 and multiple divided fluid stream passages.Figure In show the divided fluid stream passage 141 to 146 being evenly distributed on the second cylinder circumferencial direction.Separately have multiple blind holes 151, 152nd, 153 also the second cylinder 12 is extended to from the first cylinder 11.These blind holes are used for accommodating electric lead, positioning filament, shaping Silk, alignment sensor etc..Wherein alignment sensor need to be accommodated by thicker blind hole 152.Electric lead, positioning filament, shaping silk etc. can To be distributed in other blind holes.
For the ablating electrode with perfusing hole shown in Figure 1B, although taking divided fluid stream passage is evenly spaced in Measure on two cylinder circumferencial directions, but in practice, this processing mode can not still avoid shape on ablating electrode well Into coagulation.
The content of the invention
In view of this, the present invention provides a kind of ablating electrode and the catheter with the ablating electrode, helps to keep away Exempt to form coagulation on ablating electrode.
To achieve the above object, according to an aspect of the invention, there is provided a kind of ablating electrode.
The ablating electrode of the present invention includes:First cylinder, it is solid integrative-structure;Second cylinder, it is solid one Structure, it is coaxially connected and coaxial with first cylinder, and have a diameter larger than the diameter of first cylinder;One stream Body receiving channel, from the bottom surface of first cylinder, second cylinder is extended to out of described first cylinder;One Individual or multiple divided fluid stream passages, the fluid is intersected in second cylinder and with the fluid receiving channel The port of receiving channel, the port are located at the circle centre position perpendicular to the section of axial direction of second cylinder.
Alternatively, in addition to one or more blind holes, from the bottom surface of first cylinder, from first cylinder Inside extend to second cylinder.
Alternatively, the face that the cross section of the blind hole forms for circular or closure irregular curve.
Alternatively, the circumference at the edge of at least one blind hole bottom surface and the bottom surface of first cylinder has two friendships Point.
Alternatively, the fluid receiving channel and first cylinder are coaxial;Or the axle of the fluid receiving channel The axis of line and second cylinder intersects at the port.
According to another aspect of the present invention, there is provided a kind of catheter, the end of the catheter are connected with the present invention In ablating electrode.
Alternatively, the catheter end is nearby single lumen catheter, and the single lumen catheter is enclosed on first cylinder, and The end face of the single lumen catheter is bonded with the end face of second cylinder.
Alternatively, the seam crossing outer surface of the end face of the single lumen catheter and the end face of second cylinder scribbles gluing Agent.
Alternatively, the material of the single lumen catheter is polyether-ether-ketone.
Technique according to the invention scheme, for the ablating electrode with perfusing hole, make its fluid receiving channel and fluid The intersection of split channel is located at the circle centre position in the section of the second cylinder, helps to make fluid in each bar divided fluid stream passage Flow velocity as close possible to so that electrode surface can be uniformly cooled, so as to help avoid that coagulation is formed on ablating electrode. In order that other pipelines in electrode are received, in an embodiment of the present invention, can make each blind hole be shaped as it is " broken Hole " or irregularly-shaped hole, fluid receiving channel can also be made inclined, and these measures can be used in conjunction with one another.Adopt With technical scheme, no matter conduit head end reclines with tissue at any orientation, can realize maximized cooling effect Fruit.In addition, the intersection of fluid receiving channel and divided fluid stream passage is located at the center of circular cross-section, fluid can also be reduced Energy loss, improve charging efficiency.
Brief description of the drawings
Accompanying drawing is used to more fully understand the present invention, does not form inappropriate limitation of the present invention.Wherein:
Figure 1A is the side view according to catheter of the prior art;
Figure 1B is the schematic diagram according to the ablating electrode of the prior art with perfusing hole;
Fig. 2 is flow velocity of the fluid in divided fluid stream passage according in the ablating electrode of the prior art with perfusing hole The schematic diagram of distribution;
Fig. 3 is stream of the fluid in divided fluid stream passage in the ablating electrode with perfusing hole according to embodiments of the present invention The schematic diagram of speed distribution;
Fig. 4 is the schematic diagram for the ablating electrode that according to embodiments of the present invention the first has perfusing hole;
Fig. 5 is the schematic diagram for the ablating electrode that according to embodiments of the present invention second has perfusing hole;
Fig. 6 is the schematic diagram for the ablating electrode that according to embodiments of the present invention the third has perfusing hole;
Fig. 7 is the schematic diagram of section near the catheter end for being provided with ablating electrode according to embodiments of the present invention.
Embodiment
The one exemplary embodiment of the present invention is explained below in conjunction with accompanying drawing, including the various of the embodiment of the present invention Details should think them only exemplary to help understanding.Therefore, those of ordinary skill in the art should recognize Arrive, various changes and modifications can be made to the embodiments described herein, without departing from scope and spirit of the present invention.Together Sample, for clarity and conciseness, the description to known function and structure is eliminated in following description.
For it is of the prior art have perfusion in ablating electrode, fluid divided fluid stream passway velocity flow profile such as Shown in Fig. 2.Fig. 2 is flow velocity of the fluid in divided fluid stream passage according in the ablating electrode of the prior art with perfusing hole The schematic diagram of distribution.Image 20 in Fig. 2 is to use fluid calculation software such as SolidWorks Flow The emulation such as Simulation show that wherein different colours represent flow velocity (unit of the fluid in each split channel:MM/S).From Fig. 2 can be seen that speed difference of the fluid in different split channels is larger, thus fluid for ablating electrode end not Cooling effect with position differs, in this case, when conduit head end at different orientations with tissue closely against When, " focus " that the poor position of cooling effect is formed is easy for triggering coagulation when touching tissue.
Why ablating electrode of the prior art with perfusing hole still easily triggers coagulation, is primarily due to fluid The intersection of receiving channel and divided fluid stream passage is not at the circle centre position in the section of the second cylinder 12 (with reference to figure 1B).Cause This makes the fluid receiving channel in ablating electrode and the intersection of divided fluid stream passage be located at the second cylinder in the present embodiment The circle centre position in 12 section, the fluid so obtained divided fluid stream passage velocity flow profile as shown in figure 3, Fig. 3 be according to this In the ablating electrode with perfusing hole of inventive embodiments, schematic diagram of the fluid in the velocity flow profile of divided fluid stream passage.From Fig. 3 In image 30 as can be seen that each divided fluid stream passage in rate of flow of fluid relatively, so allow for outside ablating electrode Table can be cooled down fairly evenly, avoid the formation of " focus ", so as to reduce the possibility for triggering coagulation.
Because the size of cylinder electrode cross section is very limited, for the conduit with alignment sensor, its electrode sections Diameter typically not over 2.5MM, about 8F, as shown in Figure 1A, and on electrode cross-section in addition to fluid passage, also wants cloth Put other conventional inner conduit parts, such as electric lead, positioning filament, shaping silk, alignment sensor, particularly orientation sensing Device, its radial dimension is relatively large, is the principal element for influenceing the arrangement of fluid receiving channel.In most cases, if will The intersection of fluid receiving channel and divided fluid stream passage is set to be located at the circle centre position in the section of the first cylinder, and fluid receives Passage is still located on the axis of the first cylinder 11, then needs to adjust the position of blind hole.Below to the arrangement of blind hole in the present embodiment Mode is illustrated.
Fig. 4 is the schematic diagram for the ablating electrode that according to embodiments of the present invention the first has perfusing hole.Fig. 4 is ablation electricity The perspective view of pole 40, fluid receiving channel 41 therein and the intersection 49 of multiple divided fluid stream passages 421 to 426 are located at second The section center of circle of cylinder 43.Because the limited area of the cross section of the first cylinder 44, to the shape of at least one blind hole Shape is adjusted, and the situation being adjusted to blind hole 45 is shown in figure, and the blind hole 45 is a thick blind hole of comparison, be can be used for Accommodate the element of the larger external diameters such as alignment sensor.As shown in figure 4, the bottom of the edge of the bottom surface of blind hole 45 and the first cylinder 44 The circumference in face has two intersection points, so that the section of part 451 of the blind hole 45 in the first cylinder 44 is only circular one Point, it is open on the side surface of the first cylinder 44, that is, forms a kind of " holes ", the part in the second cylinder 43 452 section just reverts to circle.Can be fully using in the second thicker cylinder 43 by the way of this " holes " Space, the space of thinner the first cylinder 44 is saved, so that the axis of fluid receiving channel 41 can be with the first cylinder The axis of body 44 is overlapping.
Fig. 5 is the schematic diagram for the ablating electrode that according to embodiments of the present invention second has perfusing hole.Fig. 5 is ablation electricity The perspective view of pole 50, fluid receiving channel 51 therein and the intersection 59 of multiple divided fluid stream passages 521 to 526 are located at second The section center of circle of cylinder 53.Because the limited area of the cross section of the first cylinder 54, to the shape of at least one blind hole Shape is adjusted, and makes face of its cross section for circular or closure irregular curve composition, so as to turn into irregularly-shaped hole rather than circle Hole.The situation being adjusted to blind hole 55 is shown in figure, by its alternation of cross-section concavity, such as the kidney shape shown in figure, it is recessed The position entered is close with fluid receiving channel 51.Blind hole 55 is a thick blind hole of comparison, available for receiving alignment sensor etc. The element of larger external diameter, in this case the coil shape of alignment sensor should also adjust.It is adjusted to by blind hole 55 In the case of spill, it can also also be made to " holes ", i.e., it is open on the side surface of the first cylinder 54.
Fig. 6 is the schematic diagram for the ablating electrode that according to embodiments of the present invention the third has perfusing hole.Fig. 6 is ablation electricity The perspective view of pole 60, fluid receiving channel 61 therein and the intersection 69 of multiple divided fluid stream passages 621 to 626 are located at second The section center of circle of cylinder 63, and the other end 611 of fluid receiving channel 61 is not at the section circle of the first cylinder 64 The heart, that is to say, that the axis of fluid receiving channel 61 is inclined, and the axis of the axis and the first cylinder 64 is not parallel to each other, This mode similarly helps to save the Section Space of the first cylinder 64, and can also be with the measure phase of above-mentioned " holes " With reference to as shown in fig. 6, the cross-sectional periphery of the edge line in the section of blind hole 65 and the first cylinder 64 has two intersection points.It is in addition, right In the situation (such as shown in Fig. 5) using irregularly-shaped hole, it can equally make the axis and the first cylinder 64 of fluid receiving channel 61 Axis it is not parallel to each other.That is, fluid receiving channel can in three kinds of modes using tilt axis, " holes ", irregularly-shaped hole Used with flexible combination.
Fig. 7 is the schematic diagram of section near the catheter end for being provided with ablating electrode according to embodiments of the present invention. As shown in fig. 7, near the end of catheter, ablating electrode 71 is using any of the present embodiment ablating electrode, medical treatment The main body 72 of conduit is single lumen catheter near end, is enclosed on the first cylinder 711 of ablating electrode 71, the end face of the single lumen catheter It is bonded with the end face of the second cylinder 712 of ablating electrode 71, is bonded the outer surface of the seam crossing 73 of formation and can apply adhesive and add With fixation.The stronger polyurethanes slow curing type adhesive of bonding force can be chosen, to ensure the fixing of apex electrode connection.If Blind hole is handled by the way of " holes ", in case of need, the wall thickness of above-mentioned single lumen catheter should be sufficiently thin.The single lumen catheter can be with Using materials such as polyether-ether-ketones (PEEK).
Technical scheme according to embodiments of the present invention, for the ablating electrode with perfusing hole, make its fluid receiving channel It is located at the circle centre position in the section of the second cylinder with the intersection of divided fluid stream passage, helps to make fluid in each bar divided fluid stream Flow velocity in passage is as close possible to so that electrode surface can be uniformly cooled, so as to help avoid being formed on ablating electrode Coagulation.In order that other pipelines in electrode are received, in an embodiment of the present invention, the shape of each blind hole can be made Shape is " holes " or irregularly-shaped hole, fluid receiving channel can also be made inclined, and these measures can be combined with each other Use.Using technical scheme, no matter conduit head end reclines with tissue at any orientation, can realize maximized Cooling effect.In addition, brine channel is located at the center of circular cross-section on electrode, the energy loss of fluid can also be reduced, carried High perfusion efficiency.
Above-mentioned embodiment, does not form limiting the scope of the invention.Those skilled in the art should be bright It is white, depending on design requirement and other factors, various modifications, combination, sub-portfolio and replacement can occur.It is any Modifications, equivalent substitutions and improvements made within the spirit and principles in the present invention etc., should be included in the scope of the present invention Within.

Claims (9)

  1. A kind of 1. ablating electrode, it is characterised in that including:
    First cylinder, it is solid integrative-structure;
    Second cylinder, it is solid integrative-structure, it is coaxially connected and coaxial with first cylinder, and have a diameter larger than institute State the diameter of the first cylinder;
    One fluid receiving channel, from the bottom surface of first cylinder, described is extended to out of described first cylinder Two cylinders;
    One or more divided fluid stream passages, institute is intersected in second cylinder and with the fluid receiving channel The port of fluid receiving channel is stated, the port is located at the circle centre position perpendicular to the section of axial direction of second cylinder.
  2. 2. ablating electrode according to claim 1, it is characterised in that also including one or more blind holes, from described first The bottom surface of cylinder is risen, and second cylinder is extended to out of described first cylinder.
  3. 3. ablating electrode according to claim 2, it is characterised in that circle is in the cross section of the blind hole or closes not The face of regular curve composition.
  4. 4. ablating electrode according to claim 2, it is characterised in that the edge of at least one blind hole bottom surface with it is described The circumference of the bottom surface of first cylinder has two intersection points.
  5. 5. ablating electrode according to any one of claim 1 to 4, it is characterised in that the fluid receiving channel and institute It is coaxial to state the first cylinder;Or the axis of the axis of the fluid receiving channel and second cylinder intersects at the end Mouthful.
  6. 6. a kind of catheter, it is characterised in that the end of the catheter is connected with any one of claim 1 to 5 institute The ablating electrode stated.
  7. 7. catheter according to claim 6, it is characterised in that the catheter end is nearby single lumen catheter, should Single lumen catheter is enclosed on first cylinder, and the end face of the single lumen catheter is bonded with the end face of second cylinder.
  8. 8. catheter according to claim 7, it is characterised in that the end face of the single lumen catheter and second cylinder The seam crossing outer surface of end face scribble adhesive.
  9. 9. the catheter according to claim 7 or 8, it is characterised in that the material of the single lumen catheter is polyether-ether-ketone.
CN201711019457.7A 2013-11-15 2013-11-15 Ablating electrode and the catheter with the ablating electrode Pending CN107693112A (en)

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CN201310574396.6A CN104622567B (en) 2013-11-15 2013-11-15 Ablating electrode and catheter with the ablating electrode

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