CN109621189A - It is a kind of to be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein - Google Patents

It is a kind of to be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein Download PDF

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Publication number
CN109621189A
CN109621189A CN201910093927.7A CN201910093927A CN109621189A CN 109621189 A CN109621189 A CN 109621189A CN 201910093927 A CN201910093927 A CN 201910093927A CN 109621189 A CN109621189 A CN 109621189A
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China
Prior art keywords
pacing electrode
cylinder mould
metal cylinder
body portion
head
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CN201910093927.7A
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Chinese (zh)
Inventor
祝金明
祝文童
张磊
杨萍
孙欢
贺玉泉
曾红
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Individual
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Priority to CN201910093927.7A priority Critical patent/CN109621189A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • A61N1/3956Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A61N1/3962Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056Transvascular endocardial electrode systems
    • A61N1/0563Transvascular endocardial electrode systems specially adapted for defibrillation or cardioversion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056Transvascular endocardial electrode systems
    • A61N1/0565Electrode heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362Heart stimulators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39Heart defibrillators
    • A61N1/3968Constructional arrangements, e.g. casings

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Electrotherapy Devices (AREA)

Abstract

Automatic fixed head end diplocardia room synchronous pacing electrode cable is implanted into through vein the present invention relates to a kind of, including head, body portion and tail portion, wherein, body portion and head are connected by master-slave socket mode, body portion is fixedly connected with tail portion, tail portion uses IS-1 connector, body portion is made of diameter of the conducting wire of 1~2mm, absolute electrode is provided in body portion, absolute electrode is 10~20mm at a distance from head, head is metal cylinder mould, the shape of metal cylinder mould is double-face circular disc shape, cylindrical waist body is provided between preceding metal dish and rear metal dish, the diameter of waist body is 2mm, the length of waist body is 2~3mm, metal cylinder mould is worked out by shape-memory alloy wire.The beneficial effect of pacing electrode wire of the present invention is: do not need through arterial system implantable atrial pacing electrode wire reach atrium sinistrum it is intracavitary, avoid since pacing electrode wire swims in high pressure, the intracavitary risk for leading to thrombosis in atrium sinistrum of rapid flow.

Description

It is a kind of to be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein
Technical field
The invention belongs to the field of medical instrument technology, and in particular to a kind of same through the automatic fixed head end diplocardia room of vein implantation Walk pacing electrode wire.
Background technique
It is main existing for atrium pacing electrode wire implantation theory aspect in existing artificial cardiac pacemaker installation art It is disadvantageous in that, does not propose the concept of the most ideal pace-making target area in atrium, guided without specific concept, it is just not bright True operation thinking, so, subsequent instrument can not be mating, and operating technology even more cannot achieve, so, up to the present, face Bed has no idea to accomplish the auricular pacemaking for most ideal target area.
It is main existing for the pacing electrode wire implanted prosthetics aspect of atrium in existing artificial cardiac pacemaker installation art It is disadvantageous in that, is led by manipulating cardiac pacing electrode through the center cavity guide wire of wire body tail portion Line makes its head end be implanted in the manipulations processes such as atrial septum target area, readjustment and replacement implantation target area and fully relies on The subjective thinking of patient and experience accumulation are precisely completed without objective accurate localization method and corresponding auxiliary instrument.Knot Tab phenolphthaleinum causes difference of technology level between atrial lead conducting wire implant procedure patient very big, the difference in terms of existing theory, More there is the difference in terms of personal operational capacity, subjective part is relatively more anyway, can not be formulated to the standard of unified standard Change operation sequence.
Due to there are many Surgical technique difference bring operation related complications, including subclavian vein puncture is related Complication, puncture failure thromboembolism, haemopneumothorax, accidentally wears subclavian artery etc.;Pacing electrode wire head end implantation position is not When complication, including the dislocation of pacing electrode wire head end and micro- dislocation, the perforation of atrium free wall, pericardial tamponade, other are concurrent Disease includes pacemaker electrode harness damage, arrhythmia cordis, local infection and pacemaker syndrome etc., some complication pass through carefulness Operation can be to avoid some is then limited by human anatomy, or since pacing electrode wire self character is limited, can not be kept away Exempt from.
Atrium pacing electrode wire implantation instrument aspect is existing not in existing artificial cardiac pacemaker installation art Foot place is manufactured and designed thinking by pacing electrode wire overall structure and transportation system and is limited, and most important problem is scarce The softer atrial lead conducting wire head end in body portion can conveniently, accurately, be quickly and safely transported to implantation target portion less Position auxiliary duct road system, lack from external accurate manipulation enter the chambers of the heart after pacing electrode wire head end tool, lack Pacing electrode wire head end can be just fixedly secured the fixation device in implantation target area in implantation less at once, lead to not reality Now accurate, atrial lead conducting wire implant surgery is rapidly completed in safety.It is embodied in:
(1) it cannot achieve atrium sinistrum endocardial pacing.It is analyzed from the whole dissection structural point of heart, the chamber of heart Left and right atrium and Ventricular totally four chambers can be divided into, analyzed from the physiological function angle of heart, atrium sinistrum and the right side Atrium should be synchronous pacing.But under the conditions of our existing science and technology, artificial cardiac pacemaker is installed in art It is intracavitary that the head end of atrial lead conducting wire through vein implantation can only be implanted to atrium dextrum, that is to say, that can only directly pace the right side Atrium, and atrium sinistrum is electric, mechanical activity is that the atrium dextrum paced by elder generation moves up come band, it is clear that it is left not as good as directly pace-making Atrium is effective.Scientific technological advance up to the present, to the direct pace-making of atrium sinistrum, the pacing electrode wire head that is implanted into through vein End can only pace the external membrane of heart through coronary venous system implantation, still lead without any a atrial lead through vein implantation Line can be accomplished directly to pace the atrium sinistrum internal membrane of heart.
(2) it cannot achieve large area endocardial pacing.From cardiac electrophysiology angle analysis, the highest of cardiac pacing It is ideal, it should to be that by complete conducting system of heart reconstruction or replacement therapy, it is desirable to which directly pace-making to heart passes Guiding systems tissue.By taking sick sinus syndrome as an example, in sinoatrial node, cardiac pacing is most managed for pace-making and conductive impairment position Think that target area should be paced directly around sinoatrial node, enables subsequent electric signal along originals such as internodal tract, atrioventricular node, Xinier reservoirs The route and network of conducting system of heart conducts under this normal physiological conditions.However scientific technological advance is up to the present, Cardiac pacing can't be accomplished directly accurately to pace around the extra small sinoatrial node of target, have to take the second best, can only take aim at To the atrial tissue of target zone super large.
Since pacing electrode wire head end shape is limited, existing atrial septum pace-making target area can only be atrial septum The certain point of tissue, organic whole of the atrial tissue as a super large, endocardial surface product can be arrived to 100cm2, existing Atrial lead diameter of wire is about 3.2mm2, head end area about 8mm2(A=π r2=3.14 × 1.62=8mm2), and it is huge Atrial endocardium area compare, a point can only be can be regarded as, and a face cannot be can be regarded as, let alone stereochemical structure, so, it is existing Somebody's work cardiac pacing can only be referred to as dotted pace-making.The pace-making at atrium dextrum interval position each time is exactly once to originate from The atrial premature beats of atrium dextrum side certain point.
(3) it cannot achieve the earliest excitable area pace-making in super-selective atrium.Under physiological conditions, left atrium is not just to rise simultaneously It fights, in general, the position at the top of atrium dextrum where close orifice of superior vena cava angle, that is, sinoatrial node is that atrium is excited earliest Area.Atrium dextrum top area is gradually to atrium dextrum lower conduction first around sinoatrial node for electricity impulsion originating from sinoatrial node, directly After being nearly completed to entire atrium dextrum free wall and atrial septum depolarization, atrium sinistrum side just starts depolarization, in general, atrium sinistrum Excitement lag behind atrium dextrum.From the evidence of electrocardiogram, when atrium dextrum hypertrophy, P wave-amplitude increases, when atrium sinistrum hypertrophy When, P wave is broadening, shows as when serious bimodal.
The relationship of existing passive fixed head end pacing electrode wire shape design, can only be implanted within right auricle of heart, nothing Method is fixed on other any positions in atrium dextrum, can not be implanted in around the sinoatrial node of superior vena cava and atrium dextrum intersection; It is existing actively to fix head end pacing electrode wire in principle and be implanted in the intracavitary any position in atrium dextrum, but be generally implanted into Target spot selection or it is random, atrial lead conducting wire head end is implanted in a certain of atrium with cannot accomplishing super-selective A privileged site, let alone it is implanted in the earliest excitable area in atrium.
(4) it cannot achieve implantation piece pacing electrode wire simultaneous pacing two sides atrium.
The basic structure of the atrial lead conducting wire of existing cardiac pacing system and head end shape feature etc. determine One radical center room pacing electrode wire of implantation can only pace side atrium, cannot achieve two sides atrium simultaneously, synchronous pacing.At present Feasible method, must after a piece pacing electrode wire of the intracavitary implantation in atrium dextrum in order to realize left and right atrium synchronous pacing It must be in addition implanted into a Left atrium pacing electrode cable, however, Left atrium pacing electrode cable head end implant site cannot but select It is intracavitary to be implanted in selecting property atrium sinistrum, free wall limited target area in atrium sinistrum can only be branched to along coronary venous system, It can only thus realize atrium sinistrum Epicardial pacing.
(5) it is at once effectively fixed to cannot achieve the implantation of atrial lead conducting wire head end.Using existing auricular pacemaking electricity The artificial cardiac pacemaker implant surgery that polar conductor is completed, if implantation is passive fixed head end pacing electrode wire, implantation is The fixation principle at quarter is by between the inverted beard of pacing electrode wire head end and the trabecular muscles network in atrium fleshy exterior face in right auricle of heart Temporary containing, cannot achieve high-intensitive effective fixation, generally requiring to brake on patient bed will also limit in three days, one month The aggravating activities of art side upper limb.If implantation is actively to fix head end pacing electrode wire, the fixation principle for being implanted at once be according to The spiral screwed out by pacing electrode wire head end is fixed on heart muscle, is generally unlikely to fall off easily, but due to screw geometry Shape and the volume of restrained cardiac muscular tissue are limited, and fixed and insecure, patient's perioperative also has to avoid art side limbs Normal activity.
(6) complication such as cardiac perforation, dislocation of electrode not can avoid.It is completed using existing atrial lead conducting wire Artificial cardiac pacemaker implant surgery, what is no matter be implanted into is passive fixed head end pacing electrode wire, or actively fixes head end Pacing electrode wire the softer atrial lead conducting wire in body portion is convenient, accurate, can be conveyed safely due to lacking To the auxiliary duct road system and control device of ideal target area, select not can avoid that touch atrium free when target area Wall, lack from external accurate manipulation enter the chambers of the heart after pacing electrode wire head end specialist tools, push body portion softness electricity The unique method of polar conductor is the wire intracavitary by central control post, and dynamics is grasped the bad atrium free wall that is likely to cause and worn Hole;Pacing electrode wire head end can be fixedly secured the device in implantation target area in implantation at once due to lacking, it is postoperative Poor contact between electrode head end recent and at a specified future date and cardiac muscular tissue inevitably occurs, causes the risk of dislocation of electrode.
Summary of the invention
For disadvantage of the existing technology, it is same through the automatic fixed head end diplocardia room of vein implantation that the present invention provides a kind of Walk pacing electrode wire.
The technical scheme is that a kind of be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein, Including head, body portion and tail portion, wherein body portion and head are connected by master-slave socket mode, and body portion is fixedly connected with tail portion, tail Portion uses IS-1 connector, and body portion is made of diameter of the conducting wire of 1~2mm, is provided with absolute electrode in body portion, absolute electrode with The distance on head is 10~20mm, and head is metal cylinder mould, and the shape of metal cylinder mould is double-face circular disc shape, preceding metal dish and rear gold Belong to and be provided with cylindrical waist body between disk, the diameter of waist body is 2mm, and the length of waist body is 2~3mm, and metal cylinder mould is by shape Memory alloy wire weaves.
Further, the metal cylinder mould front ends mouth before head is the round and smooth cecum of smooth surface.
Further, the subsequent metal cylinder mould in head rear portion is provided with band internal thread cylindrical nuts, outside cylindrical nuts Wall is equipped with the master-slave socket interface of self-locking device.
Further, the length of waist body most preferably 2.5mm.
The beneficial effect of pacing electrode wire of the present invention is: it is synchronous and matched with electrophysiology to realize anatomy The earliest excitable area pace-making in atrium, closest to the auricular pacemaking of physiological status;It is fixedly secured at interventricular septum puncture, avoids taking off The risk fall, shifted;Do not need through arterial system implantable atrial pacing electrode wire reach atrium sinistrum it is intracavitary, avoid due to rise Electrode cable of fighting swims in high pressure, the intracavitary risk for leading to thrombosis in atrium sinistrum of rapid flow;Pass through single auricular pacemaking The pacing signal each time that electrode cable passes over all while being passed to left and right atrium two sides.The present invention is by the application The superior technology scheme that people is obtained by the repetition test that the more than ten years take infinite pains has the huge tribute for the society that promotes the well-being of mankind It offers, there is significant progress compared with prior art.
Detailed description of the invention
Fig. 1 is the structural schematic diagram of atrial lead conducting wire of the present invention.
In figure shown in label: the head 1-, 11- waist body, metal dish before 12-, metal dish after 13-, 14- cecum, 15- column spiral shell Mother, 2- body portion, 21- absolute electrode, the tail portion 3-.
Specific embodiment
A specific embodiment of the invention is described in further details with reference to the accompanying drawings of the specification.
As shown in Figure 1, pacing electrode wire of the present invention, including head 1, body portion 2 and tail portion 3, wherein body portion 2 with Head 1 is connected by master-slave socket mode, and body portion 2 is fixedly connected with tail portion 3, and tail portion 3 uses IS-1 connector, and body portion 2 is diameter Be made of the conducting wire of 1~2mm, be provided with absolute electrode 21 in body portion 2, absolute electrode 21 at a distance from head 1 for 10~ 20mm, the length of absolute electrode 21 are 3mm, and head 1 is metal cylinder mould, and the shape of metal cylinder mould is double-face circular disc shape, preceding metal It is connected between cylinder mould 12 and rear metal cylinder mould 13 by cylindrical waist body 11, the diameter of waist body 11 is 2mm, and the length of waist body 11 is 2~3mm, preceding metal cylinder mould 12 are woven with rear metal cylinder mould 13 by shape-memory alloy wire.
Further, preceding 12 front port of metal cylinder mould is the round and smooth cecum 14 of smooth surface.
Further, rear 13 rear portion of metal cylinder mould is provided with band internal thread cylindrical nuts 15,15 outer wall of cylindrical nuts Master-slave socket interface (not shown) equipped with self-locking device.
Further, the length of waist body 11 most preferably 2.5mm.
Present invention is not limited to the embodiments described above, without departing substantially from substantive content of the present invention, art technology Any deformation, improvement, the replacement that personnel are contemplated that each fall within protection scope of the present invention.

Claims (4)

1. a kind of be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein, including head (1), body portion (2) and Tail portion (3), which is characterized in that body portion (2) are connect with head (1) by master-slave socket mode, and body portion (2) and tail portion (3) are fixed Connection, tail portion (3) use IS-1 connector, and the conducting wire of body portion (2) by diameter by (1)~(2) mm is made, is arranged on body portion (2) Have absolute electrode (21), absolute electrode (21) is 10~20mm at a distance from head (1), and head (1) is metal cylinder mould, metal mesh The shape of cage is double-face circular disc shape, between preceding metal cylinder mould (12) and rear metal cylinder mould (13) even by cylindrical waist body (11) It connects, the diameter of waist body (11) is 2mm, and the length of waist body (11) is 2~3mm, preceding metal cylinder mould (12) and rear metal cylinder mould (13) It is woven by shape-memory alloy wire.
2. pacing electrode wire according to claim 1, which is characterized in that preceding metal cylinder mould (12) front port is smooth surface Round and smooth cecum (14).
3. pacing electrode wire according to claim 1, which is characterized in that rear metal cylinder mould (13) rear portion, which is provided with, to be had The cylindrical nuts (15) of internal screw thread, cylindrical nuts (15) outer wall are equipped with the master-slave socket interface of self-locking device.
4. pacing electrode wire according to claim 1, which is characterized in that the length most preferably 2.5mm of waist body (11).
CN201910093927.7A 2019-01-30 2019-01-30 It is a kind of to be implanted into automatic fixed head end diplocardia room synchronous pacing electrode cable through vein Pending CN109621189A (en)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101954147A (en) * 2010-08-30 2011-01-26 王晓舟 Electrode with intrakardial pace-making device
CN106362288A (en) * 2016-09-14 2017-02-01 郭成军 Heart implant and fixation method thereof
US20180161585A1 (en) * 2016-12-12 2018-06-14 Sorin Crm Sas System and method for extra cardiac defibrillation
CN108348756A (en) * 2015-11-20 2018-07-31 心脏起搏器股份公司 The single channel coronary vein conducting wire for sensing and pacing for multi-chamber
CN207838033U (en) * 2016-12-09 2018-09-11 复旦大学附属中山医院 A kind of no conducting wire pacemaker fixing device and without conducting wire pacemaker system
CN209827975U (en) * 2019-01-30 2019-12-24 祝金明 Transvenous implantation automatic fixed head end double-atrium synchronous pacing electrode lead

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101954147A (en) * 2010-08-30 2011-01-26 王晓舟 Electrode with intrakardial pace-making device
CN108348756A (en) * 2015-11-20 2018-07-31 心脏起搏器股份公司 The single channel coronary vein conducting wire for sensing and pacing for multi-chamber
CN106362288A (en) * 2016-09-14 2017-02-01 郭成军 Heart implant and fixation method thereof
CN207838033U (en) * 2016-12-09 2018-09-11 复旦大学附属中山医院 A kind of no conducting wire pacemaker fixing device and without conducting wire pacemaker system
US20180161585A1 (en) * 2016-12-12 2018-06-14 Sorin Crm Sas System and method for extra cardiac defibrillation
CN209827975U (en) * 2019-01-30 2019-12-24 祝金明 Transvenous implantation automatic fixed head end double-atrium synchronous pacing electrode lead

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