CN109922861A - Intracardiac defibrillation catheter system - Google Patents

Abstract

Being designed to provide can reliably avoid applying alive intracardiac defibrillation catheter system to the electrode of defibrillation catheter when the baseline of electrocardiogram moves Oscillating (drift).Conduit system of the invention includes: defibrillation catheter 100, power supply device 700 and electrocardiogram equipment 800, power supply device includes: DC power supply portion 71, applies the external switch 74 for preparing switch 744 and energy application execution switch 745 and the arithmetic processing section 75 for controlling DC power supply portion including energy, arithmetic processing section is only to detect event (V after the stand-by time as defined in beginning to pass through from the generation of the exception wave height event when producing abnormal wave height event during input energy applies and prepares switch until input energy applies and executes switch_n) in the case where, with the event (V_n) DC power supply portion synchronously is controlled with applying DC voltage to the first DC electrode group 31G and the 2nd DC electrode group 32G.

Description

Intracardiac defibrillation catheter system

Technical field

The present invention relates to intracardiac defibrillation catheter systems, more specifically, be related to include be inserted into the chambers of the heart in defibrillation catheter, The power supply device of DC voltage and the conduit system of electrocardiogram equipment are applied to the electrode of the defibrillation catheter.

Background technique

In the past, as can cardiac catheter operation in reliably to cause atrial fibrillation etc. heart supply defibrillation institute It needs and sufficient electric energy, burn can not be generated in the body surface of patient and carry out the intracardiac defibrillation catheter system of defibrillation therapy System, by present applicant has proposed a kind of conduit system, the conduit system be include be inserted into the defibrillation catheter of progress defibrillation in the chambers of the heart, The power supply device of DC voltage and the conduit system of electrocardiogram equipment are applied to the electrode of the defibrillation catheter, defibrillation catheter includes: exhausted The hose part of edge；First DC electrode group is constituted by being mounted on multiple ring electrodes of front end area of hose part；The Two DC electrode groups are constituted from being separately installed multiple ring electrodes in hose part to base end side from the first DC electrode group； First conducting wire group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the first DC electrode group；And second lead Line group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the 2nd DC electrode group, and power supply device includes: DC electricity Source portion；Conduit connects connector, connect with the base end side of the first conducting wire group of defibrillation catheter and the second conducting wire group；Electrocardiogram equipment Connector is connected, is connect with the input terminal of electrocardiogram equipment；Arithmetic processing section, the input control DC power supply based on external switch Portion, and the output circuit with the DC voltage from the DC power supply portion；And switching part, it is opened by the switching of single-pole double throw It closes and constitutes, connect connector in shared contact connecting conduit, connect connector in the first contact connection electrocardiogram equipment, and connect second Point connection arithmetic processing section (constitutes the first DC electrode group and/or the 2nd DC electrode group in the electrode by defibrillation catheter Electrode) measurement heart potential when, the first contact is selected in switching part, the heart potential information from defibrillation catheter is via power supply device Conduit connection connector, switching part and electrocardiogram equipment connection connector be input to electrocardiogram equipment, removed by defibrillation catheter When quivering, the contact of switching part is switched to by the second contact by the arithmetic processing section of power supply device, from DC power supply portion via operation Output circuit, switching part and the conduit connection connector of processing unit are to the first DC electrode group of defibrillation catheter and the 2nd DC electricity Pole group applies mutually different polar voltage (referring to following patent documents 1).

In the conduit system documented by patent document 1, if input applies switch as the energy of external switch, pass through The contact of switching part is switched to the second contact from the first contact by arithmetic processing section, it is ensured that from conduit connection connector via switching The path of portion's arrival arithmetic processing section.

After the contact of switching part is switched to the second contact, from the DC for receiving the control signal from arithmetic processing section Power supply unit connects connector via the output circuit, switching part and conduit of arithmetic processing section, to the first DC electricity of defibrillation catheter Pole group and the 2nd DC electrode group apply mutually different polar DC voltage.

Here, arithmetic processing section carries out calculation process and to DC power supply portion sending control signal, to input via electrocardiogram Apply voltage to the heart potential synchronous waveform of connector input.

In order to carry out effective defibrillation therapy, and ventricle negative effect is not given, be usually synchronously carried out defibrillation with R wave (application of voltage).

If assuming to be synchronously carried out defibrillation with T wave, cause the risk of serious ventricular fibrillation higher, therefore, it is necessary to It avoids synchronous with T wave.

Therefore, in the conduit system documented by patent document 1, in the electrocardio digit wave form for being sequentially inputted to arithmetic processing section One R wave of detection, finds out its wave height in (electrocardiogram), and after rigid input energy applies switch, identification reaches the wave height The peak value of 80% height synchronously applies voltage to first electrode group and second electrode group as R wave, and with the peak value.

It is input at operation however, generating tachiysystole in the heart for wanting to receive the patient of defibrillation therapy or generating The baseline of the electrocardiogram in reason portion (in the case where the drift (drift) of Base line) Dong Oscillating, has and applies switch in rigid input energy The case where peak value (peak value for being identified as R wave) for reaching the potential difference of triggering level later is not actually the peak value of R wave.

For example, as shown in figure 23, in the case where the heart of patient produces the tachiysystole of single, being input at operation The electrocardiogram (electrocardio digit wave form) in reason portion has the polarity of R wave (being the 4th R wave since left side in the figure) to invert, and connects The trend that the peak value of the T wave to get off increases.

Moreover, it is as shown in the drawing, if considering the application switch of the inputing power after just producing tachiysystole, will increase T wave that is big and reaching triggering level is mistakenly considered R wave and carries out sensing detection (detection), and synchronously applies voltage in fact with the T wave Apply defibrillation.

Additionally, it is contemplated that if the baseline Dong Oscillating of electrocardiogram, by usual sensing detection less than waveform be mistakenly considered R wave and pass Sense detection.For example, sometimes due to the rising of baseline, and highly read than reality not as the height of the positive waveform of R wave.Figure 24, which show generation, drifts about and baseline decline, and thereafter, baseline rises and recover to the electrocardiogram of original level, due to being in baseline The application switch of electric energy will be had input before rising, so the rising of baseline, which is mistakenly considered R wave, carries out sensing detection (detection), and Apply voltage synchronously to implement defibrillation.

Given this situation, inventors suggest that a kind of intracardiac defibrillation catheter system comprising: in the insertion chambers of the heart The power supply device and electrocardiogram equipment for carrying out the defibrillation catheter of defibrillation, applying DC voltage to the electrode of the defibrillation catheter, feature It is, above-mentioned defibrillation catheter includes: the hose part of insulating properties；First electrode group, before being mounted on above-mentioned hose part Multiple ring electrodes of end regions are constituted；Second electrode group, from from above-mentioned first electrode group to base end side be separately installed in Multiple ring electrodes of above-mentioned hose part are constituted；First conducting wire group, by front end and the electrode for constituting above-mentioned first electrode group The multiple conducting wires being separately connected are constituted；And the second conducting wire group, distinguished by front end with the electrode for constituting above-mentioned second electrode group Multiple conducting wires of connection are constituted, and above-mentioned power supply device includes: DC power supply portion；Conduit connects connector, with above-mentioned defibrillation catheter The first conducting wire group and the second conducting wire group base end side connection；External switch comprising the application of electric energy switchs；Calculation process Portion, the output circuit with the DC voltage from above-mentioned DC power supply portion, and the input based on said external switch, in control State DC power supply portion；And electrocardiogram input connector, connect with the output terminal of above-mentioned arithmetic processing section and above-mentioned electrocardiogram equipment Connect, by above-mentioned defibrillation catheter carry out defibrillation when, from above-mentioned DC power supply portion via the output circuit of above-mentioned arithmetic processing section with And above-mentioned conduit connects connector, the above-mentioned first electrode group and above-mentioned second electrode group to above-mentioned defibrillation catheter apply mutual Different polar voltage, the arithmetic processing section of above-mentioned power supply device carry out calculation process and control the (reference of above-mentioned DC power supply portion Following patent documents 2), it is successively sensed via above-mentioned electrocardiogram input connector from the electrocardiogram that above-mentioned electrocardiogram equipment inputs with basis Detection is estimated as the event of R wave, and after the input of the application switch of above-mentioned electric energy sensing detection to event (V_n) polarity Event (the V at least arrived with its previous sensing detection_n-1) the event (V that arrives of polarity and its first two sensing detection_n-2) When polarity is consistent, with the event (V_n) synchronously, alive side is applied to above-mentioned first electrode group and above-mentioned second electrode group Formula.

According to conduit system documented by patent document 2, can prevent from causing in the heart for the patient for receiving defibrillation therapy Tachiysystole or when being input to baseline Dong Oscillating (drift) of electrocardiogram of arithmetic processing section, applies the electrode of defibrillation catheter Voltage.

Advanced technical literature

Patent document

Patent document 1: No. 4545216 bulletins of Japanese Patent No.

Patent document 2: No. 5900974 bulletins of Japanese Patent No.

However, also it can be considered that even if in the electrocardiogram for the arithmetic processing section for being input to power supply device successively sensing detection To event (waveform for being estimated as R wave) polarity continuously three times same direction generate, also cause drift the case where.

Figure 25 shows stable baseline and rises, and then baseline declines and recovers to the electrocardiogram of original level, if drawing Play the application switch of inputing power at the time of shown in the arrow (SW-ON) of drift, the then event that sensing detection arrives after which (V₁) polarity and the event (V that arrives of its previous sensing detection₀) the event that arrives of polarity and its first two sensing detection (V_-1) polarity it is consistent, so with the event (V in drift_n) synchronously implement defibrillation.

Therefore, in order to avoid the defibrillation (application of voltage) in drift, reliably detection is needed to cause to drift about.

According to conduit system documented by patent document 2, although can prevent from being synchronously carried out defibrillation with T wave, from more From the viewpoint of safety, need that the event synchronous when carrying out defibrillation is more reliably made not to be T wave.

Summary of the invention

The first object of the present invention is to provide the base that can reliably avoid in the electrocardiogram for being input to arithmetic processing section When Xian Dong Oscillating (drift), voltage is applied to the electrode of defibrillation catheter, and can be same with the R wave of the electrocardiogram in baseline stability Step ground applies DC voltage to the electrode of defibrillation catheter to carry out the intracardiac defibrillation catheter system of defibrillation.

The second object of the present invention, which is to provide, can reliably avoid being synchronously carried out defibrillation with T wave, and can with it is defeated Enter to the electrocardiogram of arithmetic processing section R wave synchronously, DC voltage is applied to the electrode of defibrillation catheter to carry out the heart of defibrillation Intracavitary defibrillation catheter system.

(1) it includes: to carry out in the insertion chambers of the heart that the first aspect of the present invention, which invents related intracardiac defibrillation catheter system, The defibrillation catheter of defibrillation, the power supply device and electrocardiogram equipment for applying DC voltage to the electrode of the defibrillation catheter, wherein above-mentioned Defibrillation catheter includes: the hose part of insulating properties；First electrode group (the first DC electrode group), by being installed on above-mentioned hose part Multiple ring electrodes of front end area are constituted；Second electrode group (the 2nd DC electrode group), from from above-mentioned first DC electrode group to base End side separates and is installed in multiple ring electrodes composition of above-mentioned hose part；First conducting wire group, by front end with constitute it is above-mentioned Multiple conducting wires that the electrode of first DC electrode group is separately connected are constituted；And the second conducting wire group, by front end and constitute above-mentioned second Multiple conducting wires that the electrode of DC electrode group is separately connected are constituted, and above-mentioned power supply device includes: DC power supply portion；Conduit connection connection Device is connect with the base end side of the first conducting wire group of above-mentioned defibrillation catheter and the second conducting wire group；External switch, applying including electric energy Add preparation to switch and apply and executes switch；Arithmetic processing section, the output electricity with the DC voltage from above-mentioned DC power supply portion Road, and the input based on said external switch, control above-mentioned DC power supply portion；And electrocardiogram input connector, with above-mentioned operation The output terminal of processing unit and above-mentioned electrocardiogram equipment connection, by inputting above-mentioned application after the input that above-mentioned application prepares switch Switch is executed to carry out defibrillation by above-mentioned defibrillation catheter, when carrying out defibrillation, from above-mentioned DC power supply portion via above-mentioned operation place The output circuit in reason portion and above-mentioned conduit connect connector, above-mentioned first DC electrode group to above-mentioned defibrillation catheter and above-mentioned the Two DC electrode groups apply mutually different polar voltage, and the arithmetic processing section of above-mentioned power supply device carries out calculation process and controls Above-mentioned DC power supply portion successively senses inspection via the electrocardiogram that above-mentioned electrocardiogram input connector is inputted from above-mentioned electrocardiogram equipment with basis Survey the event of R wave of being estimated as, after the input that above-mentioned application executes switch sensing detection to event (V_n) polarity at least with Event (the V that its previous sensing detection arrives_n-1) the event (V that arrives of polarity and its first two sensing detection_n-2) polarity one Cause, also, extraordinary wave is produced during until inputting above-mentioned application and preparing switch to the above-mentioned application execution switch of input It only (is being the abnormal wave height thing initially generated when producing multiple abnormal wave height from above-mentioned abnormal wave height event when high event Part) generation begun to pass through after defined stand-by time sensing detection to above-mentioned event (V_n) in the case where, with the event (V_n) voltage synchronously is applied to above-mentioned first DC electrode group and above-mentioned 2nd DC electrode group.

(2) the above-mentioned abnormal wave height event in the intracardiac defibrillation catheter system of preferred (first aspect) of the invention is to be more than Before it will input above-mentioned application and prepare switch sensing detection to two events mean wave height 120% wave height thing Part.

(3) the above-mentioned stand-by time in the intracardiac defibrillation catheter system of preferred of the invention (first aspect) be 1000 to Between 5000m seconds.

Intracardiac defibrillation catheter system according to such composition, if in the heart for the arithmetic processing section for being input to power supply device In electrograph, three event (V that continuously sensing detection arrives_n-2)、(V_n-1) and (V_n) polarity it is inconsistent, then be judged as patient Heart cause the baseline of tachiysystole or electrocardiogram due to drift etc. and it is unstable a possibility that, and apply execute open Event (the V that sensing detection arrives after the input of pass_n) be possible to be R wave peak value, without with the event (V_n) synchronously apply electricity Pressure.Moreover, in three event (V_n-2)、(V_n-1) and (V_n) polarity it is consistent when, can be by the event (V of third time_n) be judged as The peak value of R wave.

It is easy to produce abnormal wave height when causing drift in addition, having, which usually restores in or so several seconds, Afterwards, the trend of baseline stability.

Therefore, in addition to three event (V_n-2)、(V_n-1) and (V_n) polarity it is consistent except, also apply from input it is quasi- Standby switch applies to input execute switch until during detection to exception wave height event generation when, only from abnormal wave height thing The generation of part begin to pass through as defined in after stand-by time sensing detection to event (V_n) in the case where, with the event (V_n) synchronous Ground applies voltage.

Thereby, it is possible to reliably avoid applying voltage to the electrode of defibrillation catheter when causing drift, and can be in baseline When stablizing, synchronously with the R wave of the electrocardiogram, DC voltage is applied to the electrode of defibrillation catheter and carries out defibrillation.

(4) intracardiac defibrillation catheter system of preferred (first aspect) of the invention includes: to draw in the report of above-mentioned stand-by time The function for a possibility that playing drift.

Intracardiac defibrillation catheter system according to such composition, operator can easily hold the possibility for causing drift Property, application can not be inputted and execute switch and carry out standby.

(5) intracardiac defibrillation catheter system involved in the second aspect of the present invention includes: to carry out defibrillation in the insertion chambers of the heart Defibrillation catheter, apply the power supply device and electrocardiogram equipment of DC voltage to the electrode of the defibrillation catheter, wherein above-mentioned defibrillation Conduit includes: the hose part of insulating properties；First electrode group (the first DC electrode group), by the front end for being installed on above-mentioned hose part Multiple ring electrodes in region are constituted；Second electrode group (the 2nd DC electrode group), from from above-mentioned first DC electrode group to base end side It is separately installed multiple ring electrodes composition in above-mentioned hose part；First conducting wire group by front end and constitutes above-mentioned first DC Multiple conducting wires that the electrode of electrode group is separately connected are constituted；And the second conducting wire group, by front end and constitute above-mentioned 2nd DC electrode Multiple conducting wires that the electrode of group is separately connected are constituted, and above-mentioned power supply device includes: DC power supply portion；Conduit connects connector, and upper State the base end side connection of the first conducting wire group and the second conducting wire group of defibrillation catheter；External switch, the application including electric energy prepare Switch and application execute switch；Arithmetic processing section, the output circuit with the DC voltage from above-mentioned DC power supply portion, and base In the input of said external switch, above-mentioned DC power supply portion is controlled；And electrocardiogram input connector, with above-mentioned arithmetic processing section with And the output terminal connection of above-mentioned electrocardiogram equipment, switch is executed by inputting above-mentioned application after the input that above-mentioned application prepares switch To carry out defibrillation by above-mentioned defibrillation catheter, when carrying out defibrillation, from above-mentioned DC power supply portion via the defeated of above-mentioned arithmetic processing section Circuit and above-mentioned conduit connect connector out, to the above-mentioned first DC electrode group of above-mentioned defibrillation catheter and above-mentioned 2nd DC electrode Group applies mutually different polar voltage, and the arithmetic processing section of above-mentioned power supply device carries out calculation process and controls above-mentioned DC electricity Source portion, with successively sensing detection is estimated as according to the electrocardiogram inputted via above-mentioned electrocardiogram input connector from above-mentioned electrocardiogram equipment The event of R wave, above-mentioned application execute switch input after sensing detection to event (V_n) polarity it is at least previous with it Event (the V that sensing detection arrives_n-1) the event (V that arrives of polarity and its first two sensing detection_n-2) polarity it is consistent, also, In above-mentioned event (V_n) waveform in, from reach make the baseline of electrocardiogram to above-mentioned event (V_n) polar orientation offset by 0.26V Baseline until will input above-mentioned application prepare sensing detection before switch to two events mean wave height 80% i.e. Rise time until triggering level between 45m seconds, with the event (V_n) synchronously to above-mentioned first electrode Group and above-mentioned second electrode group apply voltage.

Intracardiac defibrillation catheter system according to such composition, if in the heart for the arithmetic processing section for being input to power supply device In electrograph, three event (V that continuously sensing detection arrives_n-2)、(V_n-1) and (V_n) polarity it is inconsistent, then be judged as that have can The baseline of tachiysystole or electrocardiogram can be caused to become unstable due to drift etc. in the heart of patient, and be possible to Apply execute switch input after sensing detection to event (V_n) be R wave peak value, without with the event (V_n) synchronously apply Making alive.

Moreover, in three event (V_n-2)、(V_n-1) and (V_n) polarity it is consistent when, can be judged as the event of third time (V_n) be R wave peak value.

In addition, T wave waveform rise slowly, from baseline to triggering level until rise time usually than 45m seconds between it is long. Therefore, in event (V_n) waveform in, be more than the feelings between 45m seconds from the rise time reached until baseline reaches triggering level Under condition, there is event (V_n) waveform be T wave a possibility that without being identified as trigger point, not with the event (V_n) synchronously apply electricity Pressure, so can reliably avoid being synchronously carried out defibrillation with T wave.

(6) in intracardiac defibrillation catheter system of the invention, the arithmetic processing section of preferably above-mentioned power supply device is will Input sensing detection before above-mentioned application prepares switch to three events polarity it is same to each other in the case where, store the polarity As " polarity of primary event ", and in above-mentioned event (V_n) polarity and above-mentioned primary event the inconsistent situation of polarity Under, not with the event (V_n) synchronously above-mentioned first electrode group and above-mentioned second electrode group are carried out at operation with applying voltage It manages and controls above-mentioned DC power supply portion.

Have the polarity reversion of the event when causing drift, drift about restore when back to original polarity the case where.

Therefore, intracardiac defibrillation catheter system according to such composition, in event (V_n) polarity and primary event In the case that polarity is inconsistent, be judged as have drift continue a possibility that, without with the event (V_n) synchronously apply voltage, from And can more reliably avoid when causing drift, voltage is applied to the electrode of defibrillation catheter.

(7) in intracardiac defibrillation catheter system of the invention, the arithmetic processing section of preferably above-mentioned power supply device is being sensed It detects and is estimated as after the event of R wave, between most 50m seconds short between longest 500m seconds, preferably between 260m seconds, not to above-mentioned One DC electrode group and above-mentioned 2nd DC electrode group control above-mentioned DC power supply portion with applying voltage.

Intracardiac defibrillation catheter system according to such composition, in sensing detection to after being estimated as the event of R wave, most It is short voltage not to be applied to the first DC electrode group and the 2nd DC electrode group between 50m seconds, thus sensing detection to event be In the case where the peak value of R wave, next T wave can reliably be avoided to carry out defibrillation at the time of appearance, that is, to being estimated as T The peak value of wave is shielded.

(8) in the intracardiac defibrillation catheter system of above-mentioned (7), the arithmetic processing section of preferably above-mentioned power supply device is being sensed It detects and is estimated as after the event of R wave, between longest 150m seconds, preferably during 100m seconds, do not passed again between most 10m seconds short Sense detection is estimated as the event of R wave.

Intracardiac defibrillation catheter system according to such composition, in sensing detection to after being estimated as the event of R wave, most It is short between 10m seconds, the not new event of sensing detection, so in the peak value that the event that sensing detection arrives is R wave, and the then peak value (state is not special when carrying out defibrillation in the case that the peak value of the S wave occurred in the opposite direction increases and reaches triggering level Cheng Wei problem), the peak value of the sensing detection S wave can be prevented, and damages polar continuity (the same polar meter of event Number resets).

(9) in the intracardiac defibrillation catheter system of above-mentioned (7) or (8), the arithmetic processing section of preferably above-mentioned power supply device It is not right preferably between 260m seconds during longest 500m seconds between most 10m seconds short after the input that above-mentioned application executes switch Above-mentioned first DC electrode group and above-mentioned 2nd DC electrode group control above-mentioned DC power supply portion with applying voltage.

Intracardiac defibrillation catheter system according to such composition, it is most short after the application of electric energy executes the input of switch Between 10m seconds, voltage is not applied to the first DC electrode group and the 2nd DC electrode group, so can prevent from executing due to applying The input of switch and the noise (with its last and upper last time same polar noise of event) generated is mistakenly considered R wave and carries out Sensing detection, and with the Noise Synchronization carry out defibrillation.

In addition, the noise generated due to applying the input for executing switch can be prevented (with its last and upper last time The different polar noise of event), and damage the polar continuity (same polar count resets) of event.

Also, can also prevent by rigid input apply execute the baseline generated after switch variation be mistakenly considered R wave into Row sensing detection, and synchronously carry out defibrillation.

Invention effect

Intracardiac defibrillation catheter system related according to the first aspect of the invention can reliably avoid being input to Voltage is applied to the electrode of defibrillation catheter when baseline Dong Oscillating (drift) of the electrocardiogram of arithmetic processing section, it can be in baseline stability DC voltage synchronously is applied to the electrode of defibrillation catheter with the R wave of the electrocardiogram to carry out defibrillation.

Intracardiac defibrillation catheter system related according to the second aspect of the invention can be avoided reliably same with T wave Step ground carries out defibrillation, can synchronously apply to the electrode of defibrillation catheter with the R wave for the electrocardiogram for being input to arithmetic processing section straight Galvanic electricity pressure carries out defibrillation.

Detailed description of the invention

Fig. 1 is the block diagram for indicating an embodiment of intracardiac defibrillation catheter system of the invention.

Fig. 2 is the explanation top view for indicating to constitute the fine motion conduit of conduit system shown in FIG. 1.

Fig. 3 be indicate to constitute the fine motion conduit of conduit system shown in FIG. 1 explanation top view (for illustrate size with And the figure of hardness).

Fig. 4 is the sectional elevation for indicating the A-A section of Fig. 2.

Fig. 5 is the sectional elevation of the B-B section for indicating Fig. 2, C-C section, D-D section.

Fig. 6 is the perspective view for indicating the internal structure of the handle of an embodiment of defibrillation catheter shown in Fig. 2.

Fig. 7 is the magnified partial view of handle inner shown in fig. 6 (front end side).

Fig. 8 is the magnified partial view of handle inner shown in fig. 6 (base end side).

Fig. 9 is schematically illustrated in conduit system shown in FIG. 1, the connector of defibrillation catheter and the conduit of power supply device Connect the explanatory diagram of the connecting state of connector.

Figure 10 is indicated in conduit system shown in Fig. 1, and the electrocardio in the case that defibrillation catheter measures heart potential is passed through The block diagram of the flow direction of position information.

Figure 11 is to indicate to use conduit system shown in FIG. 1 as the power supply in the case where system involved in first aspect The flow chart of movement and the operation of device.

Figure 12 is indicated in conduit system shown in Fig. 1, the flow direction of the heart potential information in heart potential mode determination Block diagram.

Figure 13 is involved by the measured value of the resistance in the defibrillation mode for indicate conduit system shown in Fig. 1, between electrode group And information and heart potential information flow direction block diagram.

Figure 14 is the block diagram of state when DC voltage applies in the defibrillation mode for indicate conduit system shown in Fig. 1.

Figure 15 is the electricity determined when the defibrillation catheter by constituting conduit system shown in FIG. 1 gives defined electric energy Digit wave form figure.

Figure 16 A is that energy, which applies, executes the defeated of switch in the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device Enter the explanatory diagram with the timing of the application of DC voltage.

Figure 16 B is that energy, which executes, applies the defeated of switch in the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device Enter the explanatory diagram with the timing of the application of DC voltage.

Figure 16 C is that energy, which applies, executes the defeated of switch in the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device Enter the explanatory diagram with the timing of the application of DC voltage.

Figure 16 D is that energy, which applies, executes the defeated of switch in the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device Enter the explanatory diagram with the timing of the application of DC voltage.

Figure 17 is to indicate to use conduit system shown in FIG. 1 as the power supply in the case where system involved in second aspect The flow chart of movement and the operation of device.

Figure 18 is that energy, which applies, prepares the defeated of switch in the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device Enter, energy applies the explanatory diagram for executing the timing of application of the input and DC voltage that switch.

Figure 19 is to indicate in the case where using conduit system shown in FIG. 1 as system involved in first aspect, energy Amount applies the explanatory diagram that input, the energy application that preparation switchs execute the timing of the input of switch and the application of DC voltage.

Figure 20 is to indicate in the case where using conduit system shown in FIG. 1 as system involved in second aspect, energy Amount applies the explanatory diagram of the propradation (time) of the event after executing switch input.

Figure 21 A is that (heart of patient produces single for the electrocardiogram of the arithmetic processing section for indicating to be input to power supply device Electrocardio digit wave form in the case where tachiysystole) in, energy applies the timing of the application of the input and DC voltage that execute switch Explanatory diagram.

Figure 21 B is that the electrocardiogram for the arithmetic processing section for indicating to be input to power supply device (generates continuous in the heart of patient Electrocardio digit wave form in the case where tachiysystole) in, energy applies the timing of the application of the input and DC voltage that execute switch Explanatory diagram.

Figure 22 be the arithmetic processing section for indicating to be input to power supply device baseline change electrocardiogram (electrocardio digit wave form) in, Energy applies the explanatory diagram of the timing of the application of the input and DC voltage that execute switch.

Figure 23 is to indicate that the electrocardiogram for being input to the arithmetic processing section of the power supply device of previous composition conduit system (is being suffered from The heart of person produces the electrocardio digit wave form in the case where the tachiysystole of single) in, energy applies input and the direct current of switch The explanatory diagram of the timing of the application of voltage.

Figure 24 is to indicate that the baseline for being input to the arithmetic processing section of the power supply device of previous composition conduit system changes In electrocardiogram (electrocardio digit wave form), energy applies the explanatory diagram of the timing of the input of switch and the application of DC voltage.

Figure 25 is to indicate that the baseline for being input to the arithmetic processing section of the power supply device of previous composition conduit system changes In electrocardiogram (electrocardio digit wave form), energy applies the explanatory diagram of the timing of the input of switch and the application of DC voltage.

Specific embodiment

Hereinafter, being illustrated to one embodiment of the present invention.

The intracardiac defibrillation catheter system of present embodiment can be as system and second party involved in first aspect System involved in face uses.

As shown in Figure 1, the intracardiac defibrillation catheter system of present embodiment include defibrillation catheter 100, power supply device 700, Electrocardiogram equipment 800 and heart potential determination unit 900.

As shown in Fig. 2~Fig. 5, constitute the defibrillation catheter system of present embodiment defibrillation catheter 100 include multi-lumen tube 10, Handle 20, the first DC electrode group 31G, the 2nd DC electrode group 32G, base end side potential measurement electrode group 33G, the first conducting wire group 41G, Second conducting wire group 42G and privates group 43G.

As shown in Figure 4 and 5, (there is the insulating properties of multi-cavity structure in the multi-lumen tube 10 for constituting defibrillation catheter 100 Hose part) there are four lumen (the first lumen 11, the second lumen 12, third lumens 13, the 4th lumen 14) for formation.

In Fig. 4 and Fig. 5,15 be the fluororesin layer for dividing lumen, and 16 are made of the nylon elastomer of soft Interior (core) portion, 17 be outer (shell) portion being made of the nylon elastomer of high rigidity, and 18 in Fig. 4 be to form braiding layer stainless Steel bare wire.

The fluororesin layer 15 of lumen is divided for example by perfluoroalkyl vinyl ether copolymer (PFA), polytetrafluoroethylene (PTFE) (PTFE) etc. the higher material of insulating properties is constituted.

The nylon elastomer for constituting the outside 17 of multi-lumen tube 10 uses the elastomer of different hardness according to axial.By This, multi-lumen tube 10 is configured to hardness and periodically gets higher from front end side towards base end side.

If showing a preferred example, in Fig. 3, the hardness in region shown in L1 (length 52mm) is (hard based on D type Spend the hardness of meter) it be the hardness in region shown in 40, L2 (length 108mm) is region shown in 55, L3 (length 25.7mm) It is the hardness in region shown in 68, L5 (length 500mm) is 72 that hardness, which is the hardness in region shown in 63, L4 (length 10mm),.

Only region shown by L5 forms the braiding layer being made of stainless steel bare wire 18 in Fig. 3, as shown in figure 4, setting Between inside 16 and outside 17.

The outer diameter of multi-lumen tube 10 is, for example, 1.2~3.3mm.

Method as manufacture multi-lumen tube 10 is not particularly limited.

The handle 20 for constituting the defibrillation catheter 100 in present embodiment includes that handle main body 21, knob 22 and strain disappear Except part 24.

By carrying out rotation process to knob 22, the front end of multi-lumen tube 10 can be made to deflect (yaw).

The first DC electrode group 31G, the are installed in the periphery (not in the internal front end area for forming braiding) of multi-lumen tube 10 Two DC electrode group 32G and base end side potential measurement electrode group 33G.Here, " electrode group " refers to that constituting same pole (has identical Polarity), or the aggregate of multiple electrodes that there is same purpose, and installed with relatively narrow interval (such as 5mm or less).

First DC electrode group multi-lumen tube front end area, with relatively narrow interval installation constituted same pole (- pole or+ Pole) multiple electrodes.Here, although constituting the number of the electrode of the first DC electrode group also according to the width of electrode, configuration space And it is different, but for example, 4~13, preferably 8~10.

In the present embodiment, the first DC electrode group 31G is by eight that are mounted on the front end area of multi-lumen tube 10 cyclic annular electricity Pole 31 is constituted.

Constitute the electrode 31 of the first DC electrode group 31G via conducting wire (conducting wire 41 for constituting the first conducting wire group 41G) and after The connector stated connect connector connection with the conduit of power supply device 700.

Here, it is preferred that the width (axial length) of electrode 31 is 2~5mm, it is if a preferred example is shown 4mm。

If the width of electrode 31 is narrow, it is excessive there is calorific value when voltage application, and gives the anxiety of peripheral tissue injury. On the other hand, if the width of electrode 31 is wide, it has damage the part provided with the first DC electrode group 31G in multi-lumen tube 10 The case where pliability/flexibility.

The installation interval (separating distance of adjacent electrode) of preferred electrode 31 is 1~5mm, if showing a suitable example It is sub then be 2mm.

In the use of defibrillation catheter 100 (when configuration is in the chambers of the heart), the first DC electrode group 31G is for example positioned at coronary venous It is interior.

2nd DC electrode group is separated from the installation site of the first DC electrode group of multi-lumen tube to base end side, with relatively narrow interval Installation constitutes the multiple electrodes of the pole (+pole or-pole) opposite with the first DC electrode group.Here, the 2nd DC electrode group is constituted Although the number of electrode also difference, for example, 4~13, preferably 8~10 according to the width of electrode, configuration space.

In the present embodiment, the 2nd DC electrode group 32G from the installation site of the first DC electrode group 31G to base end side from dividing Liftoff eight ring electrodes 32 for being installed on multi-lumen tube 10 are constituted.

Constitute the electrode 32 of the 2nd DC electrode group 32G via conducting wire (conducting wire 42 for constituting the second conducting wire group 42G) and after The connector stated connect connector connection with the conduit of power supply device 700.

Here, it is preferred that the width (axial length) of electrode 32 is 2~5mm, it is if a preferred example is shown 4mm。

If the width of electrode 32 is narrow, it is excessive there is calorific value when voltage application, and gives the anxiety of peripheral tissue injury. On the other hand, if the width of electrode 32 is wide, by the part provided with the 2nd DC electrode group 32G in damage multi-lumen tube 10 The case where pliability/flexibility.

The installation interval (separating distance of adjacent electrode) of preferred electrode 32 is 1~5mm, if showing a preferred example It is sub then be 2mm.

In the use of defibrillation catheter 100 (when configuration is in the chambers of the heart), the 2nd DC electrode group 32G is for example positioned at atrium dextrum.

In the present embodiment, base end side potential measurement electrode group 33G from the installation site from the 2nd DC electrode group 32G to Base end side is separately installed four ring electrodes 33 composition in multi-lumen tube 10.

The electrode 33 for constituting base end side potential measurement electrode group 33G (constitutes the conducting wire of privates group 43G via conducting wire 43) connector connection and aftermentioned connector, is connect with the conduit of power supply device 700.

Here, it is preferred that the width (axial length) of electrode 33 is 0.5~2.0mm, if showing a preferred example For 1.2mm.

If the width of electrode 33 is wide, the measurement accuracy of heart potential reduce or the generating unit of abnormal potential really Surely it becomes difficult.

The installation interval (separating distance of adjacent electrode) of preferred electrode 33 is 1.0~10.0mm, if showing suitably One example is then 5mm.

In the use of defibrillation catheter 100 (configuration in the chambers of the heart when), base end side potential measurement electrode group 33G for example positioned at It is easy to produce the upper big vein of abnormal potential.

Front-end chip 35 is installed in the front end of defibrillation catheter 100.

It has been not connected to conducting wire in the front-end chip 35, has been used in the present embodiment not as electrode.But it is also possible to logical Crossing makes its connecting wire, as electrode use.The constituent material of front-end chip 35 be platinum or stainless steel and other metal materials, Various resin materials etc., are not particularly limited.

It is preferred that the first DC electrode group 31G (electrode 31 of base end side) and the 2nd DC electrode group 32G (electrode 32 of front end side) Separating distance d2 be 40~100mm, be 66mm if a preferred example is shown.

It is preferred that the 2nd DC electrode group 32G (electrode 32 of base end side) and base end side potential measurement electrode group 33G (front end side Electrode 33) separating distance d3 be 5~50mm, be 30mm if a preferred example is shown.

As the first DC electrode group 31G of composition, the 2nd DC electrode group 32G and base end side potential measurement electrode group 33G Electrode 31,32,33, in order to make the radiography for X-ray become well, to be preferably made of the alloy of platinum or platinum system.

Fig. 4 and the first conducting wire group 41G shown in fig. 5 is eight electrodes (31) with the first DC electrode group (31G) of composition The aggregate for eight conducting wires 41 being separately connected.

By the first conducting wire group 41G (conducting wire 41), can will constitute eight electrodes 31 of the first DC electrode group 31G respectively with Power supply device 700 is electrically connected.

Eight electrodes 31 for constituting the first DC electrode group 31G are connected from different conducting wires 41 respectively.Conducting wire 41 is respectively at it Front end portion is welded in the inner peripheral surface of electrode 31, and enters the first lumen 11 from the side opening for the tube wall for being formed in multi-lumen tube 10. Eight conducting wires 41 into the first lumen 11 are used as the first conducting wire group 41G, extend in the first lumen 11.

Fig. 4 and the second conducting wire group 42G shown in fig. 5 is eight electrodes (32) with the 2nd DC electrode group (32G) of composition The aggregate for eight conducting wires 42 being separately connected.

By the second conducting wire group 42G (conducting wire 42), can will constitute eight electrodes 32 of the 2nd DC electrode group 32G respectively with Power supply device 700 is electrically connected.

Eight electrodes 32 for constituting the 2nd DC electrode group 32G are connected from different conducting wires 42 respectively.Conducting wire 42 is respectively at it Front end portion is welded in the inner peripheral surface of electrode 32, and enters the second lumen 12 from the side opening for the tube wall for being formed in multi-lumen tube 10 (lumens different from the first lumen 11 that the first conducting wire group 41G extends).Into the second lumen 12 eight conducting wires 42 as the Two conducting wire group 42G extend in the second lumen 12.

As described above, the first conducting wire group 41G extends in the first lumen 11, and the second conducting wire group 42G is in the second lumen 12 Extend, so that the two is fully dielectrically separated from multi-lumen tube 10.It therefore, can when being applied with voltage required for defibrillation It is reliably prevented between the first conducting wire group 41G (the first DC electrode group 31G) and the second conducting wire group 42G (the 2nd DC electrode group 32G) Short circuit.

Privates group 43G shown in Fig. 4 is and constitutes the electrode (33) of base end side potential measurement electrode group (33G) respectively The aggregate of four conducting wires 43 of connection.

By privates group 43G (conducting wire 43), the electrode 33 for constituting base end side potential measurement electrode group 33G can be divided It is not electrically connected with power supply device 700.

Four electrodes 33 for constituting base end side potential measurement electrode group 33G are connected from different conducting wires 43 respectively.It is each to lead Line 43 is welded in the inner peripheral surface of electrode 33 in its front end portion, and enters third from the side opening for the tube wall for being formed in multi-lumen tube 10 Lumen 13.Four conducting wires 43 into third lumen 13 are used as privates group 43G, extend in third lumen 13.

As described above, in the privates group 43G and the first conducting wire group 41G and the second conducting wire of the extension of third lumen 13 Any of group 42G is fully dielectrically separated from.Therefore, when being applied with voltage required for defibrillation, can reliably prevent Only privates group 43G (base end side potential measurement electrode group 33G) and the first conducting wire group 41G (the first DC electrode group 31G) or Short circuit between second conducting wire group 42G (the 2nd DC electrode group 32G).

The tree that conducting wire 41, conducting wire 42 and conducting wire 43 cover the outer peripheral surface of plain conductor by the resins such as polyimides are passed through Rouge covering thread is constituted.It here, is 2~30 μm or so as resin-coated film thickness.

65 be bracing wire in Fig. 4 and Fig. 5.

Bracing wire 65 the 4th lumen 14 extend, and the eccentricity of central axis relative to multi-lumen tube 10 extend.

Front-end chip 35 is fixed on by solder in the front end portion of bracing wire 65.Alternatively, it is also possible in the front end shape of bracing wire 65 At there is anticreep large-diameter portion (anti-delinking part).Front-end chip 35 is fixedly combined with bracing wire 65 as a result, is reliably prevented from front end Chip 35 falls off.

On the other hand, the base end portion of bracing wire 65 is connect with the knob 22 of handle 20, by being operable to knob 22 Bracing wire 65 is pulled, as a result, the front end deflection of multi-lumen tube 10.

Bracing wire 65 is made of stainless steel, Ni-Ti class superelastic alloy, but does not need centainly to consist of metal.Bracing wire 65 Such as it can also be made of high-intensitive no conductive etc..

In addition, it's not limited to that for the mechanism for more deflecting the front end of lumen, such as it is also possible to have leaf spring and forms Mechanism.

It is only extended with bracing wire 65 in the 4th lumen 14 of multi-lumen tube 10, not extension wire (group).Thereby, it is possible to prevent more When the deflecting operation of the front end of lumen 10, due to the bracing wire 65 that moves axially, conducting wire is damaged (for example, scratch).

For the defibrillation catheter 100 in present embodiment, in the inside of handle 20, the first conducting wire group 41G, second are led Line group 42G and privates group 43G are also dielectrically separated from.

Fig. 6 is the perspective view for indicating the internal structure of handle of the defibrillation catheter 100 in present embodiment, and Fig. 7 is handle The magnified partial view of internal (front end side), Fig. 8 is the magnified partial view of handle inner (base end side).

As shown in fig. 6, the front opening of the base end part insertion handle 20 of multi-lumen tube 10, multi-lumen tube 10 and handle 20 as a result, Connection.

As shown in Fig. 6 and Fig. 8, it is built-in in the base end part of handle 20 and configures extreme direction protrusion forward in front end face 50A Multiple pin terminals (51,52,53) made of cylindric connector 50.

In addition, as shown in Figure 6 to 8, handle 20 internal stretch there are three conducting wire group (the first conducting wire group 41G, second Conducting wire group 42G, privates group 43G) be inserted through respectively three insulating properties hoses (the first insulating properties hose 26, second insulation Property hose 27, third insulating properties hose 28).

As shown in Fig. 6 and Fig. 7, multi-cavity is inserted into the front end (10mm or so since front end) of the first insulating properties hose 26 First lumen 11 of pipe 10, the first lumen 11 that the first insulating properties hose 26 and the first conducting wire group 41G extend as a result, link.

It is soft by the first protection of the internal stretch in handle 20 with the first insulating properties hose 26 of the first lumen 11 connection The inner hole of pipe 61 extends near connector 50 (the front end face 50A for being configured with pin terminal), is formed the first conducting wire group 41G's Base end part is guided to the insert road near connector 50.First extended as a result, from multi-lumen tube 10 (the first lumen 11) is led Line group 41G can not twist together, and extend at the inside of handle 20 (inner hole of the first insulating properties hose 26).

The the first conducting wire group 41G extended from the cardinal extremity opening of the first insulating properties hose 26, which is divided into, constitutes the conducting wire group Eight conducting wires 41, these conducting wires 41 respectively by solder connection be fixed on configuration connector 50 front end face 50A it is each Sell terminal.Here, configuration has been connected and fixed to the region for constituting the pin terminal (pin terminal 51) of the conducting wire 41 of the first conducting wire group 41G It is set as " first end subset area ".

Second lumen 12 of front end (10mm or so since front end) the insertion multi-lumen tube 10 of the second insulating properties hose 27, The second lumen 12 that the second insulating properties hose 27 and the second conducting wire group 42G extend as a result, links.

It is soft by the second protection of the internal stretch in handle 20 with the second insulating properties hose 27 of the second lumen 12 connection The inner hole of pipe 62 simultaneously extends near connector 50 (the front end face 50A for being configured with pin terminal), is formed the second conducting wire group 42G Base end part guide to the insert road near connector 50.Second extended as a result, from multi-lumen tube 10 (the second lumen 12) Conducting wire group 42G can not twist together, and extend at the inside of handle 20 (inner hole of the second insulating properties hose 27).

The the second conducting wire group 42G extended from the cardinal extremity opening of the second insulating properties hose 27, which is divided into, constitutes the conducting wire group Eight conducting wires 42, these conducting wires 42 respectively by solder connection be fixed on configuration connector 50 front end face 50A it is each Sell terminal.Here, configuration has been connected and fixed to the region for constituting the pin terminal (pin terminal 52) of the conducting wire 42 of the second conducting wire group 42G It is set as " second end subset area ".

The third lumen 13 of front end (10mm or so since front end) the insertion multi-lumen tube 10 of third insulating properties hose 28, The third lumen 13 that third insulating properties hose 28 and privates group 43G extend as a result, links.

The third insulating properties hose 28 linked with third lumen 13 is soft by the second protection of the internal stretch in handle 20 The inner hole of pipe 62 simultaneously extends near connector 50 (the front end face 50A for being configured with pin terminal), is formed privates group 43G Base end part guide to the insert road near connector 50.The third extended as a result, from multi-lumen tube 10 (third lumen 13) Conducting wire group 43G can not twist together, and extend at the inside of handle 20 (inner hole of third insulating properties hose 28).

The privates group 43G extended from the cardinal extremity opening of third insulating properties hose 28 is divided into conducting wire group composition Four conducting wires 43, these conducting wires 43 respectively by solder connection be fixed on configuration connector 50 front end face 50A it is each Sell terminal.Here, configuration has been connected and fixed to the region for constituting the pin terminal (pin terminal 53) of the conducting wire 43 of privates group 43G It is set as " third terminal group region ".

Here, as insulating properties hose, (the first insulating properties hose 26, the second insulating properties hose 27 and third insulating properties are soft Pipe 28) constituent material, polyimide resin, polyamide, polyamide-imide resin etc. can be illustrated.Wherein, especially Preferred hardness is higher, is easy insert conducting wire group, and polyimide resin that can be thin molded.

It is 30 μm if a preferred example is shown as the wall thickness of insulating properties hose, preferably 20~40 μm.

In addition, as interpolation insulating properties hose protection hose (first protection hose 61 and second protection hose 62) Constituent material can illustrate nylon-types elastomers such as " Pebax " (registered trademarks of ARKEMA society).

According to the defibrillation catheter 100 in the present embodiment with composition as described above, since the first conducting wire group 41G exists Extend in first insulating properties hose 26, the second conducting wire group 42G extends in the second insulating properties hose 27, and privates group 43G exists Extend in third insulating properties hose 28, so even if can also make the first conducting wire group 41G, the second conducting wire in the inside of handle 20 Group 42G and privates group 43G is fully dielectrically separated from.As a result, when being applied with voltage required for defibrillation, it can The short circuit being reliably prevented between the first conducting wire group 41G, the second conducting wire group 42G, privates group 43G of the inside of handle 20 (in particular, short circuit between the conducting wire group that extends about out of opening of lumen).

Also, in the inside of handle 20, the first insulating properties hose 26 is protected by the first protection hose 61, and the second insulating properties is soft Pipe 27 and third insulating properties hose 28 are protected by the second protection hose 52, to can for example prevent in the front end of multi-lumen tube 10 The insulating properties hose damage due to component parts (movable member) contact/friction of knob 22 when the deflecting operation in portion.

Defibrillation catheter 100 in present embodiment has and will be configured with the front end face 50A of the connector 50 of multiple pin terminals It is divided into first end subset area, second end subset area and third terminal group region, makes conducting wire 41, conducting wire 42 and conducting wire 43 mutually isolated partitions 55.

Separate the partition 55 in first end subset area, second end subset area and third terminal group region by that will insulate Property resin forming be processed as two sides have flat surface channel-shaped form.It is not special as the insulative resin for constituting partition 55 It does not limit, is able to use the resins for universal use such as polyethylene.

The thickness of partition 55 is, for example, 0.1~0.5mm, is 0.2mm if showing a preferred example.

The height (distance from proximate edge to front edge) of partition 55 need than connector 50 front end face 50A and absolutely The separating distance of edge hose (the first insulating properties hose 26 and the second insulating properties hose 27) is high, is 7mm in the separating distance In the case where, the height of partition 55 is, for example, 8mm.In partition of the height less than 7mm, its front edge and insulation can not be made Property hose cardinal extremity compare be located at front end side.

According to such composition, the conducting wire 41 for constituting the first conducting wire group 41G can be made (from the base of the first insulating properties hose 26 The base end portion for the conducting wire 41 that end opening extends) and the conducting wire 42 of the second conducting wire group 42G is constituted (from the second insulating properties hose 27 The base end portion of conducting wire 42 extended of cardinal extremity opening) it is reliable and be fitly isolated.

In the case where not having partition 55, (separated) conducting wire 41 and conducting wire 42 can not be fitly isolated by having, and they The anxiety got lines crossed.

Moreover, because apply mutually different polar voltage, constitute the conducting wire 41 of the first conducting wire group 41G and constitute the The conducting wire 42 of two conducting wire group 42G is mutually isolated without contacting by partition 55, so in defibrillation catheter 100 in use, i.e. Make voltage required for applying intracardiac defibrillation, constitutes the conducting wire 41 of the first conducting wire group 41G (from the first insulating properties hose 26 The base end portion for the conducting wire 41 that cardinal extremity opening is extended) and the conducting wire 42 of the second conducting wire group 42G is constituted (from the second insulating properties hose The base end portion for the conducting wire 42 that 27 cardinal extremity opening is extended) between will not generate short circuit.

In addition, in the manufacture of defibrillation catheter, in the case where producing mistake when conducting wire is connected and fixed on pin terminal, Such as in the case where the conducting wire 41 for constituting the first conducting wire group 41G to be connect with the pin terminal in second end subset area, this is led Line 41 is across next door 55, so the mistake of connection can be easily found out.

Although in addition, constitute the conducting wire 43 (pin terminal 53) of privates group 43G and conducting wire 42 (pin terminal 52) together by Partition 55 is from conducting wire 41 (pin terminal 51) isolation, and but not limited to this, can also pass through with conducting wire 41 (pin terminal 51) together Partition 55 is isolated from conducting wire 42 (pin terminal 52).

In defibrillation catheter 100, the cardinal extremity and the second insulation of the front edge of partition 55 and the first insulating properties hose 26 Property hose 27 cardinal extremity any one compared to being respectively positioned on front end side.

(leading for the first conducting wire group 41G is constituted in the conducting wire extended from the cardinal extremity opening of the first insulating properties hose 26 as a result, Line 41) with the conducting wire conducting wire 42 of the second conducting wire group 42G (constitute) that extends from the cardinal extremity opening of the second insulating properties hose 27 it Between always exist partition 55, so being reliably prevented from conducting wire 41 and short circuit caused by the contact of conducting wire 42.

As shown in figure 8, extending from the cardinal extremity opening of the first insulating properties hose 26 and being connected and fixed on the pin of connector 50 Eight conducting wires 41 of terminal 51 extend from the cardinal extremity opening of the second insulating properties hose 27 and are connected and fixed on the pin of connector 50 Eight conducting wires 42 of terminal 52 and extends from the cardinal extremity opening of third insulating properties hose 28 and be connected and fixed on connector 50 Four conducting wires 43 of pin terminal 53 fixed around them using resin 58, so being kept fixed respective shape.

The resin 58 of the shape of conducting wire is kept to be configured to the cylindrical shape with connector 50 with diameter, and in the ester moulding The state of terminal, conducting wire, the base end part of insulating properties hose and partition 55 is sold in the inside embedment of body.

Moreover, resin can be passed through according to the composition of the base end part in the inside of resin molded body embedment insulating properties hose 58 are completely covered the conducting wire (base end portion) extended out to until being connected and fixed with pin terminal from the cardinal extremity opening of insulating properties hose Whole region, can fully be kept fixed the shape of conducting wire (base end portion).

Additionally, it is preferred that the height (distance until from cardinal extremity face to front end face) of resin molded body is than the height of partition 55 Height, in the case where the height of partition 55 is 8mm, for example, 9mm.

Here, be not particularly limited as the resin 58 for constituting resin molded body, but it is preferable to use heat-curing resin or Person's light-cured resin.Specifically, polyurethanes, epoxies, polyurethane-epoxies curable resin can be illustrated.

According to composition as described above, the shape of conducting wire is kept fixed by resin 58, so in manufacture defibrillation catheter 100 When (when connector 50 is installed on the inside of handle 20), the conducting wire that can prevent the cardinal extremity opening from insulating properties hose from extending Kink, or with the EDGE CONTACT of pin terminal and damage (for example, in resin-coated generation crack of conducting wire).

As shown in Figure 1, the power supply device 700 for constituting the defibrillation catheter system of present embodiment includes: DC power supply portion 71, leads Pipe connect connector 72, electrocardiogram equipment connection connector 73, external switch (input unit) 74, arithmetic processing section 75, switching part 76, Electrocardiogram input connector 77 and display unit 78.

It is built-in with capacitor in DC power supply portion 71, by the input of external switch 74 (charge switch 743), to built-in capacitance Device charges.

Conduit connection connector 72 is connect with the connector 50 of defibrillation catheter 100, is led with the first conducting wire group (41G), second The electrical connection of the base end side of line group (42G) and privates group (43G).

As shown in figure 9, the connector 50 of defibrillation catheter 100, which connect connector 72 with the conduit of power supply device 700, passes through company Device cable C1 connection is connect, so that the pin terminal 51 for being connected and fixed eight conducting wires 41 of the first conducting wire group of composition (is actually eight It is a) terminal 721 (the being actually eight) connection of connector 72 is connect with conduit, it has been connected and fixed and has constituted the eight of the second conducting wire group The pin terminal 52 (being actually eight) of root conducting wire 42 connect the terminal 722 (being actually eight) of connector 72 with conduit even It connects, the pin terminal 53 (being actually four) for being connected and fixed four conducting wires 43 of composition privates group connect connection with conduit The terminal 723 (being actually four) of device 72 connects.

Here, conduit connection connector 72 terminal 721 and terminal 722 connect with switching part 76, terminal 723 not via Switching part 76 and connect connector 73 with electrocardiogram equipment and be directly connected to.

The heart potential information determined as a result, by the first DC electrode group 31G and the 2nd DC electrode group 32G is via switching Portion 76 reaches electrocardiogram equipment and connects connector 73, the heart potential information determined by base end side potential measurement electrode group 33G without By switching part 76, and reach electrocardiogram equipment connection connector 73.

Electrocardiogram equipment connection connector 73 is connect with the input terminal of electrocardiogram equipment 800.

External switch 74 as input unit is by the pattern switching for switching heart potential mode determination and defibrillation mode Switch 741, the application energy configuration switch 742 of the electric energy applied when being set in defibrillation, for charging to DC power supply portion 71 Charge switch 743, by inputting for determining the polarity of aftermentioned primary event, triggering level, extraordinary wave high level and doing The energy for carrying out the preparation of defibrillation, which applies, prepares switch 744 and for by after the input that energy applies preparation switch 744 The energy application that (can also be at the same time) be inputted and apply electric energy execution defibrillation executes the composition of switch (discharge switch) 745. Input signal from these external switches 74 is all sent to arithmetic processing section 75.

It further include that energy applies preparation other than energy applies and executes switch 745 as the switch for applying energy Switch 744, so user can confirm the state of ecg wave form before input energy applies and executes switch 745.

As a result, when input energy applies preparation switch 744 and the contact of switching part is switched to the second contact, assuming that producing In the case where the disorder (such as drift, noise etc.) for having given birth to ecg wave form, the application for executing energy can be avoided.

Input of the arithmetic processing section 75 based on external switch 74, control DC power supply portion 71, switching part 76 and display unit 78。

The arithmetic processing section 75 has to be removed for the DC voltage from DC power supply portion 71 to be output to via switching part 76 Quiver conduit 100 electrode output circuit 751.

By the output circuit 751, the terminal 721 of connector 72 can be connected (ultimately, with conduit shown in Fig. 9 It is the first DC electrode group 31G of defibrillation catheter 100) terminal 722 of connector 72 is connected with conduit (is ultimately, that defibrillation is led 2nd DC electrode group 32G of pipe 100) become mutually different polarity (be in the electrode group of a side-pole when, the electrode of another party Group become+pole) mode apply DC voltage.

Switching part 76 is connect by connecting connector 72 (terminal 721 and terminal 722) in shared contact connecting conduit first Point is connected with electrocardiogram equipment connection connector 73, and is connected with the single-pole double throw (Single of arithmetic processing section 75 in the second contact Pole Double Throw) switching switch constitute.

That is, when having selected the first contact (when the first contact is connect with shared contact), it is ensured that connecting conduit connection connection Device 72 connect the path of connector 73 with electrocardiogram equipment, when having selected the second contact (when the second contact is connect with shared contact), Ensure the path of connecting conduit connection connector 72 and arithmetic processing section 75.

The defeated of external switch 74 (741/ energy of mode selector switch, which applies, prepares switch 744) is based on by arithmetic processing section 75 Enter to control the switching action of switching part 76.

Electrocardiogram input connector 77 is connect with arithmetic processing section 75, in addition, connecting with the output terminal of electrocardiogram equipment 800.

It, can be by the heart potential information exported from electrocardiogram equipment 800 (in general, being defeated by the electrocardiogram input connector 77 Enter a part to the heart potential information of electrocardiogram equipment 800) it is input to arithmetic processing section 75, in arithmetic processing section 75, Neng Gouji In the heart potential information, DC power supply portion 71 and switching part 76 are controlled.

Display unit 78 is connect with arithmetic processing section 75, is shown in display unit 78 defeated from electrocardiogram input connector 77 Enter the heart potential information (mainly electrocardiogram (electrocardio digit wave form)) to arithmetic processing section 75, operator can input in monitoring To arithmetic processing section 75 heart potential information (electrocardiogram) while carry out defibrillation therapy (input etc. of external switch).

Constitute the electrocardio of electrocardiogram equipment 800 (input terminal) and power supply device 700 of the defibrillation catheter system of present embodiment Instrument connects connector 73 and connects, and passes through defibrillation catheter 100 (the first DC electrode group 31G, the 2nd DC electrode group 32G and base end side The composition electrode of potential measurement electrode group 33G) the heart potential information that determines from electrocardiogram equipment connection connector 73 is input to electrocardio Instrument 800.

In addition, electrocardiogram equipment 800 (other input terminals) is also connect with heart potential determination unit 900, surveyed by heart potential The heart potential information that order member 900 determines also enters into electrocardiogram equipment 800.

Here, as heart potential determination unit 900, it can enumerate to measure 12 lead electrocardiogram and be pasted onto patient's The electronic pads in body surface face, the electrode catheter being mounted in the heart of patient (electrode catheters different from defibrillation catheter 100).

Electrocardiogram equipment 800 (output terminal) is connect with the electrocardiogram input connector 77 of power supply device 700, can will enter into Heart potential information (the heart potential information from defibrillation catheter 100 and from heart potential determination unit 900 of electrocardiogram equipment 800 Heart potential information) a part send via electrocardiogram input connector 77 to arithmetic processing section 75.

Defibrillation catheter 100 in present embodiment, can be as the electricity of electrocardio position-finding when not needing defibrillation therapy Pole conduit uses.

Figure 10 is shown when carrying out cardiac catheter operation (such as high-frequency treatment), passes through defibrillation involved in present embodiment The flow direction of heart potential information in the case where the measurement heart potential of conduit 100.

At this point, the switching part 76 of power supply device 700 selects the first contact for being connected to electrocardiogram equipment connection connector 73.

It is surveyed by the electrode of composition the first DC electrode group 31G and/or the 2nd DC electrode group 32G of defibrillation catheter 100 The heart potential made is input to electrocardiogram equipment via conduit connection connector 72, switching part 76 and electrocardiogram equipment connection connector 73 800。

In addition, the heart potential gone out by the determination of electrode of the composition base end side potential measurement electrode group 33G of defibrillation catheter 100 Connector 73 is not directly connected via electrocardiogram equipment by switching part 76 from conduit connection connector 72 and is input to electrocardiogram equipment 800.

Heart potential information (electrocardiogram) from defibrillation catheter 100 is shown in the monitor of electrocardiogram equipment 800 (diagram is omitted).

In addition, defibrillation can will be come from from electrocardiogram equipment 800 via electrocardiogram input connector 77 and arithmetic processing section 75 A part of the heart potential information of conduit 100 is (for example, constitute the electrode 31 (the first pole and the second pole) of the first DC electrode group 31G Between potential difference) input and be shown in display unit 78.

As described above, when not needing defibrillation therapy in cardiac catheter is performed the operation, it is able to use 100 conduct of defibrillation catheter The electrode catheter of electrocardio position-finding.

Moreover, when causing atrial fibrillation in cardiac catheter operation, it can be by the defibrillation that is used as electrode catheter Conduit 100 carries out defibrillation therapy immediately.As a result, it is possible to save when causing atrial fibrillation, new insertion leading for defibrillation The trouble of pipe etc..

Arithmetic processing section 75 is according to the one of the heart potential information sent via electrocardiogram input connector 77 from electrocardiogram equipment 800 Partially (electrocardiogram), successively sensing detection is estimated as the event (waveform) of the R wave of the electrocardiogram.

Such as the peak-peak waveform in the previous period for passing through the detection desired period (beating) for carrying out sensing detection Peak-peak waveform (event) in (event) and the first two period, calculates the mean wave height of these peak-peak waveforms, and examine Know that potential difference reaches 80% height of the average height be estimated as the sensing detection of the event of R wave.

After arithmetic processing section 75 applies the input for preparing switch 744 in energy, it is stored in sensing detection before will inputting 80% height of the mean wave height of two events arrived is used as " triggering level ", and leads using the defibrillation of present embodiment In the case that guard system is as system involved in first aspect, 120% height of the mean wave height is stored as " extraordinary wave High level ".

In addition, each event that arithmetic processing section 75 arrives sensing detection, identify its polarity (with ± the peak value that indicates of symbol Direction), if input energy apply prepare switch 744, the polarity for three events that sensing detection arrives before it will input In the case where same to each other, which is stored as " polarity of primary event ", otherwise, cancels energy and applies preparation switch 744 Input.

Then, arithmetic processing section 75 is after input energy applies and executes switch 745, the sensing detection in the n-th period Event (the V arrived_n) polarity and sensing detection arrives in its previous period event (V_n-1) polarity and at it the first two Event (the V that sensing detection arrives in period_n-2) polarity and storage primary event polarity it is consistent, also, meet first In the case where the aftermentioned condition required respectively in aspect or second aspect, with the event (V_n) synchronously, it carries out at operation It manages and controls DC power supply portion 71 and connection is connected with conduit to the terminal 721 (the first DC electrode group 31G) of conduit connection connector 72 The terminal 722 (the 2nd DC electrode group 32G) of device 72 applies voltage.

Figure 16 A~Figure 16 D is shown input into the electrocardiogram of arithmetic processing section 75, and energy, which applies, executes the defeated of switch 745 Enter the timing with the application of DC voltage.

In Figure 16 A~Figure 16 D, arrow (SW2-ON) is that energy applies the input time for executing switch 745, arrow (DC) be DC voltage the application moment.

In the electrocardiogram shown in Figure 16 A~Figure 16 D, be estimated as R wave sensing detection to six events in, opened from left side The polarity of beginning third event is (-) (its peak value waveform is downward), and the polarity of other five events is (+) (its peak value waveform Upwards).

In addition, although it is not shown, but energy apply execute switch 745 input before, input energy apply prepare switch 744, and the polarity for being stored in the primary event of arithmetic processing section 75 is (+).

As shown in Figure 16 A, to second event (V since left side₀) held after sensing detection in energy application In the case that row switch 745 is inputted, third event (V₁) polarity (-) in the previous period sensing detection The second event (V arrived₀) polarity (+) it is different (also different from the polarity (+) of primary event), so not with the event (V₁) Synchronously apply voltage.

In addition, the 4th event (V₂) polarity (+) and the third event (V that is arrived in previous period sensing detection₁) Polarity (-) is different, thus also not with the event (V₂) synchronously apply voltage.

In addition, the 5th event (V₃) polarity (+) and sensing detection arrives in the first two period third event (V₁) Polarity (-) it is different, so also not with the event (V₃) synchronously apply voltage.

6th event (V₄) polarity (+) and sensing detection arrives in the previous period the 5th event (V₃) pole Property (+) and the 4th event (V that sensing detection arrives in the first two period₂) polarity (+) it is identical, so with the event (V₄) synchronously, voltage is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G.

As shown in fig 16b, in sensing detection to the third event (V since left side₀) apply to execute in energy later and open In the case that pass 745 is inputted, the 4th event (V₁) polarity (+) with sensing detection arrives in the previous period the Three event (V₀) polarity (-) it is different, so not with the event (V₁) synchronously apply voltage.

In addition, the 5th event (V₂) polarity (+) and sensing detection arrives in the first two period third event (V₀) Polarity (-) it is different, so also not with the event (V₂) synchronously apply voltage.

6th event (V₃) polarity (+) and sensing detection arrives in the previous period the 5th event (V₂) pole Property (+) and the 4th event (V that sensing detection arrives in the first two period₁) polarity (+) it is identical, so with the event (V₃) synchronously, voltage is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G.

As shown in figure 16 c, in sensing detection to the 4th event (V since left side₀) apply to execute in energy later and open In the case that pass 745 is inputted, the 5th event (V₁) polarity (+) with sensing detection arrives in the first two period the Three event (V_-1) polarity (-) it is different, so not with the event (V₁) synchronously apply voltage.

6th event (V₂) polarity (+) and sensing detection arrives in the previous period the 5th event (V₁) pole Property (+) and the 4th event (V that sensing detection arrives in the first two period₀) polarity (+) it is identical, so with the event (V₂) synchronously, voltage is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G.

As seen in fig. 16d, in sensing detection to the 5th event (V since left side₀) apply to execute in energy later and open In the case that pass 745 is inputted, the 6th event (V₁) polarity (+) with sensing detection arrives in the previous period the Five event (V₀) polarity (+) and sensing detection arrives in the first two period the 4th event (V_-1) polarity (+) phase Together, so with the event (V₁) synchronously, voltage is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G.

As described above, no matter which timing input energy shown in Figure 16 A~Figure 16 D, which applies, executes switch 745 In the case of, all with identical polarity (+) it is continuous three times when third event (the 6th event since left side) synchronously apply Making alive.

Arithmetic processing section 75 is with the thing that after input energy applies and executes switch 745, sensing detection is arrived in n-th of period Part (V_n) polarity and storage primary event polarity it is inconsistent in the case where, not with the event (V_n) synchronously to the first DC Electrode group 31G and the 2nd DC electrode group 32G applies alive mode and carries out calculation process and control DC power supply portion 71.

Figure 18 is shown input into the electrocardiogram of arithmetic processing section 75, and energy applies the input for preparing switch 744, energy is applied Add the timing of the application of the input and DC voltage that execute switch 745.

In the figure, arrow (SW1-ON) is the input time that energy prepares switch 744, and arrow (SW2-ON) is energy Apply the input time for executing switch 745, arrow (DC) is the application moment of DC voltage.

In the electrocardiogram shown in Figure 18, be estimated as R wave sensing detection to nine events in, first since left side The polarity of~third and the 7th~the 9th event is (+) (its peak value waveform is upward), the 4th since left side~ The polarity of 6th event is (-) (its peak value waveform is downward).

As shown in the drawing, in sensing detection to the third event (V since left side_-2) apply preparation switch in energy later In the case that 744 are inputted, sensing detection arrives before it will input three event (V_-2)、(V_-3) and (V_-4) Polarity is (+), so storing the polarity of the polarity (+) as primary event.

Then, as shown in the drawing, in sensing detection to the 5th event (V since left side₀) opened later in energy execution In the case that pass 745 is inputted, the 6th event (V since left side₁) polarity be (-), although in previous week The 5th event (V that phase sensing detection arrives₀) polarity (-), the 4th event that sensing detection arrives in the first two period (V_-1) polarity (-) unanimously, but it is inconsistent with the polarity (+) of primary event, thus not with the event (V₁) synchronously apply electricity Pressure.

In addition, the 7th event (V since left side₂) polarity be (+), unanimously with the polarity (+) of primary event, but with In the 6th event (V that previous period sensing detection arrives₁) polarity (-) it is inconsistent, so not with the event (V₂) synchronous Ground applies voltage.

In addition, the 8th event (V since left side₃) polarity be (+), with the polarity (+) of primary event, previous The 7th event (V that period sensing detection arrives₂) polarity (+) unanimously, but not in the first two period sensing detection arrive 6th event (V₁) polarity (-) unanimously, so also not with the event (V₂) synchronously apply voltage.

The 9th event (V since left side₄) polarity be (+), with the polarity (+) of primary event, in the previous period The 8th event (V that sensing detection arrives₃) polarity (+), the 7th event (V that sensing detection arrives in the first two period₂) Polarity (+) unanimously, so with the event (V₄) synchronously, electricity is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G Pressure.

In the case where using the defibrillation catheter system of present embodiment as system involved in first aspect, at operation Reason portion 75 produces different during until input energy applies preparation switch 744 to input energy application execution switch 745 When the high event of ordinary wave (event for reaching extraordinary wave high level), with only as defined in begin to pass through from the generation of abnormal wave height event Sensing detection is to event (V after stand-by time_n) in the case where, with event (V_n) synchronously to the end of conduit connection connector 72 The terminal 722 (the 2nd DC electrode group 32G) that 721 (the first DC electrode group 31G) of son connect connector 72 with conduit is applied alive Mode carries out calculation process and controls DC power supply portion 71.

Here, as stand-by time, usually between 1000~5000m seconds, between preferably 2000~4000m seconds, if showing A preferred example is then between 3000m seconds (between 3 seconds).

In addition, during applying preparation switch 744 until input energy applies and executes switch 745 from input energy, In the case where producing multiple abnormal wave height, from (being strictly speaking, that its waveform reaches when producing initial abnormal wave height event At the time of extraordinary wave high level) start to calculate stand-by time.

Figure 19 is shown input into the electrocardiogram (electrocardio digit wave form identical with waveform shown in Figure 25) of arithmetic processing section 75 In, energy applies determining for the input for preparing switch 744, the input of energy application execution switch 745 and the application of DC voltage When.

In the figure, arrow (SW1-ON) is the input time that energy prepares switch 744, and arrow (SW2-ON) is energy Apply the input time for executing switch 745, arrow (DC) is the application moment of DC voltage.

In the electrocardiogram shown in the figure, stable baseline rises, and thereafter, baseline declines and restores to original level.

If in sensing detection to event (V_-5) after arrow (SW1-ON) shown at the time of input energy apply prepare open 744 are closed, then three event (V that sensing detection arrives before it will input_-5)、(V_-6) and (V_-7) polarity be (+), institute Polarity using polarity (+) as primary event is stored in arithmetic processing section 75.

In addition, be stored in will input before two event (V arriving of sensing detection_-5) and (V_-6) mean wave height 80% height stores average wave as " triggering level " (showing in the figure with the solid line TL extended to time-axis direction) 120% high height with the dotted line HL extended to time-axis direction as " extraordinary wave high level " (being shown) in the figure.

It has input energy at the time of shown in arrow (SW2-ON) to apply in the case where execute switch 745, from input energy During amount applies preparation switch 744 until input energy applies and executes switch 745, three abnormal wave height (V are generated_-2)、 (V_-1) and (V₀), in this case, will not be from initial abnormal wave height event (V_-2) generation start defined stand-by time The event recognition that interior sensing detection arrives is trigger point, does not apply voltage with the event synchronization.

Here, apply the event (V after executing switch 745 in rigid input energy₁) due to from abnormal wave height event (V_-2) start sensing detection in defined stand-by time (WAITING TIME) and arrive, so not with the event (V₁) synchronously apply Voltage.

Sensing detection is to event (V after the warp of stand-by time₁) next cycle in event (V₂).In addition, the thing Part (V₂) polarity (+) and the polarity (+) of primary event, the event (V that sensing detection arrives in the previous period₁) polarity (+) and event (V that sensing detection arrives in the first two period₀) polarity (+) it is identical, so with the event (V₂) synchronously Apply voltage.

In addition, 260m after event of the arithmetic processing section 75 to be estimated as R wave in the electrocardiogram of sensing detection to input Between second, is not applied by alive mode and controls DC power supply portion 71 by the first DC electrode group 31G and the 2nd DC electrode group 32G.

As a result, in the case where the event that sensing detection arrives is the peak value of R wave, can reliably it avoid in its next T Defibrillation is carried out at the time of wave occurs, and in other words, shielding can be carried out to the peak value for being estimated as T wave and forbids carrying out defibrillation.

In addition, during not applying DC voltage, being not limited to 260m seconds as after sensing detection to event Between, most short can be between 50m seconds, and longest can be between 500m seconds.In the case where short between this period ratio 50m seconds, having can not The case where peak value for being estimated as T wave is shielded.On the other hand, in the case where long between this period ratio 500m seconds, having cannot The case where reaching the R wave in sensing detection next cycle (beating).

In addition, arithmetic processing section 75 is programmed between 100m seconds, not weigh after sensing detection to the event for being estimated as R wave New sensing detects the event for being estimated as R wave.

Thereby, it is possible to prevent from increasing in then R wave in the peak value of the S wave occurred with the R wave opposite direction (opposite polarity) It is big and reach in that case of triggering level (even if in this state, problem will not be become when carrying out defibrillation), it senses It detects the peak value of the S wave, and damages the polar continuity (same polar count resets) of event.

In addition, as after sensing detection to event, not again during sensing detection to the event for being estimated as R wave (during blanking) was not limited between 100m seconds, and most short can be between 10m seconds, and longest can be between 150m seconds.

Also, arithmetic processing section 75 in energy to apply after the input for executing switch 745 between 260m seconds, not electric to the first DC Pole group 31G and the 2nd DC electrode group 32G control DC power supply portion 71 with applying voltage.

Thereby, it is possible to prevent will due to energy apply execute switch 745 input and generate noise (with its last time with And the noise of the event identical polar of upper last time) it is mistakenly considered R wave progress sensing detection, and with the Noise Synchronization carry out defibrillation.

In addition, can prevent due to energy apply execute switch 745 input and generate noise (with its last time with And/or the different polar noise of event of person's upper last time), damage event polar continuity (it is same it is polar count it is multiple Position).

Also, it can also prevent from input energy being applied to the variation mistake for executing the baseline generated after switch 745 Think that R wave carries out sensing detection, and synchronously carries out defibrillation.

In addition, during not applying DC voltage, not limited after as the input for executing switch 745 is applied in energy Between 260m seconds, most short can be between 10m seconds, and longest can be between 500m seconds.

Figure 11 is to indicate to use the intracardiac defibrillation catheter system of present embodiment as system involved in first aspect In the case where defibrillation therapy an example flow chart.

(1) firstly, using radioscopic image, confirm electrode (the first DC electrode group 31G, the 2nd the DC electricity of defibrillation catheter 100 The composition electrode of pole group 32G and base end side potential measurement electrode group 33G) position, and select from heart potential determination unit 900 (electronic pads for being pasted on body surface face) are input to a part of the heart potential information (12 lead electrocardiogram) of electrocardiogram equipment 800, from Electrocardiogram input connector 77 is input to the 75 (step 1) of arithmetic processing section of power supply device 700.At this point, being input to calculation process A part of the heart potential information in portion 75 is shown in display unit 78 (referring to Fig.1 2).In addition, from the first DC of defibrillation catheter 100 The composition electrode of electrode group 31G and/or the 2nd DC electrode group 32G via conduit connection connector 72, switching part 76 and Electrocardiogram equipment connection connector 73 is input to the heart potential information of electrocardiogram equipment 800, the base end side potential measurement electricity from defibrillation catheter 100 The composition electrode of pole group 33G connects the heart that connector 73 is input to electrocardiogram equipment 800 via conduit connection connector 72 with electrocardiogram equipment Electrical potential information is shown in the monitor of electrocardiogram equipment 800 (diagram is omitted).

(2) next, mode selector switch 741 of the input as external switch 74.Power supply device in present embodiment 700 be " heart potential mode determination " in the initial state, and switching part 76 selects the first contact, it is ensured that connects connector 72 from conduit Via switching part 76 to the path of electrocardiogram equipment connection connector 73.

Become " defibrillation mode " (step 2) by the input of mode selector switch 741.

(3) as shown in figure 13, if input pattern switching switch 741 is switched to defibrillation mode, pass through arithmetic processing section 75 Control signal the contact of switching part 76 is switched to the second contact, it is ensured that from conduit connection connector 72 via switching part 76 to Up to the path of arithmetic processing section 75, and cuts off from conduit connection connector 72 via switching part 76 and reach electrocardiogram equipment connection connector 73 path (step 3).When switching part 76 selects the second contact, the first DC electrode group 31G from defibrillation catheter 100 and The heart potential information of the composition electrode of 2nd DC electrode group 32G can not be input to electrocardiogram equipment 800 (therefore, can not should Heart potential information is sent to arithmetic processing section 75.).But base end side potential measurement electrode group 33G is not come from via switching part 76 Composition electrode heart potential information input to electrocardiogram equipment 800.

(4) even if the contact of switching part 76 is switched to the second contact, the first DC electrode group of defibrillation catheter 100 is also measured Resistance (step 4) between (31G) and the 2nd DC electrode group (32G).It is inputted from conduit connection connector 72 via switching part 76 To arithmetic processing section 75 resistance value be input to the heart potential information from heart potential determination unit 900 of arithmetic processing section 75 A part display together in display unit 78 (referring to Fig.1 3).

(5) contact of switching part 76 is switched to the first contact, restored from conduit connection connector 72 via switching part 76 Reach the path (step 5) of electrocardiogram equipment connection connector 73.

In addition, the time of contact the second contact of selection of switching part 76, (above-mentioned step 3~step 5) was, for example, between 1 second.

(6) whether arithmetic processing section 75 determines in the resistance that step 4 determines to be more than defined value, the case where being less than Under, into next step 7 (for applying the preparation of DC voltage), step 1 (defibrillation catheter is returned in the case of exceeding The location confirmation of 100 electrode) (step 6).

Here, in the case where resistance is more than defined value, it is meant that the first DC electrode group and/or the 2nd DC electrode Group is not abutted with defined position (for example, inner wall of the tube wall of coronary venous, atrium dextrum) reliably, so needing back to step Rapid 1, readjust the position of electrode.

In such manner, it is possible to only the first DC electrode group of defibrillation catheter 100 and the 2nd DC electrode group reliably with it is defined Position (for example, inner wall of the tube wall of coronary venous, atrium dextrum) applies voltage when abutting, and controls so being able to carry out effective defibrillation It treats.

(7) application energy configuration switch 742 of the input as external switch 74 sets application energy (step when defibrillation 7)。

Electrode assembly 700 according to the present embodiment can set every 1J in 1J~30J and apply energy.

(8) energy, is charged to the built-in capacitor in DC power supply portion 71 by charge switch 743 of the input as external switch 74 (step 8).

(9) after charging complete, operator, which inputs to apply as the energy of external switch 74, prepares 744 (step 9) of switch.

(10) arithmetic processing section 75 determine will input apply prepare switch 744 before sensing detection to three events Polarity it is whether same to each other, 12 are entered step in the case where same to each other (at this point, showing in display unit 78 The character of " Waiting Trigger "), in different situation, cancels energy and apply the input for preparing switch 744, and return Return to step 9 (step 10).

(11) contact of switching part 76 is switched to by the second contact by arithmetic processing section 75, it is ensured that connect from conduit Device 72 via switching part 76 reach arithmetic processing section 75 path, and cut off from conduit connection connector 72 via switching part 76 to Up to the path (step 11) of electrocardiogram equipment connection connector 73.

(12) arithmetic processing section 75 be stored in will input apply prepare switch 744 before sensing detection to three events Polarity as " polarity of primary event ", be stored in will input apply prepare switch 744 before sensing detection to two 80% height of the mean wave height of event is used as " triggering level ", and stores 120% height conduct of the mean wave height " extraordinary wave high level " (step 12).

(13) operator's input applies as the energy of external switch 74 executes 745 (step 13) of switch.

(14) the current event (V arrived as expression in 16 sensing detection of subsequent steps_n) it is to apply from input energy Execute switch 745 start which time sensing detection to the number (n) of event make " 1 " generation.(step 14).

(15) arithmetic processing section 75 will be from sensing detection to last event (V_n-1) (holding input energy application The event that sensing detection arrives before row switch 745) between 100m second for starting as during blanking, progress is standby thus without new Sensing detection (step 15).

(16) during blanking after, 75 sensing detection event (V of arithmetic processing section_n) (step 16).

(17) arithmetic processing section 75 determines the event (V arrived in step 16 sensing detection_n) polarity whether in step 12 The polarity of the primary event of storage is consistent, and 18 are entered step under unanimous circumstances, in the case of inconsistencies, in step 14 ', Above-mentioned number (n) is added 1 and returns to step 15 (step 17).

(18) arithmetic processing section 75 determines the event (V arrived in step 16 sensing detection_n) polarity whether with it is last (preceding One sensing detection arrives) event (V_n-1) polarity it is consistent, under unanimous circumstances, 19 are entered step, in inconsistent situation Under, in step 14 ' in, 1 is added to above-mentioned number (n) and returns to step 15 (step 18).

(19) arithmetic processing section 75 determines the event (V arrived in step 16 sensing detection_n) polarity it is whether (preceding with last time Two sensing detections arrive) event (Vn-2) polarity it is consistent, under unanimous circumstances, 20 are entered step, in inconsistent feelings Under condition, in step 14 ' in, 1 is added to above-mentioned number (n) and returns to step 15 (step 19).

(20) arithmetic processing section 75 determines from sensing detection to last event (V_n-1) start to sensing detection to event (V_n) until time whether more than 260m seconds, 21 are entered step in the case of exceeding, in the case where being less than, in step In 14 ', 1 is added to above-mentioned number (n) and returns to step 15 (step 20).

(21) arithmetic processing section 75 determines from input energy application execution switch 745 to sensing detection to event (V_n) until Time whether more than 260m seconds, 22 are entered step in the case of exceeding, in the case where being less than, in step 14 ' in, it is right Above-mentioned number (n) adds 1 and returns to step 15 (step 21).

(22) arithmetic processing section 75 determines applying preparation switch 744 until input applies and executes switch 745 from input During whether produce abnormal wave height event (event for reaching extraordinary wave high level), entered step in the case where generation 23,25 (steps 22) are entered step in the case where not generating.

(23) the defined stand-by time (between 3 seconds) the generation since abnormal wave height event, it is aobvious in display unit 78 Show " DRIFT " (step 23).

(24) arithmetic processing section 75 determines event (V_n) it whether is (multiple different producing from the generation of abnormal wave height event It is the generation of initial abnormal wave height event when ordinary wave is high) begin to pass through sensing detection after defined stand-by time (3 seconds) The event arrived, if after stand-by time sensing detection to event then enter step 25, if pass through stand-by time The event that sensing detection arrives before, then in step 14 ' in, 1 is added to above-mentioned number (n) and returns to step 15 (step 24).

(25) event (V that arithmetic processing section 75 will be arrived in step 16 sensing detection_n) it is identified as trigger point, and enter step 26 (steps 25).

(26) switch of the output circuit 751 of arithmetic processing section 75, which becomes, connects (ON), and enters step 27 (steps 26).

(27) from the DC power supply portion 71 of the control signal from arithmetic processing section 75 is received via arithmetic processing section 75 Output circuit 751, switching part 76 and conduit connection connector 72 are to the first DC electrode group of defibrillation catheter 100 and the 2nd DC (step 27, referring to Fig.1 4) electrode group applies mutually different polar DC voltage.

Here, arithmetic processing section 75 and the event (V arrived in step 12 sensing detection_n) synchronously, to the first DC electrode group And above-mentioned second electrode group carries out calculation process and to 71 sending control signal of DC power supply portion with applying DC voltage.

Specifically, in the (V from sensing detection to event_n) at the time of while rising (next R wave) when beginning to pass through regulation Between (for example, as event (V_n) R wave spike width 1/10 or so extremely short time) after start to apply.

Figure 15 is to indicate giving defined electric energy (for example, setting output by the defibrillation catheter 100 in present embodiment =10J) when the figure of potential waveform that determines.In the figure, horizontal axis indicates the time, and the longitudinal axis indicates current potential.

Firstly, arithmetic processing section 75 is in (the V from sensing detection to event_n) begin to pass through stipulated time (t₀) after, with first DC electrode group 31G is-pole, and the 2nd DC electrode group 32G is+and the mode of pole applies DC voltage therebetween, from supply of electrical energy And it measures current potential and rises (E₁It is crest voltage at this time.).Passing through stipulated time (t₁) after, with the first DC electrode group 31G be+ Pole, the 2nd DC electrode group 32G are the-mode of pole, apply therebetween inverted ± DC voltage, thus supply of electrical energy And it measures current potential and rises (E₂It is crest voltage at this time.).

Here, (the V from sensing detection to event_n) to start apply until time (t₀) it is, for example, 0.01~0.05 second, if Showing a preferred example is then 0.01 second, time (t=t₁+t₂) it is, for example, 0.006~0.03 second, if showing preferred one A example is then 0.02 second.Thereby, it is possible to the event (V as R wave_n) synchronously apply voltage, it is able to carry out and effectively removes It quivers treatment.

Crest voltage (the E determined₁) it is, for example, 300~600V.

(28) in (V from sensing detection to event_n) begin to pass through stipulated time (t₀+ t) after, receive at operation The control signal in reason portion 75 stops the application (step 28) from the voltage in DC power supply portion 71.

(29) after it stopped the application of voltage, the record of application is shown (as shown in Figure 15 in display unit 78 Electrocardio digit wave form when application) (step 29).As display the time, for example, 5 seconds.

(30) contact of switching part 76 is switched to the first contact, restore from conduit connection connector 72 via switching part 76 to Up to the path of electrocardiogram equipment connection connector 73, from the first DC electrode group 31G of defibrillation catheter 100 and the 2nd DC electrode group The heart potential information input of the composition electrode of 32G is to 800 (step 30) of electrocardiogram equipment.

(31) to the monitor for being shown in electrocardiogram equipment 800, composition electrode (the first DC electrode from defibrillation catheter 100 Group 31G, the 2nd DC electrode group 32G and base end side potential measurement electrode group 33G composition electrode) heart potential information (electrocardio Figure) and heart potential information (12 lead electrocardiogram) from heart potential determination unit 900 observed, tied if " normal " Beam returns to step 2 (step 31) in the case where " abnormal (atrial fibrillation is not calmed down) ".

In the case where using the defibrillation catheter system of present embodiment as system involved in second aspect, at operation Reason portion 75 with energy apply execute switch 745 input after sensing detection to event (V_n) polarity and its previous sensing Event (the V detected_n-1) the event (V that arrives of polarity and its first two sensing detection_n-2) polarity it is consistent, also, in thing Part (V_n) waveform in, rise time until triggering level is reached since reaching baseline between 45m seconds within the case where Under, with the event (V_n) synchronously the terminal 721 (the first DC electrode group 31G) of conduit connection connector 72 is connected with conduit The terminal 722 (the 2nd DC electrode group 32G) of connector 72 applies alive mode and carries out calculation process and control DC power supply portion 71.

Here, " baseline " is to instigate the baseline (voltage=0V) of electrocardiogram to the event (V that should measure the rise time_n) Polar orientation deviates the level of the voltage after 0.26V.

That is, in event (V_n) baseline of polarity when being (+) be+0.26V, in event (V_n) polarity be (-) when bottom Line is -0.26V.

Figure 20 is shown input into the electrocardiogram of arithmetic processing section 75, and energy applies the thing after the input for executing switch 745 Part (event (V₂)) propradation (time).

In the figure, baseline is shown with the chain-dotted line BL extended to time-axis direction, and to extend to time-axis direction Solid line TL shows triggering level.

If input energy, which applies, at the time of shown in arrow (SW1-ON) prepares switch 744, in the forward pass that will be inputted Feel the three event (V detected_-2)、(V_-3) and (V_-4) polarity be (+), so the polarity as primary event is by pole Property (+) is stored in arithmetic processing section 75.

In addition, be stored in will input before two event (V arriving of sensing detection_-2) and (V_-3) mean wave height 80% height is used as " triggering level " (TL).

If input energy, which applies, at the time of shown in arrow (SW2-ON) executes switch 745, due to applying in input energy Add execute switch 745 after between 260m seconds within sensing detection arrive followed by event (V₁), so not with the event (V₁) synchronous Ground applies voltage.

Apply from input energy execute switch 745 begin to pass through 260m seconds between later sensing detection to event (V₁) under Event (V in a cycle₂)。

In addition, event (V₂) polarity (+) and primary event the event that arrives of polarity (+), previous sensing detection (V₁) the event (V that arrives of polarity (+) and the first two sensing detection₀) polarity (+) it is consistent.

But in the event (V₂) waveform in, until triggering level (TL) is reached since reaching baseline (BL) Rise time (t) was more than 45m seconds, so being set as event (V₂) waveform be T wave a possibility that without being identified as trigger point, no Synchronously apply voltage with the event (V2).

Figure 17 is to indicate to use the intracardiac defibrillation catheter system of present embodiment as system involved in second aspect In the case where defibrillation therapy an example flow chart.

Step 1~21 of defibrillation therapy in the case where using as system involved in second aspect are in addition in step 12 In do not store other than " extraordinary wave high level ", with used as system involved in first aspect in the case where defibrillation therapy Step 1~21 are identical.

As step 22, arithmetic processing section 75 measures the event (V arrived in step 16 sensing detection_n) waveform in, from reaching Rise time until baseline reaches triggering level, and 23 are entered step within 45m seconds in the time, The time is more than in the case where 45m seconds, in step 14 ' in, 1 is added to above-mentioned number (n) and returns to step 15.

Step 23~29 of defibrillation therapy in the case where being used as system involved in second aspect with as first Step 25~31 of defibrillation therapy in the case where system use involved in aspect are identical.

Conduit system according to the present embodiment can pass through the first DC electrode group 31G of defibrillation catheter 100 and second DC electrode group 32G directly gives the heart electric energy for causing fibrillation, can reliably only give required for defibrillation therapy to heart And sufficient electro photoluminescence (electric shock).

Moreover, because cardiac electric energy can directly be given, so the body surface of patient will not be made to generate burn.

In addition, the heart potential information determined by the composition electrode 33 of base end side potential measurement electrode group 33G is from conduit Connector 72 is connected not via switching part 76, and is input to electrocardiogram equipment 800 via electrocardiogram equipment connection connector 73, also, at this Electrocardiogram equipment 800 is connected with heart potential determination unit 900, so even if can not obtain in electrocardiogram equipment 800 from defibrillation catheter 100 The first DC electrode group 31G and the 2nd DC electrode group 32G heart potential defibrillation therapy when (switching part 76 is switched to second and connects Point, when cutting reaches the path of electrocardiogram equipment connection connector 73 via switching part 76 from conduit connection connector 72), electrocardiogram equipment 800 can also obtain the heart potential letter determined by base end side potential measurement electrode group 33G and heart potential determination unit 900 Breath, can monitor in electrocardiogram equipment 800 and carry out defibrillation therapy while (monitoring) heart potential.

Also, the arithmetic processing section 75 of power supply device 700 with the heart potential that is inputted via electrocardiogram input connector 77 Alive mode is applied to synchronous waveform to carry out calculation process and control DC power supply portion 71 (from the potential difference in electrocardio digit wave form Reach after triggering level begins to pass through stipulated time (such as 0.01 second) and start to apply), so can be with heart potential synchronous waveform Ground applies voltage to the first DC electrode group 31G of defibrillation catheter 100 and the 2nd DC electrode group 32G, is able to carry out and effectively removes It quivers treatment.

Also, the control of arithmetic processing section 75 is less than defined value for the resistance only between the electrode group of defibrillation catheter 100 In the case where, i.e., only in the first DC electrode group 31G and the 2nd DC electrode group 32G reliably with defined position (for example, coronal The tube wall of vein, atrium dextrum inner wall) when abutting, the preparation for applying DC voltage is able to enter, so being able to carry out The defibrillation therapy of effect.

Also, arithmetic processing section 75 via electrocardiogram input connector 77 from the electrocardiogram that electrocardiogram equipment 800 inputs, according to Secondary sensing detection is estimated as the event of R wave, if energy apply execute switch 745 input after n-th sensing detection to thing Part (V_n) the event (V that is not arrived with its previous sensing detection of polarity_n-1) the thing that arrives of polarity and its first two sensing detection Part (V_n-2) polarity it is consistent, then not with event (V_n) synchronously apply voltage, causing tachiysystole so can be avoided, or Person carries out defibrillation when the baseline of electrocardiogram is not stable.

Figure 21 A is to produce to be input to the electrocardiogram of arithmetic processing section 75 when the tachiysystole of single in the heart of patient (electrocardio digit wave form identical with electrocardiogram shown in Figure 23).In Figure 21 A, the 4th R wave (event (V since left side₀)〕 Polarity be (-), the peak value of next T wave increases, and the T wave is as event (V₁) by sensing detection.

As shown in the drawing, in sensing detection to event (V₀) after, it has input energy and applies the case where executing switch 745 Under, sensing detection arrives after just inputting event (V₁) polarity (+) and the event (V that arrives of its previous sensing detection₀) Polarity (-) is different, thus not with the event (V₁) synchronously apply voltage.Thereby, it is possible to avoid with peak value increase and be easily mistaken for Synchronously apply voltage for the T wave of R wave.

In addition, event (V₁) the event (V that arrives of next sensing detection₂) be R wave peak value, but its polarity (+) and the first two Event (the V that a sensing detection arrives₀) polarity (-) it is different, so not with the event (V₂) synchronously apply voltage.

Moreover, event (V₂) the event (V that arrives of next sensing detection₃) polarity (+) and previous sensing detection arrive Event (V₂) the event (V that arrives of polarity (+) and the first two sensing detection₁) polarity (+) it is identical, so with can be assured that as R Event (the V of the peak value of wave₃) synchronously, voltage is applied to the first DC electrode group 31G and the 2nd DC electrode group 32G.

Figure 21 B is to be input to the electrocardiogram of arithmetic processing section 75 when the heart of patient continuously causes tachiysystole.

As shown in the drawing, in sensing detection to event (V of the polarity reversion as (-) due to tachiysystole₀) defeated later Enter in the case that energy applies and execute switch 745, sensing detection arrives after just inputting event (V₁) polarity be (+), the event (V that following sensing detection arrives₂) polarity be (-), the event (V that following sensing detection arrives₃) polarity be (+), the event (V that following sensing detection arrives₄) polarity be (-), the event (V that following sensing detection arrives₅) polarity be (+) changes to the alternating polarity of event.Therefore, as described above, the polarity for three events that continuously sensing detection arrives is inconsistent In the state of, it is judged as that being possible to each of these events is not the peak value of R wave, without with event synchronization applying voltage.

In addition, though event (V₅) the event (V that arrives of next sensing detection₆) polarity (+) be R wave peak value, but its Event (the V that polarity (+) and the first two sensing detection arrive₄) polarity (-) it is different, so not with the event (V₆) synchronously apply Voltage.

Moreover, event (V₆) the event (V that arrives of next sensing detection₇) polarity (+) and event (V₆) polarity (+) And event (V₅) polarity (+) it is identical, so being judged as in event (V₇) sensing detection when tachiysystole reliably calm down, And with can be assured that the event (V for the peak value of R wave₇) synchronously, to the first DC electrode group 31G and the 2nd DC electrode group 32G Apply voltage.

Figure 22 is to generate to drift about and baseline declines, and thereafter, baseline rises and recovers to the electrocardiogram of original level (with figure The identical electrocardio digit wave form of electrocardiogram shown in 24), the decline and rising of baseline are mistaken as R wave, respectively by sensing detection For event (V_-1) and event (V₁)。

As shown in figure 22, in the case where energy application execution switch 745 are had input before baseline will rise, just Event (the V that sensing detection arrives after input₁) polarity (+) and the event (V that arrives of its previous sensing detection₀) polarity (+) phase Together, but the first two sensing detection arrives with it event (V_-1) polarity (-) it is different, so not with the event (V₁) synchronously apply Making alive synchronously applies voltage when thereby, it is possible to avoid and be mistaken as the rising of the baseline of R wave.

Moreover, event (V₁) the event (V that arrives of next sensing detection₂) polarity (+) and previous sensing detection arrive Event (V₁) the event (V that arrives of polarity (+) and the first two sensing detection₀) polarity (+) it is identical, so being judged as in event (V₂) sensing detection base line stablize, and with can be assured that the event (V for the peak value of R wave₂) synchronously to the first DC electrode group 31G and the 2nd DC electrode group 32G applies voltage.

Also, arithmetic processing section 75 is between the 260m second after sensing detection to the event for being estimated as R wave, not to the first DC Electrode group 31G and the 2nd DC electrode group 32G controls DC power supply portion 71 with applying DC voltage, so can reliably avoid In the case that the event that sensing detection arrives is the peak value of R wave, defibrillation is carried out at the time of next T wave occurs.

Also, arithmetic processing section 75 was programmed between the 100m second after sensing detection to the event for being estimated as R wave, no Again sensing detection is estimated as the event of R wave, so in the peak value that the event that sensing detection arrives is R wave, and next opposite In the case that the peak value for the S wave that direction occurs increases and reaches triggering level, sensing detection can be prevented to the peak value of the S wave and By same polar count resets.

Also, arithmetic processing section 75 with energy apply execute switch 745 input after the 260m second during, not to first The mode that DC electrode group 31G and the 2nd DC electrode group 32G apply DC voltage controls DC power supply portion 71, thus can prevent by Since energy applies the input for executing switch 745 and the noise that generates is mistakenly considered R wave progress sensing detection, and with the Noise Synchronization Ground carries out defibrillation, or due to the noise and by same polar count resets.

Also, in the case where using the defibrillation catheter system of present embodiment as system involved in first aspect, Abnormal wave height is produced during until input energy applies preparation switch 744 to input energy application execution switch 745 When event, arithmetic processing section 75 is only to begin to pass through defined stand-by time (3 from the generation of initial abnormal wave height event Second) after sensing detection to event (V_n) in the case where, with event (V_n) synchronously to the terminal 721 of conduit connection connector 72 The terminal 722 (the 2nd DC electrode group 32G) that (the first DC electrode group 31G) connects connector 72 with conduit applies alive mode It carries out calculation process and controls DC power supply portion 71, so can reliably avoid when causing drift to the first DC electrode group 31G And the 2nd DC electrode group 32G apply DC voltage, can be restored in drift and when baseline stability, it is same with the R wave of the electrocardiogram Step ground applies voltage to the first DC electrode group 31G and the 2nd DC electrode group 32G and carries out defibrillation.

Also, in the case where using the defibrillation catheter system of present embodiment as system involved in second aspect, Arithmetic processing section 75 is in event (V_n) waveform in, from the rise time reached until baseline reaches triggering level in 45m In the case where within second, with event (V_n) synchronously, to conduit connection connector 72 terminal 721 (the first DC electrode group 31G), The terminal 722 (the 2nd DC electrode group 32G) that connector 72 is connected with conduit applies alive mode and carries out calculation process and control DC power supply portion 71, so in the case where the rise time being more than 45m seconds, it is possible to event (V_n) waveform be T wave, without with The event (V₂) synchronously apply voltage, so can reliably avoid being synchronously carried out defibrillation with T wave.

Also, arithmetic processing section 75 with will input apply prepare switch 744 before sensing detection to three events Polarity it is same to each other in the case where, store polarity of the polarity as primary event, energy apply execute switch 745 it is defeated Enter the event (V that rear sensing detection arrives_n) polarity and primary event polarity it is inconsistent in the case where, not with the event (V_n) same Step ground carries out calculation process to the first DC electrode group 31G and the 2nd DC electrode group 32G mode for applying DC voltage and controls DC power supply portion 71, so can more reliably avoid carrying out defibrillation when causing drift.

Description of symbols

100 ... defibrillation catheters, 10 ... multi-lumen tubes, 11 ... first lumens, 12 ... second lumens, 13 ... third lumens, 14 ... 4th lumen, 15 ... fluororesin layers, 16 ... interior (core) portions, 17 ... outer (shell) portions, 18 ... stainless steel bare wires, 20 ... handles, 21 ... handle main bodies, 22 ... knobs, 24 ... strain relief members, 26 ... first insulating properties hoses, 27 ... second insulating properties hoses, 28 ... third insulating properties hoses, the first DC electrode group of 31G ..., 31 ... ring electrodes, the 2nd DC electrode group of 32G ..., 32 ... is cyclic annular Electrode, 33G ... base end side potential measurement electrode group, 33 ... ring electrodes, 35 ... front-end chips, 41G ... the first conducting wire group, 41 ... Conducting wire, 42G ... the second conducting wire group, 42 ... conducting wires, 43G ... privates group, 43 ... conducting wires, the connector of 50 ... defibrillation catheters, 51,52,53 ... pin terminal, 55 ... partitions, 58 ... resins, 61 ... first protection hoses, 62 ... second protection hoses, 65 ... draw Line, 700 ... power supply devices, 71 ... DC power supply portions, 72 ... conduits connect connector, 721,722,723 ... terminals, 73 ... electrocardiogram equipments Connector is connected, 74 ... external switches (input unit), 741 ... mode selector switch, 742 ... apply energy configuration switch, 743 ... charge switch, 744 ... energy, which apply, prepares switch, and the application of 745 ... energy executes switch (discharge switch), 75 ... operations Processing unit, 751 ... output circuits, 76 ... switching parts, 77 ... electrocardiogram input connectors, 78 ... display units, 800 ... electrocardios Instrument, 900 ... heart potential determination units.

Claims (9)

1. a kind of intracardiac defibrillation catheter system comprising: the defibrillation catheter of defibrillation is carried out in the insertion chambers of the heart, to the defibrillation catheter Electrode apply DC voltage power supply device and electrocardiogram equipment, which is characterized in that

The defibrillation catheter includes:

The hose part of insulating properties；

First electrode group is constituted by being mounted on multiple ring electrodes of front end area of the hose part；

Second electrode group, multiple ring-types from the hose part is separated and be installed in from the first electrode group to base end side Electrode is constituted；

First conducting wire group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the first electrode group；And

Second conducting wire group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the second electrode group,

The power supply device includes:

DC power supply portion；

Conduit connects connector, connect with the base end side of the first conducting wire group of the defibrillation catheter and the second conducting wire group；

External switch, the application including electric energy prepare switch and apply to execute switch；

Arithmetic processing section, the output circuit with the DC voltage from the DC power supply portion, the arithmetic processing section are based on institute The input for stating external switch controls the DC power supply portion；And

Electrocardiogram input connector is connect with the output terminal of the arithmetic processing section and the electrocardiogram equipment,

Switch is executed by inputting the application after the input for applying preparation switch, to be carried out by the defibrillation catheter Defibrillation is connected when carrying out defibrillation from the DC power supply portion via the output circuit of the arithmetic processing section and the conduit Connector applies mutually different polar electricity to the first electrode group and the second electrode group of the defibrillation catheter Pressure,

The arithmetic processing section of the power supply device carries out calculation process and controls the DC power supply portion, according to via the electrocardio Successively sensing detection is estimated as the event of R wave to the electrocardiogram that figure input connector is inputted from the electrocardiogram equipment, holds in the application Event (the V that sensing detection arrives after the input of row switch_n) the event (V that is at least arrived with its previous sensing detection of polarity_n-1) Event (the V that polarity and its first two sensing detection arrive_n-2) polarity it is consistent, also, preparing to switch from inputting applications When producing abnormal wave height event during until inputting applications and executing switch, only from the exception wave height event It generates by event (V described in sensing detection after defined stand-by time_n) in the case where, with the event (V_n) synchronously to institute It states first electrode group and the second electrode group applies voltage.

2. intracardiac defibrillation catheter system according to claim 1, which is characterized in that

It is described exception wave height event be more than will input it is described apply prepare switch before sensing detection to two events Mean wave height 120% wave height event.

3. intracardiac defibrillation catheter system according to claim 1 or 2, which is characterized in that

The stand-by time is between 1000 to 5000m seconds.

4. intracardiac defibrillation catheter system according to any one of claim 1 to 3, which is characterized in that

The intracardiac defibrillation catheter system includes: the function of being reported in a possibility that stand-by time causes drift.

5. a kind of intracardiac defibrillation catheter system comprising: the defibrillation catheter of defibrillation is carried out in the insertion chambers of the heart, to the defibrillation catheter Electrode apply DC voltage power supply device and electrocardiogram equipment, which is characterized in that

The defibrillation catheter includes:

The hose part of insulating properties；

First electrode group is constituted by being mounted on multiple ring electrodes of front end area of the hose part；

Second electrode group, multiple ring-types from the hose part is separated and be installed in from the first electrode group to base end side Electrode is constituted；

First conducting wire group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the first electrode group；And

Second conducting wire group is made of multiple conducting wires that front end is separately connected with the electrode for constituting the second electrode group,

The power supply device includes:

DC power supply portion；

Conduit connects connector, connect with the base end side of the first conducting wire group of the defibrillation catheter and the second conducting wire group；

External switch, the application including electric energy prepare switch and apply to execute switch；

Arithmetic processing section, the output circuit with the DC voltage from the DC power supply portion, the arithmetic processing section are based on institute The input for stating external switch controls the DC power supply portion；And

Electrocardiogram input connector is connect with the output terminal of the arithmetic processing section and the electrocardiogram equipment,

Switch is executed by inputting the application after the input for applying preparation switch, to be carried out by the defibrillation catheter Defibrillation is connected when carrying out defibrillation from the DC power supply portion via the output circuit of the arithmetic processing section and the conduit Connector applies mutually different polar electricity to the first electrode group and the second electrode group of the defibrillation catheter Pressure,

The arithmetic processing section of the power supply device carries out calculation process and controls the DC power supply portion, according to via the electrocardio Successively sensing detection is estimated as the event of R wave to the electrocardiogram that figure input connector is inputted from the electrocardiogram equipment, holds in the application Event (the V that sensing detection arrives after the input of row switch_n) the event (V that is at least arrived with its previous sensing detection of polarity_n-1) Event (the V that polarity and its first two sensing detection arrive_n-2) polarity it is consistent, also, in the event (V_n) waveform in, Make the baseline of electrocardiogram to the event (V from reaching_n) polar orientation offset by the baseline of 0.26V until will input described Apply sensing detection before preparing switch to two events mean wave height 80% rise time i.e. until triggering level Within between 45m seconds, with the event (V_n) synchronously the first electrode group and the second electrode group are applied Making alive.

6. intracardiac defibrillation catheter system according to any one of claim 1 to 5, which is characterized in that

The arithmetic processing section of the power supply device carries out calculation process and controls the DC power supply portion, will input described apply In the case where adding the polarity for three events that sensing detection arrives before preparing to switch same to each other, the polarity is stored as initial thing The polarity of part, in the event (V_n) polarity and the primary event polarity it is inconsistent in the case where, not with the event (V_n) Voltage synchronously is applied to the first electrode group and the second electrode group.

7. intracardiac defibrillation catheter system according to any one of claim 1 to 6, which is characterized in that

The arithmetic processing section of the power supply device controls the DC power supply portion, with sensing detection to be estimated as R wave event it Afterwards, between most 50m seconds short between longest 500m seconds, voltage is not applied to the first electrode group and the second electrode group.

8. intracardiac defibrillation catheter system according to claim 7, which is characterized in that

The arithmetic processing section of the power supply device in sensing detection to after being estimated as the event of R wave, the longest between most 10m seconds short Between 150m seconds, sensing detection is not estimated as the event of R wave again.

9. intracardiac defibrillation catheter system according to claim 7 or 8, which is characterized in that

The arithmetic processing section of the power supply device controls the DC power supply portion, with it is described apply the input for executing switch after, Between most 10m seconds short between longest 500m seconds, voltage is not applied to the first electrode group and the second electrode group.