CN113729924B - Electrode catheter and ablation device - Google Patents

Electrode catheter and ablation device Download PDF

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Publication number
CN113729924B
CN113729924B CN202111162744.XA CN202111162744A CN113729924B CN 113729924 B CN113729924 B CN 113729924B CN 202111162744 A CN202111162744 A CN 202111162744A CN 113729924 B CN113729924 B CN 113729924B
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China
Prior art keywords
electrode
arm
catheter
electrode arm
arms
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CN202111162744.XA
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Chinese (zh)
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CN113729924A (en
Inventor
罗中宝
张朕华
孙佳宝
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Shanghai Ruidao Medical Technology Co ltd
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Shanghai Remedicine Co ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation

Abstract

The present disclosure relates to an electrode catheter and an ablation device, the electrode catheter comprising: a rear end control part and a front end support part respectively arranged at two ends of the electrode catheter, wherein the front end support part is configured as a front end free end of the electrode catheter; an inner tube extending at least between the front end support and the rear end control and configured to define a shape of the electrode catheter; an outer tube coating the outside of the inner tube; an electrode arm portion which is provided between the inner tube and the outer tube and which includes at least three electrode arms, each of which includes at least one electrode portion and a distal end of which is fixedly connected to the inner tube by a front end support portion and extends between the front end support portion and a rear end control portion; and an electrode arm adjusting portion, at least a part of each electrode arm being adapted to switch between a first state in which it is linear and a second state in which it is arcuate under the control of the back end control portion, the electrode arm adjusting portion being connected to at least one electrode arm to adjust the extended state of the electrode arm.

Description

Electrode catheter and ablation device
Technical Field
The present disclosure relates to the field of medical devices, and more particularly to an electrode catheter and ablation device.
Background
Atrial Fibrillation (AF) is a common arrhythmia affecting over 3300 thousands of people worldwide. Radio frequency ablation and cryoablation are currently two common methods used clinically to treat cardiac arrhythmias such as atrial fibrillation. The lesions of both ablations must be sufficient to destroy arrhythmic tissue or substantially interfere with or isolate abnormal electrical conduction within myocardial tissue, while excessive ablation affects surrounding healthy tissue as well as neural tissue, but insufficient ablation does not act to block abnormal electrical conduction. Therefore, it is important to create a suitable ablation zone.
The radio frequency ablation adopts point-by-point ablation, the operation time is long, the requirement on the catheter operation level of an operator (such as a doctor) is high, discomfort can be generated in the operation of a patient due to long time, and the problems of pulmonary vein stenosis and the like easily occur after the operation. In addition, radiofrequency ablation may damage the heart endothelial surface, activate an exogenous coagulation cascade and cause coke and thrombosis, which in turn may lead to systemic thromboembolism. It follows that the application of radio frequency energy to target tissue may have an effect on non-target tissue, for example, the application of radio frequency energy to atrial wall tissue may result in damage to the digestive or nervous system, such as the esophagus. In addition, rf ablation can also lead to tissue scarring, further leading to embolic problems. While cryoablation causes a higher probability of phrenic nerve injury, epicardial freezing near the coronary arteries may also lead to thrombosis and progressive coronary stenosis.
The head end of the currently known pulse ablation electrode catheter mainly adopts an integral soft electrode arm, and is mostly in a single circular arc shape, a basket shape, a flower shape or a cage shape, but the electrode catheters in the forms generally have the following defects that the electrode catheter products are not well attached to a target position and are easy to deform in a body, so that good effects can be achieved only by repeated ablation, and the operation time is prolonged.
Disclosure of Invention
In view of the deep understanding of the problems existing in the background art, that is, the existing electrode catheter is not well attached to the target position and is easily deformed in the body, so that multiple ablations are required to achieve a good effect, which inevitably prolongs the operation time, the inventor of the present disclosure proposes an electrode catheter and an ablation device, and in particular, the first aspect of the present disclosure proposes an electrode catheter, which can specifically adjust the extension state of the corresponding electrode arm, and the electrode catheter includes:
a front end support portion configured as a front end free end of the electrode catheter;
a rear end control part and the front end support part are respectively arranged at two ends of the electrode catheter;
an inner tube extending at least between the front end support and the rear end control and configured to define a shape of the electrode catheter;
the outer tube is coated outside the inner tube;
an electrode arm portion disposed between the inner tube and the outer tube and including at least three electrode arms, wherein each of the at least three electrode arms includes at least one electrode portion and distal ends of the at least three electrode arms are fixedly connected to the inner tube by the front end support portion and extend between the front end support portion and the rear end control portion; and
an electrode arm adjusting part, which is used for adjusting the electrode arm,
and wherein at least a portion of each of the at least three electrode arms is adapted to switch between a first state in which it appears linear and a second state in which it appears arcuate under the control of the back end control section, and wherein the electrode arm adjustment section is connected with at least one electrode arm to adjust the extended state of the at least one electrode arm.
By means of the electrode arm adjusting part provided by the disclosure, the extending state of the corresponding electrode arm can be adjusted in a targeted manner, so that the extending amount of the adjusted electrode arm can be different from that of other electrode arms which are not adjusted, and the ablation area of the electrode catheter provided by the disclosure can be adjusted in a targeted manner based on the specific form of the target tissue, and a better ablation effect is achieved.
Preferably, in one embodiment according to the present disclosure, the electrode arm further comprises:
an inner core;
a wire running along an axial direction of the inner core;
an insulating sleeve covering the inner core and the wire;
wherein the electrode portion is arranged outside the insulating sleeve, and the wire is connected to the electrode portion through the insulating sleeve at the electrode portion.
In this way, a large part of the electrode arm can be insulated, and only the part where the electrode parts are required to discharge is energized, and the electrode parts are located at the position where the pulse shock treatment is actually performed. In order to enable the electrode part to be accurately powered, the wire is connected with the electrode part through the insulating sleeve at the electrode part.
Preferably, in one embodiment according to the present disclosure, the inner core is made of a memory material or a medical grade stainless steel material.
Preferably, in one embodiment according to the present disclosure, the electrode arm adjusting part is configured to be fixedly connected with the corresponding electrode arm. Therefore, the electrode arm connected with the electrode arm adjusting part can be adjusted under the action of the electrode arm adjusting part, so that an ablation area formed by the electrode arm at the front end can be adjusted, and a better ablation effect is realized.
Preferably, in one embodiment according to the present disclosure, the electrode arm adjustment part is configured to be movable between a first position and a second position to be selectively connected with a first electrode arm of the at least three electrode arms at the first position or with a second electrode arm of the at least three electrode arms at the second position.
In this way, for example, a plurality of electrode arms can share one electrode arm adjustment portion, and when a specific electrode arm of the plurality of electrode arms needs to adjust its extension amount, the electrode arm adjustment portion can be rotated or translated, for example, and when rotated or translated to a new position, can be mechanically connected to another electrode arm, thereby adjusting the extension amount of the newly connected electrode arm.
Preferably, in one embodiment according to the present disclosure, the electrode arm adjustment part is configured to be mechanically connected with at least two electrode arms. In this way, the plurality of electrode arms can be adjusted simultaneously by one electrode arm adjusting portion, and the efficiency of adjusting the ablation region formed by the plurality of electrode arms can be improved.
Further preferably, in one embodiment according to the present disclosure, the electrode arm adjustment part is configured to be mechanically connected with the at least two electrode arms via a transmission member having different transmission ratios. In this way, the technical effect of simultaneously adjusting the plurality of electrode arms by the same electrode arm adjusting portion can be achieved, and the adjustment of the different amounts of extension of the plurality of electrode arms can be achieved.
Preferably, in one embodiment according to the present disclosure, the electrode arm adjusting part is configured as an electrode arm push-pull device including:
a card slot provided on a surface of the rear end control portion; and
and the buckles are connected with the corresponding electrode arms and are arranged in the clamping grooves.
Preferably, in one embodiment according to the present disclosure, an outer tube side cavity is formed in the annular wall of the outer tube, the outer tube side cavity being configured to receive the electrode arm. In this way an effective accommodation of the electrode arm and a better protection can be achieved, reducing the possibility of failure of the electrode arm.
Preferably, in one embodiment according to the present disclosure, the back-end control part includes:
an inner tube push-pull configured to drive the inner tube to move back and forth along a longitudinal direction of the electrode catheter.
In this way, the front-end electrode arm can be switched between a first state in which it is linear and a second state in which it is arcuate.
Preferably, in one embodiment according to the present disclosure, the electrode catheter further comprises:
and a sensor configured to detect a bonding state of the corresponding electrode portion to the target object.
In this way it is possible to determine which or which electrode arms have to be trimmed, on the basis of which the corresponding electrode arm is found and the extension of the corresponding electrode arm is adjusted by means of the electrode arm adjustment, so that a more effective ablation zone and thus a better ablation effect is achieved.
Preferably, in one embodiment according to the present disclosure, the electrode catheter further comprises a prompting device configured to generate a prompting signal based on the fit state.
Furthermore, a second aspect of the present disclosure proposes an ablation device, characterized in that it comprises:
a pulse signal generator arranged to generate a pulse signal; and
according to the electrode catheter of the first aspect of the disclosure, the electrode of the electrode catheter is electrically connected with the output end of the pulse signal generator.
In summary, by means of the electrode arm adjusting portion provided according to the present disclosure, the extension state of the corresponding electrode arm can be adjusted in a targeted manner, so that the extension amount of the adjusted electrode arm can be different from that of other electrode arms which are not adjusted, and further, the electrode arm of the electrode catheter provided according to the present disclosure can be adjusted in a targeted manner based on the specific form of the target tissue, so that the electrode catheter can be well attached to the target tissue in different forms, and a better ablation effect can be achieved.
Drawings
The embodiments are shown and described with reference to the drawings. The drawings serve to illustrate the basic principles and thus only show aspects necessary for understanding the basic principles. The figures are not to scale. In the drawings, like reference numerals refer to like features.
FIG. 1 shows a schematic side view of the front end of an electrode catheter 100 according to one embodiment of the prior art;
fig. 2 shows a forward schematic view of the front end of the electrode catheter 100 of the embodiment of fig. 1 according to the prior art;
fig. 3 shows a side schematic view of the front end of at least a portion of the electrode arms of an electrode catheter 300 having different amounts of extension in accordance with one embodiment of the present disclosure;
fig. 4 shows a forward schematic view of the front end of the electrode catheter 300 of the embodiment of fig. 3 in accordance with the present disclosure;
FIG. 5 shows a schematic view of an electrode arm adjustment portion 511 according to one embodiment of the present disclosure;
fig. 6A shows a schematic diagram of the whole of the back end control part 510 with the electrode arm adjustment part 511 of fig. 5 according to one embodiment of the present disclosure;
fig. 6B shows a schematic diagram of a back end control portion 610 having the electrode arm adjustment portion 511 of fig. 5 according to another embodiment of the present disclosure;
FIG. 7A shows an enlarged partial schematic view of an electrode arm adjustment portion in connection with an electrode arm according to one embodiment of the present disclosure;
FIG. 7B is an enlarged partial schematic view of an electrode arm adjustment portion according to another embodiment of the present disclosure when a plurality of electrode arms are connected;
fig. 8 shows a partially enlarged schematic view of a clasp 8111 of an electrode arm adjustment 811 according to yet another embodiment of the present disclosure when connected with a plurality of electrode arms;
FIG. 9 illustrates a front end elevational view of an electrode catheter in an extended state in accordance with the present disclosure;
fig. 10 shows a schematic view of an electrode catheter 1000 according to the present disclosure.
Other features, characteristics, advantages and benefits of the present disclosure will become more apparent from the following detailed description taken in conjunction with the accompanying drawings.
Detailed Description
In the following detailed description of the preferred embodiments, reference is made to the accompanying drawings which form a part hereof. The accompanying drawings illustrate, by way of example, specific embodiments in which the disclosure may be practiced. The illustrated embodiments are not intended to be exhaustive of all embodiments according to the present disclosure. It is to be understood that other embodiments may be utilized and structural or logical modifications may be made without departing from the scope of the present disclosure. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present disclosure is defined by the appended claims.
The technique used in this disclosure for treatment of atrial fibrillation is a pulsed electric field technique that applies a brief high voltage to the target tissue cells that can generate a local high voltage electric field of several hundred volts per centimeter. The local high voltage electric field disrupts the cell membrane by forming perforations in the cell membrane where the applied electric field is above the cell threshold so that the perforations do not reclose, thereby rendering such electroporation irreversible. The perforation will cause the exchange of biomolecular material across the cell membrane, resulting in necrosis or apoptosis of the cell.
Since different tissue cells have different voltage penetration thresholds, the high voltage pulse technique can selectively treat myocardial cells with relatively low threshold values without affecting other non-target cellular tissues such as nerve cells, esophageal cells, vascular cells, and blood cells. Meanwhile, the energy is released for a very short time, so that the pulse electric field technology does not generate obvious thermal effect, and the problems of tissue injury, pulmonary vein stenosis and the like are avoided.
In particular, pulsed electric field technology (PET) ablates into non-thermal damage technology, the mechanism of which is the nano-scale micro-pores of certain cell membranes by high frequency electrical pulses. Potential advantages of PET ablation techniques that can be used for atrial fibrillation ablation include the following: firstly, the PET ablation technology can pertinently select or avoid target tissues by setting different thresholds, so that surrounding tissues can be protected from damage; secondly, the PET ablation technology can be rapidly released within a few seconds, namely, the treatment time of cells of the target tissue is short, and the PET ablation technology is easy to accept by a user; furthermore, compared to cryoablation, PET ablation techniques do not exhibit coagulative necrosis, thus reducing the risk of stenosis of the Pulmonary Veins (PV).
Fig. 1 shows a side schematic view of the front end of an electrode catheter 100 according to one embodiment of the prior art, and fig. 2 shows a forward schematic view of the front end of the electrode catheter 100 according to the embodiment of fig. 1 of the prior art. As can be seen from fig. 1 and 2, the electrode catheter 100 of the prior art includes a front support 110, an inner tube 120, an outer tube 130, and electrode arms 140, each of which electrode arms 140 has at least one electrode portion 142, and the electrode arms 140 are stretched the same length, so that they must conform to regular tissue, but have poor effect on irregularly shaped tissue.
In view of the deep understanding of the problems of the prior art, that is, the existing electrode catheter 100 is not well attached to the target site and is easily deformed in vivo, so that multiple ablations are required to achieve a good effect, and the operation time is prolonged, the inventor of the present disclosure proposes an electrode catheter 300 capable of adjusting the extension state of the corresponding electrode arm.
Specifically, fig. 3 shows a side schematic view of the front end of an electrode catheter 300 according to one embodiment of the present disclosure when at least a portion of the electrode arms have different amounts of extension, while fig. 4 shows a forward schematic view of the front end of the electrode catheter 300 according to the embodiment of fig. 3 of the present disclosure.
As can be seen from fig. 3 and 4, the first aspect of the present disclosure proposes an electrode catheter 300, which electrode catheter 300 comprises a front end support portion 310, a rear end control portion (not shown in fig. 3, see fig. 10), an inner tube 320, an outer tube 330, electrode arm portions 340 and 340', and an electrode arm adjustment portion (not shown in fig. 3 and 4, which will be described in detail later with the aid of fig. 6A and 6B). Wherein the front end support portion 310 is configured as a front end free end of the electrode catheter 300, the rear end control portion and the front end support portion 310 are respectively disposed at both ends of the electrode catheter 300, the inner tube 320 extends at least between the front end support portion 310 and the rear end control portion and is configured to define a shape of the electrode catheter 300, and the outer tube 330 is wrapped outside the inner tube 320; the electrode arms (arc-shaped portions in the figures) are arranged between the inner tube 320 and the outer tube 330 and comprise at least three electrode arms (e.g. electrode arms 340 and 340 '), wherein each of the at least three electrode arms 340 and 340' (e.g. electrode arm 340 or electrode arm 340 ') comprises at least one electrode portion 342 and 342' and the distal ends of the at least three electrode arms are fixedly connected to the inner tube 320 by the front end support portion 310 and extend between the front end support portion 310 and the rear end control portion, and wherein at least a portion of each of the at least three electrode arms 340 or 340' is adapted to switch between a first state, which is linear, and a second state, which is arc-shaped, under control of the rear end control portion, and wherein the electrode arm adjustment portion is connected to at least one electrode arm for adjusting the extended state of the at least one electrode arm. The electrode arm adjusting part according to the present disclosure can purposefully adjust the corresponding extending state of the electrode arm 340', for example, so that the extending amount of the adjusted electrode arm 340' can be different from that of other electrode arms 340 which are not adjusted, and further the electrode arm of the electrode catheter 300 according to the present disclosure can be purposefully adjusted based on the specific form of the target tissue, so as to achieve good adhesion with the target tissue with different forms, and achieve better ablation effect.
For example, as can be seen from fig. 3 and 4, the extension amount of the electrode arm 340 'is significantly larger than the extension amount of the electrode arm 340, at which time, for example, in a case where the extension amount of the electrode arm 340' before the adjustment by the electrode arm adjustment portion fails to be well abutted with the corresponding target tissue, the extension amount of the electrode arm 340 'is adjusted by means of the electrode arm adjustment portion proposed according to the present disclosure until the electrode arm 340' is well abutted with the target tissue. Here, preferably, the electrode arm includes: an inner core; a wire running along an axial direction of the inner core; an insulating sleeve covering the inner core and the wire; and an electrode portion disposed outside the insulating sleeve, wherein the wire is connected to the electrode portion through the insulating sleeve at the electrode portion. The inner core can be made of memory alloy or medical stainless steel material or other suitable materials; the wire cross section can be round or rectangular; the electrode ring adopts platinum or platinum iridium, the length can be between 1mm and 10mm, the thickness can be between 0.01mm and 0.1mm, and the number of electrode parts on each electrode arm 340 can be between 6 and 12; the materials of the inner tube 320 and the outer tube 330 may be selected from appropriate materials such as PEBAX, TPU, nylon, and the outer tube 330 may have a size of 8-15F; inner tube 320 is a guide wire channel and both inner tube 320 and outer tube 330 may be woven from stainless steel to provide support strength. The maximum outer diameter of the electrode arm 340 is 1mm to 2mm, the working diameter of the electrode arm 340 after deployment may be 10mm to 20mm, and the working diameter of the second electrode arm 340, such as an arc-shaped electrode arm, may be 20mm to 30mm; possible connection modes include gluing, hot melting, welding and other processes. In this way, a large part of the electrode arm can be insulated, and only the part where the electrode parts are required to discharge is energized, and the electrode parts are located at the position where the pulse shock treatment is actually performed. In order to enable the electrode part to be accurately powered, the wire is connected with the electrode part through the insulating sleeve at the electrode part.
Preferably, in one embodiment according to the present disclosure, the inner core is made of a memory material or a medical grade stainless steel material. More preferably, in one embodiment according to the present disclosure, the memory material comprises a memory alloy that, for example, assumes a circular arc shape in a normal state, i.e., without being constrained by an external force, and is, for example, drawn into a wire shape when pulled by an external force. Of course, it will be appreciated by those skilled in the art that the memory alloy can, for example, also take on a linear shape in normal conditions, i.e. without being constrained by an external force, and be operated, for example, as a circular arc when pulled by an external force.
In order to achieve the function of the electrode arm adjustment, possible implementations of the electrode arm adjustment proposed in accordance with the present disclosure will be described below with the aid of fig. 5 to 8. Wherein fig. 5 shows a schematic view of an electrode arm adjustment portion 511 according to one embodiment of the present disclosure. As can be seen from fig. 5, the electrode arm adjusting part 511 is configured as an electrode arm push-pull 511, and the electrode arm push-pull 511 includes: a catching groove 5112, the catching groove 5112 is provided on the surface of the rear end control part so that an operator can smoothly contact and operate the electrode arm push-pull 511. The electrode arm push-pull 511 further comprises a catch 5111, wherein the catch 5111 is connected with the corresponding electrode arm and is arranged in the catch groove 5112. As can be seen from fig. 5, the buckle 5111 can move relative to the slot 5112, so that the part mechanically connected with the buckle 5111 moves, and the electrode arm indirectly connected with the buckle 5111 is pushed to move forwards or backwards, so as to adjust the whole ablation area of the electrode catheter, and achieve a better ablation effect.
Fig. 5 merely illustrates a specific implementation of the electrode arm push-pull 511, and how it is connected to the back-end control will be described with the aid of fig. 6A and 6B. Fig. 6A shows a schematic diagram of the whole of the back end control part 510 with the electrode arm adjustment part 511 of fig. 5 according to one embodiment of the present disclosure. As can be seen from fig. 6A, the rear end control unit 510 can have, for example, a plurality of electrode arm pushers 511, each electrode arm pusher 511 being mechanically connected, for example, to one or more electrode arms, so that the extension of the respective electrode arm can be controlled by means of the electrode arm pushers 511. For example, it will be appreciated by those skilled in the art that it is possible to provide each electrode arm push-pull 511, 511' mechanically coupled to only one electrode arm, which has the advantage that the amount of extension of each electrode arm can be controlled individually, enabling precise adjustment of the ablation zone. Correspondingly, each electrode arm push-pull 511 can be mechanically connected with a plurality of electrode arms (for example, three electrode arms at the same time), and the extension amount of the electrode arms connected with the push-pull 511 can be adjusted at the same time, so that the adjustment efficiency is improved. In addition, as can be seen in fig. 6A, the back end control portion 510 can also include a turn knob 512, which turn knob 512 can control the direction of deflection, e.g., upward or downward, of the electrode catheter to which it is attached.
Fig. 6B shows a schematic diagram of a back end control portion 610 having the electrode arm adjustment portion 511 of fig. 5 according to another embodiment of the present disclosure. As can be seen from fig. 6B, the rear end control unit 610 can have, for example, an electrode arm push-pull 511, which electrode arm push-pull 511 can be mechanically connected to only one electrode arm at a time, for example, so that the extension of the electrode arm connected to it can be controlled by means of the electrode arm push-pull 511. Although there is only one electrode arm push-pull 511, since the electrode arm push-pull 511 can rotate along the surface of the rear end control portion 610, for example, on the area 5110 of the rear end control portion 610, it can reach different positions before and after rotation, and connect with different electrode arms at different positions, so that the technical purpose that a plurality of electrode arms share one electrode arm push-pull 511 is achieved, the structure of the electrode catheter product is simplified, and the cost of the electrode catheter product is reduced. For example, as will be appreciated by those skilled in the art, when the electrode arm push-pull 511 is rotated into a position, the electrode arm push-pull 511 can be coupled to a corresponding portion of the electrode arm proximate the electrode arm push-pull 511, such as by the attractive effect of a magnet, for subsequent actuation purposes. In addition, as can be seen in fig. 6B, the back end control portion 610 can also include a turn knob 612, which turn knob 512 can control the direction of deflection, e.g., upward or downward, of the electrode catheter to which it is coupled.
How the mechanical connection of the electrode-arm push-pull 511 to the electrode arm or arms is achieved is described below in connection with fig. 7A and 7B. Fig. 7A shows a partially enlarged schematic illustration of an electrode arm adjustment portion 711 in connection with an electrode arm according to an embodiment of the present disclosure. As can be seen from fig. 7A, the electrode arm adjustment part 711 is configured as an electrode arm push-pull device including: a clamping groove 7112, wherein the clamping groove 7112 is arranged on the surface of the rear end control part so that an operator can smoothly contact and operate the electrode arm push-pull device. The electrode arm push-pull further comprises a catch 7111, which catch 7111 is connected to the respective electrode arm and is arranged in the catch 7112. As can be seen from fig. 7A, the buckle 7111 can move relative to the slot 7112, so that a portion mechanically connected to the buckle 7111 (for example, an area where the screw 7113 is located) moves, and further, the electrode arm 740 indirectly connected to the buckle 7111 is pushed to move forward or backward, so as to perform good abutment with target tissues in different forms, and achieve a better ablation effect.
Fig. 7B shows a partially enlarged schematic illustration of an electrode arm adjustment portion in connection with a plurality of electrode arms according to another embodiment of the present disclosure. As can be seen from fig. 7B, the electrode arm adjusting portion is configured as an electrode arm push-pull device, which includes: a clamping groove 7112', wherein the clamping groove 7112' is arranged on the surface of the rear end control part so that an operator can smoothly contact and operate the electrode arm push-pull device. The electrode arm push-pull further comprises a catch 7111', which is connected to the respective electrode arm (here, for example, simultaneously by means of screws 7113', 7113", 7113 '" and three electrode arms 740', 740", 740 '") and is arranged in the catch 7112'. As can also be seen from fig. 7B, the clasp 7111 'can move relative to the slot 7112', so that the portion mechanically connected to the clasp 7111 '(e.g., the region where the screws 7113', 7113", 7113 '" are located) moves, and further pushes the three electrode arms 740', 740", 740 '" indirectly connected to the clasp 7111' to move forward or backward, so as to perform good abutment with different forms of target tissue, and achieve better ablation effect. This allows the extension of the three electrode arms 740', 740", 740'" to be adjusted simultaneously by means of one electrode arm push-pull. It will be appreciated by those skilled in the art that the three electrode arms 740', 740", 740'" herein are merely exemplary and not limiting and that one electrode arm push-pull can be provided in connection with two or more electrode arms.
The electrode arms connected with the electrode arm push-pull device can only simultaneously adjust the same extension amount, but can not adjust different extension amounts. To better illustrate the technical details of how the clasp 8111 in fig. 8 achieves the adjustment of the different amounts of extension, the clasp groove of the electrode arm adjustment portion 811 is omitted in fig. 8, showing only the clasp 8111, in particular, fig. 8 shows a partially enlarged schematic view of the clasp 8111 of the electrode arm adjustment portion 811 in connection with a plurality of electrode arms according to yet another embodiment of the present disclosure. As can be seen from fig. 8, the electrode arm adjustment part is configured as an electrode arm push-pull 811, the electrode arm push-pull 811 comprises at least one catch 8111, the catch 8111 has two protruding parts 8112 and 8113 extending towards the electrode arm, in which two protruding parts a driving structure such as a driving rack 8119 is arranged, the movement of the catch 8111 is transmitted to the rotating shaft 8114 through the driving of the driving rack 8119, for example, so as to drive the rotating shaft 8114 to rotate, and the rotating shaft 8114 is respectively connected with the corresponding electrode arms (here, for example, by means of racks 8118 respectively connected with three electrode arms (not shown in the figure)) through gears of different sizes, so as to push the three electrode arms indirectly connected with the catch 8111 to move forwards or backwards, so as to perform good abutment with different forms of target tissues, and achieve better ablation effects. The embodiment disclosed in fig. 8 is distinguished in that in fig. 8 different gear ratios can be achieved by means of the engagement of the gear and the rack, whereby different displacement amounts of the rack 8118 and thus different extension amounts of the three electrode arms connected to the rack 8118 are achieved. Specifically, when the rotation shaft 8114 rotates by a certain angle, the radius of the intermediate gear 8116 is maximized, and thus the displacement amount of the rack connected to the gear 8116 is maximized. Accordingly, since the radius of each of the gears 8115 and 8117 is smaller than the radius of the gear 8116, the displacement amount of the racks connected to the gears 8115 and 8117 is smaller than the displacement amount of the racks connected to the gear 8116, and the extension amount of the electrode arm indirectly connected to the gears 8115 and 8117 is smaller than the extension amount of the electrode arm connected to the gear 8116. In this way, the adjustment of the different amounts of extension of the three electrode arms can be achieved simultaneously by means of one electrode arm push-pull. It will be appreciated by those skilled in the art that the three electrode arms herein are merely exemplary and not limiting, and that one electrode arm push-pull can be provided in connection with two or more electrode arms.
In a preferred embodiment, the electrode arm adjusting part capable of adjusting different extension amounts of the plurality of electrode arms simultaneously is configured to rotate around the axial direction of the rear end control part, so that the electrode arm adjusting part can reach different positions before and after rotation and can be connected with different plurality of electrode arms at different positions, thereby realizing the technical purpose that the plurality of electrode arms share one electrode arm push-pull device.
Fig. 9 shows a front end elevation view of an electrode catheter according to the present disclosure in an extended state. This front end elevation can be realized, for example, by means of an electrode arm push-pull 811 shown in fig. 8. Specifically, for example, the electrode arms 940', 940", 940'" can be indirectly connected to the gears 8116, 8115, and 8117, respectively, whereby the amount of extension of the electrode arm 940 'can be maximized, while the amount of extension of the electrode arms 940 "and 940'" is secondary.
Fig. 10 shows a schematic view of an electrode catheter 1000 according to the present disclosure. As can be seen in fig. 10, the electrode catheter 1000 includes at least an outer tube 1030, an electrode arm 1040, and a back end control 1050, and the back end control 1050 can include an electrode arm adjustment 1051, a turn knob 1052, and an inner tube push-pull 1053, the inner tube push-pull 1053 being configured to drive the inner tube back and forth along the longitudinal direction of the electrode catheter 1000. In this way, the tip electrode arm portion 1040 can be switched between the first state in which it is linear and the second state in which it is arcuate. Preferably, the annular wall of the outer tube 1030 has an outer tube side cavity formed therein that is configured to receive the electrode arm. In this way an effective accommodation of the electrode arm and a better protection can be achieved, reducing the possibility of failure of the electrode arm. In addition, in order to achieve effective monitoring of the extent of the electrode arm or of the contact state of the electrode arm with the target tissue, the electrode catheter can also comprise a sensor which is designed to detect the contact state of the respective electrode section with the target object. In this way it is possible to determine which or which electrode arms have to be trimmed, on the basis of which the corresponding electrode arm is found and the extension of the corresponding electrode arm is adjusted by means of the electrode arm adjustment, so that a more effective ablation zone and thus a better ablation effect is achieved. To further facilitate operation of the electrode arm adjustment portion, the electrode catheter 1000 further includes a prompting device configured to generate a prompting signal based on the fitting state.
Furthermore, a second aspect of the present disclosure proposes an ablation device comprising: a pulse signal generator arranged to generate a pulse signal; and an electrode catheter according to the first aspect of the present disclosure, an electrode portion of the electrode catheter being electrically connected with an output terminal of the pulse signal generator.
In summary, by means of the electrode arm adjusting portion provided according to the present disclosure, the extension state of the corresponding electrode arm can be adjusted in a targeted manner, so that the extension amount of the adjusted electrode arm can be different from that of other electrode arms which are not adjusted, and further, the electrode arm of the electrode catheter provided according to the present disclosure can be adjusted in a targeted manner based on the specific form of the target tissue, so that the electrode catheter can be well attached to the target tissue in different forms, and a better ablation effect can be achieved.
Although various exemplary embodiments of the present disclosure have been described, it will be apparent to those skilled in the art that various changes and modifications can be made which will achieve one or more of the advantages of the disclosure without departing from the spirit and scope of the disclosure. Other components performing the same function may be replaced as appropriate by those of ordinary skill in the art. It will be appreciated that features explained herein with reference to particular figures may be combined with features of other figures, even in those cases where such is not explicitly mentioned. Furthermore, the methods of the present disclosure may be implemented in either all software implementations using appropriate processor instructions or in hybrid implementations utilizing hardware logic and software logic combinations to achieve the same results. Such modifications to the solution according to the present disclosure are intended to be covered by the appended claims.

Claims (11)

1. An electrode catheter, the electrode catheter comprising:
a front end support portion configured as a front end free end of the electrode catheter;
a rear end control part and the front end support part are respectively arranged at two ends of the electrode catheter;
an inner tube extending at least between the front end support and the rear end control and configured to define a shape of the electrode catheter;
the outer tube is coated outside the inner tube;
an electrode arm portion disposed between the inner tube and the outer tube and including at least three electrode arms, wherein each of the at least three electrode arms includes at least one electrode portion and distal ends of the at least three electrode arms are fixedly connected to the inner tube by the front end support portion and extend between the front end support portion and the rear end control portion; and
an electrode arm adjusting part, which is used for adjusting the electrode arm,
and wherein at least a portion of each of the at least three electrode arms is adapted to switch between a first state in which it appears linear and a second state in which it appears arcuate under the control of the back end control section, and wherein the electrode arm adjustment section is connected with at least one electrode arm to adjust the extended state of the at least one electrode arm,
wherein the electrode arm adjustment portion is configured to mechanically connect with the at least two electrode arms via different gear ratios achieved by engagement of different sized gears and racks having a common rotational axis.
2. The electrode catheter of claim 1, wherein the electrode arm further comprises:
an inner core;
a wire running along an axial direction of the inner core;
an insulating sleeve covering the inner core and the wire,
wherein the electrode portion is arranged outside the insulating sleeve, and the wire is connected to the electrode portion through the insulating sleeve at the electrode portion.
3. The electrode catheter of claim 2, wherein the inner core is made of a memory material or a medical grade stainless steel material.
4. The electrode catheter of claim 1, wherein the electrode arm adjustment portion is configured to be fixedly connected to a corresponding electrode arm.
5. The electrode catheter of claim 1, wherein the electrode arm adjustment portion is configured to be movable between a first position and a second position to selectively connect with a first electrode arm of the at least three electrode arms in the first position or a second electrode arm of the at least three electrode arms in the second position.
6. The electrode catheter of claim 1, wherein the electrode arm adjustment portion is configured as an electrode arm push-pull device comprising:
a card slot provided on a surface of the rear end control portion; and
and the buckles are connected with the corresponding electrode arms and are arranged in the clamping grooves.
7. The electrode catheter of claim 1, wherein an outer tube side lumen is formed in an annular wall of the outer tube, the outer tube side lumen configured to receive the electrode arm.
8. The electrode catheter of claim 1, wherein the back end control portion comprises:
an inner tube push-pull configured to drive the inner tube to move back and forth along a longitudinal direction of the electrode catheter.
9. The electrode catheter of claim 1, further comprising:
and a sensor configured to detect a bonding state of the corresponding electrode portion to the target object.
10. The electrode catheter of claim 9, further comprising an alert device configured to generate an alert signal based on the fit state.
11. An ablation device, the ablation device comprising:
a pulse signal generator arranged to generate a pulse signal; and
the electrode catheter according to any one of claims 1 to 10, an electrode portion of the electrode catheter being electrically connected to an output of the pulse signal generator.
CN202111162744.XA 2021-09-30 2021-09-30 Electrode catheter and ablation device Active CN113729924B (en)

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