CN115969503A - Ablation equipment with pacing control function and ablation method - Google Patents
Ablation equipment with pacing control function and ablation method Download PDFInfo
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- CN115969503A CN115969503A CN202211042772.2A CN202211042772A CN115969503A CN 115969503 A CN115969503 A CN 115969503A CN 202211042772 A CN202211042772 A CN 202211042772A CN 115969503 A CN115969503 A CN 115969503A
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- 238000002679 ablation Methods 0.000 title claims abstract description 72
- 238000000034 method Methods 0.000 title claims abstract description 10
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- 230000033764 rhythmic process Effects 0.000 claims abstract description 6
- 210000002216 heart Anatomy 0.000 claims description 8
- 230000010247 heart contraction Effects 0.000 claims description 4
- 230000001629 suppression Effects 0.000 claims description 4
- 230000003111 delayed effect Effects 0.000 claims description 3
- 210000004165 myocardium Anatomy 0.000 claims description 3
- 208000003663 ventricular fibrillation Diseases 0.000 abstract description 6
- 239000003814 drug Substances 0.000 abstract description 2
- 210000001519 tissue Anatomy 0.000 description 5
- 230000000661 pacemaking effect Effects 0.000 description 4
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- 230000036279 refractory period Effects 0.000 description 3
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- 230000002107 myocardial effect Effects 0.000 description 2
- 208000012260 Accidental injury Diseases 0.000 description 1
- 206010003658 Atrial Fibrillation Diseases 0.000 description 1
- 206010049418 Sudden Cardiac Death Diseases 0.000 description 1
- 230000006907 apoptotic process Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 210000005242 cardiac chamber Anatomy 0.000 description 1
- 230000030833 cell death Effects 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000004520 electroporation Methods 0.000 description 1
- 230000005284 excitation Effects 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 210000005003 heart tissue Anatomy 0.000 description 1
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- 230000002427 irreversible effect Effects 0.000 description 1
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- 208000014221 sudden cardiac arrest Diseases 0.000 description 1
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- 231100000827 tissue damage Toxicity 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
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Abstract
The invention discloses an ablation device with a pacing control function and an ablation method, and the ablation device comprises an upper computer, a control system and an output system, wherein the upper computer is used for sending a control command, the control system is used for sending pacing pulses and pulse ablation, the output system is used for conveying the pacing pulses and the pulse ablation which are sent by the control system, the upper computer is used for setting pacing frequency and pulse ablation lag time, the control system is used for sending the pacing pulses through the output system, the ventricular pacing frequency is stabilized, the control system is used for sending the pulse ablation through the output system within a safe time window range, the device selects a safer and more effective time point to send the pulse ablation in a mode of actively establishing a pacing rhythm, the possible ventricular fibrillation caused by the sending of the pulse ablation is effectively avoided, the device can be used as a temporary pacemaker in an operation, and the cost of using the device in the operation and the cost of purchasing the medicine are reduced.
Description
Technical Field
The invention relates to the technical field of pulse ablation, in particular to ablation equipment with a pacing control function and an ablation method.
Background
PFA (PulsedFieldAblation) is a novel ablation method for cell death based on irreversible electroporation mechanism, and has been applied to ablation of atrial fibrillation due to its advantages of tissue specificity, non-thermal ablation, etc.
The pulse energy was passed through a 90cm/110cm length pulse ablation catheter, through the femoral vein puncture, and into the heart chamber. After reaching the target position, a doctor carries out pulse energy distribution by operating the pulse ablation catheter to ablate the target tissue, so that specific myocardial cell apoptosis is caused, and ectopic (electric impulse; electric signal) conduction is blocked.
During the pulse ablation process, when the pulse is turned on, energy is immediately released through the catheter. The electrical pulses occur at any point in time at which the cardiac cycle is at exactly that instant. If an electrical pulse is provided during the relatively refractory period (corresponding to the second half of the T wave), it is possible to induce VF (the so-called "R-on-T phenomenon"). This will lead to sudden cardiac arrest in an originally pulsed patient.
Conventional PFA solutions have difficulty delivering pulse ablation over a safe time period, and thus have the potential to induce ventricular fibrillation when pulse ablation is delivered.
Disclosure of Invention
In order to solve the technical problems, the invention provides an ablation device with a pacing control function, which can actively deliver pacing pulses to stimulate the heart to contract and deliver high-frequency pulse ablation within a safe time interval after successful pacing, so that ventricular fibrillation induced by the delivery of high-frequency pulse signals is avoided, and serious complications are caused. Including the host computer, the host computer is used for giving control command, control system is used for granting pace-making pulse and pulse ablation, output system is used for carrying pace-making pulse and pulse ablation that control system issued, the host computer sets for pace-making frequency and pulse ablation lag time, control system warp output system grants pace-making pulse, stabilizes the frequency of ventricular pacing, in safe time window within range, control system warp output system grants pulse ablation.
Preferably: the control system includes a pacing module for delivering pacing pulses and a PFA module for delivering pulse ablation.
Preferably: the pacing module can be in an R-wave trigger type, and the pacing module sends pulses to stimulate the ventricle to pace according to the pacing sending frequency set by the upper computer.
Preferably, the following components: the pacing module can be of an R wave suppression type, and delivers pulses to stimulate the ventricles to pace according to the pacing delivery frequency set by the upper computer.
Preferably: the PFA module is PFA pulse ablation.
Preferably, the following components: the delivery system includes a distal pacing catheter and a distal PFA catheter.
Preferably: the far-end pacing catheter is connected with the pacing module and is used for outputting pacing pulses delivered by the pacing module.
Preferably: the distal PFA catheter is connected to the PFA module and is used to deliver the pulse ablation delivered by the PFA module.
A method of ablation comprising the steps of:
s1, selecting a proper pacing frequency by an upper computer according to the heart rhythm of a patient;
s2, delivering a pacing pulse through a pacing electrode inserted into cardiac muscle;
s3, observing whether the pacing pulse effectively paces cardiac contraction;
s4, after judging that no effective pacing exists, replacing the position of the far-end pacing catheter;
and S5, after effective pacing is judged, selecting the time of pacing pulse delivery as a time zero point, and delivering pulse ablation within a safe time window range, wherein the pulse ablation can be delivered synchronously with a pacing signal or delayed for a certain time.
The invention has the technical effects and advantages that:
1. the device selects safer and more effective time points to deliver the pulse ablation by actively establishing a pacing rhythm mode, thereby effectively avoiding the possible ventricular fibrillation induced by the delivery of the pulse ablation.
2. The device can be used as a temporary pacemaker in an operation, and the cost of using the device in the operation and the cost of purchasing the device for medicines are reduced.
Drawings
Fig. 1 is a block diagram of an ablation device with pacing control provided by an embodiment of the present application;
fig. 2 is a schematic control flow diagram of an ablation device with pacing control provided by an embodiment of the present application;
fig. 3 is an electrocardiogram of an ablation device with pacing control functionality provided by an embodiment of the present application after delivery of a pacing stimulus.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings and specific embodiments. The embodiments of the present invention have been presented for purposes of illustration and description, and are not intended to be exhaustive or limited to the invention in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art. The embodiment was chosen and described in order to best explain the principles of the invention and the practical application, and to enable others of ordinary skill in the art to understand the invention for various embodiments with various modifications as are suited to the particular use contemplated.
Referring to fig. 1 to fig. 3, in the present embodiment, an ablation apparatus with pacing control function is provided, including an upper computer, a control system and an output system, where the upper computer is configured to send a control command, and the control system includes a pacing module and a PFA module.
The output system comprises a far-end pacing catheter and a far-end PFA catheter which are connected with the control system, the far-end pacing catheter is connected with the pacing module and used for outputting pacing pulses issued by the pacing module, the far-end PFA catheter is connected with the PFA module and used for outputting pulse ablation issued by the PFA module.
The upper computer sets pacing frequency and pulse ablation lag time, the upper computer sends a control command, the pacing module actively sends pacing signals, the pacing pulse is output through the far-end pacing catheter to stimulate cardiac contraction, the voltage of the pulse stimulation is 1-10V, the time is 0.1-1.5ms, and in a safe time interval after pacing is successful, the PFA module sends high-frequency pulse ablation to avoid sending of the high-frequency pulse signals to induce ventricular fibrillation.
The R wave trigger type (VVT) can be selected as the pacing module, the pacing module sends a pulse to stimulate the ventricle to pace according to the pacing sending frequency set by the upper computer, if the ventricle has self excitation (QRS), the pacemaker ventricular electrode can sense the QRS wave, the QRS wave which is excited by the pacemaker triggers the pacemaker to immediately send an electric pulse, the electric pulse happens to accompany with the QRS wave of the heart beat of the pacemaker, the triggered pulse is taken as a starting point, the pacemaker resets the pulse sending period, the pulse is sent within the specified time (the period of the frequency set by the pacemaker) after the pulse, if no heart beat occurs, the pacemaker sends a pulse to stimulate the ventricle to pace, and the mechanism can stabilize the ventricular pacing frequency.
The pacing module can also select an R wave suppression type (VVI), the pacing module sends pulses according to the pacing sending frequency set by the upper computer to stimulate the ventricle to pace, if the ventricle is excited by itself, a pacemaker ventricular electrode can sense the QRS wave suppression pacemaker excited automatically, the next pulse is not sent according to the original period, but the period is rearranged from the QRS wave excited by itself, and in the specified time after the QRS wave (the period of the pacing device setting frequency), if no heart beat occurs by itself, the pacemaker sends pulses to stimulate the ventricle to pace, so that the mechanism can stabilize the ventricular pacing frequency.
The PFA module is PFA pulse ablation, the safety is high, the provided non-thermal energy source has high tissue selectivity, can generate lasting heart tissue damage of a target area within a few seconds, simultaneously reserves non-target tissues, can selectively ablate target myocardial cells, avoids 'accidental injury' to peripheral organs, tissues, blood vessels and nerves, realizes 'selective' ablation, and reduces the incidence rate of complications.
The distal PFA catheter can adapt to different pulmonary vein forms, realize stable attachment and improve the clinical operation flexibility, and after the distal PFA catheter is in place, the energy provided by the PFA module can be released within seconds, thereby greatly shortening the operation time.
Also included are embodiments of a method of ablation, comprising the steps of:
s1, selecting a proper pacing frequency (usually higher than the self-rhythm) by using an upper computer according to the rhythm of the heart of a patient;
s2, delivering a pacing pulse through a pacing electrode inserted into the cardiac muscle;
s3, observing whether the pacing pulse effectively paces the cardiac contraction;
s4, after judging that no effective pacing exists, replacing the position of the far-end pacing catheter;
and S5, after effective pacing is judged, selecting the time of pacing pulse delivery as a time zero point, and delivering pulse ablation within a safe time window range, wherein the pulse ablation can be delivered synchronously with a pacing signal or delayed for a certain time.
The working principle of the invention is as follows:
the PFA module selects a refractory period in a cardiac cycle of a heart to discharge, the PFA module collects human body electrocardiosignals by using an electrocardio gate control, analyzes the cardiac cycle, gives out a refractory period indication signal, and delivers pulses through the pacing module to stabilize ventricular pacing frequency, so that the human body electrocardiosignals collected by the electrocardio gate control are more stable, a clinician can select a safe pulse ablation time point, the safer and more effective time point is selected to deliver pulse ablation by actively establishing a pacing rhythm mode, and possible ventricular fibrillation is effectively prevented from being induced by the delivery of the pulse ablation.
It is to be understood that the described embodiments are merely a few embodiments of the invention, and not all embodiments. All other embodiments, which can be derived by one of ordinary skill in the art and related arts based on the embodiments of the present invention without any creative effort, shall fall within the protection scope of the present invention. Structures, devices, and methods of operation not specifically described or illustrated herein are generally practiced in the art without specific recitation or limitation.
Claims (9)
1. An ablation device with pacing control, comprising:
the upper computer is used for sending out a control command;
a control system for delivering pacing pulses and pulse ablations;
an output system for delivering pacing pulses and pulse ablations delivered by the control system;
the upper computer sets pacing frequency and pulse ablation lag time, the control system delivers pacing pulses through the output system, the ventricular pacing frequency is stabilized, and the control system delivers pulse ablation through the output system within a safe time window range.
2. The ablation device with pacing control function of claim 1, wherein the control system includes a pacing module for delivering pacing pulses and a PFA module for delivering pulse ablation.
3. The ablation device with the pacing control function according to claim 2, wherein the pacing module is of an R-wave trigger type, and delivers pulses to stimulate ventricular pacing according to the pacing delivery frequency set by the host computer.
4. The ablation device with the pacing control function according to claim 2, wherein the pacing module is of an R-wave suppression type, and delivers pulses to stimulate ventricular pacing according to the pacing delivery frequency set by the upper computer.
5. The ablation device with pacing control function according to claim 2, wherein the PFA module is PFA pulse ablation.
6. The ablation device with pacing control function of claim 1, wherein the output system includes a distal pacing catheter and a distal PFA catheter.
7. The ablation device with pacing control function as claimed in claim 6, wherein the distal pacing catheter is connected with the pacing module, and the distal pacing catheter is used for outputting the pacing pulse delivered by the pacing module.
8. The ablation device with pacing control of claim 6, wherein the distal PFA catheter is connected to the PFA module, the distal PFA catheter being configured to deliver pulsed ablation delivered by the PFA module.
9. Method of ablation using an ablation device as claimed in any of claims 1-8, characterized by the steps of:
s1, selecting a proper pacing frequency by an upper computer according to the heart rhythm of a patient;
s2, delivering a pacing pulse through a pacing electrode inserted into the cardiac muscle;
s3, observing whether the pacing pulse effectively paces cardiac contraction;
s4, after judging that no effective pacing exists, replacing the position of the far-end pacing catheter;
and S5, after effective pacing is judged, pulse ablation is delivered within a safe time window range by taking the pacing pulse delivery time as a time zero point, wherein the pulse ablation can be delivered synchronously with a pacing signal or delayed for a certain time.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202211042772.2A CN115969503A (en) | 2022-08-29 | 2022-08-29 | Ablation equipment with pacing control function and ablation method |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202211042772.2A CN115969503A (en) | 2022-08-29 | 2022-08-29 | Ablation equipment with pacing control function and ablation method |
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| Publication Number | Publication Date |
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| CN115969503A true CN115969503A (en) | 2023-04-18 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202211042772.2A Withdrawn CN115969503A (en) | 2022-08-29 | 2022-08-29 | Ablation equipment with pacing control function and ablation method |
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| CN (1) | CN115969503A (en) |
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2022
- 2022-08-29 CN CN202211042772.2A patent/CN115969503A/en not_active Withdrawn
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