CN116370062B - Catheter head end and catheter for heart mapping and ablation - Google Patents
Catheter head end and catheter for heart mapping and ablation Download PDFInfo
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- CN116370062B CN116370062B CN202310666360.4A CN202310666360A CN116370062B CN 116370062 B CN116370062 B CN 116370062B CN 202310666360 A CN202310666360 A CN 202310666360A CN 116370062 B CN116370062 B CN 116370062B
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
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- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
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- A—HUMAN NECESSITIES
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- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical 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
- A61B18/14—Probes or electrodes therefor
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
- Surgical Instruments (AREA)
Abstract
The invention relates to the field of cardiac electrophysiology mapping and ablation, in particular to a catheter head end and a catheter for cardiac mapping and ablation, wherein the catheter head end comprises a netlike head end and a distal tube end, the netlike head end is axially distributed around the distal tube end, the netlike head end is an open curved surface with one end open and the other end connected with the distal tube end, a plurality of electrodes are arranged on the netlike head end, a proximal electrode ring and a distal electrode ring are formed on the netlike head end, the outer edge of the open curved surface is the distal electrode ring, the proximal electrode ring is arranged between the distal electrode ring and the distal tube end, the netlike head end has elasticity, and the distal electrode ring can be overturned along with the netlike head end and sleeved outside the distal tube end. The catheter head has the advantages of simple structure, convenient use and good effect.
Description
Technical Field
The invention relates to the field of cardiac electrophysiology mapping and ablation, in particular to a medical electrophysiology catheter, and particularly relates to a catheter head end and a catheter for cardiac mapping and ablation.
Background
The high-voltage pulse ablation can selectively damage myocardial cells with lower voltage threshold, does not damage vascular smooth muscle cells with higher voltage threshold, does not damage nerves, adjacent blood vessels and other irrelevant tissues, has higher operation safety, and has quick ablation time and high efficiency, and has important application in the aspect of ablation of the adjacent tissues of the blood vessels (such as pulmonary vein isolation) in recent years.
Although high voltage pulse ablation does not require as much of an electrode catheter to abut against tissue as radiofrequency ablation, in practice studies have found that good abutment is still an important means of improving the effectiveness of pulse ablation. Meanwhile, most of high-voltage pulse ablation is interelectrode discharge, the distance between discharge electrodes is required to be relatively fixed, otherwise, the ablation effect is greatly different. In extreme cases, the discharge electrodes are in contact with each other with serious consequences.
The size of the blood vessel or other lumen to be ablated varies from person to person and the cross-sectional shape is irregular, making it difficult for conventional single-arm catheters to conform well to tissue.
The high-voltage pulse electric field ablation requires relatively stable discharge electrode spacing, and a plurality of electrode arms of the existing multi-arm catheter are unstable when being deformed in an abutting mode, so that the positions of electrodes between the electrode arms are not fixed after each deformation, and the requirement of stabilizing the electrode spacing is difficult to achieve.
When the conventional catheters are used for completing the ablation and the test of the ablation effect, the conventional catheters are required to be moved to perform the test of the ablation effect after the ablation, or the conventional catheters are required to be used for performing the test of the ablation effect after the ablation by using the second catheters to stretch into the catheter for matching, so that the operation is troublesome, the efficiency is low, and the cost is high.
Disclosure of Invention
The invention aims at: aiming at the problems existing in the prior art, a catheter head end and a catheter for heart mapping and ablation are provided.
In order to achieve the above purpose, the technical scheme adopted by the invention is as follows:
in a first aspect, the invention provides a catheter head for cardiac mapping and ablation, comprising a mesh head and a distal tube, wherein the mesh head is axially distributed around the distal tube, the mesh head is an open curved surface with one end open and the other end connected with the distal tube, a plurality of electrodes are arranged on the mesh head, a proximal electrode ring and a distal electrode ring are formed on the mesh head, the outer edge of the open curved surface is the distal electrode ring, the proximal electrode ring is arranged between the distal electrode ring and the distal tube, the mesh head has elasticity, and the distal electrode ring can be overturned along with the mesh head and sleeved outside the distal tube.
The reticular head end is easy to be pressed and deformed, so that when the reticular head end is used, the conduit head end stretches into a tissue, acting force is transmitted along the axial direction of the distal end of the tube body, after the reticular head end is abutted against the tissue, the reticular head end is compressed along the axial direction of the distal end of the tube body under the compression of the tissue, for example, in general, a vascular orifice communicated with a heart is horn-shaped, the soft reticular head end can conform to the structure of the tissue to deform in the process of attaching vascular orifice tissue to enter the blood vessel, even can be turned over to form an inverted horn shape, the specific distal electrode ring is firstly attached to the vascular orifice, the reticular head end is gradually compressed and turned over along with the increase of the acting force, so that the distal electrode ring and the proximal electrode ring can be positioned in the same plane, the acting force is continuously increased, the reticular head end turns over, the distal electrode ring stays at the vascular orifice, and the proximal electrode ring and the distal end of the tube body stretches into the blood vessel, and the reticular head end between the distal electrode ring and the proximal electrode ring can be attached to the wall of the vascular orifice; the net-shaped head end has elasticity, and deformation can be reset after external force is removed.
By adopting the catheter head end for heart mapping and ablation, the netlike head end can be more uniformly and fully attached to the vascular orifices and the interiors of blood vessels with different sizes and different shapes, meanwhile, the far-end electrode ring can directly act on planar tissues, the far-end electrode ring and the near-end electrode ring can jointly act on the same planar tissues, the use field is rich, and the acting area is large; the reticular head end can disperse force to each mesh wire part when being stressed, so that the electrode position on the reticular head end is not easy to be stressed and changed, the distance between the electrodes is relatively fixed, the ablation process is safer, the mapping is more accurate, and the effect is more stable; after the reticular head end is turned over, the distal electrode ring is positioned at the orifice of the blood vessel, and the proximal electrode ring is positioned in the blood vessel, one of the distal electrode ring and the proximal electrode ring is used for ablation, the other is used for mapping, and a catheter does not need to be moved or a second catheter is started for cooperation test, so that the operation flow is simplified, the operation difficulty is reduced, the efficiency is improved, and the operation time and the operation cost are saved.
As a preferable technical scheme of the invention, the included angle between the open curved surface and the axial direction of the far end of the pipe body is theta, and theta is more than or equal to 90 degrees and less than or equal to 150 degrees, so that an expansion structure is formed.
As a preferable technical scheme of the invention, the open curved surface is in a horn shape, a cone shape or a hemispherical shape.
As a preferred embodiment of the present invention, the electrode is formed with at least one intermediate electrode ring on the mesh head end, the intermediate electrode ring being located between the proximal electrode ring and the distal electrode ring.
As a preferable technical scheme of the invention, the netlike head end comprises a plurality of electrode arms, each electrode arm is in an S-shaped arrangement, a plurality of electrodes are arranged at intervals, one end of each electrode arm is connected to the far end of the tube body, the other end of each electrode arm is in butt joint with the end part of the adjacent electrode arm, and the adjacent electrode arms are fixed in a staggered manner to form a netlike shape.
As a further preferable technical scheme of the invention, the mesh head end comprises at least two groups of electrode arms, each group of electrode arms comprises two electrode arms, each group of electrode arms is symmetrically arranged, and all groups of electrode arms are axially distributed around the far end of the tube body.
As a further preferable technical scheme of the invention, each electrode arm comprises an electrode arm distal end and an electrode arm proximal end, at least one outer bending point and at least one inner bending point are arranged between the electrode arm distal end and the electrode arm proximal end, the outer bending points and the inner bending points are arranged in a staggered mode, the electrode arm distal ends in each group of the electrode arms are in butt joint and fixed, the inner bending points are fixedly connected, the outer bending points of two adjacent groups of the electrode arms are fixedly connected, the electrode arm proximal ends are connected to the distal end of the tube body, the electrode arms between all the most distal outer bending points and the electrode arm distal ends are surrounded to form a distal electrode ring, and the electrode arms between all the most proximal outer bending points and the most proximal inner bending points are surrounded to form a proximal electrode ring.
As a further preferable embodiment of the present invention, each set of the electrode arms is an integrally formed member.
As a further preferable aspect of the present invention, an angle between the electrode arms on both sides of the outer bending point is adjustable, and an angle between the electrode arms on both sides of the inner bending point is adjustable.
As a further preferable technical scheme of the invention, each electrode arm comprises a supporting framework and a shell, wherein the supporting framework is wrapped by the shell, the supporting framework is made of elastic metal or polymer plastic, and the shell is made of polyurethane, polyimide or polyether amide.
As a further preferred embodiment of the invention, the electrodes are attached to the surface of the housing by means of adhesion, printing or deposition.
As a further preferable embodiment of the present invention, the electrode is provided with insulation from the support frame.
As a preferred embodiment of the present invention, the electrodes are disposed at equal intervals along the proximal electrode ring, and the electrodes are disposed at equal intervals along the distal electrode ring.
As a preferable technical scheme of the invention, the electrode adopts gold, silver, platinum or alloy thereof, or copper with the surface plated with the above materials.
As a preferable technical scheme of the invention, the surface area ratio between the positive electrode and the negative electrode in the electrode is 1:1 to 3:1.
as a preferable technical scheme of the invention, the width of the electrode is 0.5mm-2.0mm.
As a preferable technical scheme of the invention, the spacing of the electrodes is 1 mm-4mm.
As a preferable technical scheme of the invention, a plurality of positioning sensors are arranged on the net-shaped head end, and at least one positioning sensor is arranged on the far end of the tube body.
In a second aspect, the invention also provides a catheter for cardiac mapping and ablation, comprising a tube, a handle and a connector, the tube being connected to a catheter head end for cardiac mapping and ablation as described in any of the preceding claims, the proximal end of the tube being connected to the handle end, the handle tail being provided with the connector.
As a preferable technical scheme of the invention, a perfusion channel is arranged in the tube body, one end of the perfusion channel penetrates through the distal end of the tube body, and the other end of the perfusion channel extends into the handle.
In summary, due to the adoption of the technical scheme, the beneficial effects of the invention are as follows:
1. according to the catheter head end for heart mapping and ablation, the reticular head end can be more uniformly and fully attached to the vascular orifices and the interiors of blood vessels with different sizes and different shapes, meanwhile, the distal electrode ring can directly act on planar tissues, the distal electrode ring and the proximal electrode ring can jointly act on the same planar tissues, the use field is rich, and the acting area is large;
2. according to the catheter head end for heart mapping and ablation, the reticular head end can disperse force to each reticular wire part when being stressed, so that the electrode position on the reticular head end is not easy to be stressed and changed, the distance between the electrodes is relatively fixed, the ablation process is safer, the mapping is more accurate, and the effect is more stable;
3. according to the catheter head end for heart mapping and ablation, after the reticular head end is turned over, the distal electrode ring is positioned at a vascular orifice, and the proximal electrode ring is positioned in a blood vessel, one of the distal electrode ring and the proximal electrode ring is used for ablation, the other is used for mapping, and a catheter does not need to be moved or a second catheter is started for matching test, so that the operation flow is simplified, the operation difficulty is reduced, the efficiency is improved, and the operation time and the operation cost are saved.
Drawings
FIG. 1 is a schematic structural view of a catheter for cardiac mapping and ablation;
fig. 2 is a schematic diagram of a front view of a mesh headend;
FIG. 3 is a schematic side view of a mesh headend;
FIG. 4 is a schematic view of the structure of an electrode arm;
fig. 5 is a schematic view of the use of a catheter for cardiac mapping and ablation.
The marks in the figure: 1-mesh head end, 10-electrode arm, 101-electrode arm proximal end, 102-electrode arm distal end, 103-inner bending point, 104-outer bending point, 105-proximal electrode ring, 106-intermediate electrode ring, 107-distal electrode ring, 11-support skeleton, 12-housing, 13-electrode, 14-positioning sensor, 2-tube, 21-tube proximal end, 22-tube distal end, 3-handle, 4-connector, 5-irrigation channel, 51-irrigation joint.
Detailed Description
The present invention will be described in detail with reference to the accompanying drawings.
The present invention will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present invention more apparent. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the invention.
Example 1
As shown in fig. 1 to 5, a catheter head for cardiac mapping and ablation according to the present invention includes a mesh head 1 and a distal tube 22.
As shown in fig. 2 and fig. 3, the mesh-shaped head ends 1 are axially distributed around the distal end 22 of the pipe body, the mesh-shaped head ends 1 are open curved surfaces with one ends open and the other ends connected with the distal end 22 of the pipe body, the included angle between the open curved surfaces and the axial direction of the distal end 22 of the pipe body is θ, θ is more than or equal to 90 ° and less than or equal to 150 °, and an expansion structure is formed, and the open curved surfaces can be specifically in a horn shape, a cone shape or a hemispherical shape.
As shown in fig. 2 and 3, the mesh-shaped head end 1 includes a plurality of electrode arms 10, each electrode arm 10 is provided with a plurality of electrodes 13 at intervals, each electrode arm 10 is disposed in an S-shape, one end of each electrode arm 10 is connected to the distal end 22 of the tube body, the other end is in butt joint with the end of the adjacent electrode arm 10, and the adjacent electrode arms 10 are fixed in a staggered manner to form a mesh shape; in a specific embodiment, the mesh head 1 includes at least two groups of electrode arms 10, each group of electrode arms 10 includes two electrode arms 10, each group of electrode arms 10 is symmetrically disposed, and the directions of the electrode arms are opposite, and all groups of electrode arms 10 are distributed around the axial direction of the distal end 22 of the tube body, as shown in fig. 2, and the mesh head 1 formed by combining three groups of six electrode arms 10 is shown; in a specific embodiment, each set of said electrode arms 10 is an integral component.
As shown in fig. 2 and fig. 4, each electrode arm 10 includes an electrode arm distal end 102 and an electrode arm proximal end 101, at least one outer bending point 104 and at least one inner bending point 103 are disposed between the electrode arm distal end 102 and the electrode arm proximal end 101, the outer bending points 104 and the inner bending points 103 are staggered, the electrode arm distal ends 102 in each group of electrode arms 10 are butt-fixed, the inner bending points 103 are fixedly connected, the outer bending points 104 of two adjacent groups of electrode arms 10 are fixedly connected, and the electrode arm proximal end 101 is connected to the distal end 22 of the tube body to form the mesh-shaped head end 1.
As shown in fig. 2, fig. 3 and fig. 4, the angle between the electrode arms 10 at two sides of the outer bending point 104 can be adjusted, the angle between the electrode arms 10 at two sides of the inner bending point 103 can be adjusted to form a mesh structure with different shapes, as shown in fig. 2, the bending angle between the inner bending point 103 and the outer bending point 104 is approximately 180 °, at this time, a plurality of coaxial annular areas are formed between the electrode arms 10 of the mesh head 1, a plurality of proximal electrode rings 105 and distal electrode rings 107 are formed on the mesh head 1, the proximal electrode rings 105 are arranged between the distal electrode rings 107 and the distal electrode rings 22 of the tube body, all the electrode arms 10 between the distal outer bending point 104 and the distal electrode arms 102 enclose the distal electrode rings 107, that is, the outer edges of the open curved surfaces are the distal electrode rings 107, all the electrode rings 10 between the proximal bending point 104 and the inner bending point 103 are coaxial annular areas, the proximal electrode rings 105 are formed between the proximal electrode rings 105 and the proximal electrode rings 106, the proximal electrode rings 106 are formed by at least one electrode ring, and the electrode rings 106 are formed by at least one intermediate electrode ring 106, and the electrode rings 106 include a plurality of intermediate electrode rings 106.
As shown in fig. 4, each electrode arm 10 includes a supporting skeleton 11 and a casing 12, the casing 12 wraps the supporting skeleton 11, the supporting skeleton 11 is made of an elastic metal material or a polymer plastic material, and has elasticity, the supporting skeleton 11 is preformed into a required bending shape, the supporting skeleton 11 is specifically made of a memory alloy wire, the casing 12 is made of a polymer material such as polyurethane, polyimide or polyether amide, the memory alloy wire is soft and has super elasticity, the memory alloy wire can be quickly restored to an original shape after being deformed under the action of external force, the memory alloy wire is specifically made of a nickel-titanium alloy wire, the casing 12 is made of a polyurethane tubule, and also has excellent elasticity, the supporting skeleton 11 can be greatly deformed according to tissues, and the distal electrode ring 107 can be overturned along with the reticular head end 1 and sleeved outside the distal end 22 of the tube body, so that the original shape can be quickly restored when the distal electrode ring does not contact with the tissues, as shown in fig. 5.
The supporting strength and the compliance of the netlike head end 1 can be adjusted by changing the thickness of the supporting framework 11, the thinner the supporting framework 11 is, the smaller the supporting strength is, but the better the compliance is, and vice versa; it will be appreciated that, with respect to the existing single electrode tube arm (such as the annular head end), the mesh head end 1 distributed in a central symmetrical structure has a certain structural strength, so if the mesh head end 1 has the same supporting strength as the existing annular head end, the supporting framework 11 adopted by the mesh head end 1 can be thinner and softer, and can be deformed to a greater extent, and meanwhile, the stress of each electrode 13 is more uniform when the electrode is attached to a tissue.
The netlike head end is easy to be pressed and deformed, so that when the catheter head end stretches into tissues, acting force is transmitted along the axial direction of the distal end 22 of the tube body, the netlike head end 1 can be deformed by the force from all directions of surrounding tissues in the abutting process, the netlike head end 1 is compressed along the axial direction of the distal end 22 of the tube body under the compression of the tissues, but the deformation is integral, the force is dispersed by the netlike structure, so that the electrode arms 10 are not easy to collide, the resilience force of the supporting framework 11 can provide better support for the tissues, the electrode 13 is well abutted with the tissues in the ablation or mapping process, that is, the electrode arms 10 distributed in the netlike manner are abutted with the whole curved surface in a single point formed by the existing annular head end or independent electrode tube arm, on one hand, the shape of the tissues can be complied, the abutting between the electrode 13 and the tissues is promoted, on the other hand, the stable supporting can be formed, the abutting force between the electrode 13 and the tissues is relatively balanced, and the formed band is relatively uniform.
For example, in a normal case, the vessel orifice communicated with the heart is in a horn shape, the soft reticular head end 1 can conform to the structure of the tissue and deform in the process of attaching the tissue of the vessel orifice into the vessel, even can be turned over to form an inverted horn shape, at this time, the smaller diameter end of the reticular head end 1 is positioned at the far end, the larger diameter end is positioned at the near end, the far end electrode ring 107 is sleeved outside the distal end 22 of the tube body, and can be just anastomosed with the vessel orifice, as shown in fig. 5; the distal electrode ring 107 is firstly attached to a vascular orifice, the reticular head end 1 is gradually compressed and turned over along with the increase of the stress, so that the distal electrode ring 107 and the proximal electrode ring 105 can be positioned in the same plane, the stress is continuously increased, the reticular head end 1 is turned over, the distal electrode ring 107 stays at the vascular orifice, the proximal electrode ring 105 and the distal end 22 of the catheter body extend into the vascular, and the reticular head end 1 between the distal electrode ring 107 and the proximal electrode ring 105 can be attached to the horn-shaped wall of the vascular orifice; the netlike head end 1 has elasticity, and can reset after deformation is removed by external force.
The electrode 13 is made of a material with good conductivity, such as gold, silver, platinum, gold alloy, silver alloy, platinum alloy, or copper plated with the above materials, in this embodiment, a platinum iridium alloy material is adopted, the impedance is lower, the chemical property is very stable, electrolysis on the electrode surface when energy is emitted can be prevented or reduced, ionization and bubble generation can be further caused, the electrode 13 can be connected to the surface of the housing 12 in a bonding, printing or vapor deposition manner, the distribution of the electrode 13 on each electrode arm 10 can be equidistant, or can be arranged according to a certain rule, for example, the electrode 13 is arranged at equal intervals along the proximal electrode ring 105, the electrode 13 is arranged at equal intervals along the intermediate electrode ring 106, and the electrode 13 is arranged at equal intervals along the distal electrode ring 107.
The electrodes 13, the electrodes 13 and the supporting frame 11 can be insulated under the high-voltage pulse electric field, and the method for increasing the insulation comprises the following steps: the supporting framework 11 made of high polymer materials is selected, an insulating layer is added on the surface of the supporting framework 11 made of metal, an insulating layer is added between wires of the electrode 13, and the shell 12 material with good insulating performance is used in the installation area of the electrode 13.
As shown in fig. 2, the electrodes 13 are coaxially and annularly distributed, and sequentially form the distal electrode ring 107, at least one intermediate electrode ring 106, and the proximal electrode ring 105, where the electrodes 13 are divided into an ablation electrode and a mapping electrode according to different functional requirements; in a specific embodiment, the electrodes 13 on the distal electrode ring 107 and the middle electrode ring 106 are ablation electrodes, the electrodes 13 on the proximal electrode ring 105 are mapping electrodes, when ablation is performed, the turnover reticular head end 1 enables the mapping electrodes to enter into blood vessels, the ablation electrodes are positioned at the blood vessel ports, after the ablation is completed, a stimulation signal is sent through the mapping electrodes to detect the ablation effect, a catheter does not need to be moved, a second catheter does not need to be used, the operation efficiency is improved, the operation cost is reduced, meanwhile, the electrodes 13 are distributed in an approximate annular area, the electrode 13 interval is relatively stable, the ablation effect is relatively stable, the ablation process is safer, more than one turn of the ablation is performed through the distal electrode ring 107 and the middle electrode ring 106, and a wider isolation belt can be obtained; in a specific embodiment, the function between the ablation electrode and the mapping electrode is not strictly differentiated, the ablation electrode may also be used for mapping and delivering stimulation, and the mapping electrode may also be used for ablation.
The high-voltage pulse ablation is interelectrode discharge, ablation electrodes are distributed in one or more annular areas at the far end of the open curved surface, and one-to-one discharge, one-to-many discharge, and many-to-many discharge can be realized between the electrodes 13, depending on the ablation effect to be achieved.
In a specific embodiment, the surface area ratio between the positive and negative electrodes in the electrode 13 is 1:1 to 3:1, the width of the electrode 13 is 0.5mm-2.0mm, the ablation in the blood vessel usually needs to form a complete annular isolation belt, the larger the distance between the electrodes 13 is, the larger the ablation range is, but the distance between the electrodes 13 is too large, the ablation belt formed by insufficient electric field intensity between the electrodes 13 is possibly discontinuous, and the preferred distance between the electrodes 13 is 1 mm-4mm in this embodiment.
In a specific embodiment, as shown in fig. 2 and 3, a plurality of positioning sensors 14 are disposed on the mesh head end 1, at least one positioning sensor 14 is disposed on the distal end 22 of the tube body, and the positioning sensors 14 are preferably magnetic coil positioning sensors, where the magnetic coil positioning sensors can transmit the position information to a host computer when used with a matched electrophysiology three-dimensional mapping system, and then display the positions and forms of the distal end 22 of the tube body and the mesh head end 1 through a series of algorithms, and in this embodiment, the positions and forms of the distal ends 102 of the electrode arms 10 in each group of the electrode arms 10 are connected to the positioning sensors 14 as shown in fig. 2.
According to the catheter head end for heart mapping and ablation, the netlike head end can be more uniformly and fully attached to blood vessel openings and blood vessel interiors with different sizes and different shapes, meanwhile, the distal electrode ring 107 can directly act on planar tissues, the distal electrode ring 107 and the proximal electrode ring 105 can jointly act on the same planar tissues, the use scene is rich, and the acting area is large; the reticular head end can disperse force to each mesh wire part when being stressed, so that the position of the electrode 13 on the reticular head end is not easy to be stressed and changed, the distance between the electrodes 13 is relatively fixed, the ablation process is safer, the mapping is more accurate, and the effect is more stable; after the reticular head end 1 is turned over, the distal electrode ring 107 is positioned at the orifice of a blood vessel, and the proximal electrode ring 105 is positioned in the blood vessel, one of the distal electrode ring 107 and the proximal electrode ring 105 is used for ablation, the other is used for mapping, and a catheter does not need to be moved or a second catheter is started for cooperation test, so that the operation flow is simplified, the operation difficulty is reduced, the efficiency is improved, and the operation time and the operation cost are saved.
Example 2
As shown in fig. 1 to 5, a catheter for cardiac mapping and ablation according to the present invention includes a tube body 2, a handle 3, and a connector 4.
The tube body 2 is connected with the head end of the catheter for heart mapping and ablation according to the embodiment 1, the tube body proximal end 21 of the tube body 2 is connected with the end of the handle 3, and the tail of the handle 3 is provided with the connector 4 and the perfusion joint 51.
In a specific embodiment, the tube body 2 is a multi-layered structure, the distal tube end 22 is connected to the proximal tube end 101, the proximal tube end 21 is connected to the distal end of the handle 3, one or more cavities are provided in the tube body 2 for providing channels for wires of the electrodes 13 and other devices (such as traction members or the positioning sensor 14), each of the electrodes 13 is electrically connected to the connector 4 via the wires, and the distal tube end 22 and the proximal tube end 21 may be flexible differently as required, and typically, the distal tube end 22 is softer relative to the proximal tube end 21 and may bend under manipulation of the handle 3, and the handle 3 is a hand-held portion of an operator provided with a manipulation mechanism for controlling bending of the distal tube end 22.
In a specific embodiment, the tube body 2 is provided with a pouring channel 5, one end of the pouring channel 5 penetrates through the distal end 22 of the tube body, the other end extends into the handle 3 and is communicated with the pouring joint 51, the pouring joint 51 is connected with a pouring machine, and the pouring channel 5 is used for pouring anti-condensation liquid into the netlike head end 1, so that thrombus formation of the netlike head end 1 in use is avoided.
The foregoing description of the preferred embodiments of the invention is not intended to be limiting, but rather is intended to cover all modifications, equivalents, and alternatives falling within the spirit and principles of the invention.
Claims (18)
1. The utility model provides a catheter head end for heart mapping and ablation, its characterized in that, including netted head end (1) and body distal end (22), netted head end (1) include two at least groups electrode arm (10), every group electrode arm (10) are the S type setting, and the interval sets up a plurality of electrode (13), every group electrode arm (10) symmetry sets up, all groups electrode arm (10) are around the axial distribution of body distal end (22), netted head end (1) be one end open, the other end is connected body distal end (22) open curved surface, every electrode arm (10) one end connect in body distal end (22), the other end with adjacent electrode arm (10) tip butt joint is connected, adjacent electrode arm (10) are crisscross fixed, be formed with proximal electrode ring (105) and distal electrode ring (107) on netted head end (1), outer fringe ring (22) are for one end open curved surface, electrode ring (107) can be located distal end (107) distal end (22) the body distal end (107).
2. Catheter head end for cardiac mapping and ablation according to claim 1, characterized in that the angle of the open curved surface with the axial direction of the distal tube end (22) is θ,90 ° or less θ or less 150 °.
3. The catheter tip for cardiac mapping and ablation according to claim 1, wherein the open curved surface is flared, tapered or hemispherical.
4. Catheter head end for cardiac mapping and ablation according to claim 1, characterized in that the electrode (13) is formed with at least one intermediate electrode ring (106) on the mesh head end (1), the intermediate electrode ring (106) being located between the proximal electrode ring (105) and the distal electrode ring (107).
5. Catheter head end for cardiac mapping and ablation according to claim 1, characterized in that each of the electrode arms (10) comprises an electrode arm distal end (102) and an electrode arm proximal end (101), the electrode arm distal end (102) and the electrode arm proximal end (101) having at least one outer bending point (104) and at least one inner bending point (103) between them, the outer bending points (104) and the inner bending points (103) being staggered, the electrode arm distal ends (102) of each set of the electrode arms (10) being fixed in close proximity, the inner bending points (103) being fixedly connected, the outer bending points (104) of two adjacent sets of the electrode arms (10) being fixedly connected, the electrode arm proximal ends (101) being connected to the tube distal end (22), all distal-most the outer bending points (104) and the electrode arms (10) between the electrode arm distal ends (102) enclosing the electrode ring (107), all proximal-most the outer bending points (104) and the electrode arm proximal ends (10) enclosing the electrode ring proximal ends (105).
6. Catheter head end for cardiac mapping and ablation according to claim 5, characterized in that each set of electrode arms (10) is an integrally formed member.
7. Catheter head end for cardiac mapping and ablation according to claim 5, characterized in that the angle between the electrode arms (10) on both sides of the outer bending point (104) is adjustable, and the angle between the electrode arms (10) on both sides of the inner bending point (103) is adjustable.
8. Catheter head end for cardiac mapping and ablation according to claim 1, characterized in that each electrode arm (10) comprises a supporting skeleton (11) and a housing (12), the housing (12) encloses the supporting skeleton (11), the supporting skeleton (11) is made of elastic metal material or polymer plastic material, and the housing (12) is made of polyurethane, polyimide or polyether amide.
9. Catheter tip for cardiac mapping and ablation according to claim 8, characterized in that the electrode (13) is attached to the surface of the housing (12) by means of bonding, printing or deposition.
10. Catheter head end for cardiac mapping and ablation according to claim 8, characterized in that the electrodes (13) are arranged insulated from the support skeleton (11).
11. Catheter head for cardiac mapping and ablation according to claim 1, characterized in that the electrodes (13) are equally spaced along the proximal electrode ring (105) and the electrodes (13) are equally spaced along the distal electrode ring (107).
12. Catheter tip for cardiac mapping and ablation according to claim 1, characterized in that the electrode (13) is gold, silver, platinum or an alloy thereof, or copper with a surface plated with gold, silver, platinum or an alloy thereof.
13. Catheter head for cardiac mapping and ablation according to claim 1, characterized in that the surface area ratio between the positive and negative electrodes in the electrode (13) is 1:1 to 3:1.
14. catheter head for cardiac mapping and ablation according to claim 1, characterized in that the width of the electrode (13) is 0.5-2.0 mm.
15. Catheter head for cardiac mapping and ablation according to claim 1, characterized in that the spacing of the electrodes (13) is 1 mm-4mm.
16. Catheter head end for cardiac mapping and ablation according to any of claims 1-15, characterized in that a number of positioning sensors (14) are provided on the mesh head end (1), at least one of the positioning sensors (14) being provided on the distal end (22) of the tube body.
17. Catheter for cardiac mapping and ablation, comprising a tube (2), a handle (3) and a connector (4), characterized in that the tube (2) is connected to the catheter head end for cardiac mapping and ablation according to any of claims 1-16, the proximal tube end (21) of the tube (2) is connected to the end of the handle (3), and the tail of the handle (3) is provided with the connector (4).
18. Catheter for cardiac mapping and ablation according to claim 17, characterized in that an irrigation channel (5) is provided in the tube (2), one end of the irrigation channel (5) extending through the tube distal end (22) and the other end extending into the handle (3).
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| CN117481789B (en) * | 2024-01-03 | 2024-04-02 | 梅奥心磁(杭州)医疗科技有限公司 | Double-energy multifunctional electrophysiology catheter |
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