CN117064507A - Multipurpose electrode for positioning, guiding and puncturing - Google Patents

Multipurpose electrode for positioning, guiding and puncturing Download PDF

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Publication number
CN117064507A
CN117064507A CN202310787731.4A CN202310787731A CN117064507A CN 117064507 A CN117064507 A CN 117064507A CN 202310787731 A CN202310787731 A CN 202310787731A CN 117064507 A CN117064507 A CN 117064507A
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China
Prior art keywords
mapping
tube
electrode
bending
sheath
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CN202310787731.4A
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Chinese (zh)
Inventor
唐瑜珅
姚佳佳
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Individual
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Priority to CN202310787731.4A priority Critical patent/CN117064507A/en
Publication of CN117064507A publication Critical patent/CN117064507A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means
    • 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
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • 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

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Otolaryngology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

The invention provides a multipurpose electrode for positioning, guiding and puncturing, which comprises a mapping electrode head, a bending sheath tube, a magnetic positioning sensor, a mapping tube electrode, a mapping tube, a handle and a guide wire; the mapping tube is a multi-cavity tube and comprises a signal tube cavity, a magnetic sensor cable cavity and a bending sheath tube cavity for the bending sheath tube to pass through; the guide wire is arranged in the bending sheath tube, the mapping electrode head is arranged at one end of the mapping tube, the handle is connected with the other end of the mapping tube, two mapping tube electrodes are arranged on the mapping tube, and the magnetic positioning sensor is arranged between the two mapping tube electrodes; the invention integrates the functions of electromagnetic positioning, endocardial potential mapping, electric activation sequence mapping, activation time slot mapping, accurate positioning of catheter head end area, punctiform radio frequency ablation, guide wire conveying and the like. A catheter may be used in a variety of different surgical formats and scenarios.

Description

Multipurpose electrode for positioning, guiding and puncturing
Technical Field
The invention relates to the technical field of myocardial ablation, in particular to a multipurpose electrode for positioning, guiding and puncturing.
Background
Atrial septal aspiration is one of the most common techniques for interventional cardiology, and in recent years, with the development of three-dimensional electronics, new clinical awareness of atrial septal aspiration has been developed. Anatomically, the discovery of the fossa ovalis potential represents the reconstruction of the anatomy by an electrical method, and is helpful for converting the room septum recognition and puncture into fossa ovalis recognition and puncture. In terms of instruments, the emerging radiofrequency needles and piercing guidewires can facilitate the piercing process. In methodology, compared with an X-ray method, the three-dimensional electroanatomical mapping method presents a three-dimensional view angle, and the oval fossa can be accurately positioned through potential mapping, so that the success rate of puncture is improved; the latter does not need to be equipped with an electro-anatomical mapping system, does not need to be mapped in advance, and is simple to operate. Compared with an ultrasonic method, the three-dimensional electroanatomical mapping method has the advantages that the centremost position of the oval fossa can be mapped, the positioning is accurate, and meanwhile, the puncture needle point can be tracked in real time; the latter has clear anatomical hierarchy, but only can display a two-dimensional interface, and the cost is high due to the need of adding ultrasonic equipment. While X-ray guided atrial septal puncture is safe and effective in most cases, and ultrasound assisted positioning can improve safety, the more recently emerging three-dimensional electroanatomical mapping technique is a more applicable, wireless atrial septal puncture method.
The atrial septum puncture sheath used clinically at present is made of PEEK and PEBAX materials. The operator still needs to use mechanical force to puncture the septum, the mode needs to be aided by the hand feeling of the operator, and in the puncture process, puncture errors still occur due to the fact that the sheath tube cannot be accurately positioned and supported in place, and sliding or improper force is applied.
Disclosure of Invention
In order to solve the technical problems, the invention discloses a multipurpose electrode for positioning, guiding and puncturing, and the technical scheme of the invention is implemented as follows:
a multipurpose electrode for positioning, guiding and puncturing comprises a mapping electrode head, a bending sheath tube, a magnetic positioning sensor, a mapping tube electrode, a mapping tube, a handle and a guide wire;
the mapping tube is a multi-cavity tube and comprises a signal tube cavity, a magnetic sensor cable cavity and a bending sheath tube cavity for the bending sheath tube to pass through;
the guide wire is arranged in the bending sheath tube, the mapping electrode head is arranged at one end of the mapping tube, the handle is connected with the other end of the mapping tube, two mapping tube electrodes are arranged on the mapping tube, and the magnetic positioning sensor is arranged between the two mapping tube electrodes;
the bending-adjusting sheath tube comprises a sheath tube head end, and an ablation electrode ring is arranged at the sheath tube head end.
Preferably, the mapping electrode head comprises a mapping electrode, an electrode arm and a guiding cap; one end of the electrode arm is connected with the mapping tube, the other end of the electrode arm is connected with the guide cap, and the mapping electrode is arranged on the electrode arm.
Preferably, the number of electrode arms is 4-6.
Preferably, the number of said mapping electrodes on each of said electrode arms is 4-8, and the spacing between said mapping electrodes on each of said electrode arms is 1.5mm-2.5mm.
Preferably, the electrode arm is made of platinum iridium alloy, the outer diameter is 1.4mm-1.7mm, and the length is 0.5mm-2mm.
Preferably, the guide cap is of a hollow annular structure, a developing ring is arranged outside the guide cap, and a magnet is arranged inside the guide cap.
Preferably, two intermediate pipes are also included; one intermediate pipe is connected with the end part of the bending sheath pipe and the guide cap, and the other intermediate pipe is arranged at the other end of the bending sheath pipe; long holes of 3mm-4mm are formed in two sides of the middle pipe.
Preferably, the handle comprises a mapping tube bending knob, a sheath tube bending knob, an ablation locking mechanism, a connector and an irrigation interface;
the perfusion interface is communicated with a bending regulating sheath lumen of the mapping tube; the connector is arranged at one end of the handle and is connected with the bending adjusting sheath tube.
The invention integrates the functions of electromagnetic positioning, endocardial potential mapping, electric activation sequence mapping, activation time slot mapping, accurate positioning of catheter head end area, punctiform radio frequency ablation and guide wire conveying. A catheter may be used in a variety of different surgical formats and scenarios. Can be used as a radio frequency ablation instrument in the intracardiac intervention operation; can also be used as an electrophysiology mapping instrument; can also be used as a guide wire conveying appliance in a micro-cavity channel. The design goal of All in one is realized. Such as: atrial septal puncture in structural heart disease, particularly where precision is required for the puncture site, such as transatrial mitral valve-like interventions or implantation of transatrial left ventricular assist devices. Or in electrophysiological operation, high-density mapping and real-time mapping of endocardial potential are required to be performed on the mapping part; or in surgery, the guide wire is delivered when positioning a tiny aperture in the heart chamber, such as a narrow pulmonary vein or left atrial appendage.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions of the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, and it is obvious that the drawings in the following description are only one embodiment of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
Wherein like parts are designated by like reference numerals. It should be noted that the words "front", "back", "left", "right", "upper" and "lower" used in the following description refer to directions in the drawings, and the words "bottom" and "top", "inner" and "outer" refer to directions toward or away from, respectively, the geometric center of a particular component.
FIG. 1 is a schematic diagram of a multi-purpose electrode embodiment for positional guidance and lancing;
FIG. 2 is a partial schematic view of an embodiment of a multi-purpose electrode for positional guidance and lancing;
FIG. 3 is a schematic view of another partial construction of an embodiment of a multi-purpose electrode for positional guidance and lancing;
FIG. 4 is a schematic view of a cut-away configuration of an embodiment of a bend-regulating sheath;
FIG. 5 is a schematic view of an expanded configuration of an embodiment of a multi-purpose electrode for positional guidance and puncture in the heart;
fig. 6 is a schematic view of another embodiment of a multi-purpose electrode for positional guidance and lancing (handle not shown).
In the above drawings, each reference numeral indicates:
1, mapping an electrode head;
1-1, mapping electrodes; 1-2, an electrode arm; 1-3, a guide cap;
2, bending the sheath tube;
2-1, ablating an electrode ring;
3, a magnetic positioning sensor;
mapping a tube electrode;
5, mapping a tube;
5-1, a signal conduit lumen; 5-2, a magnetic sensor cable cavity; 5-3, bending the sheath lumen;
6, a handle;
6-1, mapping a tube bending adjustment knob; 6-2, adjusting a bending knob of the bending sheath tube; 6-3, ablating the locking mechanism; 6-4, a connector; 6-5, pouring an interface;
7, a middle pipe;
8, a guide wire.
Detailed Description
The technical solutions of the present invention will be clearly and completely described below with reference to the embodiments of the present invention and the accompanying drawings, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In one specific embodiment 1, as shown in fig. 1-5, a multi-purpose electrode for positioning guidance and puncture comprises a mapping electrode tip 1, a bending sheath 2, a magnetic positioning sensor 3, a mapping tube electrode 4, a mapping tube 5, a handle 6, and a guidewire 8.
The mapping tube 5 is a multi-cavity tube and comprises a signal tube cavity 5-1, a magnetic sensor cable cavity 5-2 and a bending sheath cavity 5-3 for the bending sheath tube 2 to pass through.
The guide wire 8 is arranged in the bending sheath tube 2, the mapping electrode head 1 is arranged at one end of the mapping tube 5, the handle 6 is connected with the other end of the mapping tube 5, two mapping tube electrodes 4 are arranged on the mapping tube 5, and the magnetic positioning sensor 3 is arranged between the two mapping tube electrodes 4; the head end of the bending sheath tube 2 is provided with an ablation electrode ring 2-1.
The mapping electrode head 1 comprises a mapping electrode 1-1, an electrode arm 1-2 and a guide cap 1-3; one end of the electrode arm 1-2 is connected with the mapping tube, the other end is connected with the guide cap 1-3, and the mapping electrode 1-1 is arranged on the electrode arm 1-2.
The number of electrode arms 1-2 is 4. The number of the mapping electrodes 1-1 on each electrode arm 1-2 is 4-8, and the mapping electrodes 1-1 are sequentially and uniformly distributed downwards from the head end of the electrode arm 1-2, and the distance between the mapping electrodes 1-1 on each electrode arm 1-2 is 1.5mm-2.5mm.
The electrode arm 1-2 is made of platinum iridium alloy, and has an outer diameter of 1.4mm-1.7mm and a length of 0.5mm-2mm.
In this embodiment, the guide cap 1-3 has a hollow ring structure, a developing ring is provided on the outside, and a magnet is provided inside.
In this embodiment, the mapping electrode head 1 is used for endocardial potential mapping and cardiac tissue impedance detection of the inner wall of the heart, either monopolar or bipolar. Meanwhile, the three-dimensional mapping system can be connected through the connector 6-4 to perform magneto-electric fusion positioning. The guide cap 1-3 is made of metal (such as stainless steel) and can absorb the ablation electrode ring 2-1 at the head end of the bending sheath tube 2.
In this embodiment, the length of the bending sheath tube 2 at the head part of the mapping electrode 1-1 at the part of the mapping electrode head 1 is 4F-7F (the length is the unit symbol commonly used in the field).
The bending sheath tube 2 is hollow inside and has an inner diameter of 1mm and is used for accommodating a guide wire 8 for guiding or puncturing which is common in intracardiac interventional operations.
The adjustable bending angle of the bending sheath tube 2 is +/-180 degrees. The ablation electrode ring 2-1 is made of metal, such as stainless steel, and is conveniently absorbed in the groove in the guide cap 1-3. Except for endocardial potential mapping and tissue impedance detection for monopolar or bipolar endocardial wall. Meanwhile, the three-dimensional mapping system can be connected, and besides magneto-electric fusion positioning, high-frequency electric knives, a radio frequency generator and other energy generating equipment can be connected for myocardial tissue ablation.
The bending sheath 2 is free to move within the mapping tube 5. When the bending is required, the bending-adjusting sheath tube 2 is withdrawn so that the ablation electrode ring 2-1 at the head end of the sheath tube is separated from the guide cap 1-3 and then bending is adjusted.
In this embodiment, the magnetic positioning sensor 3 is used for plugging the rear end three-dimensional mapping system, and is combined with the electric field positioning of the ablation electrode ring 2-1 and the mapping tube electrode 4, so as to achieve a more accurate positioning effect.
In this embodiment, the signal wire tube cavity 5-1 is used for accommodating a signal wire (enameled wire) connected with the mapping electrode 1-1; the bending-adjusting sheath lumen 5-3 is used as a perfusion lumen at the same time and is connected with the perfusion interface 6-5 for perfusion operation in operation.
The handle 6 comprises a mapping tube bending knob 6-1, a sheath tube bending knob 6-2, an ablation locking mechanism 6-3, a connector 6-4 and an infusion interface 6-5; the mapping tube bending adjusting knob 6-1 is used for controlling the bidirectional bending of the mapping tube 5, the sheath tube bending adjusting knob 6-2 is used for controlling the bidirectional bending of the tube body of the bending adjusting sheath tube 2 at the part of the mapping electrode head 1, and the ablation locking mechanism 6-3 is used for positioning the bending after the bending adjusting sheath tube 2 is bent to a certain angle; the connector 6-4 is used for connecting with a rear end three-dimensional mapping and a high-frequency electric knife or a radio frequency generator for magneto-electric positioning and ablation; the perfusion interface 6-5 is used for intra-operative contrast agent or heparin perfusion.
The perfusion interface 6-5 is communicated with the bending regulating sheath lumen 5-3 of the mapping tube 5; the connector 6-4 is arranged at one end of the handle 6 and is connected with the bending sheath tube 2.
The deployed state of the present embodiment in the heart is shown in fig. 5.
Example 2
In a preferred embodiment 2, as shown in fig. 6, a multipurpose electrode for positioning guidance and puncture comprises a mapping electrode tip 1, a bending sheath 2, a magnetic positioning sensor 3, a mapping tube electrode 4, a mapping tube 5, a handle 6, 2 intermediate tubes 7 and a guide wire 8.
This embodiment relies on the structural implementation of embodiment 1, unlike embodiment 1, two intermediate tubes are added.
Wherein, one middle tube 7 is connected with the end part of the bending sheath tube 2 and the guide cap 1-3, and the other middle tube 7 is arranged at the other end of the bending sheath tube 2; long holes of 3mm-4mm are formed in two sides of the middle pipe 7.
In this embodiment, the middle tube 7 is a fixed structure, and long holes of 3-4 mm are respectively formed in the middle positions of two sides (perpendicular to the arrangement direction of the electrode arms 1-2), and the long holes are used for bending the head end of the bending sheath tube 2 and then penetrate out of the middle tube 7.
It should be noted that the above embodiments are only preferred embodiments of the present invention, and are not intended to limit the present invention, and any modifications, equivalent substitutions, improvements, etc. within the spirit and principle of the present invention should be included in the scope of the present invention.

Claims (8)

1. The multipurpose electrode for positioning, guiding and puncturing is characterized by comprising a mapping electrode head, a bending sheath tube, a magnetic positioning sensor, a mapping tube electrode, a mapping tube, a handle and a guide wire;
the mapping tube is a multi-cavity tube and comprises a signal tube cavity, a magnetic sensor cable cavity and a bending sheath tube cavity for the bending sheath tube to pass through;
the guide wire is arranged in the bending sheath tube, the mapping electrode head is arranged at one end of the mapping tube, the handle is connected with the other end of the mapping tube, two mapping tube electrodes are arranged on the mapping tube, and the magnetic positioning sensor is arranged between the two mapping tube electrodes;
the bending-adjusting sheath tube comprises a sheath tube head end, and an ablation electrode ring is arranged at the sheath tube head end.
2. The multipurpose electrode for positional guidance and puncture of claim 1, wherein the mapping electrode head comprises a mapping electrode, an electrode arm, and a guide cap; one end of the electrode arm is connected with the mapping tube, the other end of the electrode arm is connected with the guide cap, and the mapping electrode is arranged on the electrode arm.
3. The multipurpose electrode for positional guidance and puncture of claim 2, wherein the number of electrode arms is 4-6.
4. A multi-purpose electrode for positional guidance and puncture as claimed in claim 3, wherein the number of the mapping electrodes on each of the electrode arms is 4-8, and the spacing between the mapping electrodes on each of the electrode arms is 1.5mm-2.5mm.
5. The multipurpose electrode for positioning, guiding and puncturing as claimed in claim 4, wherein the electrode arm is made of platinum iridium alloy, has an outer diameter of 1.4mm-1.7mm and a length of 0.5mm-2mm.
6. The multipurpose electrode for positioning, guiding and puncturing as claimed in claim 5, wherein the guide cap is of a hollow ring-shaped structure, and is provided with a developing ring at an outer portion and a magnet at an inner portion.
7. The multipurpose electrode for positional guidance and puncture of claim 6, further comprising two intermediate tubes; one intermediate pipe is connected with the end part of the bending sheath pipe and the guide cap, and the other intermediate pipe is arranged at the other end of the bending sheath pipe; long holes of 3mm-4mm are formed in two sides of the middle pipe.
8. The multipurpose electrode for positional guidance and penetration of claim 7, wherein the handle comprises a mapping tube bend knob, a sheath bend knob, an ablation locking mechanism, a connector, and an irrigation interface;
the perfusion interface is communicated with a bending regulating sheath lumen of the mapping tube; the connector is arranged at one end of the handle and is connected with the bending adjusting sheath tube.
CN202310787731.4A 2023-06-30 2023-06-30 Multipurpose electrode for positioning, guiding and puncturing Pending CN117064507A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202310787731.4A CN117064507A (en) 2023-06-30 2023-06-30 Multipurpose electrode for positioning, guiding and puncturing

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202310787731.4A CN117064507A (en) 2023-06-30 2023-06-30 Multipurpose electrode for positioning, guiding and puncturing

Publications (1)

Publication Number Publication Date
CN117064507A true CN117064507A (en) 2023-11-17

Family

ID=88715951

Family Applications (1)

Application Number Title Priority Date Filing Date
CN202310787731.4A Pending CN117064507A (en) 2023-06-30 2023-06-30 Multipurpose electrode for positioning, guiding and puncturing

Country Status (1)

Country Link
CN (1) CN117064507A (en)

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