CN217793303U - Spline basket ablation catheter capable of being bent in two directions - Google Patents

Abstract

The utility model provides a spline basket pulsed electric field ablation catheter capable of being bent in two directions, which comprises an adjusting handle, a catheter main body and a treatment head; the adjusting handle comprises a bending control knob, and the bending control knob is connected with 2 pull wires; the catheter body comprises at least 2 axially symmetrically distributed pull wire cavities; the bending control knob bends the distal end of the main body catheter through at least 2 pull wires, so that the treatment head is bent in two directions; the adjusting handle is also provided with a friction control module which can control the friction force between the pull wire and the adjusting handle to keep the bending angle of the catheter fixed; the treatment head includes a splined basket having a plurality of splines. The utility model discloses a spline basket pipe has controllable bidirectional bending's performance, and help the doctor reachs different spatial position's four pulmonary veins easily, makes the fine laminating pulmonary vein vestibule of spline basket pipe through the control of complex angle.

Description

Spline basket ablation catheter capable of being bent in two directions

Technical Field

The utility model belongs to the technical field of medical instrument and specifically relates to a spline basket that can two-way bending melts pipe.

Background

Cardiac ablation has undergone a great deal of innovation and rapid development since its first implementation in 1969. Ablation was used primarily for the treatment of supraventricular tachycardia patients with accessory pathways and pre-excitation syndrome, and today ablation is also used for the treatment of atrial flutter, atrial fibrillation and ventricular arrhythmias.

The purpose of ablation is to destroy potentially arrhythmic tissue and form transmural and continuous permanent lesions. Percutaneous catheter ablation to achieve Pulmonary Vein (PV) isolation in atrial tissue using radio-frequency ablation (RFA) and cryoablation therapy has become a widely accepted procedure for treating Atrial Fibrillation (AF). Other energy forms of catheter ablation include microwaves, high-intensity focused ultrasound, low-intensity collimated ultrasound, lasers, cryogenic energy, and heated saline. Radio-frequency (RF) energy is currently the most commonly used energy source. RF creates lesions by heating tissue through impedance and then conducting heat to deeper tissue.

The cornerstone of atrial fibrillation therapy is the isolation of the pulmonary veins in the left atrium, which typically have four pulmonary veins, namely the left superior pulmonary vein, the left inferior pulmonary vein, the right superior pulmonary vein, and the right inferior pulmonary vein. The normal value for the size of the left atrium is 45-55mm, and the four pulmonary veins are completely isolated in such a narrow space.

US patent US20170071665A1 discloses a bendable spinal basket catheter, a catheter adapted for mapping and/or ablation in the atrium having a basket electrode array with two or more position sensors with deflectable dilators. The catheter includes a catheter body, a basket electrode assembly at a distal end of the catheter body, and a control handle at a proximal end of the catheter body. The basket electrode assembly has a plurality of spines with electrodes and a dilator adapted to move longitudinally relative to the catheter body to expand and collapse the assembly by extending beyond a proximal portion of the control handle, which can be pushed or pulled by the control handle. The dilator is also adapted to flex in response to an actuator on the control handle that allows a user to control at least one pull wire extending through the catheter body and the dilator. However, like the above patent products, the therapy head can only be bent in a small degree, and cannot meet the bending requirement of complex blood vessel environment. In addition, the spinal basket catheter is mainly used for mapping but not ablation.

US patent US 9101734B 2 discloses a force sensing catheter for diagnosing or treating blood vessels found in a body or body space, the sensing catheter comprising a central strut which is thermally bonded, preferably along its longitudinal axis, to a thermoplastic tubular member contained therein. The tubular member preferably has three layers: inner layer, weaving layer and outer layer. One or more semiconductor or metal foil strain gauges are affixed to the central strut to provide a measurement of the bending and torsional forces of the distal end of the catheter. This patent is through setting up the strainometer at the bracing piece and measuring and control crooked, and the structure is comparatively complicated.

European patent EP3915477A1 discloses an electrode device for diagnosing arrhythmia, wherein fig. 7 is an illustration of the middle part of the catheter shaft deflected approximately 360 °. The end effector has a first side and a second side. This allows the user to place the first side on the tissue surface with at least the intermediate portion (if not the distal portion of the catheter body) substantially perpendicular to the tissue surface, and actuate the control handle to deflect the intermediate deflection portion to various deflections or radii of curvature such that the second side is deflected toward the catheter body. Such positioning may allow for drag of the second side as the intermediate portion deflects, the cross-section of the end-effector comprising the loop members 1, 2, 3 across the tissue surface. The intermediate portion can be deflected by manipulating the pull wire. However, the patent only realizes the deflection of the middle part of the catheter and cannot quickly and accurately control the direction of the treatment head.

At present, the spline basket catheters of the pulse electric field at home and abroad can not be actively bent in a bidirectional mode, and the catheters are difficult to reach the pulmonary venous vestibules at different angles for treatment, so that the operation difficulty of doctors is increased, and the risk of operation is increased. Therefore, how to provide a bendable spline basket ablation catheter with good controllability is suitable for ablation diagnosis and treatment of an annular vascular orifice and also suitable for ablation diagnosis and treatment of a non-vascular orifice; an ablation system which can be used for radio frequency ablation, pulsed electric field ablation and the like is a technical problem to be solved urgently by those skilled in the art at present.

SUMMERY OF THE UTILITY MODEL

In order to achieve the purpose, the application provides a spline basket ablation catheter capable of being bent in two directions, which is characterized by comprising an adjusting handle, a catheter main body and a treatment head;

the adjusting handle comprises a bending control knob, and the bending control knob is connected with 2 pull wires;

the catheter main body comprises at least 2 axially symmetrically distributed stay wire cavities;

the bending control knob bends the distal end of the catheter body through at least 2 pull wires, so that the treatment head can be bent in two directions.

The adjusting handle is also provided with a friction control module which can control the friction force between the pull wire and the adjusting handle to keep the bending angle of the catheter fixed.

The treatment head includes a splined basket having a plurality of splines, wherein each spline includes at least 1 ring electrode. Preferably, each spline comprises 1 to 5 ring electrodes. The electrodes on the splines may be of equal length or of different lengths. The ring electrode is circular, and may be elliptical, or chamfered, elongated, or intermediate in shape.

Preferably, each spline comprises 2-4 ring electrodes.

Preferably, the splined basket includes 4-10 splines.

Preferably, the annular electrodes on the splines are distributed at the far end of the spline basket and occupy 1/10-2/3 of the length of the whole splines.

Preferably, the ring electrode of each spline comprises 1 short electrode at the distal end of the spline and 1 to 4 long electrodes in the middle and proximal part.

Preferably, the catheter main body is of a hollow tubular structure, the middle of the catheter main body is a guide wire cavity, and the pull wire cavity channels are symmetrically distributed in the wall of the catheter along the axial direction.

In one embodiment, a plurality of cavities are uniformly distributed in the tube wall of the catheter body, wherein 2 cavities which are symmetrically distributed along the axial direction are used as the stay wire cavities.

Preferably, the number of the plurality of cavities is 2-10.

Preferably, the shape of the tube wall cavity channel can be circular, oval or long-strip.

Preferably, the bending angle of the treatment head of the ablation catheter and the distal end of the catheter main body can be regulated and controlled within the range of 0-180 degrees, so that the treatment head can quickly reach pulmonary vein vestibules or other vein targets with different angles.

In one embodiment, the distal end of the catheter main body is a bendable section, and the wall of the bendable section is made of a flexible polymer material with the elastic modulus of less than 1 MPa.

In one embodiment, the size of the bending angle of the treatment head is related to the rotating angle of the bending control knob. The periphery of the bending control knob is provided with scale marks of displacement or angle, and the bending angle of the treatment head can be accurately adjusted through the scales.

In one embodiment, the pull wire position is fixed by pressing or rotating the friction control button so that the friction between the handle and the pull wire is greater than the pull wire tension, so that the bend angle of the catheter remains fixed.

The beneficial technical effect of this application:

(1) The spline basket catheter has controllable bidirectional bending performance, helps doctors to easily reach four pulmonary veins or other vein targets at different spatial positions, and is well attached to the pulmonary vein vestibules or other vein targets through control of a complex angle, so that the pulmonary veins can be quickly and effectively isolated, X-ray exposure of the doctors and patients is reduced, the time of the whole operation can be greatly shortened, the efficiency of the doctors and an interventional catheter room is improved, and the risk of the operation is reduced;

(2) The spline in the spline basket is covered with a plurality of annular electrodes, the spline basket can form umbrella-shaped, oval, spherical, flat and petal-shaped continuous deformation, and the spline basket is suitable for different requirements of ablation parts; the effect of adjusting the ablation range can be achieved by controlling the combination of a plurality of electrode pairs of each spline, so that the flexibility is strong, and the application range is wide;

(3) When other electrodes of the spline basket are subjected to discharge ablation, the ring electrode at the far end of each spline can be matched with the electrode on the adjacent spline to carry out real-time mapping on electrocardiosignals, and once the real-time mapping meets the electrocardio blocking requirement, the ablation can be stopped, so that the damage to tissues is reduced to the maximum extent, and the ablation safety is improved;

(4) The longer annular electrode in each spline can cover the vascular vestibules with different calibers, and the design can meet the requirements of all patients by using a spline basket catheter with one size; the longer electrode can be flexible, so that the longer electrode can be perfectly attached to the surface of the ablation tissue, and the success rate of ablation is improved;

(5) The spline basket catheter has a plurality of splines which are uniformly distributed, under the control of a double-bending function, the spline basket catheter can conveniently reach a pulmonary vein port, a doctor can flexibly push the catheter forward, a far hemisphere of the spline basket is easily attached to a pulmonary vein vestibular tissue, and ablation energy is efficiently transmitted to an ablation target. Meanwhile, the integral supporting force of the spline basket is shared by the multiple splines, so that the occurrence of cardiac perforation and pericardial effusion is prevented, and the safety and effectiveness of ablation are improved;

(6) The periphery of the handle bending control knob is provided with scale marks of displacement or angle, the bending angle of the treatment head can be accurately adjusted through the scale marks, and the handle bending control knob is convenient and quick;

(7) By means of the friction control module of the application, the bending angle of the treatment head can be fixed, so that an operator can use the rocker and the deflection tip in a free state.

The foregoing description is only an overview of the technical solutions of the present application, so that the technical means of the present application can be more clearly understood and the present application can be implemented according to the content of the description, and in order to make the above and other objects, features and advantages of the present application more clearly understood, the following detailed description is made with reference to the preferred embodiments of the present application and the accompanying drawings.

The above and other objects, advantages and features of the present application will become more apparent to those skilled in the art from the following detailed description of specific embodiments thereof, as illustrated in the accompanying drawings.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below, and it is obvious that the drawings in the following description are some embodiments of the present application, and for those skilled in the art, other drawings can be obtained according to these drawings without creative efforts, and these drawings are all within the protection scope of the present application. Throughout the drawings, like elements or portions are generally identified by like reference numerals. In the drawings, elements or portions are not necessarily drawn to scale.

FIG. 1 is a schematic view of the overall construction of a bidirectionally bendable spline basket ablation catheter disclosed herein;

FIG. 2 is a schematic structural view of a first embodiment of a splined basket of the ablation catheter disclosed herein;

FIG. 3 is a structural schematic view of a second embodiment of a spline basket of an ablation catheter as disclosed herein;

FIG. 4 is a structural schematic view of a third embodiment of a spline basket of the ablation catheter disclosed herein;

FIG. 5 is a structural schematic view of a fourth embodiment of a spline basket of the ablation catheter disclosed herein.

FIG. 6 is a schematic view of a multi-layer construction of an ablation catheter body as disclosed herein;

FIG. 7 is a schematic cross-sectional channel configuration of an ablation catheter body disclosed herein;

FIG. 8 is a schematic structural view of a second embodiment of a cross-sectional lumen of an ablation catheter body disclosed herein;

FIG. 9 is a schematic structural view of a third embodiment of a cross-sectional channel of an ablation catheter body disclosed herein;

FIG. 10 is a structural schematic view of a fourth embodiment of a cross-sectional channel of an ablation catheter body according to the present disclosure;

Detailed Description

In order to make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are some embodiments of the present application, but not all embodiments. In the following description, specific details such as specific configurations and components are provided only to help the embodiments of the present application be fully understood. Accordingly, it will be apparent to those skilled in the art that various changes and modifications may be made to the embodiments described herein without departing from the scope and spirit of the present application. In addition, descriptions of well-known functions and constructions are omitted in the embodiments for clarity and conciseness.

It should be appreciated that reference throughout this specification to "one embodiment" or "the embodiment" means that a particular feature, structure or characteristic described in connection with the embodiment is included in at least one embodiment of the present application. Thus, the appearances of the phrase "one embodiment" or "the present embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

Further, the present application may repeat reference numerals and/or letters in the various examples. This repetition is for the purpose of simplicity and clarity and does not in itself dictate a relationship between the various embodiments and/or configurations discussed.

The term "and/or" herein is merely an association describing an associated object, meaning that three relationships may exist, e.g., a and/or B, may mean: a exists alone, B exists alone, and A and B exist at the same time, and the term "/and" is used herein to describe another association object relationship, which means that two relationships may exist, for example, A/and B, may mean: a alone, and both a and B alone, and further, the character "/" in this document generally means that the former and latter associated objects are in an "or" relationship.

The term "at least one" herein is merely an association relationship describing an associated object, and means that there may be three relationships, for example, at least one of a and B, may mean: a exists alone, A and B exist simultaneously, and B exists alone.

It is further noted that, herein, relational terms such as first and second, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion.

The application figure 1 introduces a schematic overall structure diagram of a spline basket ablation catheter capable of being bent in two directions.

Referring to fig. 1, a bidirectionally bendable spline basket ablation catheter is shown comprising:

comprises an adjusting handle 1, a catheter main body 2 and a treatment head 3;

the adjusting handle 1 comprises a bending control knob 13, and the bending control knob is connected with 2 pull wires; one end of the pull wire is fixed in the retraction part 12 of the adjusting handle 1.

The catheter main body 2 comprises at least 2 axially symmetrically distributed stay wire cavities;

preferably, the shape of the tube wall cavity channel can be circular, oval or long strip.

The bending control knob 13 bends the distal end 22 of the catheter body 2 through at least 2 pull wires, so that the treatment head can be bent bidirectionally.

In one embodiment, the distal end 22 of the catheter body 2 is a bendable section, and the wall of the bendable section is made of a flexible polymer material with an elastic modulus of less than 1 MPa.

In one embodiment, the bending angle of the treatment head 3 is related to the rotation angle of the bending control knob 13. The periphery of the bending control knob 13 can also be provided with scale marks of displacement or angle, and the bending angle of the treatment head can be accurately adjusted through the scale marks.

In one embodiment, the adjustment handle 1 is further provided with a friction control module 14. The pull wire position can be fixed by pressing or rotating the button of the friction control module 14 so that the friction force between the handle and the pull wire is greater than the pull wire tension force, thereby keeping the bending angle of the catheter fixed.

In one embodiment, the treatment head 3 comprises a splined basket having a plurality of splines, the splined basket comprising 4-10 splines, each spline comprising 1-5 ring electrodes. The electrodes on the splines may be of equal length or of different lengths. The ring electrode is circular, and may be elliptical, or chamfered, elongated, or intermediate in shape.

The annular electrodes on the splines are distributed at the far ends of the spline baskets and occupy the range of 1/10-2/3 of the length of the whole spline.

The length of the annular electrode is 0.5 mm-5 mm, the outer diameter is 2F-10F, the annular electrode is tightly attached to the outer wall of the spline, the inner diameter of the annular electrode is close to that of the spline, and the distance between adjacent electrodes on the same spline is 0.5 mm-20 mm.

The material of the ring electrode includes, but is not limited to, metal platinum, platinum alloy, gold alloy, copper, stainless steel, nickel-titanium alloy, MP35N, and metal composite structure with X-ray development component, such as non-development bulk composite structure with X-ray development coating, and composite structure of development metal powder and macromolecule.

Preferably, the ring electrode of each spline comprises 1 short electrode at the distal end of the spline and 1-2 long electrodes at the middle proximal part.

In one embodiment, the long electrode length is more than 1.5 times, preferably more than 2 times the short electrode length.

In one embodiment, the ring electrode of each spline comprises 1-5 short electrodes.

In one embodiment, a plurality of cavities are uniformly distributed in the tube wall of the catheter main body, wherein 2 cavities which are symmetrically distributed along the axial direction are used as stay wire cavities.

In one embodiment, the distal end 22 of the catheter body 2 is a bendable section having a modulus of elasticity less than the modulus of elasticity of the rest of the catheter body. Preferably, the wall of the bendable section has an open structure (e.g., includes a plurality of hollow channels).

Preferably, the bending angle of the treatment head of the ablation catheter and the distal end of the catheter main body can be regulated and controlled within the range of 0-180 degrees, so that the treatment head can quickly reach the pulmonary vein vestibules with different angles.

Referring to fig. 2, the treatment tip 3 comprises a splined basket having 10 splines 33, and the ring electrodes of each spline comprise 1 short electrode 342 at the distal end of the spline and 1 long electrode 341 in the middle.

One end of the 10 splines is fixed at the pipe orifice 31 of the catheter main body, and the other end is fixed at the foremost end of the hollow push rod 32.

Referring to fig. 3, in a second embodiment of the splined basket of the ablation catheter, the treatment tip 3 comprises a splined basket having 8 splines 33, and the ring electrodes of each spline comprise two ring electrodes, namely a first ring electrode 351 and a second ring electrode 352.

One end of each spline is fixed on the pipe orifice 31 of the catheter main body, and the other end of each spline is fixed on the foremost end of the hollow push rod 32.

Referring to fig. 4, in a third embodiment of the spline basket of the ablation catheter, the treatment tip 3 comprises a spline basket having 8 splines 33, and the ring electrode of each spline comprises a short electrode 361, a second electrode 362 and a third electrode 363.

One end of the 8 splines is fixed at the pipe orifice 31 of the catheter main body, and the other end is fixed at the foremost end of the hollow push rod 32.

Referring to fig. 5, in a fourth embodiment of the splined basket of the ablation catheter, the treatment head 3 comprises a splined basket having 8 splines 33, and the ring electrodes of each spline comprise four short ring electrodes, namely a first ring electrode 371, a second ring electrode 372, a third ring electrode 373, and a fourth ring electrode 374.

One end of the 8 splines is fixed at the pipe orifice 31 of the catheter main body, and the other end is fixed at the foremost end of the hollow push rod 32.

The catheter body is composed of a three-layer structure, and fig. 6 shows a manufacturing method of the catheter body by a heat shrinkage method, wherein the catheter body is respectively provided with a heat-shrinkable mandrel 21, an inner pipe layer 22, a braided layer 23, an outer pipe layer 24 and a heat-shrinkable layer 25 from inside to outside. And after the thermal shrinkage is finished, taking out the mandrel, and stripping the thermal shrinkage layer to obtain the three-layer braided structure of the catheter main body. The bracing wire cavity with two sides symmetrically distributed or other cavities can be added between the inner layer tube and the braided layer through a similar thermal shrinkage process.

The mandrel 21 is made of a stainless steel bar with a PTFE coating, a PEEK bar and the like; the material of the inner tube layer 22 is TPU or Pebax, nylon, or polyimide, FEP, ETFE, PTFE with smaller friction coefficient and better insulation property; the braided layer 23 is made of stainless steel braided net or other metal net, and can also be high-strength polymer braided net; the outer tube layer 24 is made of TPU, pebax, nylon and other materials; the heat-shrinkable layer 25 is made of heat-shrinkable materials such as FEP and PTFE.

The catheter body may also be prepared by an extrusion process. The inner pipe layer is extruded on a soft mandrel, the woven mesh is woven outside the inner pipe layer, the outer pipe layer is extruded outside the woven mesh, and the outer pipe layer is ground to a proper size.

The catheter body may also be a multi-lumen structure without a braided layer, prepared directly by an extrusion process.

The pull wire is a stainless steel wire or a nickel titanium wire and is fixed to the catheter main body near the pipe orifice 31.

Referring to fig. 7, the catheter main body is a hollow tubular structure, a guide wire cavity 202 is arranged in the middle, and the pull wire cavity channels 203 are symmetrically distributed in the tube wall along the axial direction. Two other lumens 204 are included for the lead wires or saline lumens. The outer pipe layer 201 is wrapped outside the cavity and is made of TPU, peBax, nylon and other materials.

Referring to fig. 8, in another embodiment, the catheter body is a hollow tubular structure, the middle is a guide wire lumen 213, and 4 lumens 212 are uniformly distributed in the wall of the catheter body, wherein 2 of the lumens symmetrically distributed along the axial direction are used as pull wire lumens. The multi-lumen tube 211 may be prepared by extrusion, heat shrinking, or the like.

Referring to fig. 9, in another embodiment, the catheter body is a hollow tubular structure, the middle is a guide wire cavity 223, and 8 cavities 222 are uniformly distributed in the tube wall of the catheter body, wherein 2 cavities symmetrically distributed along the axial direction are used as pull wire cavities. The multi-lumen tube 221 may be prepared by extrusion, heat shrinking, or the like.

Referring to fig. 10, in another embodiment, the catheter body is a hollow tubular structure, the middle is a guide wire cavity 233, 2 pull wire cavities 232 are uniformly distributed in the wall of the catheter body, and two elongated cavities 234 are used for arranging other wires or serving as saline cavities. The multi-lumen tube 231 may be prepared by extrusion, heat shrinking, or the like.

The above description is only a preferred embodiment of the present application and is not intended to limit the scope of the present application, and various modifications and changes may be made by those skilled in the art. Variations, modifications, substitutions, integrations and parameter changes of the embodiments may be made without departing from the principle and spirit of the application by conventional substitution or by implementing the same function within the spirit and principle of the application.

Claims (10)

1. A spline basket ablation catheter capable of being bent in two directions is characterized by comprising an adjusting handle, a catheter main body and a treatment head;

the adjusting handle comprises a bending control knob, and the bending control knob is connected with 2 pull wires;

the main body of the catheter is a slender hollow tube extending along the axial direction, the proximal end of the main body of the catheter is connected to the adjusting handle, the distal end of the main body of the catheter is connected with the treatment head, and the main body of the catheter comprises at least 2 axially symmetrically distributed pull wire cavities;

the bending control knob bends the distal end of the catheter main body through at least 2 pull wires, so that the treatment head is bent in two directions;

the adjusting handle is also provided with a friction control module which can control the friction force between the pull wire and the adjusting handle to keep the bending angle of the catheter fixed.

2. The bidirectionally bendable spline basket ablation catheter of claim 1, wherein the treatment head comprises a spline basket having a plurality of splines, wherein each spline comprises at least 1 ring electrode.

3. The bidirectionally bendable spline basket ablation catheter of claim 2, wherein the annular electrodes on the splines are distributed at the distal end of the spline basket in the range of 1/10 to 2/3 of the total spline length.

4. The bidirectionally bendable spline basket ablation catheter of claim 3, wherein each spline comprises 1-5 ring electrodes.

5. The bidirectionally bendable spline basket ablation catheter of claim 3, wherein the ring electrode of each spline comprises 1 short electrode at the distal end of the spline and 1-4 long electrodes in the proximal portion.

6. The bidirectionally bendable spline basket ablation catheter of claim 1, wherein the catheter body is a hollow tubular structure with a guidewire lumen in the middle, and the guidewire lumens are axially symmetrically distributed in the catheter wall.

7. The bidirectionally bendable spline basket ablation catheter of claim 6, wherein a plurality of lumens are distributed in the wall of the catheter body, wherein 2 of the axially symmetrically distributed lumens are used as pull wire lumens.

8. The bidirectionally bendable spline basket ablation catheter of claim 7, wherein the plurality of lumens is 2-8 in number.

9. The bidirectionally bendable spline basket ablation catheter of claim 7, wherein the shape of the tube wall channel comprises one of a circle, an ellipse, and an elongated strip.

10. A bidirectionally bendable spline basket ablation catheter according to any of claims 1-9, wherein the bending angle of the treatment head and the distal end of the catheter body of the ablation catheter can be adjusted within the range of 0-180 °, so that the treatment head can rapidly reach the vestibular of pulmonary vein or other vein targets with different angles.

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