EP1017444A1 - Dispositif pour effectuer une echocardiographie transoesophagienne et une cardioversion - Google Patents
Dispositif pour effectuer une echocardiographie transoesophagienne et une cardioversionInfo
- Publication number
- EP1017444A1 EP1017444A1 EP97913231A EP97913231A EP1017444A1 EP 1017444 A1 EP1017444 A1 EP 1017444A1 EP 97913231 A EP97913231 A EP 97913231A EP 97913231 A EP97913231 A EP 97913231A EP 1017444 A1 EP1017444 A1 EP 1017444A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- endoscope
- electrode
- articulated
- cardioversion
- distal
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0517—Esophageal electrodes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/395—Heart defibrillators for treating atrial fibrillation
Definitions
- the present invention relates to a device for performing transesophageal echocardiography and cardioversion, in particular for the treatment of arrhythmia.
- Atrial fibrillation is now the most common rhythm disorder in an increasingly stressed population, especially since the population is older.
- the risks linked to atrial fibrillation are numerous, in particular a risk of thromboembolic accident which can lead to cerebrovascular accidents responsible for very high morbidity and mortality, as well as a reduction in cardiac output due to loss of atrial systole and impaired systolic function of the left ventricle.
- cardioversion is generally performed to restore the sinus rhythm in the patient by electric shock.
- cardioversion can lead to stroke or peripheral embolism, by detaching all or part of a preexisting thrombus in the left auricle under the action of electric shock.
- a known probe for transesophageal echocardiography generally includes an ultrasonic sensor at the distal end of an endoscope. The latter method requires only a short duration of anticoagulation for its implementation. When the result of the transesophageal echocardiography reveals the absence of thrombus, cardioversion is immediately carried out.
- a first method consists in restoring the sinus rhythm by pharmacological treatment by oral or intravenous route. However, this method is long to implement and not always effective. Another method is to produce electric shocks internally or endocavitary. However, such a cardioversion method is an invasive act and very cumbersome to implement.
- Yet another method consists in producing electric shocks by the esophageal route using an endoscope provided at its distal portion with several electrodes.
- this operation does not require general anesthesia, but a simple sedation, it can lead to complications when following a previous transesophageal echocardiography.
- the operator sometimes experiences difficulties in reintroducing a new probe into the patient's mouth where it can be wound up, because there is a risk of rejection of the probe by the patient due to the fact that the esophageal tissues are already irritated, not to mention the risk of damage or perforation of the esophagus as a result of repeated introductions of endoscopes.
- the present invention therefore aims to eliminate the aforementioned drawbacks and to propose a new device for performing transesophageal echocardiography and cardioversion which is rapid and simple to use, effective in the treatment of rhythm disorders and relatively well supported by the patient.
- the subject of the invention is a device for performing transoesophageal echocardiography and cardioversion, comprising an endoscope provided at its distal end with an ultrasound sensor for echocardiography, characterized in that the same endoscope is provided with at least one electrode in the vicinity of its distal end to produce electric shocks for cardioversion by the esophageal route.
- both echocardiography and cardioversion can be performed during the same operation either simultaneously or successively, without requiring several introductions and withdrawals of probes through the esophagus.
- the risk of laceration of the esophagus and rejection of the probe by the patient is thus significantly reduced.
- the distal portion of the endoscope which comprises the sensor is articulated with respect to the rest of the endoscope, controlled in flexion and provided with at least one electrode.
- the fact of providing at least one electrode on the distal articulated portion of the endoscope makes it possible to bring this electrode as close as possible to the ear tissue and to ensure perfect contact between the remaining electrodes and the : underlying the ear tissue at the time cardioversion. So the quantity of energy required for cardioversion can be optimized and reduced.
- at least one electrode can be provided on the articulated distal portion of the endoscope between the articular part and the sensor, and at least one other electrode on the flexible but non-articulated distal portion of the endoscope in the vicinity of the part. articular.
- the extreme distal electrode is located approximately 4-5 cm from the distal end of the endoscope and approximately 1 cm from the articular part.
- the endoscope is provided at its proximal end with a handle incorporating the control members for the flexion of the articulated distal portion, for the rotation of a multi-plane ultrasonic sensor and for triggering electric shock.
- the guide for actuating the articulated portion of the endoscope and the electrical connection wires of the electrodes are coaxially housed in the endoscopic tube.
- Each electrode can be independently connected to the handle of the endoscope.
- Figure 1 is a schematic and plan view of the device of the invention.
- FIG. 2 is a partial and enlarged view of the distal portion of the endoscope of FIG. 1.
- FIG. 3 is a partial and enlarged view of the control handle of the device of FIG. 1.
- Figure 4 is a schematic and plan view of the connection device of the chest electrode for cardioversion by esophageal route.
- the device of the invention comprises a single flexible tubular endoscope 1 of structure known per se, and connected at its proximal end to a control handle 2 and comprising at its distal end an assembly ultrasonic transducer 3.
- the distal portion of the endoscope 1 which includes the multiplan sensor 3 is articulated at 4 relative to the rest of the endoscope.
- This articulated distal portion is maneuvered in flexion by means of a control guide (not shown) coaxially housed in the endoscopic tube 1, by two knobs 5 and 6 provided on the handle 2.
- One of the knobs allows movement vertical of the articulated distal portion and one other wheel allows the horizontal displacement of the latter.
- One of the wheels for example the large wheel 6 makes it possible to control deflection movements of the articulated distal portion, in a plane parallel to its axis upwards and downwards, with an angle which goes up to 90 ° , the other wheel has lateral deflections in a plane perpendicular to the first.
- These movements are possible thanks to a system known per se, which is equipped with a cable sliding on a pulley and fixed by both sides at the level of the articulated part, above and below for one and on the side sides for each other.
- each wheel is equipped with an independent brake that can be activated by pressing the selected wheel. The brake will be deactivated by pulling the appropriate wheel.
- the distal portion with the sensor 3 and the electrode 8 can be positioned exactly in the esophagus and the brakes allow its articulated distal portions to keep its position. This can only be changed after pulling the knobs. So, by maneuvering the knobs 5 and 6, the sensor 3 can be positioned exactly in the esophagus.
- each electrode 8 is connected by a wire 9 independently to the control handle 2.
- these four electrodes are arranged over a length of approximately 12 cm from the distal top of the endoscope, each electrode possibly having a length of approximately 2 cm.
- the extreme distal electrode can be placed about 4.5 cm from the distal tip of the endoscope in its articulated portion.
- the distance between the extreme distal electrode and the next electrode on the non-articulated portion can be approximately 2 cm, while the remaining electrodes are spaced only 1 cm apart.
- control handle 2 further comprises a button 10 for charging energy and triggering the electric shock.
- a button 10 for charging energy and triggering the electric shock.
- the control handle 2 also comprises a digital display screen 11 to indicate the number of Joules selected of the electric charge to be triggered and an audible warning to indicate the end of the energy charge.
- the control handle 2 is in turn connected by a cable 12, on the one hand to an echocardiography device (not shown) by a connector 12a, and on the other hand, to the defibrillation device by a connector 12b .
- the cable 12 therefore branches off at its distal end for connection respectively to the echocardiography and defibrillation apparatus.
- the defibrillator 13 is connected by a standard cable 14 to the defibrillator device.
- the number of electrodes can vary depending on the applications envisaged and the operator can activate the echocardiograph and the defibrillator simultaneously or successively.
- the endoscope 1 is provided with several electrodes 8 to increase the energy transfer surface at the time of defibrillation.
- the electrodes are arranged in a circular fashion.
- the endoscopic probe is first introduced into the patient's esophagus through his mouth through a toothpick.
- the endoscope is positioned in the esophagus so that the ultrasonic sensor 3 makes it possible to view the atria and the auricles of the heart 30-40 cm from the dental arches in order to eliminate the presence of a thrombus, this position being maintained by actuating the brake of the wheels 5 and 6.
- the articulated part allows the first electrode a close approximation against the myocardial wall and this thanks to a bending which is ensured by the large wheel.
- the operator is able, using button 10, to manage the achievement of cardioversion.
- the operator can perform the gesture to trigger the dump. Thanks to these easy working conditions, the operator cardiologist can activate the device himself and perform this gesture several times. Furthermore, the self-adhesive external electrode 13 is positioned at the level of the sternum to allow defibrillation during the same operation.
- this device makes it possible to shorten the time for taking care of the patient and to improve his comfort.
- the implementation of the device requires only a short duration of anticoagulation and a light sedation.
- the device according to the invention provides a diagnosis by means of echocardiography, namely the ultrasound sensor, and a therapy by the delivery of a previously regulated electrical discharge (that is to say, say by cardioversion and therefore restoration of the sinus rhythm).
- a previously regulated electrical discharge that is to say, say by cardioversion and therefore restoration of the sinus rhythm.
- the arrangement of an electrode on the articulated part therefore close to the ultrasound sensor, gives the operator the possibility of visualizing exactly where he wants to practice his cardioversion. This one thus has the possibility of being guided which gives him technically a good control.
- This arrangement also makes it possible to study the behavior of the left auricle (degree of appearance of contrast, formation of thrombus) at the time of cardioversion on which the management in terms of anticoagulation will depend.
- buttons 10 located on the control handle of the device provide the operator cardiologist with complete independence from his assistants.
- the device allows the operator to carry out all the operations on his own whenever he deems it necessary instead of asking the assistant nurse, especially in emergency situations or in the situation where the first electric shock failed to obtain the sinus rhythm. This operation can be repeated up to three consecutive times.
Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Electrotherapy Devices (AREA)
Abstract
Description
Claims
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9613367A FR2755020B1 (fr) | 1996-10-31 | 1996-10-31 | Dispositif pour effectuer une echocardiographie transoesophagienne et une cardioversion |
FR9613367 | 1996-10-31 | ||
PCT/FR1997/001958 WO1998018519A1 (fr) | 1996-10-31 | 1997-10-31 | Dispositif pour effectuer une echocardiographie transoesophagienne et une cardioversion |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1017444A1 true EP1017444A1 (fr) | 2000-07-12 |
Family
ID=9497263
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP97913231A Withdrawn EP1017444A1 (fr) | 1996-10-31 | 1997-10-31 | Dispositif pour effectuer une echocardiographie transoesophagienne et une cardioversion |
Country Status (4)
Country | Link |
---|---|
US (1) | US6142941A (fr) |
EP (1) | EP1017444A1 (fr) |
FR (1) | FR2755020B1 (fr) |
WO (1) | WO1998018519A1 (fr) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1203564A2 (fr) * | 2000-11-02 | 2002-05-08 | GE Medical Systems Global Technology Company LLC | Sonde transoesophagienne à rigidité variable |
Families Citing this family (20)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6547739B2 (en) * | 2001-01-08 | 2003-04-15 | Ge Medical Systems Global Technology Company Llc | Transesophageal probe with improved control panel |
US20020198583A1 (en) * | 2001-06-22 | 2002-12-26 | Joseph Rock | Disposable sheath providing cardiac stimulation and method |
US20030097167A1 (en) * | 2001-11-13 | 2003-05-22 | Friedman Paul A. | Transesophageal cardiac probe and methods of use |
FR2847480B1 (fr) | 2002-11-27 | 2005-02-25 | Bouziane Benhalima | Systeme a electrode pret-a-monter pour cardioversion et ensemble dudit systeme et d'un endoscope |
WO2004110556A1 (fr) * | 2003-04-16 | 2004-12-23 | New York University | Sonde combinee d'echocardiographie transoesophagienne et de cardioversion transoesophagienne |
EP1622508B1 (fr) * | 2003-05-12 | 2014-04-09 | Cheetah Medical, Inc. | Système et procede pour mesurer le debit sanguin et le volume sanguin |
US20060241476A1 (en) * | 2005-02-10 | 2006-10-26 | Loubser Paul G | Apparatus and method for holding a transesophageal echocardiography probe |
EP1848326B1 (fr) * | 2005-02-15 | 2016-11-16 | Cheetah Medical, Inc. | Systeme, procede et appareil permettant de mesurer le debit sanguin et le volume sanguin |
US8172758B2 (en) * | 2006-03-06 | 2012-05-08 | Imacor Inc. | Transesophageal ultrasound probe with an adaptive bending section |
US20080081980A1 (en) * | 2006-09-18 | 2008-04-03 | Michael Maschke | Apparatus and process for stroke examination and treatment using a C-arch X-ray system |
US8876725B2 (en) * | 2007-02-23 | 2014-11-04 | Cheetah Medical, Inc. | Method and system for estimating exercise capacity |
US9095271B2 (en) | 2007-08-13 | 2015-08-04 | Cheetah Medical, Inc. | Dynamically variable filter |
US8764667B2 (en) * | 2007-03-07 | 2014-07-01 | Cheetah Medical, Inc. | Method and system for monitoring sleep |
US8523777B2 (en) * | 2007-04-19 | 2013-09-03 | Cheetah Medical, Inc. | Method, apparatus and system for predicting electromechanical dissociation |
US10613355B2 (en) | 2007-05-04 | 2020-04-07 | E-Vision, Llc | Moisture-resistant eye wear |
US11061252B2 (en) | 2007-05-04 | 2021-07-13 | E-Vision, Llc | Hinge for electronic spectacles |
JP5660890B2 (ja) * | 2007-06-26 | 2015-01-28 | バソノバ・インコーポレイテッドVasonova, Inc. | 血管アクセス及びガイダンスシステム |
US20090292309A1 (en) * | 2008-05-20 | 2009-11-26 | Michael Maschke | System and workflow for diagnosing and treating septum defects |
EP2350999A4 (fr) | 2008-09-25 | 2017-04-05 | CAE Healthcare Canada Inc. | Simulation d imagerie médicale |
CN113693632B (zh) * | 2021-10-26 | 2022-02-08 | 广东恒腾科技有限公司 | 一种超声波探头用三维姿态调整装置 |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4351330A (en) * | 1978-01-30 | 1982-09-28 | Scarberry Eugene N | Emergency internal defibrillation |
DE3829603A1 (de) * | 1988-09-01 | 1990-03-15 | Kontron Holding Ag | Ultraschallendoskopeinrichtung |
US5343860A (en) * | 1989-02-06 | 1994-09-06 | Arzco Medical Systems, Inc. | Esophageal recording/pacing catheter with thermistor and cardiac imaging transceiver |
US5191885A (en) * | 1989-02-06 | 1993-03-09 | Arczo Medical Electronics, Inc. | Method of terminating an arrhythmia |
DE3914619A1 (de) * | 1989-05-03 | 1990-11-08 | Kontron Elektronik | Vorrichtung zur transoesophagealen echokardiographie |
US5178149A (en) * | 1989-11-06 | 1993-01-12 | Michael Imburgia | Transesophageal probe having simultaneous pacing and echocardiographic capability, and method of diagnosing heart disease using same |
NL9001755A (nl) * | 1990-08-02 | 1992-03-02 | Optische Ind De Oude Delft Nv | Endoscopische aftastinrichting. |
US5228441A (en) * | 1991-02-15 | 1993-07-20 | Lundquist Ingemar H | Torquable catheter and method |
US5325860A (en) * | 1991-11-08 | 1994-07-05 | Mayo Foundation For Medical Education And Research | Ultrasonic and interventional catheter and method |
US5417713A (en) * | 1993-02-09 | 1995-05-23 | Leonard Bloom | Transesophageal defibrillating system |
US5749833A (en) * | 1995-08-15 | 1998-05-12 | Hakki; A-Hamid | Combined echo-electrocardiographic probe |
-
1996
- 1996-10-31 FR FR9613367A patent/FR2755020B1/fr not_active Expired - Fee Related
-
1997
- 1997-10-31 US US09/297,336 patent/US6142941A/en not_active Expired - Fee Related
- 1997-10-31 WO PCT/FR1997/001958 patent/WO1998018519A1/fr not_active Application Discontinuation
- 1997-10-31 EP EP97913231A patent/EP1017444A1/fr not_active Withdrawn
Non-Patent Citations (1)
Title |
---|
See references of WO9818519A1 * |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1203564A2 (fr) * | 2000-11-02 | 2002-05-08 | GE Medical Systems Global Technology Company LLC | Sonde transoesophagienne à rigidité variable |
EP1203564A3 (fr) * | 2000-11-02 | 2002-10-23 | GE Medical Systems Global Technology Company LLC | Sonde transoesophagienne à rigidité variable |
US6585641B1 (en) | 2000-11-02 | 2003-07-01 | Ge Medical Systems Global Technology Company, Llc | Transesophageal probe with variable stiffness |
Also Published As
Publication number | Publication date |
---|---|
FR2755020B1 (fr) | 1999-05-28 |
FR2755020A1 (fr) | 1998-04-30 |
WO1998018519A1 (fr) | 1998-05-07 |
US6142941A (en) | 2000-11-07 |
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