JP2004209262A - 心内膜の写像システム - Google Patents
心内膜の写像システム Download PDFInfo
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Abstract
【解決手段】患者の心臓の電気的活動を写像するシステムは、心臓壁18から離隔された電極セット19と、心臓壁18に接触した電極セット24,26とを備える。此等の電極からの電圧測定値は心臓の電気的活動の3次元写像及び2次元写像を生成すべく使用される。
【選択図】図1
Description
全体として本発明は、心臓チャンバーの内面における電気的活動に関する高分解能の3次元写像を作り出す方法を提供するものである。
一般に本発明のシステムは、心臓チャンバー80の内側面における電気的な活動の写像又はマッピングに使用される。写像カテーテルアセンブリ14は変形自在な末端リード体74に連結された軟質リード体72を含む。この変形自在な末端リード体74は心臓キャビティ80内に導入された後、幾何学的な形状を満たす安定空間に形成され得る。この変形自在な末端リード体74は複数の電極サイトを画定する電極アレイ19を含む。また写像カテーテルアセンブリ14は軟質リード体72及び末端リード体74内に形成された中央管膣又は中央ルーメンを貫通している基準カテーテル16上に都合良く配置された基準電極を含む。基準カテーテルアセンブリ16は心臓壁を精査すべく使用することができる末端電極アセンブリ24を有する。この末端の接触用電極アセンブリ24は較正用の表面電気的基準を提供する。電極アレイ19と共に該電極アレイの位置で計られた基準カテーテル16の物理的な長さはこの電極アレイ19を較正するために使われ得る基準を提供している。またこの基準カテーテル16は電極アレイ19の望ましい位置を安定化している。
図1はある患者の心臓12に連結された写像システム10を示す。写像カテーテルアセンブリ14は心臓チャンバー内に挿入され、基準電極24は心内膜表面18に触れている。
図2は心臓チャンバー80内に据えられた写像カテーテルアセンブリ14の一部を示している。写像カテーテルアセンブリ14は基準カテーテル16及びアレイカテーテル20を含む。図2においてアレイカテーテル20は、スタイレット92の使用を通じてその電極アレイ19を安定的且つ再現性ある幾何学的形状になすべく膨張させられている。基準カテーテル16はアレイカテーテル20の管腔82に通過させられて、末端電極アセンブリ24を心内膜表面の然るべき位置に据えるようにしている。使用中、基準カテーテル16は電極アレイ19のための機械的な配置基準を提供し、末端電極アセンブリ24は写像工程のための心臓壁上の或いは心臓壁内の電位を提供する。
例証となる方法は図12に示されるように9ステップ又は9段階に区割りされる。このステップ的な系列の区割りは本発明を説明する補助としてなされるものであり、本発明の適用範囲から逸脱することなく他の同等な区割りで容易に置き換えることができる。
本発明の異なる複数の段階を遂行するために2つの異なるアルゴリズムが適当である。
ここで、V(θ,ψ)はプローブ半径R上の測定されたポテンシャルであり、dΩは立体角の微分であり、球座標において以下のように定義される。
dΩ=sinθdθdψ
ここで、pのq倍は球形状プローブアレイ上の電極の総数と等しい。角度θはゼロからπラジアンの範囲であり、ψはゼロから2πラジアンの範囲である。
ここで、V(X)は3次元ベクトルXによって定義される所望の点におけるポテンシャルを表し、Viは3次元ベクトルiによって定義される点のnコの公知ポテンシャルの各々を表し、kは組織媒体の物理的振る舞いに釣り合うべき指数である。
Claims (10)
- 患者の心臓内で展開され得る電極セットを有するタイプで、患者の心臓(12)の電気的ポテンシャルを写像するために使用する写像カテーテルにおいて、
複数電極のセット(19)と、
前記電極セットに連結され、複数電極の第1のサブセットとしての該電極セットの一部を、前記心臓(12)の表面とは非接触状態で且つ該表面から離隔させる第1位置付け手段と、
前記電極セットに連結され、該電極セットの第2の所定サブセット(24)を前記心臓の表面に接触させる第2位置付け手段と、
前記電極セットに連結され、前記複数電極の第3の所定サブセット(26)を前記心臓の壁内の然るべき位置に配置させる第3位置付け手段を更に備えることから成る写像カテーテル。 - 前記電極セットは12を越える電極数であることから成る請求項1に記載の写像カテーテル。
- 前記第1のサブセットは1を越える電極数であることから成る請求項1に記載の写像カテーテル。
- 前記第2の所定サブセットは少なくとも1つであることから成る請求項1に記載の写像カテーテル。
- 前記第1位置付け手段は形状において略々球であることから成る請求項1に記載の写像カテーテル。
- 前記第2位置付け手段は略々円筒形状を有することから成る請求項1に記載の写像カテーテル。
- 患者の心臓の内側を写像するカテーテルアセンブリ(10)において、
略々球形状を成す第1の電極アレイ(19)を画成する複数電極サイトの第1セットであって、前記電極アレイが、前記心臓に対して非接触状態となる数の電極を備える大きさを有するようになっている複数電極サイトの第1セットと、
前記心臓に対して接触状態となって配置され、前記電極アレイから変移された複数電極サイト(24)の第2セットと、を備えて成るカテーテルアセンブリ。 - 患者の心臓の心臓チャンバーの内側における電気的ポテンシャルを写像するカテーテルアセンブリ(10)において、
変形自在リード体(74)に連結され、かつ、該変形自在リード体(74)と共に管膣を有する軟質リード体(72)であって、前記変形自在リード体は、該変形自在リード体が略々円筒形状となる第1圧潰位置まで変形可能であり、且つ、該変形自在リード体が略々球形状となる第2膨張位置まで変形可能である、軟質リード体(72)と、
前記変形自在リード体上に配置された複数の電極サイトを有する電極アレイ(19)であって、前記変形自在リード体が前記第2膨張位置にある際に前記電極サイトが電極サイトの球状アレイを形成する電極アレイ(19)と、
先端電極アセンブリを有する基準カテーテル(16)であって、前記管膣内に配置され、前記電極アレイが前記心臓内にある際に前記先端電極アセンブリが前記心臓に対して接触するように前記電極アレイに対しての相対的運動のために支持されている基準カテーテル(16)と、を備えることから成るカテーテルアセンブリ。 - 前記変形自在リード体が前記第2膨張位置にある際に該変形自在リード体の内側から血液を排除するための手段(77)を更に備えることから成る請求項8に記載のカテーテルアセンブリ。
- カテーテルを形成する方法において、
a)各々が内側導体と、外側絶縁コーティングとを有する複数の絶縁ワイヤの集合を形成し、
b)ステップa)で形成されたワイヤを編組状として中央管膣を有する編組状構造を形成し、
c)前記編組状構造を軟質リード体を形成する高分子材内に組み入れ、
d)前記軟質リード体の一部から前記高分子材を取り除き、前記絶縁ワイヤの前記編組を露出して変形自在リード体を形成し、
f)選択された絶縁ワイヤ上の選択された位置から絶縁物を取り除いて、前記変形自在リード体上に電極サイトを形成する、諸ステップを含むことから成る方法。
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US07/949,690 US5311866A (en) | 1992-09-23 | 1992-09-23 | Heart mapping catheter |
US07/950,448 US5297549A (en) | 1992-09-23 | 1992-09-23 | Endocardial mapping system |
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- 2005-11-03 US US11/265,138 patent/US20060084971A1/en not_active Abandoned
- 2005-11-03 US US11/265,137 patent/US20060084970A1/en not_active Abandoned
- 2005-11-03 US US11/265,139 patent/US20060084972A1/en not_active Abandoned
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JP2010520780A (ja) * | 2007-03-09 | 2010-06-17 | セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド | 不均一な場を補正するシステムと方法 |
US9549689B2 (en) | 2007-03-09 | 2017-01-24 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for correction of inhomogeneous fields |
US9591990B2 (en) | 2007-03-09 | 2017-03-14 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Automated catalog and system for correction of inhomogeneous fields |
US10433929B2 (en) | 2007-03-09 | 2019-10-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | System and method for local deformable registration of a catheter navigation system to image data or a model |
US10945633B2 (en) | 2007-03-09 | 2021-03-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Automated catalog and system for correction of inhomogeneous fields |
JP2009106633A (ja) * | 2007-10-31 | 2009-05-21 | Toshiba Corp | 医用画像表示装置及び術中ナビゲーションシステム |
Also Published As
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JP3581888B2 (ja) | 2004-10-27 |
EP0661948B1 (en) | 1997-11-19 |
US8208998B2 (en) | 2012-06-26 |
CA2447239A1 (en) | 1994-03-31 |
DE69315354D1 (de) | 1998-01-02 |
JPH08501477A (ja) | 1996-02-20 |
CA2144973A1 (en) | 1994-03-31 |
CA2678625A1 (en) | 1994-03-31 |
DE69315354T2 (de) | 1998-03-19 |
US20060058692A1 (en) | 2006-03-16 |
US6826421B1 (en) | 2004-11-30 |
WO1994006349A1 (en) | 1994-03-31 |
JP3876344B2 (ja) | 2007-01-31 |
US6826420B1 (en) | 2004-11-30 |
CA2144973C (en) | 2010-02-09 |
US7289843B2 (en) | 2007-10-30 |
US20060058693A1 (en) | 2006-03-16 |
US20030176799A1 (en) | 2003-09-18 |
ATE160273T1 (de) | 1997-12-15 |
CA2447239C (en) | 2010-10-19 |
US20060084884A1 (en) | 2006-04-20 |
US20050101874A1 (en) | 2005-05-12 |
EP0661948A1 (en) | 1995-07-12 |
US20060084970A1 (en) | 2006-04-20 |
US20060084972A1 (en) | 2006-04-20 |
US20060052716A1 (en) | 2006-03-09 |
US6978168B2 (en) | 2005-12-20 |
US20060084971A1 (en) | 2006-04-20 |
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