JP2012176119A - Electrode catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrode catheter excelling in effects of cooling the surface of a distal end electrode and suppressing thrombus formation on the surface of the distal end electrode without causing an abnormal temperature rise (a high temperature part) to a part of the distal end electrode in cauterization, and moreover attaining efficient cauterization treatment.SOLUTION: The electrode catheter includes: a catheter shaft 10 having a lumen 11 serving as a liquid passage; an insulated irrigation member 20 connected to the leading end side of the catheter shaft; and the distal end electrode 30 connected to the leading end side of the irrigation member. The irrigation member 20 is formed with a storage space 24 for liquid supplied from the catheter shaft 10; a plurality of apertures 25 arranged at equal angle spaces along the outer periphery of the irrigation member 20 to discharge the liquid in the storage space 24; and liquid guide grooves 26 extending toward the leading end from the respective apertures 25. The proximal end surface of the distal end electrode 30 is formed with liquid guide grooves 36 connected to the respective guide grooves 26 of the irrigation member 20.

Description

  The present invention relates to an electrode catheter, and more particularly to an electrode catheter having an electrode attached to the tip of the catheter and a mechanism for irrigating a liquid such as physiological saline to the electrode.

  In an ablation catheter that is an electrode catheter, an ablation catheter having an irrigation mechanism for cooling a tip electrode that has become hot during cauterization is used.

  As a conventional catheter equipped with an irrigation mechanism, a catheter that injects physiological saline supplied into the tip electrode through a catheter shaft from a plurality of openings formed on the surface of the tip electrode has been introduced. (For example, refer to Patent Document 1 and Patent Document 2).

Japanese Patent No. 2562681 JP 2006-239414 A

  However, conventionally known catheters in which an irrigation opening is formed on the surface of the tip electrode have the following problems (1) to (3).

(1) When an opening is provided on the surface of the tip electrode, an edge is inevitably formed at the opening edge or the like. When cauterization is performed with the tip electrode having such an edge, the current density in the edge portion becomes extremely high, and an abnormal temperature rise occurs in this portion, so that a thrombus may be rapidly formed. .
(2) Even if physiological saline is injected from the opening formed on the surface of the tip electrode, sufficient irrigation cannot be performed on the surface of the tip electrode (the surface is covered with a liquid). The surface cannot be cooled sufficiently. In particular, in the catheters described in Patent Document 1 and Patent Document 2 that inject physiological saline in a direction perpendicular to the axis of the tip electrode, the saline can be sufficiently brought into contact with the surface of the tip electrode. Since this is not possible, the cooling effect on the electrode surface is extremely low.
(3) By forming a plurality of openings on the electrode surface, it is impossible to ensure a sufficient surface area of the tip electrode, and efficient cauterization treatment cannot be performed.

The present invention has been made based on the above situation.
The purpose of the present invention is to produce an abnormal temperature rise (high temperature part) in a part of the tip electrode during cauterization, and is excellent in the cooling effect of the tip electrode surface and the thrombus formation suppression effect on the tip electrode surface, It is an object of the present invention to provide an electrode catheter equipped with an irrigation mechanism capable of performing efficient cauterization treatment.

(1) An electrode catheter of the present invention includes a catheter shaft having at least one lumen serving as a liquid flow path;
An insulating irrigation member connected to the distal end of the catheter shaft;
A tip electrode connected to the tip side of the insulating irrigation member,
The insulating irrigation member is disposed at equiangular intervals along the outer periphery of the insulating irrigation member in order to discharge the liquid storage space supplied from the catheter shaft and the liquid in the storage space. A plurality of openings, and a liquid guide groove extending in a distal direction from each of the plurality of openings,
A liquid guide groove that is continuous with each of the guide grooves of the insulating irrigation member is formed on the base end portion (base end surface) of the tip electrode,
A central lumen for extending the lead wire of the tip electrode is formed on the catheter shaft, and a lumen serving as a liquid flow path is formed around the central lumen (along the outer periphery of the catheter shaft). Multiple)
The insulative irrigation member has a double tube structure of an inner tube portion that defines a space communicating with the inner recess of the tip electrode and an outer tube portion, and the liquid storage space includes the inner tube portion and the inner tube portion. It is a jacket space partitioned by the outer pipe part,
By inserting the proximal end portion of the insulating irrigation member into the distal end portion (concave portion) of the catheter shaft, the insulating irrigation member is connected to the distal end side of the catheter shaft,
A central lumen formed in the catheter shaft communicates with an internal space of the inner tube of the insulating irrigation member via a first joint tube;
Each of the plurality of lumens serving as liquid flow paths disposed on the catheter shaft communicates with a jacket space of the insulating irrigation member via a second joint tube.

According to the electrode catheter having such a configuration, since the irrigation opening is formed in the insulating irrigation member, it is not necessary to form an opening in the tip electrode. As a result, since there is no edge associated with the formation of the opening in the tip electrode, an abnormal temperature rise does not occur in a part of the tip electrode during cauterization, thereby suppressing thrombus formation.
Even if an edge due to the formation of the opening is present in the insulating irrigation member, since the edge portion is insulative, current does not concentrate on the portion and the temperature does not increase.
Therefore, the electrode catheter of the present invention is remarkably superior in the thrombus formation suppressing effect on the tip electrode surface as compared with a conventionally known catheter having an irrigation mechanism.

  In addition, according to the electrode catheter having such a configuration, since the liquid is irrigated from the insulating irrigation member to the surface of the tip electrode, a sufficient amount of liquid can be brought into contact with the surface of the tip electrode. Since the liquid for irrigating the surface of the distal electrode flows along the surface of the distal electrode from the proximal end portion of the distal electrode toward the distal end portion, the distal electrode is compared with a conventional catheter having an irrigation mechanism. In addition to being excellent in the surface cooling effect, the blood in the vicinity of the tip electrode surface is sufficiently agitated and diluted to exert an excellent thrombus formation suppressing effect.

  In addition, since a plurality of openings arranged at equiangular intervals along the outer periphery of the insulating irrigation member and a plurality of guide grooves extending from each of the openings in the tip direction are formed, the surface of the tip electrode is circumferentially Can be irrigated over the entire area.

  Moreover, since it is not necessary to form an opening in the tip electrode, a sufficient surface area can be ensured, and an efficient ablation treatment can be performed.

  In addition, since the liquid storage space is formed in the insulating irrigation member, the liquid supplied from the catheter shaft to the inside of the insulating irrigation member is arranged at equiangular intervals after the flow is adjusted in the storage space. Since the liquid is ejected (discharged) from the plurality of openings, there is no variation in the amount of liquid ejected between the plurality of openings, and uniform ejection can be performed in the circumferential direction of the insulating irrigation member. Can be uniformly irrigated over the entire circumferential direction.

  In addition, since the insulating irrigation member is formed with a liquid guide groove extending in the distal direction from each of the plurality of openings, the liquid discharged (injected) from the opening is reliably guided toward the distal electrode ( Can be induced).

  In addition, a liquid guide groove that is continuous with each of the guide grooves of the insulating irrigation member is formed on the base end surface of the tip electrode, so that the tip electrode passes through the guide groove formed in the insulating irrigation member. The liquid that has reached the base end portion of the tip electrode can be guided (guided) to the tip end portion of the tip electrode, whereby the liquid can be supplied to the entire surface of the tip electrode.

  In addition, a central lumen for extending the lead wire of the tip electrode is formed on the catheter shaft, and a plurality of lumens serving as liquid flow paths are arranged around the central lumen, and the insulating irrigation member is A jacket space that has a double tube structure of an inner tube portion that divides a space communicating with the inner recess of the tip electrode and an outer tube portion, and the liquid storage space is partitioned by the inner tube portion and the outer tube portion Accordingly, the liquid supplied to the insulating irrigation member from the plurality of lumens arranged on the catheter shaft can be merged in the storage space (jacket space).

  Further, according to the electrode catheter having the above-described configuration, the central lumen formed in the catheter shaft communicates with the internal space of the inner tube of the insulating irrigation member, so that the lead wire of the tip electrode is connected to the tip electrode. Can extend into the inner recess of the tube, the inner space of the inner tube of the insulating irrigation member and the central lumen of the catheter shaft.

  In addition, since each of the plurality of lumens serving as liquid flow paths disposed on the catheter shaft communicates with the jacket space of the insulating irrigation member, the liquid from the catheter shaft (plural lumens) is allowed to flow through the insulating irrigation member. It can be reliably supplied to the jacket space.

  In addition, a first joint tube is interposed to communicate the central lumen formed in the catheter shaft with the inner space of the inner tube of the insulating irrigation member, and the liquid flow path disposed in the catheter shaft Since the second joint tube is interposed to communicate each of the plurality of lumens and the jacket space of the insulating irrigation member, the connection of the insulating irrigation member to the distal end side of the catheter shaft is ensured. Can be.

  In addition, since the second joint tube is interposed to communicate each of the plurality of lumens serving as the liquid flow path with the jacket space of the insulating irrigation member, the distal end surface of the catheter shaft (liquid flow Leakage of liquid from a contact point between the opening surface of the lumen serving as the path and the proximal end surface of the insulating irrigation member (liquid intrusion into the central lumen associated therewith) can be prevented.

(2) In the electrode catheter of the present invention, the sealing material is filled in the jacket space (the space between the adjacent second joint tubes) of the insulating irrigation member into which the second joint tube is inserted. Is preferred.
According to the electrode catheter having such a configuration, it is possible to reliably prevent the liquid from entering the central lumen.

(3) In the electrode catheter of the present invention, each of the plurality of guide grooves formed on the surface of the insulating irrigation member and the proximal end portion of the distal electrode preferably extends in the distal direction while being inclined outward. .
According to the electrode catheter having such a configuration, it is possible to sufficiently irrigate the surface of a tip electrode having a certain size (for example, a tip electrode having a diameter equal to or larger than the tube diameter of the catheter shaft). .

(4) In the electrode catheter of the present invention, the tip of the tip electrode bulges, and when the maximum diameter of the tip electrode is D1 and the tube diameter of the catheter shaft is D2, the value of D1 / D2 is 1. It is preferably 0 or more.

  According to the electrode catheter having such a configuration, a sufficient surface area for ablation treatment can be secured at the distal electrode.

(5) In the electrode catheter of the present invention, a lumen in which a pull wire for performing a tip deflection operation is formed on the catheter shaft around the central lumen, and the insulating irrigation member has the pull A wire insertion path is preferably formed.

(6) In this case, the lumen in which the tension wire formed on the catheter shaft extends is communicated with the insertion path of the tension wire in the insulating irrigation member via the third joint tube. preferable.

  According to the electrode catheter of the present invention, an abnormal temperature rise does not occur in a part of the tip electrode during cauterization, it is excellent in the effect of cooling the surface of the tip electrode and the effect of suppressing thrombus formation on the surface of the tip electrode, Can perform efficient cauterization treatment.

It is a front view of the ablation catheter which concerns on one Embodiment of the electrode catheter of this invention. It is a front view which shows the front-end | tip part of the ablation catheter shown in FIG. It is a longitudinal cross-sectional view (III-III sectional view of FIG. 2) in the front-end | tip part of the ablation catheter shown in FIG. FIG. 4 is a transverse sectional view (IV-IV sectional view of FIG. 3) at the distal end portion of the ablation catheter shown in FIG. 1. It is a cross-sectional view (VV cross-sectional view of FIG. 3) at the distal end portion of the ablation catheter shown in FIG. It is a longitudinal cross-sectional view (VI-VI sectional drawing of FIG. 4) in the front-end | tip part of the ablation catheter shown in FIG. FIG. 7 is a transverse sectional view (sectional view taken along the line VII-VII in FIG. 6) at the distal end portion of the ablation catheter shown in FIG. 1. It is a perspective view which shows the irrigation member which comprises the ablation catheter shown in FIG. It is a perspective view which shows the irrigation member which comprises the ablation catheter shown in FIG. It is a cross-sectional perspective view which shows the inside of the irrigation member which comprises the ablation catheter shown in FIG. It is a perspective view which shows the state by which the joint tube was inserted in the jacket space of an irrigation member. It is a cross-sectional perspective view which shows the inside of the irrigation member in the state by which the joint tube was inserted in the jacket space. It is a perspective view which shows the state by which the sealing material was filled in the jacket space of the insulating irrigation member in which the joint tube was inserted. FIG. 2 is a perspective view showing a connection state of a catheter tube, an irrigation member, and a tip electrode in the ablation catheter shown in FIG. 1.

Hereinafter, an embodiment of an electrode catheter of the present invention will be described with reference to the drawings.
The electrode catheter shown in FIGS. 1 to 7 is an ablation catheter used for treatment of arrhythmia in the heart.

The ablation catheter 100 of this embodiment includes a catheter shaft 10 having eight lumens 11 serving as liquid flow paths, an insulating irrigation member 20 connected to the distal end side of the catheter shaft 10, and the irrigation member 20. A distal electrode 30 connected to the distal end of the catheter, a ring electrode 40 attached to the distal end of the catheter shaft 10, tension wires 61 and 62 for performing distal deflection operation of the catheter, and a proximal end of the catheter shaft 10 A control handle 70 connected to the side and a liquid injection tube 78;
The catheter shaft 10 has a central lumen 13 for extending (passing through) a lead wire (not shown) connected to the tip electrode 30, and an equiangular interval (36 ° interval) around the central lumen 13. 10 lumens are arranged (eight lumens 11 serving as liquid flow paths and two lumens 12 serving as insertion paths for the pulling wire),
The irrigation member 20 has a double tube structure of an inner tube portion 23 that defines a space communicating with the inner concave portion 35 of the tip electrode 30 and an outer tube portion (the outer tube thin portion 21 and the outer tube thick portion 22). The irrigation member 20 includes an inner tube portion 23 and an outer tube portion (the outer tube thin portion 21 and the outer tube thick portion 22) as a storage space for the liquid supplied from each lumen 11 of the catheter shaft 10. A partitioned jacket space (hereinafter referred to as “storage jacket space”) 24 is formed, and equidistant intervals are provided along the outer periphery of the irrigation member 20 in order to discharge the liquid supplied to the storage jacket space 24. Eight openings 25 arranged at (45 ° intervals) and liquid guide grooves 26 extending from each of the openings 25 in the distal direction are formed.
A liquid guide groove 36 that is continuous with each of the guide grooves 26 of the irrigation member 20 is formed at the proximal end portion (neck portion 32) of the distal electrode 30;
The irrigation member is inserted into the distal end side of the catheter shaft 10 by inserting the proximal end portion (the inner tube portion 23 and the outer tube thin portion 21) of the irrigation member 20 into the distal end portion (a recessed portion formed at the distal end) of the catheter shaft 10. 20 is connected,
The central lumen 13 formed in the catheter shaft 10 communicates with the internal space of the inner tube portion 23 of the irrigation member 20 via the first joint tube 51, and the eight lumens 11 ( Each of the lumens serving as a liquid flow path communicates with the storage jacket space 24 of the irrigation member 20 via the second joint tube 52, and the two lumens 12 (of the tension wire) formed in the catheter shaft 10. Each of the lumens serving as the insertion passages is an electrode catheter that communicates with the insertion passage 27 of the tension wire in the irrigation member 20 via the third joint tube 53.

  The infusion tube 78 shown in FIG. 1 is connected to the catheter shaft 10 through the inside of the control handle 70, and liquid is supplied to the lumen 11 of the catheter shaft 10 through the infusion tube 78. Here, as the “liquid”, physiological saline can be exemplified.

  The control handle 70 shown in FIG. 1 is connected to the proximal end side of the catheter tube 10 and includes a rotating plate 75 for performing a distal end deflection operation of the catheter.

  As shown in FIG. 7, the catheter shaft 10 constituting the ablation catheter 100 is formed so as to surround the central axis, and is connected to each of the tip electrode 30 and the ring electrode 40 (not shown). And 10 lumens arranged at equiangular intervals (36 ° = 360 ° / 10) are formed around the central lumen 13.

  Ten lumens formed at equal intervals around the central lumen 13 have the same outer diameter. Two of the ten lumens 12 are inserted through pulling wires 61 and 62 for performing a tip deflection operation of the ablation catheter 100. The eight lumens 11 through which the pulling wires 61 and 62 are not inserted serve as liquid flow paths.

In FIG. 7, reference numeral 15 denotes a rigid body embedded in the catheter shaft 10 in order to surely perform the deflection operation by the tension wires 61 and 62.
The rigid body 15 is made of a metal bar spring, such as a Ni—Ti alloy, and has different bending directions due to the rigid bodies 15, 15 arranged in a direction perpendicular to the bending direction (arrangement direction of the tension wires 61, 62). The direction can be secured.

  The catheter shaft 10 may be made of a material having the same characteristics along the axial direction, but is preferably formed integrally using materials having different rigidity (hardness) along the axial direction. Specifically, it is preferable that the constituent material on the proximal end side has relatively high rigidity, and the constituent material on the distal end side has relatively low rigidity.

  The catheter shaft 10 is made of a synthetic resin such as polyolefin, polyamide, polyether polyamide, polyurethane, nylon, or PEBAX (polyether block amide). The proximal end side of the catheter shaft 10 may be a blade tube obtained by braiding a tube made of these synthetic resins with a stainless steel wire.

The outer diameter of the catheter shaft 10 is preferably 1.0 to 3.0 mm, more preferably 1.6 to 2.7 mm, and 2.36 mm as a suitable example.
The length of the catheter shaft 10 is preferably 600 to 1500 mm, and more preferably 900 to 1200 mm.

8 to 10 showing the irrigation member 20, reference numeral 21 denotes an outer tube thin portion, 22 denotes an outer tube thick portion, 23 denotes an inner tube portion, 24 denotes a storage jacket space, and 25 denotes a liquid in the storage jacket space 24. , 26 is a liquid guide groove, 27 is a pulling wire insertion passage, 28 is a central opening, and 29 is a retaining projection.
In the irrigation member 20, eight openings 25 and eight liquid guide grooves 26 are provided at intervals of 45 ° along the outer periphery of the irrigation member 20.

  The irrigation member 20 is made of a molded product of insulating resin or insulating ceramic. Thereby, even if it is a complicated shape and structure, it can be manufactured at low cost, and even when the irrigation member 20 has an edge, current is concentrated on the edge portion when the ablation catheter 100 is used (cauterization). And never get hot.

  As shown in FIGS. 6, 9, and 10, the irrigation member 20 constituting the ablation catheter 100 includes an inner tube portion 23 and an outer tube portion (the outer tube thin portion 21 and the outer tube thick portion 22). The storage jacket space 24 is partitioned by the inner tube portion 23 and the outer tube portion (the outer tube thin portion 21 and the outer tube thick portion 22).

The internal space of the inner tube portion 23 is a space that communicates with the inner concave portion 35 of the tip electrode 30.
The storage jacket space 24 partitioned by the inner tube portion 23 and the outer tube portion (the outer tube thin portion 21 and the outer tube thick portion 22) allows the liquid supplied to the irrigation member 20 from each of the lumens 11 of the catheter shaft 10. It is a space for joining.
As shown in FIGS. 9 and 10, the storage jacket space 24 is divided into two chambers by a tubular portion that divides the insertion path 27 of the pull wire.
Since there is no circumferential partition in the storage jacket space 24 other than the tubular portion that defines the insertion passage 27, the liquid flowing into the storage jacket space 24 (any chamber) can freely move in the circumferential direction in the chamber. It can be made to flow.

  The irrigation member 20 is formed with eight openings 25 arranged at equiangular intervals (45 ° intervals) along the outer periphery thereof. The opening 25 is an injection port for discharging the liquid stored in the storage jacket space 24.

In addition, a liquid guide groove 26 is formed at the distal end (outside) of the irrigation member 20 and extends in the distal direction from the position where each opening 25 is formed.
By this guide groove 26, the liquid discharged (injected) from the opening 25 can be reliably guided (guided) toward the tip electrode 30.

Further, as shown in FIG. 6, each of the guide grooves 26 is formed so as to be inclined outward (outside in the radial direction of the irrigation member 20) with respect to the axial direction of the irrigation member 20.
Thereby, the liquid discharged | emitted from the opening 25 is ejected toward the front end direction outer side (the front end side in the axial direction of the irrigation member 20 and the outer side in the radial direction). For this reason, it is possible to irrigate the surface of the tip electrode 30 that is somewhat large in size.

Further, as shown in FIGS. 3 and 8 to 10, the irrigation member 20 is formed with an insertion passage 27 for a pulling wire for performing a tip deflection operation.
The proximal ends of the pull wires 61 and 62 are connected to the rotating plate 75 (see FIG. 1) of the control handle 70, and as shown in FIG. 3, the lumens 12 and 12 of the catheter shaft 10 and the irrigation member 20 are connected. The distal ends of the irrigation members 20 are fixed at the distal ends thereof.
Thereby, for example, when the rotating plate 75 is rotated in the A1 direction shown in FIG. 1, the pulling wire 61 is pulled, the distal end portion of the catheter 100 is deflected in the arrow A direction, and the rotating plate is rotated in the B1 direction shown in FIG. When 75 is rotated, the pulling wire 62 is pulled, and the distal end portion of the catheter 100 is deflected in the direction of arrow B.

  The resin material constituting the irrigation member 20 is not particularly limited as long as it is an insulating resin used in the medical field, but an aromatic polyether ketone such as polyether ether ketone (PEEK) is preferable. . Further, the ceramic material constituting the irrigation member 20 is not particularly limited. The irrigation member 20 can be manufactured by injection molding, for example.

The length of the irrigation member 20 (including the portion to be embedded when connected to the catheter shaft 10) is, for example, 1 to 5 mm, and is 2 mm if a suitable example is shown.
The outer diameter of the irrigation member 20 (the outer diameter of the outer tube thick portion 22) is preferably the same as the outer diameter of the catheter shaft 10.

  As shown in FIGS. 3 and 6, the proximal end portion (the inner tube portion 23 and the outer tube thin wall) of the irrigation member 20 is formed in the distal end portion of the catheter shaft 10 (a concave portion formed in a range of about 1 to 5 mm from the distal end). The irrigation member 20 is connected to the distal end side of the catheter shaft 10 by inserting the portion 21).

In this state, the opening edge (end surface portion around the opening) of the central lumen 13 in the distal end portion (concave portion) of the catheter shaft 10 and the proximal end side end surface of the inner tube portion 23 of the irrigation member 20 are in contact with each other. The first joint tube 51 is inserted into the distal end region (about 1 to 10 mm from the opening) of the central lumen 13 and the proximal end region (about 0.5 to 5 mm from the proximal end) of the inner space of the inner tube portion 23. Has been.
Thereby, the central lumen 13 of the catheter shaft 10 communicates with the internal space of the inner tube portion 23 of the irrigation member 20 via the first joint tube 51.

Further, as shown in FIG. 6, in this state, each distal end region (about 1 to 10 mm from the opening) of the lumen 11 in the distal end portion (recessed portion) of the catheter shaft 10 and the proximal end region of the storage jacket space 24 ( A second catheter tube 52 is inserted at about 0.5 to 5 mm from the base end.
As a result, each of the eight lumens 11 (lumens serving as liquid flow paths) formed in the catheter shaft 10 communicates with the storage jacket space 24 of the irrigation member 20 via the second joint tube 52. Yes.

Further, as shown in FIG. 3, in this state, the distal end regions (about 1 to 10 mm from the opening) of the two lumens 12 in the distal end portion (concave portion) of the catheter shaft 10 and the insertion passage 27 for the tension wire The third joint tube 53 is inserted in the base end region (about 0.5 to 3 mm from the base end).
As a result, each of the two lumens 12 (lumens serving as the insertion passages for the tension wire) formed in the catheter shaft 10 is connected to the insertion passage 27 for the tension wire in the irrigation member 20 via the third joint tube 53. Communicate.

  11 and 12 show a state in which the joint tube is inserted into the irrigation member 20. Here, the first joint tube 51, the second joint tube 52, and the third joint tube 53 are inserted into the internal space of the inner pipe portion 23, the storage jacket space 24, and the insertion passage 27 of the tension wire, respectively. Yes.

Here, in order to ensure insertion of the second joint tube 52 into the storage jacket space 24, as shown in FIG. 9, on the outer periphery of the inner tube portion 23 and the inner periphery of the outer tube portion constituting the irrigation member 20. Are formed with a groove 23 </ b> C and a groove 21 </ b> C for ensuring the insertion of the second joint tube 52. The groove 23 </ b> C and the groove 21 </ b> C have a shape that fits the outer periphery of the second joint tube 52. By forming these grooves, it is possible to facilitate the operation of inserting the joint tube into the storage jacket space 24.
In addition, the irrigation member 20 can be easily formed by ensuring the sufficient thickness of the inner tube portion 23 and the outer tube portion (outer tube thin portion 21). If such a groove is not formed, the thickness of the inner tube portion and the outer tube portion must be extremely thin in order to insert the joint tube, which may cause a problem in the formability of the irrigation member. .

FIG. 13 shows a state in which the storage jacket space 24 (the space between the joint tubes) of the irrigation member 20 in which the second joint tube 52 is inserted is filled with the sealing material 80.
Thereby, the infiltration of the liquid into the central lumen 13 can be reliably prevented.

  The tip electrode 30 constituting the ablation catheter 100 has a hemispherical tip bulge portion 31, a neck portion 32, and a cylindrical portion 33.

  As shown in FIGS. 3 and 6, the tip electrode 30 has its cylindrical portion 33 inserted and fixed to the inside of the irrigation member 20 (inner space of the inner tube portion 23) from the central opening 28 shown in FIG. 8. Thus, the irrigation member 20 is connected to the distal end side.

  The diameter of the tip bulging portion 31 of the tip electrode 30 is preferably 1.0 to 3.3 mm, more preferably 2.2 to 2.6 mm, particularly preferably 2.3 to 2.5 mm. An example is 2.36 mm.

Further, when the diameter of the tip bulging portion 31 (the maximum diameter of the tip electrode 30) is D1 and the tube diameter of the catheter shaft 10 is D2, the value of D1 / D2 is preferably 1.0 or more, and more preferably. Is 1.0 to 1.5, and 1.0 (D1 / D2 = 2.36 mm / 2.36 mm) is shown as a preferable example.
When the value of D1 / D2 is too small, it is difficult to perform efficient cauterization treatment with a catheter provided with such a tip electrode.
On the other hand, if the value of D1 / D2 is excessive, irrigate a sufficient amount of liquid to the surface of such a tip electrode (sufficient cooling effect / thrombus formation inhibiting effect). It becomes difficult.

  It should be noted that a sufficient amount of liquid can be irrigated with respect to the surface of the tip electrode 30 having a value of D1 / D2 of 1.0 or more because each of the guide grooves 26 formed in the irrigation member 20 is irrigated. This is because the opening 25 is positioned on the outer side than the case where it is not inclined by inclining outward (outward in the radial direction of the irrigation member 20) with respect to the axial direction of 20. Also in this point, it is meaningful to interpose the irrigation member 20.

In addition, a liquid guide groove 36 that is continuous with each of the guide grooves 26 of the irrigation member 20 is formed at the proximal end portion (neck portion 32) of the distal electrode 30.
By forming the guide groove 36, the liquid that has reached the proximal end portion of the distal electrode 30 through the guide groove 26 formed in the irrigation member 20 is guided (guided) to the distal end portion of the distal electrode 30. Accordingly, the liquid can be supplied to the entire surface of the tip electrode 30 including the tip bulge portion 31.
Since the guide groove 36 formed in the tip electrode 30 has a gentle R shape, an abnormal temperature rise does not occur in this portion even during cauterization.

The ablation catheter 100 of this embodiment can be manufactured as follows.
First, the distal end side of the first joint tube 51 is inserted into the proximal end region of the inner space of the inner pipe portion 23, and the distal end sides of the eight second joint tubes 52 are inserted into the proximal end region of the storage jacket space 24. Then, the sealing material 80 is filled in the proximal end region of the storage jacket space 24 into which the second joint tube 52 is inserted (the gap portion between the joint tubes), and the proximal end region of the insertion path 27 of the tensile wire is filled with two pieces. The distal end side of the third joint tube 53 is inserted, and the irrigation member 20 in a state where the tension wires 61 and 62 are inserted into the insertion path 27 (third joint tube 53) of the tension wire is prepared.
Next, as shown in FIG. 14, the base end side of the first joint tube 51 is inserted into the central lumen 13, and the base end side of each of the second joint tubes 52 is inserted into the lumen 11, and the tension wires 61, 62 and The proximal end portions of the irrigation member 20 (the inner tube portion 23 and the outer tube thin-walled portion 21) are connected to the distal end portion of the catheter shaft 10 (the inner tube portion 23 and the outer tube thin-walled portion 21). Insert into the recess. As a result, the irrigation member 20 is connected to the distal end side of the catheter shaft 10. The rear ends of the tension wires 61 and 62 are connected to a rotating plate 75 (see FIG. 1) of the control handle 70.
Next, as shown in FIG. 14, the distal end of the irrigation member 20 is inserted and fixed to the inside of the irrigation member 20 (inner space of the inner tube portion 23) through the central opening 28. The tip electrode 30 is connected to the side.

According to the ablation catheter 100 of this embodiment, the opening 25 for ejecting the liquid is formed in the insulating irrigation member 20, and it is not necessary to form the opening in the conductive tip electrode 30. Since the accompanying edge does not exist, when the ablation catheter 100 is used (cautery), an abnormal temperature rise (high temperature part) does not occur in a part of the tip electrode 30, and blood contacts such high temperature part. Thrombus formation due to is suppressed.
Therefore, the ablation catheter 100 is significantly superior in the thrombus formation suppressing effect on the surface of the tip electrode 30 as compared with a conventionally known catheter in which an irrigation opening is formed in the tip electrode.
In addition, since there is no need to form an opening in the tip electrode 30, a sufficient surface area for cauterization can be ensured, and efficient cauterization treatment can be performed.

Further, according to the ablation catheter 100 of this embodiment, the liquid is irrigated from the irrigation member 20 on the rear side to the surface of the tip electrode 30, so that a sufficient amount of liquid is brought into contact with the surface of the tip electrode 30. Can do.
Moreover, the liquid irrigated on the surface of the tip electrode 30 flows along the surface of the tip electrode 30 from the base end portion (neck portion 32) of the tip electrode 30 toward the tip portion (tip bulge portion 31). (The blood around the tip electrode 30 is sufficiently stirred and diluted).
Therefore, the ablation catheter 100 has an excellent cooling effect on the surface of the tip electrode 30 and sufficient blood around the tip electrode 30 as compared with a conventionally known catheter in which an irrigation opening is formed in the tip electrode. By further stirring and diluting, a further excellent thrombus formation inhibitory effect is exhibited.

  Further, eight openings 25 arranged at equiangular (45 °) intervals along the outer periphery of the irrigation member 20 and eight guide grooves 26 extending from the formation positions of these openings 25 in the distal direction are formed. Thus, the surface of the tip electrode 30 can be irrigated over the entire circumferential direction (360 °).

  Further, the liquid supplied to the irrigation member 20 from each of the lumens 11 arranged along the outer periphery of the catheter shaft 10 joins in the storage jacket space 24 and arranges the flow, and then follows the outer periphery of the irrigation member 20. Therefore, the amount of liquid supplied from the catheter shaft 10 to the irrigation member 20 is varied in the circumferential direction (for example, liquid). Liquid that is ejected between the eight openings 25 in spite of the fact that the lumen 12 that does not serve as the flow path is formed and the lumen 11 that is the liquid flow path is not formed over the entire circumference. There is no variation in the amount, and the surface of the tip electrode 30 can be uniformly irrigated over the entire region in the circumferential direction (360 °).

  In addition, since the liquid guide groove 26 extending in the distal direction from the formation position of each opening 25 is formed in the irrigation member, the liquid discharged (sprayed) from each of the openings 25 is directed toward the distal electrode 30. It is possible to guide (guide) reliably.

  In addition, a liquid guide groove 36 that is continuous with each of the guide grooves 26 is formed on the surface of the proximal end portion (neck portion 32) of the distal electrode 30 so that it passes through the guide grooves 26 formed in the irrigation member 20. Thus, the liquid that has reached the proximal end portion of the distal electrode 30 can be guided (guided) to the distal end portion (distal bulge portion 31) of the distal electrode 30, thereby supplying liquid to the entire surface of the distal electrode 30. can do.

  Further, the irrigation member 20 is connected to the distal end side of the catheter shaft 10 by inserting the proximal end portion (the inner tube portion 23 and the outer tube thin portion 21) of the irrigation member 20 into the distal end portion (concave portion) of the catheter shaft 10. The central lumen 13 formed on the catheter shaft 10 communicates with the internal space of the inner tube portion 23 of the irrigation member 20 via the first joint tube 51, and the eight lumens 11 disposed on the catheter shaft 10 are connected. Each communicates with the storage jacket space 24 of the irrigation member 20 via the second joint tube 52, and each of the two lumens 12 disposed on the catheter shaft 10 passes through the third joint tube 53. The storage jacket space 24 into which the second joint tube 52 is inserted is communicated with the insertion passage 27, and the sealing material 80 is filled, And the distal end portion of the tape ether shaft 10 can be made reliable the connection between the rear end portion of the irrigation member 20.

  Further, since the central lumen 13 of the catheter tube 10 and the internal space of the inner tube portion 23 of the irrigation member 20 communicate with each other via the first joint tube 51, the lead wire of the tip electrode 30 can be connected to the tip electrode. 30 inner recesses 35, the inner space of the inner tube portion 23 of the irrigation member 20, and the central lumen 13 of the catheter shaft 10.

Further, each of the lumens 11 of the catheter tube 10 and the storage jacket space 24 of the irrigation member 20 communicate with each other via the second joint tube 52, so that liquid from each of the lumens 11 can be supplied to the storage jacket space 24. It can be reliably supplied.
Moreover, while inserting the 2nd joint tube 52 by inserting in each front-end | tip area | region of the lumen | rumen 11, and the proximal end area | region of the storage jacket space 24, while storing the storage jacket space 24 (between the adjacent 2nd joint tubes 52). When the sealing material 80 is filled in the gap portion, the liquid leaks from the contact portion between the distal end surface of the catheter shaft 10 (the opening surface of the lumen 11) and the proximal end surface of the irrigation member 20 (the center associated therewith). Intrusion of liquid into the lumen 13) can be reliably prevented.

  Further, each of the guide groove 26 formed in the irrigation member 20 and the guide groove 36 formed in the tip electrode 30 is formed so as to be inclined outward with respect to the axial direction of the irrigation member 20, so that it has a certain size. Can be sufficiently irrigated even on the surface of a large tip electrode (tip electrode 30 having a D1 / D2 value of 1.0 or more).

As mentioned above, although one Embodiment of this invention was described, this invention is not limited to these, A various change is possible.
For example, the number of openings in the irrigation member does not have to be 8, and can be appropriately selected within a range of 3 to 12, for example.
Further, the internal structure of the catheter shaft is not particularly limited as long as it has at least one lumen serving as a liquid flow path.
The shape of the tip electrode is not particularly limited, and may be a shell shape. However, it is necessary that a sharp edge where current is concentrated is not formed when the electrode catheter is used (cauterization).

100 Ablation catheter 10 Catheter shaft 11 Lumen (liquid flow path)
12 lumens (Tension wire insertion path)
13 Central lumen (lead wire insertion path)
15 Rigid body (wire)
20 Irrigation member 21 Outer tube part (outer tube thin part)
22 Outer tube (outer tube thick wall)
DESCRIPTION OF SYMBOLS 23 Inner pipe part 24 Storage jacket space 25 Opening 26 Liquid guide groove 27 Tensile wire insertion path 29 Relief convex part 30 Tip electrode 31 Tip bulge part 32 Neck part 33 Cylindrical part 35 Inner recessed part 36 Liquid guide groove 40 ring-shaped electrode 51 first joint tube 52 second joint tube 53 third joint tube 61 tension wire 62 tension wire 70 control handle 75 rotating plate 78 liquid injection tube 80 sealing material

Claims (6)

A catheter shaft having at least one lumen serving as a liquid flow path;
An insulating irrigation member connected to the distal end of the catheter shaft;
A tip electrode connected to the tip side of the insulating irrigation member,
The insulating irrigation member is disposed at equiangular intervals along the outer periphery of the insulating irrigation member in order to discharge the liquid storage space supplied from the catheter shaft and the liquid in the storage space. A plurality of openings, and a liquid guide groove extending in a distal direction from each of the plurality of openings,
A liquid guide groove that is continuous with each of the guide grooves of the insulating irrigation member is formed at the proximal end of the tip electrode,
The catheter shaft is formed with a central lumen for extending the lead wire of the tip electrode, and a plurality of lumens serving as liquid flow paths are arranged around the central lumen,
The insulative irrigation member has a double tube structure of an inner tube portion that defines a space communicating with the inner recess of the tip electrode and an outer tube portion, and the liquid storage space includes the inner tube portion and the inner tube portion. It is a jacket space partitioned by the outer pipe part,
By inserting the proximal end portion of the insulating irrigation member into the distal end portion of the catheter shaft, the insulating irrigation member is connected to the distal end side of the catheter shaft,
A central lumen formed in the catheter shaft communicates with an internal space of the inner tube of the insulating irrigation member via a first joint tube;
An electrode catheter characterized in that each of a plurality of lumens serving as a liquid flow path disposed on the catheter shaft communicates with a jacket space of the insulating irrigation member via a second joint tube.   The electrode catheter according to claim 1, wherein a sealing material is filled in a jacket space of the insulating irrigation member into which the second joint tube is inserted.   The plurality of guide grooves formed at the base end portion of the insulating irrigation member and the tip electrode extend in the tip direction while being inclined outward. Electrode catheter.   The tip of the tip electrode bulges, and the value of D1 / D2 is 1.0 or more, where D1 is the maximum diameter of the tip electrode and D2 is the tube diameter of the catheter shaft. The electrode catheter according to any one of claims 1 to 3. In the catheter shaft, a lumen in which a tension wire for performing a tip deflection operation extends is formed around the central lumen,
The electrode catheter according to any one of claims 1 to 4, wherein an insertion passage for the tension wire is formed in the insulating irrigation member.   The lumen in which the tension wire formed in the catheter shaft extends is communicated with the insertion path of the tension wire in the insulating irrigation member via a third joint tube. The electrode catheter as described.

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