JP2013111332A - Cauterization condition notification device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cauterization condition notification device which permits the cauterization condition of an affected region to be easily and reliably ascertained in a myocardial ablation therapy.SOLUTION: The cauterization condition notification device includes: a biological impedance acquisition section 320 acquiring the value of biological impedance between an electrode catheter 120 and a counter electrode plate 140 during energization between the electrode catheter 120 brought into contact with the myocardium and the counter electrode plate 140 pasted to a body surface; a notification sound output control section 340 outputting a control signal varying a notification sound in accordance with the change of the biological impedance acquired by the biological impedance acquisition section 320; and a notification sound output section 290 outputting the notification sound on the basis of the control signal from the notification sound output control section 340. Consequently, the cauterization condition notification device permits the cauterization condition of the affected region to be intuitively obtained only by hearing the notification sound. The notification device, therefore, permits the cauterization condition of the affected region to be easily and reliably ascertained.

Description

  The present invention relates to an ablation state notification device, for example, for use in a high-frequency output device that conducts a high-frequency current between an electrode catheter that is in contact with the myocardium and a counter electrode that is attached to the body surface in order to treat arrhythmia and the like. And suitable.

  2. Description of the Related Art Conventionally, in order to treat arrhythmia and the like, myocardial ablation treatment is known in which an affected part is cauterized by inserting an electrode catheter (ablation catheter) into the heart percutaneously and energizing a high-frequency current. When performing a myocardial ablation treatment, a preliminary electrophysiological examination is performed. In an electrophysiological test, an electrode catheter is placed inside the heart, and the electrical potential of each part of the heart is recorded while stimulating the myocardium using an electrical stimulation device, and the stimulation conduction system is examined and arrhythmia is induced and stopped. . Thereby, mapping (identification) of the cauterization position which is an affected part is performed.

  In myocardial ablation treatment, a doctor who is an operator operates an electrode catheter and moves the tip with the electrode little by little within the heart. At this time, the tip electrode position of the electrode catheter is imaged by an X-ray camera. The doctor confirms the electrode position by viewing the image displayed on the X-ray monitor. Then, the operator operates the high-frequency energization switch according to the doctor's instruction to turn on / off the energization to the ablation position. If it is determined from the waveforms appearing on the electrocardiogram displayed on a polygraph (cardiac potential monitor device) or the like that there is no energization effect, the energization to the ablation position is cut off according to the doctor's instruction. This operation is repeated until the effect of energization appears while changing the electrode position. And if the effect of electricity supply appears, high frequency electricity supply will be continued and the affected part will be cauterized.

  In addition, the technique which can detect the temperature of a treatment site | part correctly and can prevent an excessive heating and cauterization even if it is a beginner is proposed (for example, refer patent document 1). . The technique described in Patent Document 1 includes a first catheter on which a heating electrode is mounted and a second catheter on which a temperature sensor is mounted, and includes a second catheter for temperature measurement and a first catheter for treatment. Are placed in different positions. And the electric power applied to the electrode for a heating of a 1st catheter is controlled based on the output signal from a temperature sensor.

JP 2006-325916 A

  By the way, the cauterization state of the affected part in the conventional myocardial ablation treatment has been determined by a doctor based on the temperature of the affected part, the high frequency power supplied to the affected part, the bioimpedance of the affected part, and the energization time in high frequency energization. Specifically, the doctor visually observes the display unit on which the temperature, high-frequency power, bioelectrical impedance, and energization time are displayed, and the temperature, high-frequency power, bioimpedance, and energization time that the operator reads and reads the display unit. By listening, they made a comprehensive judgment about the ablation of the affected area.

  However, as described above, in the case of myocardial ablation treatment, in addition to an electrocardiogram displayed on an X-ray monitor or a polygraph showing the electrode position, a display unit for displaying temperature, high-frequency power, bioimpedance, and energization time can also be considered. Therefore, the burden on the doctor is great, and it is difficult to properly instruct the timing of power-off.

  The present invention has been made to solve such a problem, and an object of the present invention is to provide an ablation state notification device capable of easily and surely determining the ablation state of an affected area during myocardial ablation treatment. And

The ablation state notification device according to the present invention acquires a bioimpedance value for obtaining a bioimpedance value between the electrode catheter and the counter electrode plate when energized between the electrode catheter in contact with the myocardium and the counter electrode affixed to the body surface. And
A notification sound output control unit that outputs a control signal for changing the notification sound in accordance with a change in the bioelectrical impedance acquired by the bioelectrical impedance acquisition unit;
A notification sound output unit that outputs a notification sound based on a control signal from the notification sound output control unit;
Is provided.

  According to the present invention, it is possible to intuitively grasp the cauterization state of the affected area simply by listening to the notification sound. Therefore, it is possible to easily and reliably determine the cautery state of the affected part. Further, by listening to the notification sound output in the operation room, doctors other than the operator and the operator can easily and reliably determine the cautery state of the affected area.

It is a block diagram which shows the structural example of the ablation system in this Embodiment. It is a flowchart which shows the operation example of the high frequency output device in this Embodiment.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is a block diagram showing a configuration example of an ablation system 100 in the present embodiment.

  The ablation system 100 includes an electrode catheter 120, a counter electrode plate 140, and a high-frequency output device 160. The electrode catheter 120 and the high-frequency output device 160 are electrically connected. Further, the counter electrode plate 140 and the high-frequency output device 160 are electrically connected. The high-frequency output device 160 functions as a cautery state notification device of the present invention.

  A high frequency current is supplied to the electrode catheter 120 from the high frequency output device 160. The electrode catheter 120 is moved by the doctor to the treatment site (myocardium) of the patient before the myocardial ablation treatment.

  The electrode catheter 120 incorporates a temperature measurement circuit 130 such as a thermistor at the tip. The temperature measurement circuit 130 measures the temperature of the treatment site and outputs the measured temperature value to the high-frequency output device 160.

  The counter electrode plate 140 is affixed to the patient's body surface (rear surface) by a doctor prior to myocardial ablation treatment. Thereafter, the high frequency output device 160 supplies a high frequency current to the electrode catheter 120 by the operation of the operator. As a result, a high-frequency current is passed between the electrode catheter 120 and the treatment site, Joule heat is generated, and the treatment site is cauterized. The high-frequency current supplied from the high-frequency output device 160 finally returns to the high-frequency output device 160 via the electrode catheter 120, the treatment site of the patient, and the counter electrode 140.

  Next, the configuration of the high-frequency output device 160 will be described. As shown in FIG. 1, the high-frequency output device 160 includes an operation receiving unit 200, an energization control unit 220, a bioelectrical impedance calculation unit 240, a display control unit 260, a display unit 280, a notification sound output unit 290, a bioelectrical impedance acquisition unit 320, and A notification sound output control unit 340 is provided. Notification sound output unit 290 includes notification sound signal generation unit 291 and speaker 292.

  The operation reception unit 200 receives various operations on the high-frequency output device 160 via an operation unit (for example, an operation switch) (not shown). The operations received by the operation receiving unit 200 include, for example, an ablation condition (output power, output voltage, etc.) setting operation, an ablation execution instruction operation, and an ablation stop instruction operation. When the operation reception unit 200 receives various operations on the high-frequency output device 160, the operation reception unit 200 notifies the energization control unit 220 of the operation content.

  When receiving a notification from the operation receiving unit 200 that the ablation execution instruction operation has been received, the energization control unit 220 starts outputting a high-frequency current to the electrode catheter 120. Further, when receiving a notification from the operation receiving unit 200 that the ablation stop instruction operation has been received, the energization control unit 220 ends the output of the high-frequency current to the electrode catheter 120. In addition, the energization control unit 220 outputs the energization time from the start of the output of the high-frequency current to the end of the output to the display control unit 260.

  Further, the energization control unit 220 outputs the high-frequency current value measured by the current measurement circuit (not shown) and the high-frequency voltage measured by the voltage measurement circuit (not shown) while outputting the high-frequency current. Is output to the bioelectrical impedance calculation unit 240. The energization control unit 220 calculates the value of the high frequency power by multiplying the value of the high frequency current and the value of the high frequency voltage, and outputs the calculated value of the high frequency power to the display control unit 260.

  The bioelectrical impedance calculation unit 240 divides the value of the high-frequency voltage output from the energization control unit 220 by the value of the high-frequency current, thereby calculating the bioimpedance of the treatment site (that is, the portion where the electrode catheter 120 is in contact with the myocardium). Calculate the value. Then, the bioelectrical impedance calculation unit 240 outputs the calculated bioelectrical impedance value to the display control unit 260 and the bioelectrical impedance acquisition unit 320.

  The display control unit 260 includes a temperature value output from the temperature measurement circuit 130, a high-frequency power value output from the energization control unit 220, an energization time value output from the energization control unit 220, and a bioelectrical impedance calculation unit. The bioelectrical impedance values output from 240 are displayed on the display unit 280, respectively. The display unit 280 is, for example, a digital display.

  The bioelectrical impedance acquisition unit 320 acquires the bioelectrical impedance value output from the bioelectrical impedance calculation unit 240, and outputs the acquired bioelectrical impedance value to the notification sound output control unit 340.

  The notification sound output control unit 340 outputs a control signal that changes the notification sound in accordance with the change in the bioelectrical impedance acquired by the bioelectrical impedance acquisition unit 320. In the present embodiment, the notification sound output control unit 340 outputs a control signal that changes the frequency of the notification sound according to the change in the bioelectrical impedance.

  Notification sound output unit 290 outputs a notification sound based on a control signal from notification sound output control unit 340. Specifically, the notification sound signal generation unit 291 included in the notification sound output unit 290 generates a notification sound signal based on the control signal output from the notification sound output control unit 340. The generated notification sound signal is output from the speaker 292 included in the notification sound output unit 290.

  Next, the operation of the high-frequency output device 160 in the present embodiment will be described. FIG. 2 is a flowchart showing an operation example of the high-frequency output device 160 in the present embodiment. Each process in FIG. 2 is a process performed in conjunction with the control cycle of the high-frequency output device 160. It is assumed that high-frequency current output to the electrode catheter 120 has already been started by the energization control unit 220.

  First, the bioelectrical impedance acquisition unit 320 acquires the bioelectrical impedance value output from the bioelectrical impedance calculation unit 240 and outputs the acquired bioelectrical impedance value to the notification sound output control unit 340 (step S100).

  Next, the notification sound output control unit 340 outputs a control signal for changing the notification sound according to the change in the bioelectrical impedance acquired by the bioelectrical impedance acquisition unit 320 (step S120).

  Finally, the notification sound output unit 290 outputs a notification sound based on the control signal from the notification sound output control unit 340 (step S140). When the process of step S140 is completed, the high-frequency output device 160 ends the process in FIG.

  As described above in detail, the high-frequency output device 160 of the present embodiment is configured such that the electrode catheter 120 and the counter electrode plate 140 are energized between the electrode catheter 120 in contact with the myocardium and the counter electrode plate 140 attached to the body surface. A bio-impedance acquisition unit 320 that acquires a bio-impedance value, a notification sound output control unit 340 that outputs a control signal that changes a notification sound according to a change in the bio-impedance acquired by the bio-impedance acquisition unit 320, and a notification sound A notification sound output unit 290 that outputs a notification sound based on a control signal from the output control unit 340 is provided.

  According to the present embodiment configured as described above, different notification sounds are output according to changes in bioelectrical impedance, which is an important index representing the cauterization state of the affected area. Accordingly, the doctor can listen to the notification sound without having to look at a lot of information (temperature, high-frequency power, bioelectrical impedance, and energization time) displayed on the display unit 280 or listen to the operator's reading. You can intuitively understand the state of shochu. Therefore, it is possible to easily and reliably determine the cautery state of the affected part. Further, by listening to the notification sound output in the operation room, doctors other than the operator and the operator can easily and reliably determine the cautery state of the affected area.

  The function of the high-frequency output device 160 according to the embodiment described above is realized by software. Actually, the high-frequency output device 160 is configured as a computer including a CPU or MPU, RAM, ROM, and the like, and can be realized by operating a program stored in the RAM or ROM. Note that it is also possible to realize by recording a program that operates so as to fulfill the functions of the present embodiment on a recording medium such as a CD-ROM and causing the high-frequency output device 160 to read the program.

  In the above-described embodiment, the example in which the frequency of the notification sound is changed as an aspect in which the notification sound is changed according to the change in the bioelectrical impedance has been described, but the present invention is not limited to this. For example, the frequency of the notification sound may be changed stepwise or gradually to a higher frequency as the bioimpedance increases. Moreover, you may make it change the tone color of a notification sound according to the change of bioimpedance. As one aspect thereof, a notification sound having a shorter output interval may be output discontinuously as the bioimpedance value is higher. Moreover, you may change the volume of a notification sound according to the change of bioimpedance.

  Moreover, although the said embodiment demonstrated the example which changes a notification sound according to the change of bioimpedance, the value of the said bioimpedance is displayed on the display part 280 by a different display mode according to the change of bioimpedance. Also good. Further, instead of displaying the value of bioimpedance, a change in bioimpedance may be notified by a change in display brightness or color. That is, the cauterization state of the affected part may be intuitively grasped by using not only hearing but also vision as in the above embodiment.

  In addition, each of the above-described embodiments is merely an example of actualization in carrying out the present invention, and the technical scope of the present invention should not be construed as being limited thereto. That is, the present invention can be implemented in various forms without departing from the gist or the main features thereof.

DESCRIPTION OF SYMBOLS 100 Ablation system 120 Electrode catheter 130 Temperature measurement circuit 140 Counter electrode 160 High frequency output device 200 Operation reception part 220 Current supply control part 240 Bioimpedance calculation part 260 Display control part 280 Display part 290 Notification sound output part 291 Notification sound signal generation part 292 Speaker 320 Bioimpedance acquisition unit 340 Notification sound output control unit

Claims (5)

A bioimpedance acquisition unit that acquires a value of bioimpedance between the electrode catheter and the counter electrode plate when energized between the electrode catheter in contact with the myocardium and a counter electrode affixed to the body surface;
A notification sound output control unit that outputs a control signal for changing the notification sound in accordance with a change in the bioelectrical impedance acquired by the bioelectrical impedance acquisition unit;
A notification sound output unit that outputs a notification sound based on a control signal from the notification sound output control unit;
A device for notifying the state of ablation.   The ablation state notification device according to claim 1, wherein the notification sound output control unit outputs a control signal that changes a frequency of the notification sound according to a change in the bioelectrical impedance.   The ablation state notification device according to claim 2, wherein the notification sound output control unit outputs a control signal for changing the frequency of the notification sound stepwise or gradually to a higher frequency in accordance with an increase in the bioelectrical impedance.   2. The cautery state notification device according to claim 1, wherein the notification sound output control unit outputs a control signal that changes a tone color of the notification sound according to a change in the bioelectrical impedance. The ablation state notification apparatus according to any one of claims 1 to 4, wherein the notification sound output control unit changes a volume of the notification sound according to a change in the bioelectrical impedance.

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