JP2021526401A - 高周波アブレーション及び直流電気穿孔カテーテル - Google Patents
高周波アブレーション及び直流電気穿孔カテーテル Download PDFInfo
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Abstract
Description
この出願は、2018年5月21日に出願された、米国仮特許出願第62/674,314号の利益を主張し、本明細書に完全に記載されているかのように、参照により本明細書に組み込まれる。
Claims (20)
- 平面アレイ・カテーテルであって、
近位端及び遠位端を有するとともに長手方向軸を画定する細長いカテーテル・シャフトと、
可撓な平面アレイであって、
前記カテーテル・シャフトの前記遠位端に連結され、
組織に沿って当接するように構成され、
前記長手方向軸に実質的に平行に延在する2本以上のストラットを有し、
前記2本以上のストラットのそれぞれは、共通の平面に配置されるとともに当該ストラットに連結された複数の電極を有する、前記平面アレイと、
を備え、
前記複数の電極は、前記平面アレイと接触している組織の電気生理学的特性を検出するとともに前記組織を選択的にアブレーションするように構成及び配置される、平面アレイ・カテーテル。 - 前記平面アレイの前記複数の電極は、さらに、高周波組織アブレーションを実施するとともに組織のアブレーションのために単極構成及び双極構成の両方で動作するように構成される、請求項1に記載の平面アレイ・カテーテル。
- 前記複数の電極のうちの1つ又は複数は、スポット電極であり、
前記2本以上のストラットのうちの1本又は複数本は、前記複数の電極に通信可能であるとともに機械的に結合された可撓な電子回路基板を備える、請求項1に記載の平面アレイ・カテーテル。 - 前記平面アレイ・カテーテルは、さらに、
複数の温度センサであって、前記複数の温度センサのそれぞれは、前記ストラットに機械的に連結されるとともに前記複数の電極の少なくとも1つに対して熱に関する通信を実行可能に配置される、前記複数の温度センサと、
前記複数の温度センサ及び前記複数の電極と通信可能に結合されるアブレーション・コントローラ回路であって、前記アブレーション・コントローラ回路は、前記複数の温度センサによって測定された各電極付近の温度に少なくとも部分的に基づいて、各電極への電力供給を制御するように構成及び配置される、前記アブレーション・コントローラ回路と、
を備える、請求項1に記載の平面アレイ・カテーテル。 - 前記平面アレイは、さらに、前記複数の電極に通信可能に結合されるアブレーション・コントローラ回路を備え、
前記アブレーション・コントローラ回路は、
前記複数の電極から、前記平面アレイと接触している前記組織の前記電気生理学的特性を示すの信号を受信し、
前記組織の電気生理学的マップを生成し、
前記電気生理学的マップに少なくとも部分的に基づいて、前記組織のアブレーション療法を制御する
ように構成及び配置される、請求項1に記載の平面アレイ・カテーテル。 - 前記アブレーション・コントローラ回路は、さらに、各電極での所望の変化の特性に応じて、前記アブレーション療法の際に単極構成又は双極構成で前記複数の電極を動作させるように構成及び配置される、請求項5に記載の平面アレイ・カテーテル。
- 前記複数の電極は、前記平面アレイの隣り合うストラット上の各電極を含む双極電極対を含む、請求項1に記載の平面アレイ・カテーテル。
- 前記双極電極対は、前記接触している組織の電気的特性をサンプリングするとともに制御された組織アブレーション療法を実施するように構成され、
前記複数の電極は、さらに、前記接触している組織の貫壁性の変化を容易にするため、患者の皮膚に導電的に結合された接地パッドと組み合わせて、単極構成で動作するように構成される、請求項7に記載の平面アレイ・カテーテル。 - 前記複数の電極は、前記平面アレイの隣り合うストラットを斜めにわたる双極電極対を含む、請求項1に記載の平面アレイ・カテーテル。
- バスケット・カテーテルであって
近位端及び遠位端を有する細長いカテーテル・シャフトと、
前記カテーテル・シャフトの前記遠位端に結合されるとともに複数のスプラインを備え、組織に沿って当接するように構成される可撓なバスケットと、
前記複数のスプラインに取り付けられた複数の電極と、
を備え、
前記複数の電極は、前記バスケットと接触している組織の電気生理学的特性を検出するとともに前記組織を選択的にアブレーションするように構成及び配置される、バスケット・カテーテル。 - 前記複数のスプライン上の前記複数の電極は、さらに、高周波組織アブレーションを実施するとともに組織のアブレーションのために単極構成及び双極構成の両方で動作するように構成される、請求項10に記載のバスケット・カテーテル。
- 前記複数の電極のうちの1つ又は複数は、スポット電極であり、
前記前記複数のスプラインは、前記複数の電極に通信可能であるとともに機械的に結合された可撓な電子回路基板を備える、請求項10に記載のバスケット・カテーテル。 - 前記バスケット・カテーテルは、さらに、
複数の温度センサであって、前記複数の温度センサのそれぞれは、前記スプラインに機械的に連結されるとともに前記複数の電極の少なくとも1つに対して熱に関する通信を実行可能に配置される、前記複数の温度センサと、
前記複数の温度センサ及び前記複数の電極と通信可能に結合されるアブレーション・コントローラ回路であって、、前記アブレーション・コントローラ回路は、前記複数の温度センサによって測定された各電極付近の温度に少なくとも部分的に基づいて、各電極への電力供給を制御するように構成及び配置される、前記アブレーション・コントローラ回路と、
を備える、請求項10に記載のバスケット・カテーテル。 - 前記バスケット・カテーテルは、さらに、前記複数の電極に通信可能に結合されるアブレーション・コントローラ回路を備え、
前記アブレーション・コントローラ回路は、
前記複数の電極から、前記バスケットと接触している前記組織の前記電気生理学的特性を示す信号を受信し、
前記組織の電気生理学的マップを生成し、
前記電気生理学的マップに少なくとも部分的に基づいて、前記組織のアブレーション療法を制御する
ように構成及び配置される、請求項10に記載のバスケット・カテーテル。 - 前記アブレーション・コントローラ回路は、さらに、各電極での所望の変化の特性に応じて、前記アブレーション療法の際に単極構成又は双極構成で前記電極を動作させるように構成及び配置される、請求項14に記載のバスケット・カテーテル。
- 前記アブレーション・コントローラ回路は、さらに、前記複数の電極を双極構成で動作させるとともに高電圧直流を前記接触している組織に供給して組織のアブレーションに影響を与えるように構成及び配置され、且つ
前記アブレーション・コントローラ回路は、さらに、前記複数の電極への電流引き込みを最小限に抑えるとともに所望の電圧勾配を供給するように構成及び配置される、請求項14に記載のバスケット・カテーテル。 - 前記複数の電極は、前記バスケットの隣り合うスプラインを斜めにわたる双極電極対を含む、請求項10に記載のバスケット・カテーテル。
- 前記双極電極対は、前記接触している組織の電気的特性をサンプリングするとともに制御された組織アブレーション療法を実施するように構成され、
前記複数の電極は、さらに、前記接触している組織の貫壁性の変化を容易にするため、患者の胸部に導電的に結合された接地パッドと組み合わせて動作するように単極構成で構成される、請求項17に記載のバスケット・カテーテル。 - 前記複数の電極は、隣り合うスプライン上の電極を有する双極電極対を含む、請求項10に記載のバスケット・カテーテル。
- 前記平面アレイの前記複数の電極は、さらに、双極構成で動作するとともに前記接触している組織に高電圧直流を供給して組織のアブレーションに影響を与えるように構成される、請求項1に記載の平面アレイ・カテーテル。
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