JP2022133763A - catheter - Google Patents

Abstract

To provide a catheter in which conductor wires are hardly short-circuited.SOLUTION: A catheter includes: a shaft 2 having a first side hole and a second side hole; a first electrode disposed outside the first side hole; a second electrode disposed outside the second side hole; a first conductor wire 41 connected to the first electrode; a second conductor wire 42 connected to the second electrode; and an inner member 50 disposed in a lumen 20. At least one of the shaft 2 and the inner member 50 includes at least one partition part 53 for partitioning the lumen 20 at least into a first lumen region 21 and a second lumen region 22. The first lumen region 21 and the second lumen region 22 extend along a longitudinal axis direction respectively. Parts 181 and 182 of the gap with the inner member 50 of the shaft 2 are smaller than a diameter of the first conductor wire 41 and smaller than a diameter of the second conductor wire 42. The first conductor wire 41 is disposed in the first lumen region 21 and the second conductor wire 42 is disposed in the second lumen region 22.SELECTED DRAWING: Figure 4

Description

TECHNICAL FIELD The present invention relates to an electrode catheter used for defibrillation, cauterization of body tissue, potential measurement of body organs, and the like.

Electrode catheters, which have electrodes on their shafts, are medical devices that apply electrical stimulation to treat arrhythmias such as atrial fibrillation and ventricular fibrillation, ablate body tissues, or measure the potential of organs such as the heart. It is mainly used as Electrode catheters have a plurality of electrodes disposed on the outside of a shaft having a lumen. Conductors electrically connected to the inner surface of the electrode extend through the lumen of the shaft to external equipment, such as a defibrillator power supply or an electrocardiograph. Patent Documents 1 and 2 disclose examples of devices provided with electrodes.

JP 2014-97084 A Japanese Patent Publication No. 2006-506195

Multiple conductors are placed in the lumen of the shaft, and the narrow lumen of the shaft can cause short circuits between the conductors. SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide a catheter that is less likely to short-circuit between conductors.

One embodiment of the catheter of the present invention that has achieved the above objects is a shaft that extends longitudinally from a distal end to a proximal end and has a lumen and a first side hole communicating with the lumen. and a second side hole on the proximal side of the first side hole, a first electrode arranged outside the first side hole, and a second electrode arranged outside the second side hole a first conductor electrically connected to the first electrode and extending through the first side hole into the lumen of the shaft; and a second electrode electrically connected to the shaft through the second side hole. and an inner member disposed within the lumen of the shaft, wherein at least one of the shaft and the inner member extends through the lumen of the shaft. at least one partition separating a first lumen region and a second lumen region, the first lumen region and the second lumen region each extending along a longitudinal axis, the shaft comprising: , and the inner member, a portion of the gap being less than the diameter of the first conductor and less than the diameter of the second conductor, the first conductor disposed in the first lumen region. and the gist is that the second lead wire is arranged in the second lumen region. In the catheter according to the present invention, the lumen of the shaft is partitioned by the partition section, and the size of a part of the gap between the shaft and the inner member is set as described above. The first conductor placed in the second lumen area is less likely to move to the second lumen area, and the second conductor placed in the second lumen area is less likely to move to the first lumen area. As a result, the first conducting wire and the second conducting wire are less likely to come into contact with each other, and a short circuit between the conducting wires can be prevented. In addition, since the first lumen region and the second lumen region are easily communicated with each other through the gap, it becomes easier to spread fluid such as gas for sterilization into the lumen of the shaft.

Either the shaft or the inner member may have at least one partition and the other may have no partition. At least one partition may extend from the center side of the longitudinal axis of the shaft to the inner wall side of the shaft. At least one partition may extend in the radial direction of the shaft or may extend in the longitudinal direction of the shaft. Also, the entire inner member may be at least one partition.

At least one partition may have a plurality of partitions, and the plurality of partitions may be arranged in the circumferential direction of the shaft.

At least one of the plurality of partitions may be part of the inner wall of the shaft. In that case, at least one of the plurality of partitions of the shaft may be fixed to the inner member.

At least one of the plurality of partitions may be part of the inner member. At least one of the partitions of the inner member may be fixed to the inner wall of the shaft. Also, at least one of the plurality of partitions of the inner member may extend in the longitudinal direction of the shaft, and the at least one partition may not be in contact with the inner wall of the shaft in part in the longitudinal direction. The inner member may have a tubular portion extending in the longitudinal direction of the shaft, and a plurality of partitions may be arranged around the outer periphery of the tubular portion.

At least one divider in at least one of the shaft and the inner member divides the lumen of the shaft into at least a first lumen region, a second lumen region, and a third lumen region; No leads may be placed in the cavity region. At least one partitioning portion of at least one of the shaft and the inner member divides the lumen of the shaft into at least a first lumen region, a second lumen region, a third lumen region, and a fourth lumen region. The first lumen region, the third lumen region, the second lumen region, and the fourth lumen region are arranged in this order in the circumferential direction of the shaft. No leads may be placed in the cavity region.

The length of the first conductor may be longer than the length of the lumen of the shaft. The inner member may be rotatable relative to the shaft. In a catheter, when performing defibrillation, a voltage with a polarity different from that of the first electrode may be applied to the second electrode.

In the catheter according to the present invention, the first conductor placed in the first lumen area is less likely to move to the second lumen area, and the second conductor placed in the second lumen area is also prevented from moving to the first lumen area. difficult to move to. As a result, the first conducting wire and the second conducting wire are less likely to come into contact with each other, and a short circuit between the conducting wires can be prevented. In addition, since the first lumen region and the second lumen region are easily communicated with each other through the gap, it becomes easier to spread fluid such as gas for sterilization into the lumen of the shaft.

1 is a side view of a catheter according to one embodiment of the invention; FIG. FIG. 2 is a cross-sectional view (partial side view) taken along II-II of the catheter shown in FIG. 1; FIG. 2 is a cross-sectional view (partial side view) of the catheter shown in FIG. 1 taken along line III-III. FIG. 4 is a cross-sectional view IV-IV of the catheter shown in FIG. 3; 5 is a perspective view of an inner member of the catheter shown in FIGS. 1-4; FIG. FIG. 5 is a cross-sectional view showing a modification of the catheter shown in FIG. 4; FIG. 5 is a cross-sectional view showing another modification of the catheter shown in FIG. 4; 8 is a perspective view of an inner member of the catheter shown in FIG. 7; FIG. FIG. 5 is a cross-sectional view showing another modification of the catheter shown in FIG. 4; FIG. 10 is a perspective view of an inner member of the catheter shown in FIG. 9; FIG. 5 is a cross-sectional view showing another modification of the catheter shown in FIG. 4; FIG. 12 is a cross-sectional view showing a modification of the catheter shown in FIG. 11; FIG. 5 is a cross-sectional view showing another modification of the catheter shown in FIG. 4; 4 is a cross-sectional view showing a modification of the shaft and inner member shown in FIG. 3; FIG. 15 is a cross-sectional view of the shaft and inner member shown in FIG. 14 taken along line XV-XV; FIG.

Hereinafter, the present invention will be described in more detail based on the following embodiments, but the present invention is not limited by the following embodiments, and can be modified appropriately within the scope of the above and later descriptions. It is of course possible to carry out in addition, and all of them are included in the technical scope of the present invention. In each drawing, for the sake of convenience, hatching, member numbers, etc. may be omitted. In such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various members in the drawings may differ from the actual dimensions, since priority is given to helping to understand the features of the present invention.

Catheters are used, for example, for treating and diagnosing arrhythmias such as atrial fibrillation and ventricular fibrillation. In the treatment of arrhythmia, for example, defibrillation and cauterization of body tissue can be performed by applying a high-frequency current to electrodes of a catheter. In diagnosing arrhythmia, an electrocardiogram can be obtained by inserting a catheter into a patient's body, placing electrodes in or near a tissue to be diagnosed in the heart, and measuring the electrical potential of the tissue. The catheter may be an intracardiac defibrillation catheter.

One embodiment of the catheter of the present invention is a shaft extending longitudinally from a distal end to a proximal end having a lumen, a first side hole communicating with the lumen, and a side hole proximal to the first side hole. a shaft having a second side hole on the position side; a first electrode arranged outside the first side hole; a second electrode arranged outside the second side hole; a first conductor electrically connected to the second electrode and extending into the shaft lumen through the first side hole; and a second electrode electrically connected to the second electrode and extending into the shaft lumen through the second side hole. and an inner member disposed within the lumen of the shaft, wherein at least one of the shaft and the inner member defines the lumen of the shaft at least as a first lumen region and a second lumen region. having at least one partition dividing it into two lumen regions, the first lumen region and the second lumen region each extending along a longitudinal axis, the shaft between the inner member and the inner member; a gap, a portion of the gap being smaller than the diameter of the first conductor and smaller than the diameter of the second conductor, the first conductor disposed in the first lumen region, and the second lumen region; The gist is that the second conductor is arranged in the cavity region. In the catheter according to the present invention, the lumen of the shaft is partitioned by the partition section, and the size of a part of the gap between the shaft and the inner member is set as described above. The first conductor placed in the second lumen area is less likely to move to the second lumen area, and the second conductor placed in the second lumen area is less likely to move to the first lumen area. As a result, the first conducting wire and the second conducting wire are less likely to come into contact with each other, and a short circuit between the conducting wires can be prevented. In addition, since the first lumen region and the second lumen region are easily communicated with each other through the gap, it becomes easier to spread fluid such as gas for sterilization into the lumen of the shaft.

An example configuration of the catheter will be described with reference to FIGS. 1 to 15. FIG. 1 is a side view of a catheter according to one embodiment of the invention; FIG. FIG. 2 is a cross-sectional view (partial side view) of the catheter shown in FIG. 1 taken along line II-II. FIG. 3 is a cross-sectional view (partial side view) of the catheter shown in FIG. 1 taken along line III-III. FIG. 4 is a IV-IV cross-sectional view of the catheter shown in FIG. FIG. 5 is a perspective view of an inner member of the catheter shown in FIGS. 1-4. 6 to 7, 9, 11 and 13 are sectional views showing modifications of the catheter shown in FIG. 8 is a perspective view of an inner member of the catheter shown in FIG. 7. FIG. 10 is a perspective view of an inner member of the catheter shown in FIG. 9. FIG. 12 is a sectional view showing a modification of the catheter shown in FIG. 11. FIG. 14 is a cross-sectional view showing a modification of the shaft and inner member shown in FIG. 3; FIG. 15 is a cross-sectional view of the shaft and inner member shown in FIG. 14 taken along line XV-XV. The catheter 1 has a shaft 2 , a first electrode 31 , a second electrode 32 , a first lead 41 , a second lead 42 and an inner member 50 .

The distal side of the catheter 1 refers to the distal end side of the shaft 2 in the longitudinal direction x and the treatment target side. The proximal side of the catheter 1 refers to the proximal end side of the shaft 2 in the longitudinal direction x and the user's hand side. When each member is divided into two halves along its longitudinal axis, the proximal side may be called the proximal portion, and the distal side may be called the distal portion.

The shaft 2 is an elongated member having a longitudinal axis direction x, a radial direction and a circumferential direction p. The shaft 2 extends in the longitudinal direction x from the distal end to the proximal end. Catheter 1 is inserted into the patient's body from the distal end side of shaft 2 . A handle 70 gripped by the operator is preferably connected to the proximal portion of the shaft 2 . The shaft 2 may have an insertion path for a guide wire that guides the advancement of the shaft 2 therein. Catheter 1 may include a guidewire extending in longitudinal direction x.

Shaft 2 has a bore 20 . Lumen 20 extends in longitudinal direction x. A plurality of lumens 20 may be provided for one shaft 2, but preferably only one is provided. Shaft 2 preferably has a tubular structure for arranging the conductors in its lumen 20 . The lumen 20 of the shaft 2 is arranged over the entire lengthwise direction x of the shaft 2, and preferably has openings on the distal end side and the proximal end side of the shaft 2, respectively.

A distal tip 72 may be arranged at the distal end of the shaft 2 . The distal tip 72 may be composed of a conductive material or an insulating material. The tip 72 may block part or all of the opening on the distal end side of the shaft 2 .

Shaft 2 preferably has flexibility. As a result, the shaft 2 can be deformed along the shape of the body cavity. The shaft 2 preferably has elasticity for shape retention. Shaft 2 is preferably made of resin, metal, or a combination of resin and metal. The shaft 2 may be a resin tube; a metal tube; a hollow body formed by arranging wires in a predetermined pattern; , such as those connected in the longitudinal direction. A resin tube can be manufactured, for example, by extrusion molding. Hollow bodies in which wires are arranged in a predetermined pattern include tubular bodies having a mesh structure simply by crossing or weaving wires, and coils in which wires are wound. The wire may be one or more solid wires or one or more twisted wires. The cross-sectional shape of the wire may be circular, oval, polygonal, or a combination thereof, for example. The oval shape includes an elliptical shape, an oval shape, and a rounded rectangular shape, and the same applies to the following description. The type of network structure is not particularly limited, nor is the number of coil turns or density. The mesh structure or coils may be formed with a constant density over the entire longitudinal direction of the shaft 2 or may be formed with different densities depending on the position in the longitudinal direction of the shaft 2 . In order to increase the flexibility of the metal tube, the outer surface of the metal tube may be cut or grooved. The shape of the incision or groove can be linear, arcuate, annular, spiral, or a combination thereof. When the shaft 2 is a cylindrical resin tube, the shaft 2 can be composed of a single layer or a plurality of layers. It may be composed of multiple layers.

By using resin as the constituent material of the shaft 2, it becomes easy to impart flexibility and elasticity to the shaft 2. As shown in FIG. By using metal as the constituent material of the shaft 2, the deliverability of the catheter 1 can be improved. Examples of resins that constitute the shaft 2 include polyolefin resins (eg, polyethylene and polypropylene), polyamide resins (eg, nylon), polyester resins (eg, PET), aromatic polyether ketone resins (eg, PEEK), and polyether polyamides. Resins, polyurethane resins, polyimide resins, fluorine resins (eg, PTFE, PFA, ETFE), vinyl chloride resins, synthetic resins such as silicone resins, natural rubbers, synthetic rubbers, and the like. Examples of the metal forming the shaft 2 include stainless steel such as SUS304 and SUS316, carbon steel, platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni—Ti alloy, Co—Cr alloy, or combinations thereof. is mentioned. These may use only 1 type and may use 2 or more types together. The shaft 2 may be a laminated structure of different materials or the same material.

The shaft 2 is configured to be bendable. The shaft 2 may be curved two-dimensionally or three-dimensionally. That the shaft 2 bends in a plane means that the distal end and the proximal end of the bending portion of the shaft 2 are substantially on the same plane before and after bending. Bending three-dimensionally means that the curved portion of the shaft 2 is different from the plane on which the distal end and the proximal end of the portion lie before bending and the plane on which they lie after bending. . That is, it means that the shaft 2 is twisted by bending.

The shaft 2 has a plurality of side holes. The side holes are arranged in the wall of the shaft 2, in particular in the peripheral wall. The side hole is arranged so as to penetrate from the outside of the shaft 2 to the lumen 20 . A wire connected to the electrode through the side hole can be inserted into the lumen 20 . In FIG. 2 , the shaft 2 has at least a first side hole 11 and a second side hole 12 , the second side hole 12 being proximal to the first side hole 11 . The first side hole 11 and the second side hole 12 communicate with the lumen 20 of the shaft 2 . The number of side holes arranged in one shaft 2 should be two or more, and can be set according to the number of electrodes. In the catheter 1 shown in FIGS. 1 and 2, although not shown, the shaft 2 has six side holes on the proximal side of the second side hole 12, and electrodes are arranged in these side holes. there is

The first side hole 11 and the second side hole 12 may be aligned in the longitudinal axis direction x of the shaft 2 . The first side hole 11 and the second side hole 12 extend in the circumferential direction p of the shaft 2 so as to facilitate the arrangement of the first conducting wire 41 in the first lumen region 21 and the second conducting wire 42 in the second lumen region 22 . are preferably arranged at different positions. For example, in the circumferential direction p, the center of the first side hole 11 and the center of the second side hole 12 are preferably shifted by 45° or more, more preferably by 60° or more, and 90° or more. It is more preferable that they are shifted, and they may be shifted by 180° or less, 140° or less, or 120° or less. In FIG. 2, the center of the first side hole 11 and the center of the second side hole 12 in the circumferential direction p are at positions shifted by 180°.

The shape of the side hole when the shaft 2 is viewed from the direction perpendicular to the longitudinal axis direction x can be circular, oval, polygonal, or a combination thereof. The side hole may have its central axis aligned with the radial direction of the shaft 2 so that its central axis extends radially inward from the distal side of the shaft 2 toward the proximal side. may be distributed.

Electrodes are arranged outside the side hole of the shaft 2 . The electrodes can have at least one of the functions of defibrillation, cauterization, potential measurement, and reference during potential measurement. A reference electrode is, for example, a ground electrode. In FIG. 2 , the first electrode 31 is arranged outside the first side hole 11 and the second electrode 32 is arranged outside the second side hole 12 . Although the first electrode 31 is the most distal electrode in FIGS. 1-2, it need not be the most distal. In FIGS. 1 and 2, the second electrode 32 is one electrode closer to the first electrode 31 than the first electrode 31, but another electrode may be arranged between the first electrode 31 and the second electrode 32. good.

Besides the first electrode 31 and the second electrode 32, the catheter 1 may have one or more electrodes. In FIG. 1, a third electrode 33, a fourth electrode 34, a fifth electrode 35, a sixth electrode 36, a seventh electrode 37, and an eighth electrode 38 are arranged on the proximal side of the second electrode 32 in order toward the proximal side. are distributed. The eighth electrode 38 is the most proximal electrode. It is preferable that one electrode is arranged outside each of the side holes that the shaft 2 has.

Examples of the shape of the electrode include a ring shape, a C-shaped cross section in which the ring is notched, and a coil shape in which a wire is wound. The electrodes can be attached to the shaft 2 by crimping the electrodes from the outside of the shaft 2 . The electrodes may be sheets, lamellas or chips of any shape arranged on the shaft 2 .

The electrodes may be made of a conductive material, and may be made of metal or a mixture containing resin and metal. More specifically, conductive resins, platinum, platinum-iridium alloys, stainless steel, tungsten, and other metals can be used as materials for forming the electrodes. When the electrodes are made of a conductive resin, a contrast agent such as barium sulfate or bismuth oxide may be mixed.

The conducting wires electrically connect the electrodes to external devices of the catheter 1, such as a defibrillation power supply, an ablation power supply, an electrocardiograph, and the like. A wire is electrically connected to the electrode and extends through the side hole into the lumen 20 . Preferably, the wires are routed outside the inner member 50 within the shaft 2 . In other words, it is preferable that the conductors are not arranged so as to be enclosed in the inner member 50 . In FIG. 2, a first conductor 41 is electrically connected to the first electrode 31 and extends through the first side hole 11 into the lumen 20 of the shaft 2 . A second conductor 42 is electrically connected to the second electrode 32 and extends through the second side hole 12 into the lumen 20 of the shaft 2 . It is preferable that one conducting wire is connected to one electrode in this manner. 3 and 4 show only the first conducting wire 41 and the second conducting wire 42 for the sake of simplification, the conducting wires are also connected to the third electrode 33 to the eighth electrode 38, respectively.

The conducting wire may be electrically conductive, and for example, copper wire, iron wire, stainless steel wire, piano wire, tungsten wire, nickel-titanium wire, or the like can be used. In order to prevent short-circuiting with adjacent members, portions other than both ends in the longitudinal direction of the conductor may be covered with a covering material such as a covering tube. The covering material may be made of an insulating material. The electrodes and conductors can be connected by laser welding, resistance welding, bonding with an adhesive, or the like.

The length of the conductors is not particularly limited, but the length of each conductor may be longer or shorter than the length of the lumen 20 of the shaft 2 . For example, the length of the first conductor 41 may be longer than the length of the lumen 20 of the shaft 2 . Also, the length of the second conductor 42 may be longer than the length of the lumen 20 of the shaft 2 . Even if the conducting wires are longer than the lumen 20 of the shaft 2 and thus tend to bend in the lumen 20, the presence of the partition can prevent short circuits between the conducting wires.

Inner member 50 is disposed within lumen 20 of shaft 2 . Inner member 50 may function as a partition member that partitions lumen 20 . Alternatively, the inner member 50 may function as a housing member that houses an operating wire or elastic member for bending the shaft 2 or a guide wire for guiding the advancement of the shaft 2 .

As shown in FIGS. 2-3, inner member 50 has distal end 51 and proximal end 52 . Although the shape of the inner member 50 is not particularly limited, it is preferably an elongated member extending in the longitudinal direction x of the shaft 2 . The inner member 50 as a whole has, for example, a cylindrical shape, a plate shape, a shape in which a plate is partially bent, a coil shape, a longitudinal direction and a width direction orthogonal thereto, and the width varies depending on the position in the longitudinal direction. It may have different shapes (eg fishbone shape) or a combination of these shapes. 2 to 5 show an example in which the inner member has an elongated plate shape.

It is preferable that the inner member 50 is arranged only partially in the longitudinal direction x of the shaft 2 . Moreover, it is preferable that the inner member 50 is not arranged over the entire longitudinal axis direction x of the shaft 2 .

A distal end 51 of inner member 50 may coincide with the distal end of shaft 2 . Also, as shown in FIG. 2, the distal end 51 of the inner member 50 may be positioned closer to the proximal side than the distal end of the shaft 2, and the most distal side hole (the first side hole 11 in FIG. 2) ) may be located distal to the distal end of the . The inner member 50 may also be located inside the distal tip 72 .

As shown in FIG. 3, the proximal end 52 of the inner member 50 may be located proximal to the proximal end of the most proximal side hole. The proximal end 52 of the inner member 50 may be located distal to the proximal end of the shaft 2 . Alternatively, the inner member 50 may extend from the proximal end of the shaft 2 and the proximal end 52 of the inner member 50 may be located proximal to the proximal end of the shaft 2 . In that case, a portion of the inner member 50 would be located inside the handle 70 .

The inner member 50 preferably curves as the shaft 2 curves. For this reason, the inner member 50 preferably has flexibility. Also, the inner member 50 may have elasticity. The inner member 50 can be constructed from materials listed as preferred materials of construction for the shaft 2 . The constituent material of the inner member 50 may be the same as or different from the constituent material of the shaft 2 .

At least one of the shaft 2 and the inner member 50 of the catheter 1 has at least one partition that partitions the lumen 20 of the shaft 2 into at least a first lumen region 21 and a second lumen region 22. . The first lumen region 21 and the second lumen region 22 each extend along the longitudinal direction x. The shaft 2 has a gap with the inner member 50 , part of the gap being smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42 . A first conductor 41 is arranged in the first lumen region 21 and a second conductor 42 is arranged in the second lumen region 22 . Here, a portion of the gap means at least one of the plurality of gaps when there are a plurality of gaps. For example, in FIG. 4 the shaft 2 has at least gaps 181,182. The size 181D of the gap 181 is smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42 . Also, the size 182D of the gap 182 is smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42 . The first conducting wire 41 arranged in the first lumen region 21 cannot pass through the gaps 181 and 182, so that it becomes difficult to move to the second lumen region 22, and the second conducting wire 42 arranged in the second lumen region 22 Moreover, since it cannot pass through the gaps 181 and 182, it becomes difficult to move to the first lumen region 21.例文帳に追加Therefore, the first conducting wire 41 and the second conducting wire 42 are less likely to come into contact with each other, and a short circuit between the conducting wires can be prevented. Furthermore, since the first lumen region 21 and the second lumen region 22 communicate with each other through the gaps 181 and 182, the lumen 20 of the shaft 2 can be easily filled with fluid such as gas for sterilization.

At least one of the shaft 2 and the inner member 50 should have at least one partition, and at least one of the shaft 2 and the inner member 50 may have a plurality of partitions. In FIGS. 2 to 10 and 14 to 15, the inner member 50 has partitions, in FIGS. 11 to 12 the shaft 2 has partitions, and in FIG. 13 the shaft 2 and the inner member 50 each have partitions. It shows an example with

As shown in FIGS. 2-12 and 14-15, it is preferred that only one of the shaft 2 and the inner member 50 has at least one partition and the other does not. Since the lumen 20 is partitioned by only one of the shaft 2 and the inner member 50, the size of the gap between the shaft 2 and the inner member 50 can be easily adjusted.

The number of lumen regions formed by the partition may be 2 or more, may be 3 or more, 4 or more, or may be 8 or less, or 7 or less. Preferably, the plurality of lumen regions are aligned in the circumferential direction p of the shaft. Preferably, the multiple lumen regions are in communication with each other through gaps.

When the at least one partition partitions the lumen 20 of the shaft 2 into at least a first lumen region 21, a second lumen region 22 and a third lumen region 23, the first lumen region 21 is provided with a first conductor 41, the second lumen region 22 is provided with a second conductor 42, and the third lumen region 23 is preferably not provided with any conductor. Thereby, a member other than the first conductor 41 and the second conductor 42 can be arranged in the third lumen region 23 . 7-8, the inner member 50 has a first partition 531, a second partition 532 and a third partition 533. In FIGS. The first partition 531 partitions the lumen 20 into the first lumen region 21 and the second lumen region 22, and the second partition 532 divides the lumen 20 into the second lumen region 22 and the third lumen region. 23 , and a third partition 533 partitions the lumen 20 into the third lumen region 23 and the first lumen region 21 .

The at least one partition partitions the lumen 20 of the shaft 2 into at least a first lumen region 21, a second lumen region 22, a third lumen region 23 and a fourth lumen region 24, and the shaft 2, the first lumen region 21, the third lumen region 23, the second lumen region 22, and the fourth lumen region 24 are arranged in this order, and the third lumen region 23 and the fourth lumen region 24 are arranged in this order. Preferably, no conductors are placed in lumen region 24 . Since the first lumen region 21 and the second lumen region 22 can be separated by the third lumen region 23 and the fourth lumen region 24, the first conductor wire 41 and the second conductor wire 42 are less likely to come into contact with each other. In addition, members other than conducting wires can be arranged in the third lumen region 23 and the fourth lumen region 24 . 9-10, the inner member 50 has a first partition portion 531, a second partition portion 532, a third partition portion 533, and a fourth partition portion 534. In FIGS. As shown in FIG. 9, these partitions 531 to 534 divide the lumen 20 into first to fourth lumen regions 21 to 24 . A gap 181 is provided between the inner wall 5 of the shaft 2 and the inner member 50 by the first partition 531 . Similarly, gaps 182, 183, and 184 are arranged by the second partition portion 532, the third partition portion 533, and the fourth partition portion 534, respectively.

For example, as shown in FIGS. 7, 9, and 11 to 12, between two lumen regions adjacent in the circumferential direction p, a gap smaller than the diameter of all conductors of the catheter 1 may be arranged. preferable. By providing the partition so as to form a gap in this way, it is possible to prevent a short circuit between the conductors connected to the electrodes to which voltages of different polarities are applied.

Inner member 50 may be movable relative to shaft 2 . Since the inner member 50 can be moved, the conductor wire can be easily moved appropriately, so that the conductor wire can be prevented from being stretched due to the bending of the shaft 2 and the inner member 50. - 特許庁The inner member 50 may be slidable relative to the shaft 2 in the longitudinal direction x, and the inner member 50 may be rotatable relative to the shaft 2 .

An inner member 50 may be disposed in lumen 20 for rotation about the longitudinal axis of shaft 2 . However, the rotation range of the inner member 50 with respect to the shaft 2 is preferably 90° or less, preferably 60° or less, so that the first conductor 41 and the second conductor 42 can move within the shaft 2 only within a certain range. More preferably, 45° or less is even more preferable. The rotation range of the inner member 50 with respect to the shaft 2 may be 5° or more, 10° or more, or 20° or more.

The inner member 50 may be movably fixed relative to the shaft 2 . Inner member 50 may be rotatably fixed relative to shaft 2 . For example, the inner member 50 may have an engaging portion, and the shaft 2 may have an engaged portion that engages with the engaging portion.

The inner member 50 may be fixed to the shaft 2 so as not to slide in the longitudinal direction x with respect to the shaft 2 in order to prevent the conductive wire from being crushed due to excessive displacement of the inner member 50 . For the same reason, the inner member 50 may be fixed to the shaft 2 so that the inner member 50 does not rotate with respect to the shaft 2 .

Below, the configuration common to the partitioning portion arranged on the shaft 2 and the partitioning portion arranged on the inner member 50 will be described. At least one partition preferably extends from the center side of the longitudinal axis of shaft 2 to the inner wall 5 side of shaft 2 . This configuration allows the lumens 20 to be partitioned so that each lumen region is of moderate size while avoiding an increase in the profile of the shaft 2 . For example, in FIG. 6 , two partitions 531 and 532 of the inner member 50 extend from the center of the longitudinal axis of the shaft 2 toward the inner wall 5 . In FIG. 11, four partitions 161 to 164 of shaft 2 extend from inner wall 5 of shaft 2 toward the center of the longitudinal axis.

In a cross section perpendicular to the longitudinal axis direction x of the shaft 2, the partition may extend linearly or may extend curvedly. Moreover, in a cross section perpendicular to the longitudinal axis direction x of the shaft 2 , the partition portion may extend so as to bend in the circumferential direction p of the shaft 2 . For example, the partition may extend from the longitudinal axis center side of the shaft 2 to the inner wall 5 side of the shaft 2 so that the position of the partition in the circumferential direction p changes.

At least one partition preferably extends in the radial direction of the shaft 2 . This configuration allows the lumens 20 to be partitioned so that each lumen region is of moderate size while avoiding an increase in the profile of the shaft 2 . For example, in FIG. 4, the partition portion 53 extends in the radial direction of the shaft 2 . The inner member 50 is arranged inside the shaft 2 so that the partition portion 53 passes through the center of the longitudinal axis of the shaft 2 .

At least one partition preferably extends in the longitudinal direction x of the shaft 2, for example as shown in FIGS. This makes it easier to prevent short circuits between the conductors over a wide range in the longitudinal direction x of the shaft 2 .

It is preferable that the partition part is arranged only in a part of the shaft 2 in the longitudinal direction x. Moreover, it is preferable that the partition part is not arranged over the entire longitudinal axis direction x of the shaft 2 .

It is preferable that at least a part of the partition is arranged closer to the proximal side than the most proximal side hole. For example, in FIG. 3, the partition part 53 exists to a position on the proximal side of the most proximal side hole. This prevents short circuits between the conductors at the proximal portion of the shaft 2 . In addition, the proximal end of the partition may be located on the distal side of the proximal end of the most proximal side hole.

At least a part of the partition may be arranged on the distal side of the most proximal side hole, or may be arranged on the distal side of the most distal side hole. For example, in FIG. 2, the distal end of the partition part 53 is on the distal side of the distal end of the distalmost first side hole 11 . With this configuration, it is possible to prevent short circuits between the conductors over a wide range of the shaft 2 .

Since the number of conducting wires present in the shaft 2 increases as it is closer to the proximal end side of the shaft 2 , the partition is preferably arranged in the proximal portion of the shaft 2 . In addition, the partition does not have to be arranged on the distal side of the proximal end of the most proximal side hole. In addition, when the catheter 1 has one or more electrodes in addition to the first electrode 31 and the second electrode 32, the partition is inside the electrode to which the voltage of the same polarity as the first electrode 31 is applied. It does not have to be arranged distally of the proximal end of the side hole.

For example, as shown in FIGS. 6, 7 and 9, at least one partition may have a plurality of partitions. This configuration facilitates partitioning the lumen 20 of the shaft 2 into multiple lumen regions. The number of partitions disposed in the lumen 20 of the shaft 2 may be 1 or more, preferably 2 or more, may be 3 or more, 4 or more, and may be 8 or less and 7 or less. is also allowed.

Preferably, at least one of the plurality of partitions extends from the distal end of the most distal side hole to the proximal end of the most proximal side hole. More preferably, all partitions extend from the distal end of the most distal side hole to the proximal end of the most proximal side hole.

The plurality of partitions are preferably arranged in the circumferential direction p of the shaft 2 . This configuration facilitates partitioning the lumen 20 of the shaft 2 into multiple lumen regions. The plurality of partitions may be arranged at regular intervals in the circumferential direction p of the shaft 2 . For example, in FIG. 6, the centers of the two partitions 531 and 532 are shifted by 180° in the circumferential direction p, and in FIG. 7 the centers of the three partitions 531 to 533 are shifted by 120°. The centers of the four partitions 531 to 534 are shifted by 90°.

The plurality of partitions may be arranged so as to circle from the distal end side of the shaft 2 toward the proximal end side. For example, a plurality of partitions may be spirally arranged. In this case, each lumen region also extends spirally.

When viewed from the longitudinal axis direction x of the shaft 2, the plurality of partitions may have a rotationally symmetrical shape, and have a line-symmetrical shape with respect to a straight line passing through the center of the longitudinal axis of the shaft 2. good too. The plurality of partitions may have the same shape or different shapes.

An example in which the shaft 2 has at least one partition will be described below. At least one partition is preferably arranged on the inner wall 5 of the shaft 2 , more preferably a plurality of partitions are arranged on the inner wall 5 of the shaft 2 . Moreover, it is more preferable that at least one of the plurality of partitions of the shaft 2 is a part of the inner wall 5 of the shaft 2 . With this configuration, the size of the gap between the shaft 2 and the inner member 50 can be adjusted by changing the structure of the shaft 2 . 11 and 12, the inner wall 5 of the shaft 2 is provided with four partitions 161-164. In FIG. 11 , the partition 161 provides a gap 181 between the partition 161 and the inner member 50 . Similarly, partitions 162, 163, 164 provide gaps 182, 183, 184, respectively. In FIG. 12, gaps 181, 182 and 183 are provided by partitions 161, 162 and 163, respectively.

The partition portion of the shaft 2 is preferably a convex portion protruding from the inner wall 5 side of the shaft 2 toward the center of the longitudinal axis of the shaft 2 . The convex portion may be a projection or a ridge extending in the longitudinal axis direction x of the shaft 2 .

In a cross section perpendicular to the longitudinal axis direction x of the shaft 2 , the partition portion of the shaft 2 may have a shape that tapers toward the center of the longitudinal axis of the shaft 2 .

It is preferable that the gap between the partition portion of the shaft 2 and the inner member 50 is smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42 . Further, it is more preferable that the gaps between all the partitions of the shaft 2 and the inner member 50 are smaller than the diameters of all the conductors.

As shown in FIG. 11, the gap between the outer end of the partition and the outer surface of the inner member 50 in the radial direction of the shaft 2 is preferably smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42. . Further, it is more preferable that the gaps between the outer ends of the partitions in the radial direction of the shaft 2 and the outer surface of the inner member 50 be smaller than the diameters of all the conductors.

At least one partition of the shaft 2 may be in contact with the inner member 50 . For example, at least one partition portion of the shaft 2 may be fixed to the inner member 50 , or at least one of a plurality of partition portions of the shaft 2 may be fixed to the inner member 50 . Since the inner member 50 is less likely to move relative to the shaft 2, the size of each lumen region is maintained during use of the catheter 1, and as a result, collapse of the first conductor 41 and the second conductor 42 is less likely to occur. In FIG. 12, four partitions 161 to 164 are arranged on the inner wall 5 of the shaft 2 in the same manner as in FIG. 11 in that there is no gap between 50 and .

At least one of the plurality of partitions of the shaft 2 may be fixed to the inner member 50 and the rest may not be fixed to the inner member 50 . The partition portion of the shaft 2 fixed to the inner member 50 may be fixed to the inner member 50 only partially in the longitudinal direction of the partition portion, and the entire longitudinal direction of the partition portion may be fixed to the inner member 50. It may be fixed.

Preferably, at least one of the plurality of partitions of the shaft 2 extends in the longitudinal direction x, and the at least one partition is not in contact with the inner member 50 in part in the longitudinal direction x. A gap can be formed between the inner wall 5 of the shaft 2 and the partition portion that is not in contact with the inner member 50 .

At least one of the plurality of partitions of the shaft 2 may be fixed to the inner member 50 entirely in the longitudinal axis direction x. In that case, the number of partitions fixed to the inner member 50 is preferably less than the number of partitions not fixed to the inner member 50 . This facilitates communication between the first lumen region 21 and the second lumen region 22 through the gap while positioning the inner member 50 within the shaft 2 so that the inner member 50 does not move relative to the shaft 2 . .

All partitions of the shaft 2 may be fixed to the inner member 50 . In that case, at least one partition of the shaft 2 is preferably fixed to the inner member 50 only partially in the longitudinal direction x. That is, it is preferable that a gap exists between at least one partition and the inner member 50 .

An example in which the inner member 50 has at least one partition will be described below. More preferably, a plurality of partitions are arranged on the inner member 50 as shown in FIGS. 2-10 and 14-15. Moreover, it is more preferable that at least one of the plurality of partitions is a part of the inner member 50 . By changing the configuration of the inner member 50, the size of the gap between the shaft 2 and the inner member 50 can be adjusted.

When the inner member 50 has a partition portion, the partition portion may be arranged only in a part of the inner member 50 in the longitudinal direction, as shown in FIGS. Partitions may be arranged along the entire longitudinal axis of 50 .

The partition portion of the inner member 50 is preferably a convex portion extending from the center side of the longitudinal axis of the shaft 2 toward the inner wall 5 side of the shaft 2 . The convex portion may be a projection or a ridge extending in the longitudinal axis direction x of the shaft 2 .

In a cross section perpendicular to the longitudinal axis direction x of the shaft 2 , the partition portion of the inner member 50 may have a shape that tapers toward the inner wall 5 side of the shaft 2 .

At least part of the inner member 50 may be at least one partition. Also, the entire inner member 50 may be at least one partition. With this configuration, the space inside the shaft 2 can be effectively utilized. For example, in FIGS. 2 to 5, the inner member 50 has one long flat plate-shaped partition portion 53 . By arranging the inner member 50 in the lumen 20 , it is possible to divide one side of the partition 53 into the first lumen region 21 and the other side of the partition 53 into the second lumen region 22 . .

The inner member 50 may be configured by combining at least one plate-shaped partition. The thickness of the partition portion of the inner member 50 may be constant as shown in FIGS. You may have a part that is At least one of the plurality of partitions of the inner member 50 may have a constant thickness, and the remaining partitions may have portions that are thinner toward the inner wall 5 side of the shaft 2 .

The inner member 50 preferably has a cylindrical portion extending in the longitudinal direction x of the shaft 2, and a plurality of partitions are arranged on the outer periphery of the cylindrical portion. 9 to 10, four partitions 531 to 534 are arranged around the cylindrical portion 54. In FIGS. Each of the partitions 531-534 is a ridge extending in the longitudinal direction x. With this configuration, a member such as a guide wire can be passed through the lumen 55 of the cylindrical portion 54, and the partitions 531 to 534 make it difficult for the first conductor 41 and the second conductor 42 to come into contact with each other.

4, 6, 7 and 9, the gap between the partition of the inner member 50 and the shaft 2 is smaller than the diameter of the first conductor 41 and smaller than the diameter of the second conductor 42. is preferred. Further, it is more preferable that the gaps between all the partitions of the inner member 50 and the shaft 2 are smaller than the diameters of all the conductors.

4, 6, 7 and 9, the gap between the outer end of the partition of the inner member 50 and the inner wall 5 of the shaft 2 in the radial direction of the shaft 2 is smaller than the diameter of the first conducting wire 41, Moreover, it is preferably smaller than the diameter of the second conducting wire 42 . Further, it is more preferable that the gaps between the outer ends of the partitions in the radial direction of the shaft 2 and the inner wall 5 of the shaft 2 are smaller than the diameters of all the conductors.

As shown in FIG. 7, when the first lumen region 21, the second lumen region 22, and the third lumen region 23 are arranged in this order in the circumferential direction p of the shaft 2, the first lumen region 21, the second lumen region 22, and the third lumen region 23 are arranged in this order. A gap 181 between the outer end of the first partition 531 and the inner wall 5 of the shaft 2 is preferably smaller than the diameters of the first conductor 41 and the second conductor 42 . At least one of a gap 182 between the outer end of the second partition portion 532 and the inner wall 5 of the shaft 2 and a gap 183 between the outer end of the third partition portion 533 and the inner wall 5 of the shaft 2 in the radial direction of the shaft 2 The diameter may be equal to or greater than the respective diameters of the first conductor 41 and the second conductor 42 .

At least one partition portion of the inner member 50 may be in contact with the shaft 2 . For example, at least one partition portion of the inner member 50 may be fixed to the inner wall 5 of the shaft 2 , or at least one partition portion may be fixed to the inner wall 5 of the shaft 2 . Since the inner member 50 is less likely to move relative to the shaft 2, the size of each lumen region is maintained during use of the catheter 1, and as a result, collapse of the first conductor 41 and the second conductor 42 is less likely to occur. For example, in FIGS. 14 and 15, the inner member 50 has partitions 531 and 532 on the outer circumference of the cylindrical portion 54, and in the cross section shown in FIG. .

At least one of the plurality of partitions of the inner member 50 may be fixed to the shaft 2 and the rest may not be fixed to the shaft 2 . The partition portion of the inner member 50 fixed to the shaft 2 may be fixed to the shaft 2 only partially in the longitudinal direction of the partition portion, or the entire partition portion in the longitudinal direction may be fixed to the shaft 2 . may be

As shown in FIG. 14, at least one of the plurality of partitions of the inner member 50 extends in the longitudinal direction x of the shaft 2, and the at least one partition extends along a portion of the shaft 2 in the longitudinal direction x. preferably not in contact with the inner wall 5 of the With this configuration, a gap can be formed between the inner member 50 and the partition portion that is not in contact with the inner wall 5 .

At least one of the plurality of partitions of the inner member 50 may be fixed to the shaft 2 along the longitudinal axis x in its entirety. In that case, it is preferable that the number of partitions fixed to the shaft 2 is smaller than the number of partitions not fixed to the shaft 2 . This facilitates communication between the first lumen region 21 and the second lumen region 22 through the gap while positioning the inner member 50 within the shaft 2 so that the inner member 50 does not move relative to the shaft 2 . .

All partitions of the inner member 50 may be fixed to the shaft 2 . In that case, at least one partition of the inner member 50 is preferably fixed to the shaft 2 only partially in the longitudinal direction x. That is, it is preferable that a gap exists between at least one partition and the shaft 2 .

Although all partitions of the inner member 50 may be fixed to the shaft 2, only a part of each partition of the inner member 50 in the longitudinal direction x is fixed to the inner wall 5 of the shaft 2 as shown in FIG. It is preferable that That is, it is preferable that between the shaft 2 and all the partitions of the inner member 50 there are portions with gaps and portions with no gaps. Since the first lumen region 21 and the second lumen region 22 communicate with each other through the gap, the lumen 20 of the shaft 2 can be easily filled with fluid such as gas for sterilization. Further, the positional displacement of the inner member 50 within the shaft 2 can be prevented by the portion where no gap exists, that is, the fixed portion.

FIG. 13 shows an example in which the shaft 2 has the partition portion 16 and the inner member 50 has the partition portion 53 . In FIG. 13, the partitions 16 and 53 are arranged so as to be farthest apart in the circumferential direction p, but the partitions 16 and 53 may be arranged so as to face each other. The number of partitions of the shaft 2 and the number of partitions of the inner member 50 may be the same, or one of them may be more than the other. In addition, for the configuration of the partitions 16 and 53, it is possible to appropriately refer to the description of the aspect in which only the shaft 2 has partitions and the aspect in which only the inner member 50 has partitions.

Defibrillation may be performed using the catheter 1 . When performing defibrillation, it is preferable that a voltage with a polarity different from that of the first electrode 31 is applied to the second electrode 32 . Since the first conducting wire 41 and the second conducting wire 42 are less likely to come into contact with each other due to the partition portion, even if voltages of different polarities are applied to the first electrode 31 and the second electrode 32, the first conducting wire 41 and the second conducting wire 42 are separated. A short circuit can be prevented.

When the catheter 1 has one or more electrodes in addition to the first electrode 31 and the second electrode 32, the lead connected to the electrode to which the voltage of the same polarity as the first electrode 31 is applied is the first internal electrode. Preferably, the second lumen region 22 is provided with a conductor wire that is arranged in the cavity region 21 and is connected to an electrode to which a voltage of the same polarity as the second electrode 32 is applied. This can prevent a short circuit between conductors. A plurality of conductors may be arranged in each of the first lumen region 21 and the second lumen region 22 .

1: catheter 2: shaft 5: inner wall 11: first side hole 12: second side hole 16, 161, 162, 163, 164: partitions 181, 182, 183, 184: gap 20: lumen 21: second 1 lumen region, 22: second lumen region, 23: third lumen region, 24: fourth lumen region 31: first electrode, 32: second electrode 41: first conductor, 42: second conductor 50: Inner members 53, 531, 532, 533, 534: Partition part 54: Cylindrical part

Claims (18)

A shaft longitudinally extending from a distal end to a proximal end, comprising a lumen, a first side hole communicating with the lumen, and a second side hole proximal to the first side hole. a shaft having
a first electrode arranged outside the first side hole;
a second electrode arranged outside the second side hole;
a first conductor electrically connected to the first electrode and extending through the first side hole into the lumen of the shaft;
a second conductor electrically connected to the second electrode and extending through the second side hole into the lumen of the shaft;
an inner member disposed in the lumen of the shaft;
at least one of the shaft and the inner member has at least one divider that divides the lumen of the shaft into at least a first lumen region and a second lumen region;
the first lumen region and the second lumen region each extend along the longitudinal axis;
the shaft has a gap with the inner member;
a portion of the gap is smaller than the diameter of the first conductor and smaller than the diameter of the second conductor;
The first conductor is arranged in the first lumen region,
A catheter having said second lead disposed in said second lumen region. 2. The catheter of claim 1, wherein only one of said shaft and said inner member has said at least one divider and the other has no divider. The catheter according to claim 1 or 2, wherein the at least one partition extends from the center side of the longitudinal axis of the shaft to the inner wall side of the shaft. 4. The catheter of claim 3, wherein said at least one partition extends radially of said shaft. A catheter according to any preceding claim, wherein the at least one partition extends longitudinally of the shaft. The catheter of any one of claims 1-5, wherein the entirety of the inner member is the at least one partition. The at least one partition has a plurality of partitions,
The catheter according to any one of claims 1 to 6, wherein the plurality of partitions are arranged in a circumferential direction of the shaft. 8. The catheter of claim 7, wherein at least one of said plurality of partitions is a portion of the inner wall of said shaft. 9. The catheter of claim 8, wherein at least one of said plurality of partitions is secured to said inner member. 8. The catheter of claim 7, wherein at least one of said plurality of partitions is part of said inner member. the inner member having a tubular portion extending longitudinally of the shaft;
11. The catheter according to claim 10, wherein the plurality of partitions are arranged on the outer periphery of the tubular portion. 12. The catheter according to claim 10 or 11, wherein at least one of said plurality of partitions is fixed to the inner wall of said shaft. 13. The method according to claim 12, wherein at least one of said plurality of partitions extends in the longitudinal direction of said shaft, and said at least one partition is not in contact with said inner wall of said shaft at a portion of said longitudinal axis. Catheter as described. A catheter of any one of claims 1-13, wherein the length of the first lead is greater than the length of the lumen of the shaft. the at least one partition partitions the lumen of the shaft into at least the first lumen region, the second lumen region, and the third lumen region;
The catheter of any one of claims 1-14, wherein no leads are placed in the third lumen region. the at least one partition partitions the lumen of the shaft into at least the first lumen region, the second lumen region, the third lumen region, and the fourth lumen region;
The first lumen region, the third lumen region, the second lumen region, and the fourth lumen region are arranged in this order in the circumferential direction of the shaft,
The catheter of any one of claims 1-15, wherein no leads are disposed in the third lumen region and the fourth lumen region. A catheter according to any preceding claim, wherein the inner member is rotatable relative to the shaft. The catheter according to any one of claims 1 to 17, wherein when performing defibrillation, a voltage with a polarity different from that of the first electrode is applied to the second electrode.

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