JP3876344B2 - 写像カテーテル及びカテーテルアセンブリ - Google Patents
写像カテーテル及びカテーテルアセンブリ Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
- A61B5/6853—Catheters with a balloon
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- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
- A61B5/0538—Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
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- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
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- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/282—Holders for multiple electrodes
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- A—HUMAN NECESSITIES
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- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
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- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3625—External stimulators
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- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
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- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
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- A61B2562/043—Arrangements of multiple sensors of the same type in a linear array
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- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/30—Input circuits therefor
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/49002—Electrical device making
- Y10T29/49117—Conductor or circuit manufacturing
Description
全体として本発明は、心臓チャンバーの内面における電気的活動に関する高分解能の3次元写像を作り出す方法を提供するものである。
一般に本発明のシステムは、心臓チャンバー80の内側面における電気的な活動の写像又はマッピングに使用される。写像カテーテルアセンブリ14は変形自在な末端リード体74に連結された軟質リード体72を含む。この変形自在な末端リード体74は心臓キャビティ80内に導入された後、幾何学的な形状を満たす安定空間に形成され得る。この変形自在な末端リード体74は複数の電極サイトを画定する電極アレイ19を含む。また写像カテーテルアセンブリ14は軟質リード体72及び末端リード体74内に形成された中央管膣又は中央ルーメンを貫通している基準カテーテル16上に都合良く配置された基準電極を含む。基準カテーテルアセンブリ16は心臓壁を精査すべく使用することができる末端電極アセンブリ24を有する。この末端の接触用電極アセンブリ24は較正用の表面電気的基準を提供する。電極アレイ19と共に該電極アレイの位置で計られた基準カテーテル16の物理的な長さはこの電極アレイ19を較正するために使われ得る基準を提供している。またこの基準カテーテル16は電極アレイ19の望ましい位置を安定化している。
図1はある患者の心臓12に連結された写像システム10を示す。写像カテーテルアセンブリ14は心臓チャンバー内に挿入され、基準電極24は心内膜表面18に触れている。
図2は心臓チャンバー80内に据えられた写像カテーテルアセンブリ14の一部を示している。写像カテーテルアセンブリ14は基準カテーテル16及びアレイカテーテル20を含む。図2においてアレイカテーテル20は、スタイレット92の使用を通じてその電極アレイ19を安定的且つ再現性ある幾何学的形状になすべく膨張させられている。基準カテーテル16はアレイカテーテル20の管腔82に通過させられて、末端電極アセンブリ24を心内膜表面の然るべき位置に据えるようにしている。使用中、基準カテーテル16は電極アレイ19のための機械的な配置基準を提供し、末端電極アセンブリ24は写像工程のための心臓壁上の或いは心臓壁内の電位を提供する。
例証となる方法は図12に示されるように9ステップ又は9段階に区割りされる。このステップ的な系列の区割りは本発明を説明する補助としてなされるものであり、本発明の適用範囲から逸脱することなく他の同等な区割りで容易に置き換えることができる。
本発明の異なる複数の段階を遂行するために2つの異なるアルゴリズムが適当である。
ここで、V(θ,ψ)はプローブ半径R上の測定されたポテンシャルであり、dΩは立体角の微分であり、球座標において以下のように定義される。
dΩ=sinθdθdψ
ここで、pのq倍は球形状プローブアレイ上の電極の総数と等しい。角度θはゼロからπラジアンの範囲であり、ψはゼロから2πラジアンの範囲である。
ここで、V(X)は3次元ベクトルXによって定義される所望の点におけるポテンシャルを表し、Viは3次元ベクトルiによって定義される点のnコの公知ポテンシャルの各々を表し、kは組織媒体の物理的振る舞いに釣り合うべき指数である。
Claims (9)
- 患者の心臓内に電極を配置するタイプで、患者の心臓(12)の電気的ポテンシャルを写像するために使用する写像カテーテルにおいて、
複数の電極と、
第1電極セット(19)を、前記心臓(12)の表面と非接触状態で且つ該表面から離隔させる第1位置付け手段(20)と、
第2電極セット(24)を前記心臓の表面に接触させる第2位置付け手段(16)と、
第3電極セット(26)を前記心臓の壁内の位置に配置させる第3位置付け手段(100)と、を備える写像カテーテル。 - 前記複数の電極が12を越える電極数である、請求項1に記載の写像カテーテル。
- 前記第1電極セットが1を越える電極数である、請求項1に記載の写像カテーテル。
- 前記第2電極セットが少なくとも1つである、請求項1に記載の写像カテーテル。
- 前記第1位置付け手段が形状において略々球である、請求項1に記載の写像カテーテル。
- 前記第2位置付け手段が略々円筒形状を有する、請求項1に記載の写像カテーテル。
- 患者の心臓(12)の内側を写像するカテーテルアセンブリ(10)において、
略々球形状を成す第1の電極アレイ(19)を画成する複数電極サイトの第1セットであって、前記電極アレイが、前記心臓に対して非接触状態となる数の電極を備える大きさを有するようになっている複数電極サイトの第1セットと、
前記心臓に対して接触状態となって配置され、前記電極アレイから変移された複数電極サイト(24)の第2セットと、を備えて成るカテーテルアセンブリ。 - 患者の心臓(12)の心臓チャンバーの内側における電気的ポテンシャルを写像するカテーテルアセンブリ(10)において、
変形自在リード体(74)に連結され、かつ、該変形自在リード体(74)と共に管膣を有する軟質リード体(72)であって、前記変形自在リード体は、該変形自在リード体が略々円筒形状となる第1圧潰位置まで変形可能であり、且つ、該変形自在リード体が略々球形状となる第2膨張位置まで変形可能である、軟質リード体(72)と、
前記変形自在リード体上に配置された複数の電極サイトを有する電極アレイ(19)であって、前記変形自在リード体が前記第2膨張位置にある際に前記複数の電極サイトが電極サイトの球状アレイを形成し、かつ、前記複数の電極サイトが前記患者の心臓の表面と非接触状態である電極アレイ(19)と、
先端電極アセンブリを有する基準カテーテル(16)であって、前記管膣内に配置され、前記電極アレイが前記心臓内にある際に前記先端電極アセンブリが前記心臓に対して接触するように前記電極アレイに対しての相対的運動のために支持されている基準カテーテル(16)と、を備えることから成るカテーテルアセンブリ。 - 前記変形自在リード体が前記第2膨張位置にある際に該変形自在リード体の内側から血液を排除するための手段(77)を更に備える、請求項8に記載のカテーテルアセンブリ(10)。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/949,690 US5311866A (en) | 1992-09-23 | 1992-09-23 | Heart mapping catheter |
US07/950,448 US5297549A (en) | 1992-09-23 | 1992-09-23 | Endocardial mapping system |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP50843194A Division JP3581888B2 (ja) | 1992-09-23 | 1993-09-23 | 心内膜の写像システム |
Publications (2)
Publication Number | Publication Date |
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JP2004209262A JP2004209262A (ja) | 2004-07-29 |
JP3876344B2 true JP3876344B2 (ja) | 2007-01-31 |
Family
ID=27130293
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP50843194A Expired - Fee Related JP3581888B2 (ja) | 1992-09-23 | 1993-09-23 | 心内膜の写像システム |
JP2004019295A Expired - Lifetime JP3876344B2 (ja) | 1992-09-23 | 2004-01-28 | 写像カテーテル及びカテーテルアセンブリ |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP50843194A Expired - Fee Related JP3581888B2 (ja) | 1992-09-23 | 1993-09-23 | 心内膜の写像システム |
Country Status (7)
Country | Link |
---|---|
US (11) | US6826421B1 (ja) |
EP (1) | EP0661948B1 (ja) |
JP (2) | JP3581888B2 (ja) |
AT (1) | ATE160273T1 (ja) |
CA (3) | CA2144973C (ja) |
DE (1) | DE69315354T2 (ja) |
WO (1) | WO1994006349A1 (ja) |
Families Citing this family (327)
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US5699796A (en) * | 1993-01-29 | 1997-12-23 | Cardima, Inc. | High resolution intravascular signal detection |
US7189208B1 (en) * | 1992-09-23 | 2007-03-13 | Endocardial Solutions, Inc. | Method for measuring heart electrophysiology |
US7930012B2 (en) | 1992-09-23 | 2011-04-19 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Chamber location method |
EP0661948B1 (en) * | 1992-09-23 | 1997-11-19 | Endocardial Solutions, Inc. | Endocardial mapping system |
US5706809A (en) * | 1993-01-29 | 1998-01-13 | Cardima, Inc. | Method and system for using multiple intravascular sensing devices to detect electrical activity |
DE69428188T2 (de) * | 1993-01-29 | 2002-03-21 | Medtronic Inc | Mehrfach-sensor zur anzeige elektrischer signale in blutgefässen |
US5645082A (en) * | 1993-01-29 | 1997-07-08 | Cardima, Inc. | Intravascular method and system for treating arrhythmia |
US6522905B2 (en) | 1993-03-11 | 2003-02-18 | Jawahar M. Desai | Apparatus and method for cardiac ablation |
US5657755A (en) * | 1993-03-11 | 1997-08-19 | Desai; Jawahar M. | Apparatus and method for cardiac ablation |
US5433198A (en) | 1993-03-11 | 1995-07-18 | Desai; Jawahar M. | Apparatus and method for cardiac ablation |
IL116699A (en) | 1996-01-08 | 2001-09-13 | Biosense Ltd | Method of building a heart map |
AU7924694A (en) * | 1993-10-01 | 1995-05-01 | Target Therapeutics, Inc. | Sheathed multipolar catheter and multipolar guidewire for sensing cardiac electrical activity |
US6690963B2 (en) | 1995-01-24 | 2004-02-10 | Biosense, Inc. | System for determining the location and orientation of an invasive medical instrument |
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EP0661948B1 (en) | 1997-11-19 |
CA2447239C (en) | 2010-10-19 |
US6978168B2 (en) | 2005-12-20 |
JPH08501477A (ja) | 1996-02-20 |
DE69315354T2 (de) | 1998-03-19 |
DE69315354D1 (de) | 1998-01-02 |
US20060084970A1 (en) | 2006-04-20 |
EP0661948A1 (en) | 1995-07-12 |
ATE160273T1 (de) | 1997-12-15 |
US20060084884A1 (en) | 2006-04-20 |
CA2144973C (en) | 2010-02-09 |
US6826420B1 (en) | 2004-11-30 |
US20050101874A1 (en) | 2005-05-12 |
US20030176799A1 (en) | 2003-09-18 |
US20060058692A1 (en) | 2006-03-16 |
CA2678625A1 (en) | 1994-03-31 |
US20060052716A1 (en) | 2006-03-09 |
JP3581888B2 (ja) | 2004-10-27 |
US20060084972A1 (en) | 2006-04-20 |
CA2447239A1 (en) | 1994-03-31 |
US8208998B2 (en) | 2012-06-26 |
US6826421B1 (en) | 2004-11-30 |
WO1994006349A1 (en) | 1994-03-31 |
US20060058693A1 (en) | 2006-03-16 |
CA2144973A1 (en) | 1994-03-31 |
US20060084971A1 (en) | 2006-04-20 |
US7289843B2 (en) | 2007-10-30 |
JP2004209262A (ja) | 2004-07-29 |
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