JP5201636B2 - Electrode catheter - Google Patents

Description

  The present invention relates to an electrode catheter having a plurality of catheter tip portions.

As a catheter for mapping the electrical activity in the heart, one having a plurality of catheter tip portions (projections 14) extending radially from the tip of the catheter body is known (Patent Document 1 and Patent Document 2). reference).
A tip electrode and a ring electrode are attached to each of the catheter tip portions in this catheter, and the potential of an in-circle region having the radius of the length of the catheter tip portion as a radius can be simultaneously measured with one catheter. it can.

Japanese Patent Laid-Open No. 2003-235821 JP 2004-130114 A

A catheter having a plurality of radially extending catheter tips can be used for various medical procedures in addition to the above mapping.
For example, after the ablation treatment, it can be confirmed whether or not the intended cauterization has been performed. Specifically, two electrodes (tip electrode or ring-shaped electrode) mounted on each of the different catheter tip portions are placed so as to cross the ablation line and can be confirmed by measuring the transmission speed of the potential. it can. When cauterization is performed reliably, the potential transmission path between the two electrodes is blocked by the ablation line, and the potential is bypassed and transmitted, so the transmission speed is delayed. On the other hand, if cauterization is not performed reliably, the potential is directly transmitted (at the shortest distance) between the two electrodes, and the transmission speed is not delayed.

Various medical operations using a catheter having a plurality of catheter tip portions such as such a confirmation operation are usually performed while viewing an X-ray image.
The measured potential data is displayed on the monitor of the electrocardiograph for each used electrode (between). Therefore, it is necessary to grasp which electrode (between) the potential data (waveform) displayed on the monitor is measured.
Therefore, the operator can determine which position of each of the electrodes displayed in the X-ray image is the electrode attached at which position of the catheter tip (for example, the number of the ring attached from the tip). It is required to grasp immediately whether it is an electrode.

However, it is extremely difficult to grasp at which position of which catheter tip the electrode identified on the X-ray image is attached.
Here, in the case where all the electrodes (electrodes attached to all the catheter tip portions) are projected on the X-ray image, an arrangement position (tip end) on the catheter tip portion is determined for a certain electrode specified on the X-ray image. Can be grasped), but the arrangement of the electrodes at the catheter tip is the same, so the electrode identified on the X-ray image is attached to which catheter tip It is practically impossible to grasp immediately whether it is.
In addition, when all the electrodes are projected on the X-ray image, whether the electrodes on the image and the plurality of catheter distal ends to which these electrodes are attached are viewed from the distal end side of the catheter, the proximal end of the catheter Sometimes it is misunderstood whether it is seen from the side.

The present invention has been made based on the above situation.
An object of the present invention is an electrode catheter in which a plurality of electrodes are attached to each of a plurality of catheter tips, and the electrode specified on the X-ray image is located at any position in any catheter tip. It is an object of the present invention to provide an electrode catheter capable of easily grasping whether the electrode is attached.

(1) An electrode catheter of the present invention includes a catheter body having at least one inner hole,
A control handle connected to the proximal end of the catheter body;
At least three catheter tips extending from the tip of the catheter body at substantially equal angular intervals;
A plurality of ring electrodes mounted on each of the catheter tip portions;
The electrode width of one ring-shaped electrode attached to the first catheter tip, and the electrode width of one ring-like electrode attached to the second catheter tip adjacent to the first catheter tip Is different from the electrode width of other ring electrodes,
The two ring-shaped electrodes having different electrode widths from the other ring-shaped electrodes are different from each other in the arrangement position at the distal end portion of the catheter on which the two ring-shaped electrodes are mounted.

According to the electrode catheter of the present invention having such a configuration, two ring electrodes having different electrode widths from other ring electrodes are found on the X-ray image, so that these two ring electrodes can be obtained. Can be recognized as the first catheter tip and the second catheter tip.
In addition, since the two ring-shaped electrodes having different electrode widths are different from each other in the arrangement position at the catheter tip portion (the first catheter tip portion or the second catheter tip portion) to which each of the ring-shaped electrodes is attached, the first catheter The distal end portion and the second catheter distal end portion can be easily identified.
If the first catheter tip and the second catheter tip can be recognized on the X-ray image, the other catheter tip on the X-ray image can be any catheter tip (for example, the number of catheter tips). 3 is the third catheter tip, and the fourth catheter tip).
In addition, the arrangement position of the ring-shaped electrode mounted on each of the catheter tip portions (which electrode is mounted from the tip) can be easily grasped on the X-ray image.
As a result, it is possible to easily grasp at which catheter tip portion the electrode is mounted at which position with respect to all the ring electrodes on the X-ray image.

(2) In the electrode catheter of the present invention configured as described above, the electrode width of the first ring-shaped electrode from the distal end side at the first catheter distal end portion and the second electrode from the distal end side at the second catheter distal end portion The electrode width of the ring electrode is preferably wider than the electrode width of the other ring electrodes.

  According to the electrode catheter of the present invention having such a configuration, a catheter having the ring electrode mounted thereon is found by finding a ring electrode having the first wide electrode width from the distal end side on the X-ray image. It can be recognized that the tip is the first catheter tip. Further, by finding the ring electrode having the second wide electrode width from the distal end side, it is possible to recognize that the catheter distal end portion to which the ring electrode is attached is the second catheter distal end portion.

(3) It is preferable that the electrode catheter of the present invention having the above-described configuration includes four catheter tip portions.

Four ring-shaped electrodes (hereinafter, referred to as “corresponding electrodes” mounted at the same position of the distal end of the catheter) mounted at the same position at the four distal ends of the catheter (for example, arranged first from the distal end side) ")" Is located at the apex of the square.
According to the electrode catheter of the present invention (electrode catheter having four catheter tip portions) in which each of the corresponding ring electrodes is located at the apex of the square, for example, is cauterization reliably performed after ablation treatment? When confirming whether or not, it is possible to easily arrange the corresponding four ring-shaped electrodes at an equal distance from the ablation line.
For example, out of the corresponding four ring-shaped electrodes, if two ring-shaped electrodes attached to adjacent catheter tips are placed so that the ablation line is positioned at the midpoint between them, the remaining two This ring-shaped electrode can also be placed so that the ablation line is located at the intermediate point between them.

(4) Moreover, the electrode catheter of the present invention includes a catheter body having at least one inner hole,
A control handle connected to the proximal end of the catheter body;
At least three catheter tips extending from the tip of the catheter body at substantially equal angular intervals;
A tip electrode attached to each of the catheter tip portions;
And at least one ring electrode attached to each of the catheter tip portions;
The electrode width of the tip electrode attached to the first catheter tip is different from the electrode width of the other tip electrodes,
The electrode width of one ring electrode attached to the second catheter tip adjacent to the first catheter tip is different from the electrode width of the other ring electrodes.

According to the electrode catheter of the present invention having such a configuration, by finding a tip electrode having a different electrode width from the other tip electrodes on the X-ray image, the tip of the catheter to which the tip electrode is attached is It can be recognized that this is the catheter tip.
Further, by finding a ring-shaped electrode having a different electrode width from that of other ring-shaped electrodes on the X-ray image, it is possible to recognize that the distal end of the catheter to which this is attached is the second distal end of the catheter. it can.
If the first catheter tip and the second catheter tip can be recognized on the X-ray image, it is possible to recognize which catheter tip is the other catheter tip on the X-ray image. it can.
Moreover, the arrangement positions of the tip electrode and the ring electrode attached to each of the catheter tip portions can be easily grasped on the X-ray image.
As a result, all the electrodes (tip electrode and ring electrode) on the X-ray image can be easily grasped as to which electrode is mounted at which position at which catheter tip.

(5) In the electrode catheter of the present invention configured as described above, the electrode width of the tip electrode attached to the first catheter tip is wider than the electrode width of the other tip electrode,
It is preferable that the electrode width of one ring-shaped electrode attached to the distal end portion of the second catheter is wider than the electrode width of other ring-shaped electrodes.

  According to the electrode catheter of the present invention having such a configuration, by finding a tip electrode having an electrode width wider than that of other tip electrodes on an X-ray image, the tip of the catheter to which the tip electrode is attached can be obtained. It can be recognized that this is the first catheter tip. Further, by finding a ring-shaped electrode having a wider electrode width than other ring-shaped electrodes, it is possible to recognize that the catheter distal end portion to which the ring-shaped electrode is attached is the second catheter distal end portion.

(6) It is preferable that the electrode catheter of the present invention configured as described above includes four catheter tip portions.

Four electrodes (for example, tip electrodes) corresponding to the four catheter tip portions are respectively located at the apexes of the square.
According to the electrode catheter of the present invention (electrode catheter having four catheter tip portions) in which each of the corresponding electrodes is located at the apex of the square, for example, whether or not cauterization is reliably performed after ablation treatment. When confirming the above, it is possible to easily arrange the corresponding four electrodes at an equal distance from the ablation line.
For example, among the four tip electrodes, if two tip electrodes attached to adjacent catheter tip portions are placed so that the ablation line is positioned at the intermediate point between them, the remaining two tip electrodes However, the ablation line can be placed at the midpoint between them.

(7) In the electrode catheter of the present invention, it is preferable that the distal end portion of the catheter main body is provided with a swinging mechanism that can bend in both directions around the axis of the catheter main body (Bidirectional Control).

There is a lot of string-like tissue called tendon around the inner wall of the heart, especially around the valve. In order to avoid entanglement of the tip of the catheter with this tendon, the catheter inserted into the heart chamber It is preferable not to rotate the main body as much as possible around the axis.
Thus, according to the electrode catheter of the present invention having the above-described swing mechanism, for example, even when the distal end portion of the catheter body is deflected by 180 °, it is necessary to rotate the catheter body around the axis. This is advantageous compared to having a mechanism that can deflect only in one direction (in which case it is necessary to rotate the catheter body about its axis).

  According to the electrode catheter of the present invention, it is possible to easily grasp at which position the electrode identified on the X-ray image is attached at which position of the catheter tip.

It is a schematic front view of the electrode catheter which concerns on one Embodiment of this invention. It is a side view (II arrow view of FIG. 1) of the electrode catheter shown in FIG. It is sectional drawing in the front-end | tip part of the electrode catheter shown in FIG. 1 (II-II sectional drawing of FIG. 2). FIG. 3 is a cross-sectional view (III-III cross-sectional view of FIG. 2) at the distal end portion of the electrode catheter shown in FIG. 1. FIG. 4 is a cross-sectional view (IV-IV cross-sectional view of FIG. 1) at the distal end portion of the electrode catheter shown in FIG. 1. It is the schematic which shows the use condition of the electrode catheter shown in FIG. It is a side view of the electrode catheter which concerns on other embodiment of this invention. It is a side view which shows the modification of the electrode catheter of this invention.

<First Embodiment>
The electrode catheter 1 of this embodiment is used for diagnosis or treatment of arrhythmia in the heart, for example.
The electrode catheter 1 includes a catheter body 10, a control handle 20, four catheter tip portions (31, 32, 33, 34), and tip electrodes (41a, 42a, 43a) attached to the catheter tip portions, respectively. 44a), and eight ring-shaped electrodes (41B / 41c, 42b / 42C, 43b / 43c, 44b / 44c), two mounted on each of the distal ends of the catheter.

The catheter body 10 includes a tube member 11 and a tip member 12.
In FIG. 1, the length of the catheter body 10 is illustrated as being short, but actually, the length is several times to several tens of times longer than the length of the control handle 20 in the Z-axis direction.

  The tube member 11 constituting the catheter body 10 has at least one inner hole (lumen). A lead wire (not shown) connected to the tip electrode and the ring electrode and a tension wire (indicated by 51 and 52 in FIG. 4) constituting the swing mechanism are passed through the lumen of the tube member 11.

  The tube member 11 may be made of a material having the same characteristics along the axial direction, but is preferably formed integrally using materials having different rigidity (hardness) along the axial direction. Specifically, it is preferable that the constituent material on the proximal end side has relatively high rigidity, and the constituent material on the distal end side has relatively low rigidity.

  The tube member 11 is made of a synthetic resin such as polyolefin, polyamide, polyether polyamide, polyurethane, nylon, or PEBAX (polyether block amide). The proximal end side of the tube member 11 may be a blade tube obtained by braiding a tube made of these synthetic resins with a stainless steel wire.

The outer diameter of the tube member 11 is preferably 1.0 to 3.0 mm, and more preferably 1.6 to 2.7 mm.
The length of the tube member 11 is preferably 600 to 1500 mm, and more preferably 900 to 1200 mm.

As shown in FIG. 3, the distal end member 12 constituting the catheter body 10 includes a cylindrical portion 121 inserted into the lumen of the tube member 11 and each of the four catheter distal end portions (31, 32, 33, 34). And a holding portion 122 having four pores into which the base end portion of each is inserted.
The tip member 12 can be made of the same material as the tube member 11, for example, PEBAX.
The outer diameter of the tip member 12 (holding portion 122) is preferably the same as the outer diameter of the tube member 11.
The length of the tip member 12 (holding portion 122) is preferably 2 to 60 mm, and more preferably 5 to 10 mm.

  The control handle 20 is connected to the proximal end of the catheter body 10 (tube member 11). In FIG. 1, 21 is a gripping portion, and 22 is a rotating plate for performing a swing operation (deflection movement operation) of the distal end portion of the catheter body 10.

The electrode catheter 1 of this embodiment includes four catheter tip portions (a first catheter tip portion 31, a second catheter tip portion 32, and a third catheter tip portion) that extend while bending outward in the radial direction of the axis of the catheter body 10. Part 33 and a fourth catheter tip 34).
As shown in FIG. 2, the four catheter tip portions extend radially from the tip of the catheter body 10 (tip member 12) at substantially equal angles (about 90 ° in a side view shown in FIG. 2). Yes.

The outer diameter of the catheter tip is preferably 0.3 to 1.4 mm, more preferably 0.5 to 1.0 mm.
The outer diameter of the distal end portion of the catheter is preferably 0.15 to 0.4 times the outer diameter of the tube member 11 and the distal end member 12.
The length of the catheter tip (the portion extending from the tip member 12) is preferably 5 to 50 mm, and more preferably 10 to 30 mm.

  As shown in FIGS. 3 and 5, the catheter tip (31, 32, 33, 34) includes an elongated plate-shaped core member (311, 321, 331, 341) and a covered tube (312, 322, 332, 342).

As shown in FIG. 3, the core member 311 constituting the first catheter tip 31 extends along the inner hole of the covering tube 312 and the tip is fixed in a state of being embedded in the tip electrode 41a. .
Further, the core member 331 constituting the third catheter distal end portion 33 extends along the inner hole of the covering tube 332, and the distal end portion is fixed in a state of being embedded in the distal end electrode 43a.
Note that the second catheter tip 32 and the fourth catheter tip 34 also have the same structure as the first catheter tip 31 and the third catheter tip 33.

The core member stores the shape of the distal end portion of the catheter, and is deformed (for example, deformed linearly) by applying force. However, when the force is removed, the stored shape (as shown in FIGS. 1 to 4) is stored. Return to the unfolded shape.
Examples of the constituent material of the core member include Ni-Ti alloys. The ratio of Ni and Ti in the Ni—Ti alloy is preferably 54:46 to 57:43. Nitinol can be mentioned as a preferred Ni-Ti alloy.
Examples of the constituent material of the coated tube include a bio-acceptable resin material such as polyurethane or PEBAX.

  The proximal end portions of the four catheter distal end portions (31, 32, 33, 34) are respectively inserted into the pores formed in the distal end member 12 (holding portion 122), and the covered tubes (312,. 322, 332, 342) and the holding portion 122 are heat-sealed, whereby each of the catheter tip portions (31, 32, 33, 34) is fixed to the catheter body 10 (tip member 12). .

On the catheter tip (first catheter tip 31, second catheter tip 32, third catheter tip 33, fourth catheter tip 34), tip electrodes (41a, 42a, 43a, 44a) and two ring-shaped electrodes (41B / 41c, 42b / 42C, 43b / 43c, 44b / 44c), respectively, are mounted.
Conductive wires (not shown) connected to the distal electrode and the ring-shaped electrode are passed through the inner hole of the catheter distal end portion (covered tube) and the lumen of the catheter body 10 while being insulated from each other.

  The tip electrode and the ring electrode are made of a metal having good electrical conductivity such as aluminum, copper, stainless steel, gold, platinum, iridium, or an alloy thereof. The outer diameters of the tip electrode and the ring-shaped electrode are not particularly limited, but are preferably approximately the same as the outer diameter of the catheter tip.

As shown in FIG. 2, among the eight ring-shaped electrodes (41B / 41c, 42b / 42C, 43b / 43c, 44b / 44c) constituting the electrode catheter 1, the first catheter tip 31 was mounted. The ring-shaped electrode 41B and the ring-shaped electrode 42C attached to the second catheter distal end portion 32 have an electrode width (length in the tube axis direction) longer than the electrode widths of the other ring-shaped electrodes. Specifically, it is 1.5 to 2.0 times.
Here, the electrode width of the ring electrodes other than the ring electrode 41B and the ring electrode 42C is preferably 0.5 to 4.0 mm, and more preferably 0.6 to 1.2 mm.

According to the electrode catheter 1 having such a configuration, a ring-shaped electrode 41B having a wide electrode width is found among the first ring-shaped electrodes (41B, 42b, 43b, 44b) from the distal end side on the X-ray image. Accordingly, it can be recognized that the distal end portion of the catheter to which the ring-shaped electrode 41B is attached is the first distal end portion 31 of the catheter.
If the first catheter tip 31 can be recognized on the X-ray image, the tip electrode and the ring electrode attached to the first catheter tip 31 are recognized as the tip electrode 41a and the ring electrodes 41B and 41c, respectively. Can do.

Further, the ring-shaped electrode 42C is mounted by finding the ring-shaped electrode 42C having a wide electrode width among the ring-shaped electrodes (41c, 42C, 43c, 44c) second from the tip side on the X-ray image. It can be recognized that the catheter distal end portion is the second catheter distal end portion 32.
If the second catheter tip 32 can be recognized on the X-ray image, the tip electrode and the ring electrode attached thereto are recognized as the tip electrode 42a and the ring electrodes 42b and 42C, respectively. Can do.

In addition, if the first catheter tip 31 and the second catheter tip 32 can be recognized on the X-ray image, they are next to the second catheter tip 32 (opposite to the first catheter tip 31). The catheter tip can be recognized as the third catheter tip 33.
If the third catheter tip 33 can be recognized on the X-ray image, the tip electrode and the ring electrode attached thereto are recognized as the tip electrode 43a and the ring electrodes 43b and 43c, respectively. Can do.

In addition, if the first catheter tip 31, the second catheter tip 32, and the third catheter tip 33 can be recognized on the X-ray image, they are next to the third catheter tip 33 (the third catheter tip 33). The catheter tip (between the catheter tip 33 and the first catheter tip 31) can be recognized as the fourth catheter tip 34.
If the fourth catheter tip 34 can be recognized on the X-ray image, the tip electrode and the ring-shaped electrode attached thereto are recognized as the tip electrode 44a and the ring-shaped electrodes 44b and 44c, respectively. Can do.

As a result, it is possible to easily grasp which catheter tip is attached to all the tip electrodes (41a, 42a, 43a, 44a) on the X-ray image.
In addition, all the ring-shaped electrodes (41B / 41c, 42b / 42C, 43b / 43c, 44b / 44c) on the X-ray image are mounted at any placement position at any catheter tip. Can be easily grasped.

  In the electrode catheter 1 of this embodiment, two ring-shaped electrodes (ring-shaped electrode 41B and ring-shaped electrode 42C) having a wider electrode width than other ring-shaped electrodes are adjacent to the distal end of the catheter (first distal end of the catheter). 31 and the second catheter tip 32) are mounted at different positions.

When there is one ring-shaped electrode having a wide electrode width, for example, when only the electrode width of the ring-shaped electrode 41B is wide, the second catheter tip 32 and the fourth catheter tip on the X-ray image. 34 cannot be immediately identified. For example, the tip electrode 42a displayed on the X image may be mistaken for the tip electrode 44a.
In such a case, for example, when the tip electrode 43a attached to the third catheter tip 33 and the tip electrode 42a attached to the second catheter tip 32 are placed across the ablation line. In addition, the tip electrode 42a on the X image is mistaken as the tip electrode 44a, and is displayed on the monitor based on the potential data between the tip electrode 43a and the tip electrode 44a that does not cross the ablation line. It may be misdiagnosed as "no shochu".

  On the other hand, in the electrode catheter 1 of this embodiment, in addition to the electrode width of the ring-shaped electrode 41B, the electrode width of the ring-shaped electrode 42C attached to the second catheter distal end portion 32 is also wide. The second catheter tip 32 and the fourth catheter tip 34 can be immediately identified, and there is no possibility of misidentifying the tip electrode 42a projected on the X-ray image as the tip electrode 44a. It is possible to reliably avoid misdiagnosis.

In addition, when two ring electrodes having a wider electrode width than the other ring electrodes are mounted at the same position in each of the adjacent catheter tip portions, the ring shape having a wider electrode width in the X-ray image. It is not possible to distinguish whether each of the two catheter tips attached with the electrodes is the first catheter tip or the second catheter tip.
In such a case, it is impossible to immediately recognize whether the four catheter distal ends on the X-ray image are viewed from the distal end side of the catheter or viewed from the proximal end side of the catheter.

  On the other hand, in the electrode catheter 1 of this embodiment, the arrangement position of the ring electrode 41B attached to the first catheter tip 31 (first from the tip side as a ring electrode) and the second catheter tip Since the mounting position of the ring-shaped electrode 42C mounted on the portion 32 (second ring-shaped electrode from the distal end side) is different from each other, the first catheter distal end portion 31 and the second catheter distal end portion 32 are securely connected to each other. Can be identified. Thereby, it is possible to immediately recognize whether the four catheter distal ends on the X-ray image are viewed from the distal end side of the catheter or viewed from the proximal end side of the catheter.

  The electrode catheter 1 of this embodiment includes a swing mechanism that bends the distal end portion of the catheter body 10 in both directions around the axis of the catheter body 10.

Although it is not particularly limited as the swing mechanism, for example, a leaf spring (not shown) as a swing member housed in the distal end portion of the tube member 11, and the front and back sides of the leaf spring, Two tension wires (indicated by 51 and 52 in FIG. 4) passed through the lumen of the tube member 11 and a rotating plate 22 to which the proximal ends of the two tension wires are connected are provided. A mechanism can be mentioned.
Here, each of the distal ends of the two tension wires may be fixed to the inner wall of the tube member 11 at a position opposed to each other with the leaf spring interposed therebetween, and the front and back surfaces of the flat plate portion at the distal end of the leaf spring. It may be fixed to.

On the other hand, the proximal ends of the pull wires 51 and 52 are connected to positions separated from each other on the rotary plate 22 of the control handle 20, and the rotary plate 22 is centered on a rotary axis perpendicular to the Z axis shown in FIG. And can be rotated freely.
The operator holds the grip portion 21 of the control handle 20 with one hand, and operates (rotates in a predetermined direction) the rotating plate 22 with the finger of the one hand. Thereby, the tension | tensile_strength of the tension | pulling wires 51 and 52 changes, and the front-end | tip part of the catheter main body 10 swings as shown to the arrow A or arrow B of FIG.

  That is, for example, when the rotating plate 22 is rotated in the A1 direction shown in FIG. 1, the pulling wire 52 is pulled and the pulling wire 51 is loosened. As a result, as shown in FIG. 1, the distal end portion of the catheter body 10 is bent in the direction of arrow A, and the distal end portion of the catheter is deflected.

Similarly, when the rotating plate 22 is rotated in the B1 direction shown in FIG. 1, for example, the pulling wire 51 is pulled and the pulling wire 52 is loosened. As a result, as shown in FIG. 1, the distal end portion of the catheter body 10 is bent in the direction of arrow B, and the distal end portion of the catheter is deflected.
When the control handle 20 is rotated about the Z axis shown in FIG. 1, the direction of the A direction or the B direction with respect to the control handle 20 can be freely set while being inserted into the heart chamber.

  If an example of the usage method of the electrode catheter 1 of this embodiment is shown, the target site | part in a heart cavity will be shown first in the state inserted in the cylindrical sheath (The state where four catheter tip parts were linearly deformed). The electrode catheter 1 is moved to the vicinity of the catheter, and the four catheter tip portions are pushed out of the sheath in the vicinity of the target site to restore the memory shape of the catheter tip portion (deployed shape as shown in FIGS. 1 to 4). Let

Next, as shown in FIG. 6 (1), the distal end portion of the catheter body 10 (the distal end portion of the tube member 11) is bent, and the distal end electrode 42a attached to the second catheter distal end portion 32, The distal electrode 43a attached to the third catheter tip 33 is placed so that the ablation line AL is positioned at the intermediate point between them.
In this manner, by placing the two ring-shaped electrodes attached to the adjacent catheter distal end portions, the remaining two ring-shaped electrodes, that is, the distal electrode 41a attached to the first catheter distal end portion 31 are provided. In addition, the distal electrode 44a attached to the fourth catheter distal end portion 34 can also be placed so that the ablation line AL is positioned at an intermediate point between them. As a result, the four tip electrodes 41a, 42a, 43a, 44a can be arranged at the same distance from the ablation line AL.
After placement in this manner, electrical stimulation is applied from one of the tip electrodes (pacing), and potential measurement is performed on the other tip electrode, and the transmission speed (time at which the potential is detected) is compared, thereby ablation. The line AL can be evaluated.
It is also possible to place another electrode catheter around the catheter body 10, apply electrical stimulation from the other electrode catheter (pacing), measure the potential at each tip electrode, and compare the transmission speed. is there.

By arranging the four tip electrodes equidistant from the ablation line AL, if the intended cauterization is made along the ablation line AL, the tip electrode 41a and the tip electrode 41a The potential transmission speed between the tip electrodes 44a (potential transmission speed between electrodes across the ablation line AL) is the potential between the tip electrode 42a and the tip electrode 41a and between the tip electrode 43a and the tip electrode 44a. It becomes slower than the transmission speed (the transmission speed of the potential between the electrodes not straddling the ablation line AL).
If uniform cauterization is performed along the ablation line AL, the transmission speed of the potential between the tip electrode 42a and the tip electrode 43a is equal to the transmission speed of the potential between the tip electrode 41a and the tip electrode 44a. Become.

  The ablation line AL shown in FIG. 6 (1) does not appear on the X-ray image, but is normally grasped by the operator.

  As described above, according to the electrode catheter 1 of this embodiment in which the number of catheter tip portions is four, it is easy to arrange corresponding four electrodes (for example, tip electrodes) at an equal distance from the ablation line AL. Can be done.

  According to the electrode catheter 1 of this embodiment, whether the electrode of the X-ray image and the distal end portion of the catheter to which the electrode is mounted are viewed from the distal end side of the catheter or viewed from the proximal end side of the catheter. It can be recognized immediately.

In the X-ray image in the state as shown in FIG. 6 (1), by finding the ring electrode 41B having the first wide electrode width from the tip side, this ring electrode 41B is mounted. Can be recognized as the first catheter tip 31.
Further, by finding the ring-shaped electrode 42C having the second wide electrode width from the distal end side, the catheter distal end portion on the upper left side of the drawing, to which the ring-shaped electrode 42C is attached, is the second catheter distal end portion. It can be recognized as 32.
In FIG. 6A, the first catheter tip 31, the second catheter tip 32, the third catheter tip 33, and the fourth catheter tip 34 are arranged “clockwise”. Therefore, this X-ray image can be immediately recognized as the catheter tip viewed from the proximal end side of the catheter.

On the other hand, in the X-ray image in the state as shown in FIG. 6 (2), at first glance, it looks the same as in FIG. 6 (1), but paying attention to the electrode width of the ring electrode, it is the first from the tip side. By recognizing the ring-shaped electrode 41B having a large electrode width, the catheter tip on the lower right side of the drawing, to which the ring-shaped electrode 41B is attached, is recognized as the first catheter tip 31. Can do.
In addition, by finding the ring-shaped electrode 42C having the second wide electrode width from the distal end side, the catheter distal end portion on the upper right side of the drawing, to which the ring-shaped electrode 42C is attached, is the second catheter distal end portion. It can be recognized as 32.
In FIG. 6 (2), the first catheter tip 31, the second catheter tip 32, the third catheter tip 33, and the fourth catheter tip 34 are arranged “counterclockwise”. Therefore, this X-ray image can be immediately recognized as the catheter tip viewed from the tip of the catheter.

<Second Embodiment>
The electrode catheter 2 shown in FIG. 7 has four catheter tip portions (36, 37, 38) that extend radially from the tip of the catheter body 10 (tip member 12) at equiangular intervals (about 90 ° in side view). 39), tip electrodes (46A, 47a, 48a, 49a) attached to each of the catheter tip portions, and eight ring-shaped electrodes (46b, 46c) attached to each of the catheter tip portions. 47B · 47c, 48b · 48c, 49b · 49c).

As shown in FIG. 7, of the four tip electrodes (46A, 47a, 48a, 49a) constituting the electrode catheter 2, the tip electrode 46A attached to the first catheter tip 36 has its electrode width. Is longer than the electrode width of the other tip electrode, specifically 1.5 times.
Of the eight ring-shaped electrodes (46b / 46c, 47B / 47c, 48b / 48c, 49b / 49c) constituting the electrode catheter 2, the ring-shaped electrode 47B mounted on the second catheter tip 37 is provided. The electrode width is longer than the electrode width of the other ring electrodes, specifically 1.5 to 2.0 times.

According to the electrode catheter 2 having such a configuration, a distal end electrode 46A having a wide electrode width is found on the X-ray image, whereby the distal end portion of the catheter to which the distal end electrode 46A is attached becomes the first distal end portion of the catheter. It can be recognized that it is 36.
And if the 1st catheter front-end | tip part 36 can be recognized on an X-ray image, it can recognize that each of the ring-shaped electrode with which it was mounted | worn is the ring-shaped electrode 46b and the ring-shaped electrode 46c.

Further, by finding the ring-shaped electrode 47B having a wide electrode width on the X-ray image, it is recognized that the distal end of the catheter to which the annular electrode 47B is attached is the second distal end 37 of the catheter. it can.
If the second catheter tip 37 can be recognized on the X-ray image, the tip electrode and the ring electrode attached to the second catheter tip 37 are recognized as the tip electrode 47a and the ring electrodes 47B and 47c, respectively. Can do.

Further, if the first catheter tip 36 and the second catheter tip 37 can be recognized on the X-ray image, they are next to the second catheter tip 37 (opposite to the first catheter tip 36). The catheter tip can be recognized as the third catheter tip 38.
If the third catheter tip 38 can be recognized on the X-ray image, the tip electrode and the ring electrode attached thereto are recognized as the tip electrode 48a and the ring electrodes 48b and 48c, respectively. Can do.

Further, if the first catheter tip 36, the second catheter tip 37, and the third catheter tip 38 can be recognized on the X-ray image, they are adjacent to the third catheter tip 38 (third The catheter tip (between the catheter tip 38 and the first catheter tip 36) can be recognized as the fourth catheter tip 39.
If the fourth catheter tip 39 can be recognized on the X-ray image, the tip electrode and the ring electrode attached thereto are recognized as the tip electrode 49a and the ring electrodes 49b and 49c, respectively. Can do.

As a result, it is possible to easily grasp which catheter tip is attached to all the tip electrodes (46A, 47a, 48a, 49a) on the X-ray image.
In addition, all the ring-shaped electrodes (46b / 46c, 47B / 47c, 48b / 48c, 49b / 49c) on the X-ray image are mounted at any position on any catheter tip. Can be easily grasped.

  As mentioned above, although embodiment of this invention was described, this invention is not limited to these, As shown below, a various change is possible.

  For example, the number of ring-shaped electrodes attached to each catheter tip is not limited to two, but may be three or more. In addition, as in the second embodiment, when the electrode width of the tip electrode attached to the first catheter tip is wider than the electrode width of the other tip electrode, each of the catheter tip portions The number of the ring-shaped electrodes attached to may be one.

Further, the number of catheter tip portions extending from the tip of the catheter body is not limited to four, and may be three or five or more.
Here, the electrode catheter shown in FIG. 8 (1) has three catheter tip portions (radially extending from the tip of the catheter body 10 (tip member 12) at an equal angle (about 120 ° in a side view). 131, 132, 133), tip electrodes (141a, 142a, 143a) attached to each of the catheter tip portions, and six ring-shaped electrodes (141B. 141c, 142b · 142C, 143b · 143c), and a ring electrode 141B attached to the first catheter tip 131 and a ring electrode 142C attached to the second catheter tip 132. The electrode catheter of the present invention is wider than the electrode width of other ring electrodes.

  The electrode catheter shown in FIG. 8 (2) has five catheter tip portions (231) extending radially from the tip of the catheter body 10 (tip member 12) at an equal angle (about 72 ° in side view). 232, 233, 234, 235), tip electrodes (241a, 242a, 243a, 244a, 245a) attached to each of the catheter tip portions, and ten pieces attached to each of the catheter tip portions. Ring electrodes (241B, 241c, 242b, 242C, 243b, 243c, 244b, 244c, 245b, 245c), and the ring electrode 241B attached to the first catheter tip 231; The ring-shaped electrode 242C attached to the catheter tip 232 of the present invention is wider than the electrode width of the other ring-shaped electrodes. An electrode catheter.

  Also in the electrode catheters shown in FIGS. 8 (1) to (2), it is determined which catheter tip is attached to all the electrodes (tip electrode and ring electrode) on the X-ray image. It can be easily grasped.

  The electrode catheter of the present invention can be used not only for confirmation after ablation treatment but also for various diagnoses or treatments. For example, since the electric potential in the in-circle region having the radius of the length of the distal end portion of the catheter can be measured simultaneously, it can be suitably used as a mapping catheter.

DESCRIPTION OF SYMBOLS 1 Electrode catheter 10 Catheter main body 11 Tube member 12 Tip member 121 Cylindrical part 122 Holding part 20 Control handle 21 Gripping part 22 Rotating plate 31 First catheter tip part 32 Second catheter tip part 33 Third catheter tip part 34 Fourth catheter tip 311, 321, 331, 341 Core member 312, 322, 332, 342 Covered tube 41a Tip electrode 41B / 41c Ring electrode 42a Tip electrode 42b / 42C Ring electrode 43a Tip electrode 43b / 43c Ring shape Electrode 44a Tip electrode 44b / 44c Ring electrode

Claims (7)

A catheter body having at least one inner bore;
A control handle connected to the proximal end of the catheter body;
At least three catheter tips extending from the tip of the catheter body at substantially equal angular intervals;
A plurality of ring electrodes mounted on each of the catheter tip portions;
The electrode width of one ring-shaped electrode attached to the first catheter tip, and the electrode width of one ring-like electrode attached to the second catheter tip adjacent to the first catheter tip Is different from the electrode width of other ring electrodes,
An electrode catheter characterized in that the two ring-shaped electrodes having different electrode widths from the other ring-shaped electrodes are different from each other in the arrangement position at the distal end portion of the catheter on which the two ring-shaped electrodes are mounted.   The electrode width of the first ring-shaped electrode from the distal end side at the first catheter distal end portion and the electrode width of the second ring-shaped electrode from the distal end side at the second catheter distal end portion are the other ring electrode electrodes. The electrode catheter according to claim 1, wherein the electrode catheter is wider than a width.   The electrode catheter according to claim 2, comprising four catheter tip portions. A catheter body having at least one inner bore;
A control handle connected to the proximal end of the catheter body;
At least three catheter tips extending from the tip of the catheter body at substantially equal angular intervals;
A tip electrode attached to each of the catheter tip portions;
And at least one ring electrode attached to each of the catheter tip portions;
The electrode width of the tip electrode attached to the first catheter tip is different from the electrode width of the other tip electrodes,
An electrode catheter characterized in that the electrode width of one ring-shaped electrode attached to the second catheter tip adjacent to the first catheter tip is different from the electrode width of other ring-shaped electrodes. The electrode width of the tip electrode attached to the tip of the first catheter is wider than the electrode width of the other tip electrode,
The electrode catheter according to claim 4, wherein the electrode width of one ring-shaped electrode attached to the distal end portion of the second catheter is wider than the electrode width of other ring-shaped electrodes.   The electrode catheter according to claim 5, comprising four catheter tip portions.   The electrode catheter according to any one of claims 1 to 6, further comprising a swing mechanism that bends the distal end portion of the catheter body in both directions around the axis of the catheter body.

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