JP7055610B2 - Intracardiac defibrillation system - Google Patents

Description

The present invention relates to an intracardiac defibrillation system that performs intracardiac defibrillation and intracardiac potential measurement using an electrode catheter.

In ablation treatment of atrial fibrillation, atrial fibrillation, atrial flutter or atrial tachycardia may occur when atrial fibrillation is induced to identify the causative site or as an intraoperative spontaneous attack. Intracardiac defibrillation is the application of electrical energy to an electrode catheter previously placed in the heart chamber when it is necessary to stop the atrial fibrillation that occurred during the operation by electrical defibrillation. It eliminates fibrillation. According to intracardiac defibrillation, less electrical energy is given to the patient than extracorporeal defibrillation (for example, extracorporeal defibrillation is about 150-200 J, whereas intracardiac defibrillation is intracardiac defibrillation. There are merits such as 30J or less in motion) and a small burden on the patient.

Before the cardioversion system was used, when measuring an intracardiac electrocardiogram, connect the terminal of the electrode catheter to the terminal of the polygraph examination device, and when performing cardioversion, It was necessary for medical staff such as doctors to manually perform work such as connecting the terminal of the electrode catheter to the terminal of the defibrillator. Therefore, when the terminal of the electrode catheter is reconnected, the intracardiac electrocardiogram cannot be measured temporarily.

Patent Document 1 discloses that a 1-circuit 2-contact changeover switch for switching between a polygraph inspection device, a defibrillator, and an electrode catheter is provided. According to this configuration, it is considered that the labor of the medical staff can be reduced as compared with the case where the terminal of the electrode catheter is manually reinserted. Further, it is considered that the inconvenience that the intracardiac electrocardiogram cannot be measured temporarily when the terminal of the electrode catheter is reinserted can be solved.

Japanese Unexamined Patent Publication No. 2010-220778

By the way, as described in Patent Document 1, in a system in which an electrode catheter is connected to either a polygraph inspection device or a defibrillator by a changeover switch, (1) the electrode catheter and the polygraph inspection device are used. When connected, the defibrillator cannot measure the intracardiac potential (impedance) and cannot supply electrical energy for defibrillation to the electrode catheter. (2) Defibrillator and defibrillator When connected to a defibrillator, there is a drawback that the intracardiac potential cannot be measured on the polygraph inspection device side.

As described above, the conventional intracardiac defibrillation system is still insufficient in terms of supplying electric energy to the electrode catheter and flexibility in measuring the intracardiac potential.

The present invention has been made in consideration of the above points, and provides an intracardiac defibrillation system capable of improving the supply of electrical energy to an electrode catheter and the flexibility of measuring an intracardiac potential. ..

One aspect of the intracardiac defibrillation system of the present invention is:
An electrode catheter having an RA electrode placed in the right atrium and a CS electrode placed in the coronary sinus.
A defibrillator that is electrically connected to the RA electrode and the CS electrode of the electrode catheter and supplies electrical energy for intracardiac defibrillation to the RA electrode and the CS electrode.
An electrocardiograph that is electrically connected to the RA electrode and the CS electrode of the electrode catheter and measures the potential of the RA electrode and the CS electrode.
Intracardiac defibrillation system with
The intracardiac defibrillation system further
A first electric energy supply line capable of supplying the electric energy of the defibrillator to the first RA electrode included in the RA electrode and the first CS electrode included in the CS electrode, and
The electric energy of the defibrillator is used in a second RA electrode different from the first RA electrode included in the RA electrode and a second CS different from the first CS electrode contained in the CS electrode. A second electrical energy supply line that can be supplied to the electrodes,
With
It has a mode of supplying electric energy from both the first and second electric energy supply lines and a mode of supplying electric energy only from the first electric energy supply line .
moreover,
The electrode catheter is provided with an RA electrode and a CS electrode for voltage application and an RA electrode and a CS electrode for potential measurement separately.
The first RA electrode and the first CS electrode are the RA electrode and the CS electrode for applying the voltage.
The second RA electrode and the second CS electrode are the RA electrode and the CS electrode for potential measurement .

According to the present invention, the supply of electrical energy to the electrode catheter and the flexibility of measuring the intracardiac potential are improved.

The figure which shows the example of the electrode catheter which provided the electrode for potential measurement and the electrode for defibrillation separately. The figure which shows the example of the electrode catheter in which the electrode for potential measurement and the electrode for defibrillation are shared. Schematic diagram showing the overall configuration of the defibrillation system according to the embodiment FIG. 4A is a diagram showing a state in which the electrode catheter short SW is on, and FIG. 4B is a diagram showing a state in which the electrode catheter short SW is off. FIG. 5A is a diagram showing a state in which the on / off SW is on, and FIG. 5B is a diagram showing a state in which the on / off SW is off. Schematic diagram showing the external configuration of a defibrillator Enlarged view of the output setting dial SW The figure which shows the state of the defibrillation system in the extracorporeal defibrillation mode and the intracardiac potential measurement mode. The figure which shows the state of the defibrillation system in the intracardiac defibrillation mode 1. The figure which shows the state of the defibrillation system in the intracardiac defibrillation mode 2. The figure which shows the state when the type 2 electrode catheter (FIG. 2) is connected to the terminal T1 and the defibrillation system is in the intracardiac potential measurement mode execution. The figure which shows the state when the type 2 electrode catheter (FIG. 2) is connected to the terminal T1 and the defibrillation system is performing intracardiac defibrillation.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

<1> Configuration of Electrode Catheter First, before explaining the specific configuration of the embodiment, the configuration of the electrode catheter 20 that is supposed to be used in the present embodiment will be described. In this embodiment, it is assumed that two types of electrode catheters, the electrode catheter shown in FIG. 1 and the electrode catheter shown in FIG. 2, are used.

The electrode catheter 20 shown in FIG. 1 is provided with a potential measurement electrode and a voltage application electrode separately. Hereinafter, such an electrode catheter will be referred to as type 1. In the electrode catheter 20 shown in FIG. 2, the electrode for potential measurement and the electrode for voltage application are shared. Hereinafter, such an electrode catheter will be referred to as type 2. As the conventional electrode catheter for intracardiac defibrillation, a type 2 catheter is often used.

The type 1 electrode catheter 20 shown in FIG. 1 is provided with eight potential measurement electrodes 21X and four voltage application electrodes 21Y as RA electrode group 21. Conductors isolated from each other are connected to the eight potential measurement electrodes 21X, whereby the potentials of the eight potential measurement electrodes 21X are measured on the measurement side to which these conductors are connected. You can do it. On the other hand, a common conductor is connected to the four voltage application electrodes 21Y, which is common to the four voltage application electrodes 21Y from the defibrillator to which the conductor is connected via the conductor. Electric energy for defibrillation is being supplied.

Similarly, the type 1 electrode catheter 20 is provided with eight potential measurement electrodes 22X and four voltage application electrodes 22Y as the CS electrode group 22. Conductors isolated from each other are connected to the eight potential measurement electrodes 22X, whereby the potentials of the eight potential measurement electrodes 22X are measured on the measurement side to which these conductors are connected. You can do it. On the other hand, a common conductor is connected to the four voltage application electrodes 22Y, which is common to the four voltage application electrodes 22Y from the defibrillator to which the conductor is connected via the conductor. Electric energy for defibrillation is being supplied.

The number, arrangement pattern, and size of the potential measurement electrodes 21X and 22X and the voltage application electrodes 21Y and 22Y are not limited to the example of FIG. For example, the number of voltage application electrodes 21Y and 22Y may be one, respectively.

The type 2 electrode catheter 20 shown in FIG. 2 is provided with eight electrodes 21Z used for both potential measurement and voltage application as the RA electrode group 21. Specifically, a conducting wire that is insulated from each other is connected to each of the eight electrodes 21Z, whereby the potential of each of the eight electrodes 21Z can be measured. On the other hand, when the electric energy for definement is supplied to the eight electrodes 21Z, the same applied voltage is applied to all the eight electrodes 21Z by short-circuiting the eight conductors and supplying the electric energy for definement. Can be supplied.

<2> Configuration of Defibrillation System Next, the configuration of the defibrillation system of the embodiment will be described. The defibrillator system described below is compatible with both the type 1 electrode catheter 20 (FIG. 1) and the type 2 electrode catheter 20 (FIG. 2), but in the following embodiments, the main The case where the type 1 electrode catheter 20 (FIG. 1) is used will be described.

FIG. 3 is a schematic diagram showing the overall configuration of the defibrillation system according to the embodiment.

The defibrillator system 1000 includes a defibrillator 100, a polygraph inspection device 300 having a function as an electrocardiograph, an electrode catheter 20 (potential measuring electrodes 21X and 22X as shown in FIG. 1, and voltage application). It has an electrode catheter 20) in which electrodes 21Y and 22Y are separately provided, an extracorporeal paddle 500, and a connecting device 200. The defibrillator 100, the polygraph inspection device 300, the electrode catheter 20, and the extracorporeal paddle 500 are connected by a connecting device 200. The polygraph inspection device described in the present specification may be read as an electrocardiograph. Further, in the present embodiment, the connecting device 200 is separate from the defibrillator 100, but the connecting device 200 may be integrated with the defibrillator 100 in the defibrillator 100. .. Further, in the present embodiment, the extracorporeal paddle 500 is taken as an example as a device for performing extracorporeal defibrillation, but an electrode pad, an internal paddle, or the like may be used instead of the extracorporeal paddle 500.

The defibrillator 100 is capable of generating electrical energy for performing intracardiac defibrillation with the electrode catheter 20 and electrical energy for performing extracorporeal defibrillation with the extracorporeal paddle 500.

Specifically, as shown in FIG. 6, the defibrillator 100 has various operations such as a charging operation switch (hereinafter, the switch is abbreviated as “SW”) 111, an energizing operation SW112, and an output setting dial SW113. It has a switch, an LCD (Liquid Crystal Display) 114, an AC / DC power supply unit 115 that inputs an AC power source and converts it into a DC power source, and an input / output terminal unit 116. Further, although not shown, the defibrillator 100 includes a battery, a booster circuit, an arithmetic circuit, a control circuit, and the like.

The output setting dial SW113 has a function of setting the energization level and a function of switching the energization destination. The output setting dial SW113 also has a function of selecting a monitor mode and an AED (Automated External Defibrillator) mode.

FIG. 7 is an enlarged view of the output setting dial SW113. When the user adjusts the dial rotation position to the "monitor" position, the defibrillator 100 enters the electrocardiogram measurement mode (monitor mode), and when the dial rotation position is adjusted to the "AED" position, the defibrillator 100 enters. Is an extracorporeal defibrillation mode (AED mode). Further, when the user rotates the dial clockwise from the "off" position, the defibrillator 100 can be put into the intracardiac defibrillation mode, and 1, depending on the rotation position, 1, Any of 2, 4, 6, 8, 10, 15, 20, 30 [J] can be set. On the other hand, when the user rotates the dial counterclockwise from the "off" position, the defibrillator 100 can be set to the extracorporeal defibrillation mode, and 1, depending on the rotation position, 1, Any of 2, 4, 6, 8, 10, 15, 20, 30, 50, 70, 100, 150, 200 [J] can be set.

The polygraph inspection device 300 has an intracardiac potential input terminal portion 301. Further, although not shown, the polygraph inspection device 300 includes a calculation unit that forms an intracardiac electrocardiogram from the measured potential input from the intracardiac potential input terminal unit 301, a display unit that displays the electrocardiogram, a control unit, and the like. Have.

The electrode catheter 20 is connected to the connecting device 200 via the relay cable K1. In practice, the electrode catheter 20 includes an RA electrode group 21 indwelled in the right atrium, a CS electrode group 22 indwelled in the coronary sinus, and a 4-pole EP electrode group (SVC electrode) indwelled in the superior vena cava. And IVC electrodes, etc.) (not shown). Of these electrodes, RA electrode group 21 and CS electrode group 22 are used for intracardiac defibrillation, and RA electrode group 21, CS electrode group 22 and EP electrodes are used to measure intracardiac potential. Used.

The extracorporeal paddle 500 is composed of a pair of paddles each having an extracorporeal defibrillation electrode, and a charging operation SW501 and an energizing operation SW502 are provided on the handle portion of the paddle, and the user can charge the charging operation SW501 and the energizing operation SW502. By operating the defibrillator 100, the defibrillator 100 can be charged, and the defibrillator 100 can supply energy for defibrillation.

The connecting device 200 is connected to the defibrillator 100 by a cable K0. In the connection device 200, electrical energy for defibrillation outside the body or defibrillation within the heart cavity is input from the defibrillator 100 via the cable K0, and the electrical energy is input to the extracorporeal paddle 500 via the terminal T4 and the cable K4. It outputs electrical energy for defibrillation and outputs electrical energy for cardioversion to the electrode catheter 20 via terminal T1 and relay cable K1.

Further, the connection device 200 receives a charge switch operation signal and an energization switch operation signal from the extracorporeal paddle 500 via the cable K4 and the terminal T4, and outputs them to the defibrillator 100 via the cable K0.

Further, the connecting device 200 inputs the intracardiac potential from the electrode catheter 20 via the relay cable K1 and the terminal T1, and outputs the intracardiac potential to the polygraph inspection device 300 via the terminal T2 and the electrocardiographic output cable K2.

Further, the connecting device 200 has a switching SW 220. One of the contacts a and b of the switching SW 220 is selected according to the operation of the output setting dial SW 113 of the defibrillator 100 by the user. That is, when the user selects extracorporeal defibrillation with the output setting dial SW113, the switching SW connects to the contact a, whereas when the user selects intracardiac defibrillation with the output setting dial SW113, the switching SW220 makes contact. Connect to b.

A conductor corresponding to the RA electrode group 21 and a conductor corresponding to the CS electrode group 22 are connected to the contact b. These two conductors are connected to the terminal T1 via the electrode catheter short SW230, and are branched in front of the electrode catheter short SW230 and connected to the terminal T1.

The electrode catheter short SW230 is designed to short between a plurality of electrodes provided on the electrode catheter 20. As a result, the contact area with the heart wall can be widened to lower the impedance, and the set number of joules of defibrillation energy can be transmitted to the heart wall.

The conductor L1 branched in front of the electrode catheter short SW230 and connected to the terminal T1 is the first electricity for supplying the electric energy of the defibrillator 100 to the voltage application electrodes 21Y and 22Y of the electrode catheter 20. It has a function as an energy supply line. That is, of the conductors L1, the conductor L11 supplies electrical energy to the voltage application electrode 21Y of the RA electrode group 21, and the conductor L12 supplies electrical energy to the voltage application electrode 22Y of the CS electrode group 22.

Further, the lead wire L2 connected between the electrode catheter short SW230 and the terminal T1 is a second for supplying the electrical energy of the defibrillator 100 to the electrodes 21X and 22X for potential measurement of the electrode catheter 20. It has a function as an electric energy supply line. That is, of the conductors L2, the conductor L21 supplies electric energy to the potential measurement electrode 21X of the RA electrode group 21, and the conductor L22 supplies electric energy to the potential measurement electrode 22X of the CS electrode group 22.

With this configuration, in the defibrillation system 1000, a mode in which electrical energy is supplied to the voltage application electrodes 21Y and 22Y of the electrode catheter 20 to perform intracardiac defibrillation, and the voltage application electrodes 21Y and 22Y and the potential It is possible to select a mode in which electric energy is supplied to both the measurement electrodes 21X and 22X to perform cardioversion in the heart cavity.

Further, the connecting device 200 has an on / off SW 240 and a protection resistor 250. The protection resistor 250 is connected in parallel with the on / off SW 240. The lead wire L21 connected to the potential measurement electrode 21X of the electrode catheter 20 and the lead wire L22 connected to the potential measurement electrode 22X of the electrode catheter 20 are connected to the on / off SW 240 and the protection resistor 250. The on / off SW240 is provided with a total of 16 on / off SWs corresponding to the 8-pole RA electrode group 21X and the 8-pole CS electrode group 22X, and the protection resistor 250 is provided with the 8-pole RA electrode group 21X. A total of 16 resistors corresponding to the 8-pole CS electrode group 22X are provided.

The resistance value of each resistor constituting the protection resistor 250 is, for example, several hundred kΩ. This resistance value may be a value that can protect the polygraph inspection device 300 when energy for defibrillation in the heart chamber is supplied from the defibrillator 100.

In addition, in FIG. 3, in order to simplify the figure, the electrode catheter short SW230 and the on / off SW240 are shown in a simplified manner. 4 and 5 show the electrode catheter short SW230 and the on / off SW240 in detail.

As shown in FIG. 4, when the electrode catheter short SW230 is turned on (FIG. 4A), the same voltage is supplied to all 16 conductors constituting the conductor L2. On the other hand, when the electrode catheter short SW230 is turned off (FIG. 4B), voltage is not supplied to the 16 conductors constituting the conductor L2.

Here, the electrode catheter short SW230 is provided on the second electric energy supply line, and may be referred to as an on / off SW for switching whether or not to supply electric energy for defibrillation to the RA electrode and CS electrode for potential measurement. can.

As shown in FIG. 5, when the on / off SW240 is turned on (FIG. 5A), all 16 conductors constituting the conductor L2 are closed. On the other hand, when the on / off SW240 is in the off state (FIG. 5B), all 16 conductors constituting the conductor L2 are opened.

The operation of the electrode catheter short SW230 and the on / off SW240 is controlled by a control signal from the defibrillator 100 input via the cable K0.

<3> Operation of the defibrillation system Next, the operation of the defibrillation system 1000 will be described.

<3-1> Extracorporeal defibrillation mode, intracardiac potential measurement mode FIG. 8 shows the state of the defibrillation system 1000 in the extracorporeal defibrillation mode and the intracardiac potential measurement mode. By connecting the switching SW 220 to the contact a, the electric energy from the defibrillator 100 is supplied to the extracorporeal paddle 500.

Further, the electrode catheter short SW230 is turned off, and the on / off SW240 is turned on. As a result, the lead wire L2 connected to the potential measurement electrodes 21X and 22X of the electrode catheter 20 is electrically connected to the polygraph inspection device 300 via the on / off SW240, and the polygraph inspection device 300 can measure the intracardiac potential.

As described above, in the defibrillation system 1000, the intracardiac potential can be measured even in the extracorporeal defibrillation mode.

<3-2> Intracardiac defibrillation mode 1
FIG. 9 shows the state of the defibrillation system 1000 in the intracardiac defibrillation mode 1. By connecting the switching SW 220 to the contact b, electrical energy from the defibrillator 100 is supplied to the electrode catheter 20.

Further, the electrode catheter short SW230 is turned off, and the on / off SW240 is turned off. As a result, the electrical energy from the defibrillator 100 is supplied to the voltage applying electrodes 21Y and 22Y of the electrode catheter 20 via the conducting wire L1. Further, the lead wire L2 connected to the potential measurement electrodes 21X and 22X of the electrode catheter 20 is electrically connected to the polygraph inspection device 300 via the protection resistor 250, and the polygraph inspection device 300 can measure the intracardiac potential.

As described above, in the defibrillation system 1000, the intracardiac potential can be measured even in the intracardiac defibrillation mode.

Incidentally, in the intracardiac defibrillation mode of FIG. 9, the electrical energy for defibrillation is not directly applied to the electrodes 21X and 22X for potential positioning, but the electrode groups 21X and 22X for potential positioning are. Since it is arranged near the voltage application electrodes 21Y and 22Y, a large amount of electric energy is applied through the human body. If this large electric energy is directly input to the polygraph inspection device 300 via the on / off SW 240, the polygraph inspection device 300 may be damaged. In consideration of this, in the present embodiment, in the intracardiac thinning mode, the potential positioning electrodes 21X and 22X and the polygraph inspection device 300 are electrically connected via the protection resistance 250. There is.

<3-3> Intracardiac defibrillation mode 2
FIG. 10 shows the state of the defibrillation system 1000 in the intracardiac defibrillation mode 2. By connecting the switching SW 220 to the contact b, electrical energy from the defibrillator 100 is supplied to the electrode catheter 20.

Further, the electrode catheter short SW230 is turned on, and the on / off SW240 is turned off. As a result, the electrical energy from the defibrillator 100 is supplied to the voltage applying electrodes 21Y and 22Y of the electrode catheter 20 via the conductor L1, and the potential positioning electrode 21X of the electrode catheter 20 is supplied via the conductor L2. , 22X is also supplied. Further, the lead wire L2 connected to the potential measurement electrodes 21X and 22X of the electrode catheter 20 is electrically connected to the polygraph inspection device 300 via the protection resistor 250, and the polygraph inspection device 300 can measure the intracardiac potential.

As described above, in the defibrillation system 1000, the intracardiac potential can be measured even in the intracardiac defibrillation mode.

Here, in the intracardiac defibrillation mode 2 as compared with the above-mentioned intracardiac defibrillation mode 1, electric energy is supplied to the potential positioning electrodes 21X and 22X in addition to the voltage application electrodes 21Y and 22Y. As a result, the surface area of the heart that supplies electrical energy increases, which lowers the impedance, and as a result, has the advantage of increasing the defibrillation efficiency. On the other hand, since electrical energy for defibrillation flows through the conductor L2, the measurement accuracy of the intracardiac potential is lower than that in the intracardiac defibrillation mode 1.

It should be noted that the defibrillation mode may be configured so that only one of the intracardiac defibrillation mode 1 and the intracardiac defibrillation mode 2 can be executed. For example, the mode is switched to the defibrillator 100. The unit may be provided so that the user can select either the intracardiac defibrillation mode 1 or the intracardiac defibrillation mode 2.

Further, in the intracardiac defibrillation mode 1, when the impedance is larger than a predetermined value, the intracardiac defibrillation mode 2 may be executed. By doing so, the surface area of the portion of the electrode catheter 20 that supplies electric energy can be changed according to the situation, so that the appropriate electric energy can be obtained while avoiding an increase in unnecessary burden on the subject. Can supply.

<3-4> When the Type 2 Electrode Catheter 20 (FIG. 2) is Connected Up to this point, the operation when the Type 1 electrode catheter 20 (FIG. 1) is connected to the terminal T1 has been described. The operation when the type 2 electrode catheter 20 (FIG. 2) is connected to the terminal T1 will be described below.

FIG. 11 shows a state when the type 2 electrode catheter 20 (FIG. 2) is connected to the terminal T1 and the defibrillation system 1000 is in the intracardiac potential measurement mode. The switching SW 220 is connected to the contact b, the electrode catheter short SW230 is turned off, and the on / off SW240 is turned on. As a result, the lead wire L2 connected to the electrodes 21Z and 22Z of the electrode catheter 20 is electrically connected to the polygraph inspection device 300 via the on / off SW240, and the polygraph inspection device 300 can measure the intracardiac potential.

FIG. 12 shows a state in which a type 2 electrode catheter 20 (FIG. 2) is connected to the terminal T1 and the defibrillation system 1000 is performing intracardiac defibrillation. The switching SW 220 is connected to the contact b, the electrode catheter short SW230 is turned on, and the on / off SW240 is turned off. As a result, electrical energy is supplied to the electrodes 21Z and 22Z of the electrode catheter 20 via the conductor L2. Further, the lead wire L2 is electrically connected to the polygraph inspection device 300 via the protection resistor 250, and the polygraph inspection device 300 and the defibrillation device 100 can measure the bipolar potential between RA and CS. However, since the electrode catheter short SW230 is short-circuited, the intracardiac potential with the RAs or CSs bipolarized is averaged. Since the RA-CS lead waveform (lead waveform obtained based on the measured potentials of the RA electrode and the CS electrode) can be displayed by the polygraph inspection device, the R wave position of the ECG and the peak position of the RA-CS can be compared. If the peak positions of the R wave and RA-CS are the same in appearance, it is possible to improve the accuracy of R wave synchronous energization using RA-CS induction in the defibrillator.

Here, as can be seen from FIGS. 11 and 12, when the type 2 electrode catheter 20 (FIG. 2) is connected to the terminal T1, the conducting wire L1 is in a state of being disconnected at the position of the terminal T1. Therefore, for example, by detecting whether or not the conductor L1 is broken, it is possible to recognize which of the type 1 and type 2 electrode catheters 20 is connected to the terminal T1. Therefore, the defibrillation system 1000 can perform the above-mentioned processing of each mode after recognizing which type of electrode catheter 20 is connected.

<4> Effect of the Embodiment As described above, according to the present embodiment, the first embodiment for supplying the electric energy of the defibrillator 100 to the RA electrode 21Y and the CS electrode 22Y for applying a voltage. An electric energy supply line (lead wire L1) and a second electric energy supply line (lead wire L2) for supplying the electric energy of the defibrillator 100 to the RA electrode 21X and the CS electrode 22X for potential measurement are provided. Therefore, it becomes possible to flexibly supply electric energy to the electrode catheter 20 according to the situation.

Further, even when the protection resistance 250 is provided and the electric energy is supplied to the electrode catheter 20 from the first and / or second electric energy supply lines (lead wires L1 and L2), the electrocardiograph is provided via the protection resistance 250. By electrically connecting the (polygraph inspection device 300) with the RA electrode 21X and the CS electrode 22X for potential measurement, the intracardiac potential can be measured by the electrocardiograph (polygraph inspection device 300) even during intracardiac defibrillation. You will be able to measure.

The above-described embodiment is merely an example of the embodiment of the present invention, and the technical scope of the present invention should not be construed in a limited manner by these. That is, the present invention can be implemented in various forms without departing from its gist or its main features.

In the above-described embodiment, the first electric energy supply line (lead wire L1) for supplying the electric energy of the defibrillator 100 to the RA electrode 21Y and the CS electrode 22Y for applying a voltage, and the defibrillator 100. Although the case where the second electric energy supply line (lead wire L2) for supplying the electric energy of the above to the RA electrode 21X and the CS electrode 22X for potential measurement is provided, the present invention is not limited to this. In short, a first electric energy supply line capable of supplying the electric energy of the defibrillator to the first RA electrode included in the RA electrode group and the first CS electrode included in the CS electrode group, and demineralization. The electrical energy of the motive can be supplied to the second RA electrode different from the first RA electrode included in the RA electrode group and the second CS electrode different from the first CS electrode included in the CS electrode group. It may be configured to have a second electric energy supply line.

Further, in the above-described embodiment, the case where the defibrillator 100 having both the intracardiac defibrillation function and the extracorporeal defibrillation function is connected to the connecting device 200 has been described. A first defibrillator having a defibrillation function and a second defibrillator having an extracorporeal defibrillation function may be separately connected to the connecting device 200. However, when a defibrillator 100 having both an intracardiac defibrillation function and an extracorporeal defibrillation function is connected to the connecting device 200 as in the above-described embodiment, the connecting device 200 and the defibrillator are defibrillated. It is more preferable because only one cable is required to connect the motive 100.

In the above-described embodiment, the case where the switching SW220, the electrode catheter short SW230, the on / off switch 240 and the protection resistance 250 are provided in the connection device 200 separate from the defibrillator 100 has been described, but these are defibrillators. It may be built in the motive 100.

INDUSTRIAL APPLICABILITY The present invention can be applied to an intracardiac defibrillation system that performs intracardiac defibrillation and intracardiac potential measurement using an electrode catheter.

20 Electrode catheter 21 RA Electrode group 21X, 22X Electrode for potential measurement 21Y, 22Y Electrode for voltage application 21Z Electrode 22 CS Electrode group 100 Defibrillator 200 Connection device 220 Switching switch
230 Electrode Catheter Short SW
240 on / off SW
250 Protection resistance 300 Polygraph inspection device 500 Extracorporeal paddle L1, L2, L11, L12, L21, L22 Conductor

Claims (6)

An electrode catheter having an RA electrode placed in the right atrium and a CS electrode placed in the coronary sinus.
A defibrillator that is electrically connected to the RA electrode and the CS electrode of the electrode catheter and supplies electrical energy for intracardiac defibrillation to the RA electrode and the CS electrode.
An electrocardiograph that is electrically connected to the RA electrode and the CS electrode of the electrode catheter and measures the potential of the RA electrode and the CS electrode.
Intracardiac defibrillation system with
The intracardiac defibrillation system further
A first electric energy supply line capable of supplying the electric energy of the defibrillator to the first RA electrode included in the RA electrode and the first CS electrode included in the CS electrode, and
The electric energy of the defibrillator is used in a second RA electrode different from the first RA electrode included in the RA electrode and a second CS different from the first CS electrode contained in the CS electrode. A second electrical energy supply line that can be supplied to the electrodes,
With
It has a mode in which electric energy is supplied from both the first and second electric energy supply lines and a mode in which electric energy is supplied only from the first electric energy supply line .
moreover,
The electrode catheter is provided with an RA electrode and a CS electrode for voltage application and an RA electrode and a CS electrode for potential measurement separately.
The first RA electrode and the first CS electrode are the RA electrode and the CS electrode for applying the voltage.
The second RA electrode and the second CS electrode are the RA electrode and the CS electrode for potential measurement.
Intracardiac defibrillation system. The second electric energy supply line is provided with a first on / off switch.
A mode in which electric energy is supplied from both the first and second electric energy supply lines by controlling the first on / off switch, and a mode in which electric energy is supplied only from the first electric energy supply line. And can be selected,
The intracardiac defibrillation system according to claim 1. When the impedance when supplying electric energy only from the first electric energy supply line is equal to or higher than a predetermined value, the mode of supplying electric energy from both the first and second electric energy supply lines is executed.
The intracardiac defibrillation system according to claim 1 or 2. It has an operation unit for selecting a mode in which electric energy is supplied only from the first electric energy supply line and a mode in which electric energy is supplied from both the first and second electric energy supply lines.
The intracardiac defibrillation system according to claim 1 or 2. A protective resistance is connected between the RA electrode and the CS electrode and the electrocardiograph.
Even when electrical energy is supplied to the electrode catheter from the first and / or second electrical energy supply lines, the electrocardiograph and the RA electrode and CS electrode for potential measurement are connected via the protection resistor. Electrically connect,
The intracardiac defibrillation system according to any one of claims 1 to 4. A second on / off switch and a protection resistor are provided in parallel between the RA electrode and the CS electrode and the electrocardiograph.
The second on / off switch is turned on during intracardiac potential measurement, while the second on / off switch is turned off during intracardiac defibrillation.
The intracardiac defibrillation system according to any one of claims 1 to 5.

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