JPH08504333A - Electrode-supported splines for the cardiac system - Google Patents

Abstract

(57) Summary An electrode support for use in intracardiac heart diagnosis and therapy, the electrode support comprising at least one elongated spline (76) having at least one electrode (22). ing. The spline has a rectangular cross section and its width is much longer than its thickness. The spline is constructed to be bendable in one vertical plane passing through its longitudinal axis. The spline is constructed so that it cannot twist or bend in all other planes through the axis.

Description

DETAILED DESCRIPTION OF THE INVENTION Electrode-supporting splines for the cardiac system TECHNICAL FIELD OF THE INVENTION The present invention relates to a transcutaneous lead and associated system and method for mapping internal regions of the heart for the purpose of diagnosing cardiac conditions. Background of the Invention Cardiac mapping is used to locate abnormal electrical pathways and currents within the heart. Abnormal electrical pathways cause the muscles of the heart to contract, causing unusual, life-threatening patterns or rhythm abnormalities. To perform mapping in the heart, an array of electrodes must be carefully placed in the heart. Various configurations have been developed or proposed for these multiple electrode mapping arrays. For example, Hess U.S. Pat. Nos. 4,573,473 and 4,690,148, and Desai, U.S. Pat. No. 4,94,0064, disclose the use of a general two-dimensional mapping array. Chilson U.S. Pat. No. 4,699,147 discloses the use of a three-dimensional basket mapping array. U.S. Pat. No. 4,522,212 to Gelinas discloses an array of electrode support fingers using a spring therebetween. Regardless of the type of mapping array used, physicians are required to remotely move and manipulate electrode arrays within the heart in a variety of ways. First, the physician must deliver this electrode array from a major vein or artery to a selected ventricle. Second, the physician must place the array at the desired location on the endocardium. The practitioner must then move the array further in its desired position to ensure that any abnormal electrical paths are located. Traditional mapping array development has focused on meeting the requirements for the mapping function itself. Conventional developments neglect the important need to move and manipulate mapping arrays in a continuous and various manner before, after, and during the operation of a mapping operation. Summary of the invention The present invention provides electrode-supported splines for use in intraventricular heart diagnosis and therapy. According to one aspect of the invention, the spline comprises at least one electrode. The cross section of the spline is rectangular. Its cross section is much longer in width than in thickness. This spline has a structure that can be bent in a plane perpendicular to one spline passing through its longitudinal axis. The spline can resist twisting and bending in all other planes through its axis. According to another aspect of the invention, the spline is made of a memory wire, which at a temperature has a defined shape. According to yet another aspect of the invention, the spline has at least two regions along its longitudinal axis, which have different flexural rigidity. Brief description of the drawings FIG. 1 is a perspective view of an endocardial mapping system embodying features of the present invention. FIG. 2 is a plan view of a probe associated with the system shown in FIG. 1, showing the operation of the steering mechanism. 3 and 4 are side views of the probe associated with the system shown in FIG. 1, showing the function of the deployment mechanism of the mapping array. 5-7 are side views of a probe associated with the system shown in FIG. 1, showing the operation of the mechanism for opening and shaping the mapping array. FIG. 8 is a side view of a probe associated with the system shown in FIG. 1, showing the operation of the rotating mechanism of the mapping array. 9 is an exploded side view of a probe associated with the system shown in FIG. FIG. 10 is an enlarged cross-sectional view of the inside of the probe body shown in FIG. 9, showing a state where the proximal end of the catheter is joined to the probe body after assembly. FIG. 11 is an enlarged cross-sectional view inside the tip of the probe handle shown in FIG. 9 after assembly. FIG. 12 is an enlarged cross-sectional view of the mapping basket associated with the system shown in FIG. 1 in a partially exploded view. FIG. 13 is an enlarged perspective view, partially exploded, of a cylindrical electrode support spline that can be used with the mapping basket shown in FIG. 14 is a super-enlarged cross-sectional view of the cylindrical electrode support spline taken along line 14-14 of FIG. FIG. 15 is an enlarged perspective view of a linear spline that can be used with the mapping basket shown in FIG. 16 is a perspective view of the linear spline shown in FIG. 15 before the electrodes are attached. 17 is an enlarged perspective view of an alternative embodiment of a linear spline that can be used with the mapping basket shown in FIG. FIG. 18 is an enlarged perspective view of the linear spline shown in FIG. 15, showing its multiple conductive and non-conductive layers. 19 is a schematic exploded side view of a plurality of conductive and non-conductive layers of the linear spline shown in FIG. 20 is a greatly omitted enlarged perspective view showing one of the eight microconnector chips and a solid circuit tube associated with the mapping assembly of FIG. FIG. 21 is a plan view showing an electrical connection relationship between the micro connector chip and the solid circuit tube shown in FIG. FIG. 22 is a greatly omitted enlarged perspective view of an alternative embodiment of a solid circuit tube and microconnector chip associated with the mapping assembly shown in FIG. FIG. 23 is a schematic diagram of a power supply and signal control circuit for the microconnector shown in FIGS. 20 and 21. 24 is a schematic diagram of an alternative power and signal control circuit for the microconnector shown in FIG. FIG. 25 is a plan view of the inside of the steering mechanism associated with the probe shown in FIG. FIG. 26 shows the distal end of an alternative catheter with a mapping assembly that uses a guide wire instead of the steering mechanism. FIG. 27 is an enlarged view of the end cap of the mapping assembly shown in FIG. 28 and 29 are side cross-sectional views of an alternative deployable mapping assembly that uses an inflatable bag. 30A and 30B are side cross-sectional views of an alternative deployable mappin assembly that uses a flexible sail. 31A, B, and C are side cross-sectional views of an alternative deployable mapping assembly that uses a central spline with randomly attached electrode support filaments. 32A and B are side cross-sectional views of an alternative deployable mapping assembly using foam. FIG. 33 is a side cross-sectional view showing a collapsed base member of a dynamic mapping assembly embodying features of the present invention. 34 is a side cross-sectional view of the dynamic mapping assembly associated with the base member shown in FIG. 33 in a collapsed state. FIG. 35 is a side cross-sectional view of an expanded base member of a dynamic mapping assembly embodying features of the present invention. FIG. 36 is a side cross-sectional view of the dynamic mapping assembly associated with the base member shown in FIG. Detailed Description of the Invention FIG. 1 illustrates an endocardial mapping system 10 embodying features of the present invention. The system 10 comprises a hand held probe 12 and a controller 14 associated therewith. The probe 12 comprises a handle 16 and a flexible catheter 18 connected to it. The catheter 18 holds a mapping assembly 20 slidably within the lumen, the mapping assembly 20 being adapted to extend from the distal end of the catheter. The mapping assembly 20 constitutes a three-dimensional array of electrodes 22. In use, the mapping assembly 20 records the activation time, distribution, and waveform of the charge or potential that facilitates pumping of the heart muscle. Lead 24 passes through the lumen of the catheter and connects mapping assembly 20 to controller 14. The controller 14 receives and processes the electrical potential developed at the electrodes 22 on the mapping assembly 20. An attached CRT display 26 visually displays the processed data, which can be referenced by the treating physician. The controller 14 further comprises a printer 28, on which the processed data is printed in a strip recording format. The physician advances the catheter 18 from the major vein or artery (usually the femoral artery) to a selected ventricle to position the mapping assembly 20. At this time, the mapping assembly 20 is contained in the distal end of the catheter 18 in a small folded state (see FIG. 3). The physician may observe the progress of the distal end of the catheter by fluoroscopy, ultrasonography, or other similar method. Once the physician has placed the distal end of the catheter 18 at the desired endocardial location, the control mechanism of the probe 12 is then manipulated to deploy and open the mapping assembly 20 into the desired three-dimensional array 22 (FIG. 1). reference). The controller 14 analyzes the signal received from the electrode 22 and locates abnormal lesions in the tissue that upset the normal heart rhythm and may cause cardiac arrhythmias. Once the location is located, the doctor removes or destroys the abnormal lesion by ablation and restores normal heart rhythm. For this purpose, another radio frequency or ultra high frequency ablation probe (not shown) can be used. It should be noted that the mapping array 22 may itself include one or more stripping electrodes. According to one aspect of the invention, the probe 12 comprises four independent control mechanisms that allow the physician to perform the steps of the mapping operation outlined above. These controls are centered on the handle 16 and provide for error-free and concise maneuverability of the catheter 18 and its associated mapping assembly 20. The first control mechanism 30 tilts the distal end of the catheter 18 (see Figure 2). This allows the physician to remotely control and steer the distal end of catheter 18 to a position within the body. When the mapping assembly 20 is deployed, the first mechanism 30 can also be used to orient and steer the mapping assembly 20 itself. This allows the physician to remotely manipulate the mapping assembly 20 against endocardial tissue. The second mechanism 32 controls the deployment of the mapping assembly 20. The second mechanism 32 controls deployment of the mapping assembly 20 to deploy within the distal end of the catheter 18 from a retracted position (see FIG. 3) to an operative position outside the catheter (see FIG. 4). . When retracted, the mapping assembly 20 occupies a lower position so that it does not interfere with maneuvering within the body. Once the mapping assembly 20 is deployed in the operative position, it can be opened to perform signal mapping functions. The third mechanism 34 unfolds the mapping assembly 20 as it is deployed. The third mechanism 34 moves the mapping assembly 20 between its fully closed, folded position (see FIG. 4) and its fully open position (see FIG. 5). In the illustrated preferred embodiment, the third mechanism 34 also controls the three-dimensional shape of the mapping assembly 20. At this point, the physician can remotely control the shape of the mapping assembly 20 by manipulating the third mechanism 34. In the illustrated embodiment, the third mechanism 34 changes the shape of the mapping assembly 20 from a stretched ellipse (see FIG. 7) to a generally spherical shape (see FIG. 5) and further an annulus (see FIG. 6). ) To continuously change. Thus, by using the third mechanism 34, the practitioner can modify the shape of the mapping assembly 20 and adjust it to more closely match the particular endocardial contour to be recorded. The fourth mechanism 36 controls the rotational position of the mapping assembly 20 independently of the rotation of the catheter 18 (see Figure 8). That is, the fourth mechanism 36 rotates the mapping assembly 20 without rotating the catheter 18. Using this fourth mechanism, the physician can rotate the mapping assembly 20 within the heart without rotating the catheter 18 within the vein or artery being accessed. The structural features of the catheter, mapping assembly 20, and associated control mechanisms 30-36 may vary. These features will be explained in more detail when they appear in the illustrated embodiment. 1. Probe handle In the illustrated embodiment (see FIGS. 9-11), the probe handle 16 includes a body 38, a base 40, and a tip 42. The handle 16 and its components can be manufactured using a variety of durable metal and plastic materials. In the illustrated embodiment, the handle 16 is predominantly made of molded plastic. The body 38 has an internal channel 44 (see FIG. 10). A junction tube 46 is contained within the internal channel 44. On the other hand, the proximal end of the catheter 18 is bonded to the front end of the bonding tube 46 with an adhesive or similar method. As shown in FIG. 10, the inner channel 44 also includes an annular groove 48 near its distal end, where the separately shaped tip 42 connects. The base 40 of the handle is a pre-molded extension of the body 38 (see Figure 9). The base 40 is generally flat and carries the steering member 50. As will be described in more detail below, the steering member 50 houses the actuator for the first control mechanism 30 and steers the distal end of the catheter 18 towards a position. The steering member 50 is further capable of moving a track 52 on the base 40 end to end (see also FIGS. 1 and 2). A telescopic shaft 54 connects the steering member 50 to the rear end of the junction tube 46. As the steering member 50 moves back and forth on the track 52, the expandable shaft 52 expands and contracts. The back and forth movement of the steering member 50, as will be described in more detail below, biases the third control mechanism 34 to open the mapping assembly 20 and (in the preferred embodiment) create its shape. The tip 42 of the handle extends from the front of the body 38. The tip 42 has a flanged proximal end 56 that fits within the annular groove 48 of the body channel 44 (see FIGS. 9 and 10). Flange end 56 is free to rotate within annular groove 48. This allows the tip 42 of the handle to rotate separately from the body 38. The relative rotation of the tip 42 of the handle and the body 38 forms the basis of the fourth control mechanism 36, which will be described in detail later. As shown in FIG. 10, the handle tip 42 includes a central bore 58 that is axially aligned with the internal channel 44 of the body 38. The carriage 60 moves in the central hole 58. The movable carriage 60, as described in more detail below, biases the second control mechanism 32 and controls the deployment of the mapping assembly 20. 2. catheter Catheter 18 comprises a flexible tube 62 having an internal bore or lumen 64 (see Figure 12). The proximal end of the flexible tube 62 extends through the central bore 58 of the tip into the channel 44 of the body where it is joined to the joining tube 46 (see Figure 10). Flexible tube 62 can be constructed in a variety of ways. For example, a length of stainless steel could be configured as a flexible spring wrapped around the inner hole 64. In the preferred embodiment shown, tube 62 comprises a slotted stainless steel tube. An array of slots 66 are aligned along this tube at right angles to the axis. The slot 66 has a length shorter than the outer circumference of the shaft and is provided at an angle of 270 to 300 degrees. The slots 66 are also preferably staggered by about 30-120 degrees each. The slot 66 provides flexibility along the length of the tube 62. The pattern and arrangement of slots 66 provides tube 62 with the required flexibility and torque transmission capabilities. Details of the slotted tube 62 are disclosed in pending US patent application Ser. No. 07/657 106, Lundquist, filed February 15, 1991, "Torqued Catheter and Method." ing. The catheter 18 also has a sheath 68 that covers the flexible tube 62. The sheath 68 is made of a plastic material such as polyolefin, polyurethane, or polydimethylsiloxane. The sheath 68 has an inner diameter larger than the outer diameter of the tube 62. This causes the sheath 68 to slide along the outside of the tube 62 in response to the second control mechanism 32 to selectively encase and expose the associated mapping assembly 20. 3. Mapping assembly The mapping assembly 20 can take a variety of different shapes. In the embodiment shown in FIGS. 1-9, the mapping assembly 20 comprises a basket 70 of varying shape, the details of which are best shown in FIG. Mapping basket 70 includes a base member 72 connected to the distal end of flexible catheter tube 62. The mapping basket 70 also has an end cap 74. A plurality of flexible electrode supports or splines 76 extend circumferentially around the base member 72 and the end cap 74 at spaced intervals. A plurality of electrodes 22 are carried on the plurality of splines 76 at certain intervals. The electrodes can also be attached to the end cap 74. The outer diameters of the base member 72 and the end cap 74 are smaller than the inner diameter of the movable sheath 68. (While FIG. 12 shows the exact relationship between the movable sheath 68 and the base member 72, the end cap 74 is enlarged to show the structure in more detail.) The end cap 74 is circular or in the drawing. It is preferably dome shaped as shown. This allows the sheath 68 to approach the mapping baskets 70 as they move toward the distal end of the flexible tube 62 (flattened position) and the dome-shaped end cap. Only 74 will be exposed to the outside. Conversely, if the sheath 68 moves in the opposite direction, the mapping basket 70 is exposed and ready for use. In addition to the electrodes on the splines 76A, one or more electrodes may be attached to the end cap 74 to provide stronger signal measurement capability. Still referring to FIG. 12, the mapping assembly 70 includes a rigid control wire 78. The distal end of control wire 78 is connected to end cap 74. From there, the control wire is connected through the base member 72 and the hole 64 in the tube 62 to a third control mechanism 34, which will be described in more detail below. The control wire 78 is moved axially in response to the biasing of the third control mechanism 34, thereby moving the end cap 74 toward the base member 72 or vice versa. . This movement causes the spline 76 to flex and change the shape of the basket 70. The splines 76 of the mapping basket 70 shown in FIG. 12 can have various cross sectional shapes. Details of a representative structure are described below. A. Basket spline (I) Cylindrical spline 13 and 14 show a spline 76A having a cylindrical cross section. Spline 76A includes a plurality of sensing electrodes 22, which are mounted at regular intervals along the axis. (Only six electrodes 22 are shown in the figure for space reasons.) At the proximal end of spline 70A is a eyelet 80, which connects to a pin on base member 72. At the distal end of the spline is a hook 82, which allows immediate connection to openings 84 that are regularly spaced around the circumference of the end cap (see Figure 12). Of course, other instant coupling mechanisms can be used. The cylindrical spline 76A can have an open internal passage, which can guide a separate signal wire connected to the sensing electrode 22. However, in the embodiment shown in FIGS. 13 and 14, the body of the cylindrical spline 76A is not hollow. The body includes a plurality of discrete layers or substrates, as shown in FIG. Every other layer 86 is coated with a conductive material such as platinum. A layer 88 made of a non-conductive material such as polyimide is then placed between the conductive layers 86 to separate them. Layers 86 and 88 are formed, for example, by ion beam assisted deposition or similar deposition techniques. In the illustrated embodiment, each layer has a thickness of about 0.0005 inches (0.0127 mm) to 0.002 inches (0.0508 mm). As shown in FIG. 13, a separate signal wire 90 is connected to each conductive layer 86. The signal wire 90 passes through the proximal end of the spline 76A and is connected to the micro connector 92. The details will be described later. The number of conductive layers 86 is equal to the maximum number of electrodes 22 carried by the splines 76A. In the illustrated embodiment, each cylindrical spline 76A has a maximum of twelve sensing electrodes, resulting in twelve conductive layers 86 and twelve signal wires. (In FIG. 13, only the electrodes 22 and a portion of the signal wires are shown due to space considerations.) In the illustrated embodiment, each sensing electrode 22 comprises a flexible substrate, which includes an ionic substrate. A silicon rubber body coated with platinum by beam assisted deposition is used. Each sensing electrode is inserted into a location on spline 76A where it is secured with an adhesive or similar method. Alternatively, the rubber body can be molded in place on the spline and then coated with a conductive layer by IBADC (ion beam assisted vapor deposition). A wire or pin 94 made of a conductive material (such as platinum) is inserted through each electrode 22 into the body of spline 76A. Each pin 94 is covered with an insulating material except for the head portion and the tip. As shown in FIG. 14, the pins 94 have different predetermined lengths, and their tips reach different conductive layers 86. Each pin 94 individually conveys the signal received by its associated sensing electrode 22 to the conductive layer 86. This causes the signal sensed at each electrode 22 to be sent to the signal wire 90 connected to it by a different conductive layer 86. (Ii) Straight splice FIG. 15 shows an electrode support spline 76B having a substantially flat and linear cross section. Unlike the cylindrical spline 76A shown in FIG. 13, the linear spline 76B has anisotropic rigidity. The spline 76B has the flexibility of warping or bending (in the direction of the Y axis shown by the arrow in FIG. 15) in a plane along the vertical X axis 96. However, it has a rigidity that resists bending or twisting of its longitudinal X-axis 96 in the direction of the Z-axis. As shown in FIG. 15, each linear spline 76B carries sense electrodes 22 that are spaced apart along its longitudinal axis 96. Similar to cylindrical spline 76A, the proximal end of straight spline 76B has a eyelet 80, which connects to base member 72 of the basket. A hook 82 is provided at the distal end of the spline 76B for immediate connection to the circumferentially spaced openings 84 of the basket end cap 74 (see FIG. 12). At the time of this connection, the anisotropic rigidity of each linear spline 76B prevents the longitudinal shaft 96 from twisting. As a result, the basket 70 can maintain rigidity against twisting. Adjacent splines 76B are held in a relationship in which a desired distance is maintained on the circumference. The axial movement of the control wire 78 bends each linear spline 76B in the direction of the Y axis along the longitudinal axis 96 thereof, and outwardly around the control wire 78. As a result, the shape of the circumference of the basket 70 changes (see FIGS. 5 to 77). Adjacent splines 76B are resistant to twisting due to their anisotropic stiffness. As a result, the assembled basket 70 also resists twisting and retains the desired three-dimensional shape symmetrical about its longitudinal axis. In the embodiment shown in FIG. 15, the splines 76B comprise a plurality of conductive layers 98, which are separated by a non-conductive layer 100 therebetween (best shown in FIGS. 18 and 19). Exist). The conductive layer 98 is formed by being coated with a material that conducts electricity, such as platinum. The conductive layer is preferably 0.005 inches (0.127 mm) to 0.002 inches (0.0508 mm) thick. The non-conductive layer 100 is made of polyimide or similar polymeric material. As shown in FIGS. 18 and 19, the electrode wire 102 is welded to each conductive layer 98. The electrode wire 102 for one conductive layer 98 is spaced from the electrode wire 102 for the next conductive layer 98. As shown in FIGS. 18 and 19, the electrode wire 102 passes from the lower conductive layer 98 through the plated through openings 102 of the upper conductive layer 98 and the non-conductive layer 100 sequentially to the upper surface of the spline 76B. (See also Fig. 16). Electrodes 22 are welded to each electrode wire 102 on the upper surface. As shown in FIGS. 15, 16, 18, and 19, the proximal ends of their respective conductive layers 98 and non-conductive layers 100 are preferably configured in a stepped fashion. This exposes each conductive layer 98 and facilitates connection to the signal wire 90 to be welded. In another arrangement (see FIG. 17), the electrode 22 is deposited on the surface of the straight spline 76C. In this arrangement, the surface of spline 76C also has a solid printed circuit 104 formed by ion deposition or etching. This circuit 104 transmits the signal from each electrode 22 to a signal wire 90 attached to the proximal end of spline 76C. Also, the eyelets 80 and hooks 82 allow the splines 76C to be immediately mounted between the basket base member 72 and the end cap 74, as previously described. B. Micro connector A plurality of signal wires 90 from the sensing electrodes can be bundled together and passed through hole 64 in flexible guide tube 62 and connected to controller 14 as a single wire. By using laser welding, the cross-sectional area of the electrical connection can be kept to a minimum. In the illustrated preferred embodiment, the number of conductive wire conduits through lumen 64 is minimized by using solid microconnectors 92 within base member 72 (see FIG. 12). 20 to 24 show the micro connector 92 in detail. As shown in FIG. 20, the micro connector 92 includes one microprocessor chip 106 for each electrode support spline 76 within the basket 70. 20 to 24 assume that 56 sensing electrodes are arranged on the basket 70. One or more sensing electrodes can also be used as the stripping electrodes. In this arrangement, there are eight splines 76, and each spline 76 has seven sensing electrodes 22. In this arrangement, the microconnector 92 comprises eight individual chips 106 (see FIG. 12), with seven electrode signal wires 90 connected to each chip 106 (see FIG. 20). The chip 106 serves as a switch controlled by the controller 14. Each chip 106 receives one, or a total of seven, individual signals from each electrode 22 on its associated spline 76. Each chip 106 sends only one signal selected from the electrode signals to the controller 14 at a time, but the transfer is controlled by the switching signal generated by the controller 14. The switching signal of the controller 14 thereby multiplexes the electrode signal via the micro connector 92. This can reduce the number of electrical passages through the lumen 64. As further shown in FIG. 20, each chip 106 includes an input / output (I / O) bus 108, which includes a (+) power contact 110 and a (−) power contact 112. Power contacts 110 and 112 receive power from a power source 130 within controller 14. The I / O bus 108 also includes an input switching (or control) contact 114, which receives the switching signal from the signal generating circuit 132 in the controller 14 and selects the input signal wire to sample. The control contact 114 also receives ablation energy from the power supply 135 through the signal generating circuit 134, thereby allowing the use of one or more associated sensing electrodes for tissue ablation. The I / O bus 108 further includes an output signal contact 116, which sends the selected electrode signal to a signal processing circuit 134 in the controller 14. 23 and 24 schematically show the components 130, 132, and 134 of the controller 14. The power, control and output signals of each chip 106 are routed to and from bus 108 along a conductive conduit 118 in lumen 64 of tube 62. The conduit 118 can be configured in various ways. For example, a coaxial cable can be used. In the illustrated embodiment (see FIG. 21), conduit 118 is made of Mylar tubing. A solid printed circuit 120 formed by ion deposition or etching is arranged on the surface of the tube 118. The circuit 120 formed on the conduit 118 can take various forms. In the embodiment shown in FIG. 23, the circuit 120 has 32 individual conductive paths, which form a spiral-shaped array deposited around the axis of the tube. As further shown in FIG. 20, this array includes one (+) power line 122 and one (-) power line 124 for each chip 106 (thus a total of 16 (+) power and (-) Power line). These lines are connected to the power supply 130 in the controller 14. The array shown in FIGS. 20 and 23 also includes one input control line 126 and one signal output line 128 for each chip 106 (16 additional lines for a total of 32 conductive lines). . These lines 126 and 128 are connected to the signal multiplex communication control circuit 132 and the signal processing circuit 134 of the controller 14, respectively. As shown in FIGS. 20 and 21, a stainless steel ferrule 136 electrically interconnects each wire of circuit 120 to microconnector 92. The ferrule 136 is located within the distal end of the Mylar tube 118. Ferrule 136 has a predetermined array of 32 pointed tips 138. The pointed tip 138 connects the (+) power line 122 and the (−) power line 124, the control input line 126, and the signal output line 128 to each associated contact 110, 112, 114, of the I / O bus 108 of each chip 106. And 116 electrically interconnect. In another arrangement (see FIGS. 22 and 24), the circuit 120 on the tube 118 is reduced to 18 lines. The circuit 120 also constitutes a spiral array formed around the axis of the tube 118. The array includes only one (+) power line 122 and one (-) power line 124, which are connected to a power source 130. As shown in FIG. 24, the distal ends of the (+) power line 122 and the (−) power line 124 surround the distal end of the tube 118 in a loop at certain intervals along the axis. There is. In the array shown in FIG. 24, the loop of (+) power lines 122 is located closer to the distal end of tube 118 than the loop of (−) power lines 124 (see also FIG. 22). The array on tube 118 also includes one input control line 126 and one signal output line 128 for each chip 106, for a total of 19 lines. As previously described, these lines 126 and 128 are connected to the multiplexer circuit 132 and signal analysis circuit 134 of the controller 14 (see FIG. 24). As shown in FIG. 22, lines 126 and 128 terminate at the distal end of tube 118 below the (+) power loop 122 and (−) power loop 124 described above. In this arrangement (see FIG. 22), a part of the I / O bus 108 of each chip 106 is arranged along the circumference. The upper two contacts 110 and 112 constitute a (+) power contact and a (-) power contact, respectively. They are typically connected to a (ten) power loop 122 and a (-) power loop 124 by a pointed tip 138 on the ferrule 136, as shown in FIG. The bottom two contacts 114 and 116 of the I / O bus 108 contain the control input and signal output conductors. These contacts 114 and 116 are arranged along the circumference below the on-axis power contacts 110 and 112. As shown in FIG. 22, the pointed tip 138 on the ferrule 136 fits the control input line 126 and the signal output line 128 to the contacts 114 and 116 on the I / O bus 108 which are arranged along their circumference. Connect to. 4. Probe control mechanism A. Steering control mechanism In the arrangement shown in FIG. 1, the first probe control mechanism 30 is contained within the steering member 50. FIG. 25 shows this structure in detail. The first mechanism 30 comprises rotating cam wheels 140 housed within the steering member 50. The lever 142 (see FIG. 1) on the outside of the steering member 50 is connected to the cam wheel 140 on the inside. When the user moves the steering lever 142, the cam wheel 140 rotates. As shown in FIG. 25, the cam wheel 140 has a fastener 144 between its left and right side surfaces. Fastener 144 grips the proximal ends of the left and right probe steering wires 146 and 148 that are welded therein. Steering wires 146 and 148 extend from opposite ends of fastener 144 along the left and right sides of associated cam wheel 140. Steering wires 146 and 148 pass through the inner bores of tension screw assembly 150, through telescoping shaft 54, and then through junction tube 46 to the front of steering member 50, as shown in FIG. Missing. Steering wires 146 and 148 extend further along the flexible shaft bore 64. Near the distal end of tube 62, steering wires 146 and 148 exit exit hole 64 through exit holes (not shown). As shown in FIG. 12, the left end of the steering wire 148 and the left end of the flexible tube 62 are welded together. Similarly, the right steering wire 146 end is welded to the right distal end of the flexible tube 62. Left rotation of the cam wheel 140 pulls the left steering wire 148, bending the distal end of the tube 62 to the left. Similarly, rotating the cam wheel 140 to the right pulls the right steering wire 146, bending the distal end of the tube 62 to the right. In this way, the first control mechanism 30 steers the distal end of the flexible tube 62 and the mapping basket 70 connected thereto (see Figure 12). It should also be noted that instead of using a self-contained active mechanism to steer the flexible tube 62, a wire can be used to guide and position the distal end of the tube 62 within the heart. . 26 and 27 illustrate an alternative embodiment that utilizes wires rather than a built-in steering mechanism. In the embodiment shown in FIGS. 26 and 27, the probe 10A includes an internal guide wire 152. The guide wire 152 extends from a handle (not shown) through a hole 64 in the flexible tube 62 and through a central guide tube 154 in the mapping basket 70. In use, the physician first advances the guidewire 152 from the major vein or artery to a selected ventricle. The physician then passes the tube 62 of probe 10A and the mapping basket 70 connected thereto over the guide wire 152 and advances it into place. In this embodiment (see FIG. 26), the probe 10A comprises a sliding sheath 68 that temporarily holds the mapping basket 70 while it is being guided over the wire 152 (see FIGS. 3 and 4). It is desirable to do. As shown in FIG. 27, the on-wire probe 10A also preferably includes a one-way annular valve 156 within the guide tube 154. This valve 156 prevents blood and other fluids in the ventricle from flowing back into the guide tube 154 and probe 10A. B. Mapping assembly deployment mechanism In the illustrated embodiment, the second mechanism 32 is located at the tip 42 of the handle 16 of the probe. FIG. 11 shows the details of this structure. As shown in FIG. 11, the second mechanism 32 includes a carriage 60 that moves within a central hole 58 at the tip of the handle. Carriage 60 includes an opening 158 that is concentric with the axis of central bore 58 through which flexible tube 62 passes. As shown in FIG. 11, the outer diameter of the flexible tube 62 is smaller than the inner diameter of the opening 158 of the carriage. Carriage member 60 includes an exposed actuator 160 that extends into an elongated slot 162 at the tip of the handle (see also FIGS. 1 and 2). The slot 162 extends along the axis of the central hole 58. The user moves actuator 160 back and forth to move carriage member 60 in central bore 58 along the axis of flexible tube 62. As further shown in FIG. 11, the proximal end of the sliding sheath 68 is secured to the carriage 60 by an adhesive or similar method. As the carriage moves as described above, the glued sheath 68 also slides along the axis of the flexible tube 62. When the actuator 160 occupies the most forward position within the slot 162 of the handle tip 42 (see FIG. 3), the distal end of the sheath 68 is normally adjacent to the end cap 74 of the mapping basket 70. The distal end of the sheath 68 thus encloses the entire mapping basket 70 in the closed and collapsed state. As the physician continuously moves actuator 160 to the end within slot 162 of handle tip 42 (see FIG. 4), the distal end of sheath 68 abuts base member 72 of mapping basket 70. This exposes the mapping basket 70 for use. In this way, the second mechanism 32 deploys or retracts the mapping basket 70. As best shown in FIG. 26, the distal end of flexible tube 62 preferably includes one or more O-rings or gaskets 164. The gasket 164 forms a fluid tight seal between the flexible tube 62 and the sliding sheath 68 to prevent blood and other fluids in the heart from flowing back toward the handle 16 of the catheter. C. Mapping assembly shape creation mechanism In the arrangement shown, the third mechanism 34 is located at the base 40 of the handle. The proximal end of the control wire 78 of the mapping basket 70 passes through a telescoping shaft for connection into the steering member 50 (see Figure 25). The distal end of the control wire 78 is connected to the basket end cap 74 (see Figure 12). Forward and backward movement of the steering member 50 along the track 52 moves the control wire 78 along an axis to move the end cap 74 toward or away from the base member 72. This causes the mapping basket 70 to expand, collapse, and create a shape. When the steering member 50 is in the frontmost position on the track 52 (see FIG. 7), the end cap 74 is located furthest from the base member 72. Flexible electrode support splines 78 are located in a generally linear relationship between the base member 72 and the end caps 74. The mapping basket 70 is closed and folded as shown in FIG. In this position, the sheath control actuator 160 is moved to the forwardmost position within the tip slot 162 and the collapsed mapping basket 70 is completely contained within the sheath 68. The collapsed mapping basket 70 is therefore retracted (see Figure 3). Similarly, moving the sheath control actuator 160 rearward within the tip slot 162 moves the sheath 68 away from the collapsed mapping basket 70. The mapping basket 70 thus expands (see Figure 4). When deployed, the end cap 74 approaches the base member 72 as the steering member 50 moves to the rearmost position within the track 52 (see FIGS. 5 and 6). The elastic electrode support spline 78 is bent continuously to have a three-dimensional shape bent further downward. The shape of the mapping basket 70 varies with the position of the steering member 50 within the track 52. As the steering member 50 moves from the foremost position to the center position of the track 52 (see FIG. 5), the mapping basket 70 continuously changes from an elongated ellipse to a sphere. As the steering member 50 moves further from the center position to the rearmost position of the track 52, the mapping basket 70 continuously changes from a spherical shape to a donut or annular shape. The third control mechanism 34 preferably has a lock nut 166 on the outside. Rotating the lock nut 166 clockwise increases the bond between the steering member 50 and the handle base 40. Fully rotating the lock nut 166 clockwise prevents the steering member 50 from moving within the track 52. In this way, the user can lock the mapping basket 70 in the desired shape while performing other control or mapping operations. Rotating the lock nut 166 counterclockwise reduces the locking force and allows the steering member 50 to move within the track 52. In this way, the user can operate the third mechanism 34 to open and close the mapping basket and create shapes. D. Rotation mechanism of mapping assembly 20 In the arrangement shown, the fourth mechanism 36 defines a rotational joint between the handle base 40 and the handle tip 42. As shown in FIG. 8, the user can rotate the main body 38 of the handle 16 separately from the tip portion 42 by holding and fixing the tip portion 42 of the handle. This causes the flexible tube 62 connected to the junction tube 46 in the handle body 38 to rotate, as shown in FIG. This causes the mapping basket 70 connected to the flexible tube 62 to rotate. At this time, as shown in FIG. 11, the sheath connected to the carriage 60 in the distal end portion 42 of the handle does not rotate. In this way, the fourth control mechanism 36 rotates the mapping basket 70 without rotating the outer sheath 68. 4. Expandable electrode support mechanism with a predetermined shape A. Expandable basket assembly It should be appreciated that the mapping assembly 20 described above need not include a control mechanism for changing the shape of the basket 70. The shape of the basket 70A can be preset such that it can be bent in response to an external force, or can change into one final form defined when the external force is removed. In this arrangement, the basket splines 78 are elastically tensioned between the base member 72 and the end caps 74. The elastic splines 78 fold into a small closed mass in response to an external compressive force. In this embodiment, the second control mechanism 32 applies this compression force to compress the basket 70. When the tip actuator 160 is moved to the position of the foremost slot, the sheath 68 compresses and stores the basket 70. When the tip actuator 160 moves to the rearmost slot position, the sheath 68 moves away from the basket 70. This movement removes the compressive force and opens the open spline into the desired shape. In one preferred arrangement, at least some individual splines 78 in basket 70 have regions of different stiffness along their length. Regions of different stiffness will bend differently when pressure is applied. Therefore, when the spline bends, it does not draw a uniform arc, but the spline bends non-uniformly and can have different shapes. By placing splines with regions of different stiffness in different regions of the array, a number of different predetermined shapes for basket 70 can be obtained. In another preferred embodiment, at least some of the splines are made of a memory wire of predetermined shape, such as Nitinol. The memory wire changes into different shapes depending on the temperature condition around the memory wire. In this embodiment, at room temperature outside the body, the memory wire spline has a substantially linear form. Thus, the splines can be collapsed into a small shape for placement within the ventricle and fit within the sheath 68. At body temperature within the ventricle when deployed outside the sheath 68, the memory wire spline changes from its normal linear configuration to another predetermined shape. These different arrays can be connected to the distal ends of individual specialized catheters and can be deployed by a handle-mounted control mechanism as previously described. B. Deployable bag-like mapping assembly 28 and 29 show another mapping assembly 168 in which the support of the sensing electrodes takes the form of an inflatable bag 170. The inflatable bladder 170 resides in the interior chamber 174 of the base member 172, which is connected to the distal end of the guide tube 62. The distal end of the base member 172 is open. As shown in FIG. 28, the bag 170 is typically stored at the distal end of the catheter, or retracted and retracted into the inner chamber 174. A fluid pressure conduit 176 communicates with the bag 170. This conduit extends from the inner chamber 174 through a hole 64 in the flexible tube 62 to a port adjacent the handle 16 of the probe (not shown in FIGS. 28 and 29). In use, the physician will connect the port to a fluid pressure source, such as pressurized carbon dioxide or liquid saline. After advancing the distal end of the catheter to the desired location on the endocardium, the physician delivers positive fluid pressure to bladder 170 through delivery conduit 176. Positive fluid pressure causes bag 170 to expand or inflate. The inflatable bag 170 inflates outward from the end of the open chamber and has a predetermined three-dimensional shape (see FIG. 29). The shape can be variously changed depending on the shape of the bag. In the illustrated embodiment, the bag 170, when inflated, is shaped like a sphere. The flexibility of bladder 170 causes it to naturally conform to the shape of the endocardial surface to be mapped when inflated. Fluid can be evacuated from the bag 170 by removing the positive fluid pressure and sending the negative pressure through the supply conduit 176. The bag is collapsed (see FIG. 28) and folded back into the chamber 174 of the base member. Since the bag 170 deploys itself when inflated, it is not necessary to provide a separate control mechanism to deploy the bag. Alternatively, the movable mechanism 68 controlled by the second mechanism 32 (as previously described) may be used to selectively store the bag 170 prior to use or for use. The bag 170 can be opened. The bag has an electrically conductive surface such as platinum. This surface is formed by a method such as ion beam assisted vapor deposition. This conductive surface may cover the entire exposed surface of bag 170. In this case, the bag functions as a single sensing electrode 170 when inflated. Also, multiple conductive surfaces can be placed within zones 178 located at regular intervals on the circumference of bag 170 (see FIG. 29). In this case, each zone 178 acts as a separate sensing electrode. The regularly spaced conductive zones on the bladder 170, when inflated, together form an array of sensing electrodes. The surface of the bag also has solid state circuitry formed by vapor deposition or similar techniques. This circuit, connected to the signal wire 180, sends a signal from the conductive zone to the microprocessor 92 in the base member 172. These signals are transmitted along the catheter associated in the manner already described. C. Deployable sail-shaped mapping assembly 30A and 30B show another embodiment of the mapping assembly 182. In this embodiment, the support of the sensing electrode is a sail-like resilient body 184. The sail 184 is preferably made of elastic rubber or elastic material. Assembly 182 includes a base member 186, which includes an open distal end interior chamber 188. Base member 186 is connected to the distal end of guide tube 62. A control wire or shaft 190 is connected to the rear side of the sail 184. The control wire 190 can be moved along the axial direction of the guide tube 62 in response to a handle-mounted control mechanism, the movement of which is coordinated with a variable size mapping basket as shown in FIG. Similar to control wire 78. In the illustrated embodiment, the steering wheel mounted control mechanism can affect similar back and forth movement of the steering member 50 on the steering wheel base 40 as previously described. In this arrangement, the sail 184 is retracted into the base chamber 188 when the steering member 50 is in the rearmost position within the track 52 (see FIG. 30B). In this state, the side surface of the elastic sail body 184 is bent so as to contact the side wall of the chamber 188, and the sail body 184 has a concave shape bent in the base chamber 188. The mapping assembly 182 is retracted in this state. Thereafter, as the steering member 30 moves toward the forefront in the track 52, the sail 184 is brought out of the chamber 188. The side surface of the sail body 184 released from the chamber 188 is elastically changed into an open convex shape as shown in FIG. 30A. The mapping assembly 20 is expanded to this state. When the steering member 50 returns toward the rear in the track 52, the sail 184 is re-seat in the base chamber 188. In this process, the elastic side surfaces of sail 184 are folded back into contact with the side walls of chamber 188. The sail body is equipped with one or more sensing electrodes 192. The electrodes 192 can be physically attached to the sail 184. Alternatively, the electrodes can be applied, for example by ion beam assisted vapor deposition. The sail-shaped electrode array 182 is ideally suited for endocardial mapping. Like the bag-shaped array 168 (see FIGS. 28 and 29) previously described, the deformable elastic sail 184 is pressed against the endocardial surface during mapping and is the same as the endocardial surface. Easily change into shape. A hard wire or solid circuit on the sail 184 is connected to the signal wire 194 to carry the signal from the electrode 192 to the microconnector 92 in the base 186. These signals are thereby transmitted along the catheter in the manner previously described. D. Deployable radiator mapping assembly 31A, 31B and 31C show yet another mapping assembly 196. In this embodiment, the support for the sensing electrodes includes a central post 198 from which an array of flexible support filaments radiates. Each support filament comprises a sensing electrode 202. As previously mentioned, the assembly includes a base 204 that includes an interior chamber 206 having an open distal end. As mentioned above, the base 204 is connected to the distal end of the guide tube 62. The central post 198 can move along the axis of the guide tube 62 in response to operation of a handle-mounted control mechanism. In the illustrated embodiment, the back and forth movement of the steering member 50 can serve as this control mechanism, as has been generally described above. In this arrangement, when the steering member 50 is in the rearmost position of the track 52, the mapping assembly 200 is retracted and the array of filaments 196 is contained within the base chamber 206, as shown in FIG. 31A. There is. In this state, each filament 200 is folded against the side wall of the chamber 206. Next, when the steering member 50 moves toward the foremost portion in the track 52, the central column 198 is brought out of the chamber 206. The support filaments 200 are released from the chamber 206 and are transformed into a three-dimensional array that is radially open around the central post 198, as shown in FIG. 31B. The mapping assembly 20 is expanded in this state. When the steering member 50 returns toward the rearmost position within the track 52, the central strut 198 is re-seated within the base chamber 206. In the process, the flexible filament 200 is folded forward against the sidewall of the chamber 206, as shown in Figure 31C. The radial cluster of filaments 200, each with a sensing electrode 202, provides a high density random mapping array 196. The flexible random array 196 is pressed against the surface of the endocardium and easily changes its shape. A hard wire or solid circuit on the filament 200 and a central post 198 transfer signals from the individual electrodes 202 to the microconnectors 92 in the base 204. Thereby, these signals are transmitted along the catheter in the manner described above. E. FIG. Expandable foam tip mapping assembly 32A and 32B show yet another alternative mapping assembly 208. In this example, the support of the sensing electrode forms a porous foam 210. As mentioned above, the assembly 208 includes a base 212 that includes an interior chamber 214 having an open distal end. As mentioned above, the base 212 connects to the distal end of the guide tube 62. As with the alternative embodiment described above, the foam 210 deploys from within the interior chamber 214. The foam 210 is molded into a shape that can be called a normal shape. In the illustrated embodiment (see FIG. 32A), the uncompressed normal shape is generally spherical. However, the uncompressed normal shape can be rectangular, square, oval, annular, or virtually any shape. Due to its porous open configuration, the foam 210 is folded from the outside without being damaged by compressive forces. In the illustrated embodiment, the compressed shape is generally cylindrical and fits within the base chamber 214 (see FIG. 32B). However, other small shapes can be used. When the external compressive force is removed, the porous foam returns to its normal shape. A control wire or shaft 216 is connected to the foam 210. The control wire 216 can move along the axis of the guide tube 62 in response to operation of a handle-mounted control mechanism. In the illustrated embodiment, the steering member 50 of the probe can be moved back and forth to control the wire. In this arrangement, when the steering member 50 is in the rearmost position within the track 52, the foam 210 is contained within the base chamber 214, as shown in FIG. 32B. The side wall of the base chamber 214 compresses and presses the foam 210. When compressed, the foam 210 has a shape similar to the internal shape of the base chamber 214. The mapping assembly 208 is retracted. Next, when the steering member 50 moves toward the frontmost portion in the track 52, the foam 210 is discharged to the outside of the chamber 214, as shown in FIG. 32A. Releasing from chamber 214, foam 210 is opened to its uncompressed, normal shape. Mapping assembly 208 is expanded in this state. When the steering member 50 returns towards the rear in the track 52, the foam 210 is re-seated in the base chamber 214. The foam 210 is again compressed into a small folded configuration, as shown in Figure 32B. Foam 210 includes one or more sensing electrodes 218. The electrode 218 can be physically attached to the foam 210. The electrodes 218 can also be attached by, for example, ion beam assisted vapor deposition. The sensing electrodes 218 form a dense array and can be ideally adapted for endocardial mapping. A hard wire or solid circuit on the foam 210 carries a signal from the electrode zone 218 to the microconnector 92 in the base 212. Thereby, these signals are transmitted along the catheter in the manner already described. 5. Dynamic mapping assembly Figures 33-36 show the mapping assembly 220, which dynamically changes its shape and is synchronized with the compression of the ventricle in which it is located. Mapping assembly 220 includes a base member 222, which is connected to the distal end of guide tube 62 as previously described (see FIG. 34). The mapping assembly 220 comprises an array of elastic electrode supports 224. A base 222 is connected to its proximal end and an end cap 226 is connected to its distal end. As already mentioned, this mapping assembly 220 is similar to the mapping assembly 20 shown in FIG. As shown in FIG. 12, the mapping assembly 220 comprises a moveable sheath 68 and associated control mechanism 32 to alternate the assembly 220 for storage and deployment. During endocardial mapping, the heart muscle is continuously expanding and contracting as the heart beats. As the mapping assembly 220 is deployed, it is therefore subject to alternating stretch cycles. The surface pressure of the sensing electrode 228 against the moving endocardium is thus constantly changing, complicating the task of accurately recording the electrical potential. The electrodes may also slip on the surface of the endocardium, which is constantly moving. To address this phenomenon, the mapping assembly 220 comprises means 230 for continuously actuating the sensing electrode 228 against the endocardium to maintain a constant surface pressure despite expansion and contraction of the heart. . This means 230 can take various forms. In the illustrated embodiment, the base member 222 comprises a tubular body that houses a movable front mount 232 and a fixed rear mount 234 (best shown in FIGS. 33 and 35). The side wall 236 inside the base member 222 serves as a bearing surface for the movable mount 232. The proximal end of the electrode support 224 is connected to the movable mount 232. The spring 238 connects the front mount 232 to the rear mount 234. The front mount 232 moves toward the rear mount as the electrode support 224 encounters compression in the ventricle (see FIGS. 33 and 34). When the electrode support 224 encounters a contraction in the ventricle, the opposite occurs (see FIGS. 35 and 36). As the front mount 232 moves toward the rear mount 234, the spring 238 is compressed. However, when compressed, the spring 238 encourages the forward mount 232 to move to a distal position within the base 22 and prevents the spring 238 from being compressed. The mounts 232 and 234 and the spring 238 thus provide a dynamic interface between the electrode support 224 and the endocardium. The contraction of the ventricles surrounding the mapping assembly 220 exerts a compressive force on the electrode support 224. The front mount 232 attempts to move toward the rear mount 224 in response to this compression. Spring 238 acts to dampen and stop this movement, keeping the electrodes constant with respect to the endocardium. As the ventricle expands, the spring 238 pushes the front mount 232 forward, restoring the electrode support 224 to its original shape. Thus, the spring maintains contact between the electrode support 224 and the moving endocardium surrounding it. In the preferred embodiment shown, the spring 238 has a constant spring constant that does not change with compression. That is, the spring 238 is a constant force spring. The constant force spring 238 can have various shapes. In the illustrated embodiment (best shown in FIGS. 33 and 35), the spring 238 is a conical coil spring. When compressed, the spring exerts a constant load, regardless of the degree of compression. The constant force spring 238 applies and maintains a constant surface pressure between the mapping assembly 220 and the surrounding endocardium. This established dynamic joint always provides an accurate reading task during contraction of the surrounding heart muscle. It should be appreciated that this dynamic joint can be used in conjunction with mapping assemblies of various sizes and shapes, and for use with the particular basket mapping assembly 220 shown in FIGS. It is not limited. 6. Flushing and coagulation control in the mapping area According to another aspect of the invention, the mapping assembly may comprise means for delivering fluid to the mapping region. This fluid is, for example, saline, which flushes the mapping region and prevents tissue or blood from accumulating on the sensing electrodes. This fluid can also use pepperin or other anticoagulants to reduce the effects of coagulation during the mapping operation. There are various fluid transfer means. In the embodiment shown in FIG. 12, the mapping assembly 20 comprises a flexible central tube 240 over the control wire 78. The tube 240 extends from the end cap 74 through the holes in the base member 72 and the flexible tube 62 and extends to the fluid port 242 (see FIG. 26). Fluid delivered to the mapping region is directed through port 242 when pressure is applied. The end cap 74 includes a central channel 244, which is connected to the distal end of the tube 240. The fluid delivered by tube 240 is discharged through channel 244 to the mapping region. This central channel preferably comprises a one way annular valve 246 as shown in FIG. The valve 246 allows the fluid delivered through the tube 240 to pass through the channel 244 but not backflow in the opposite direction. This allows the valve 246 to prevent blood and other fluids within the ventricle from entering the tubing or catheter.

Claims (1)

[Claims] 1. In the electrode support used for cardiac diagnosis and treatment in the ventricle,   A spline with at least one electrode that is much wider than it is thick It has a rectangular cross section and can be bent in one vertical plane passing through its longitudinal axis. Can be twisted and bent in all other planes through the axis No splines An electrode support comprising: 2. The electrode support according to claim 1, wherein a spline is provided at a distal end of the spline. Means for quickly connecting the end cap element to the A cap is attached to the ends of multiple splines to form an electrode array. And an electrode support. 3. In an electrode assembly used for multi-electrode cardiac diagnosis and treatment in the ventricle ,   Multiple splines each holding multiple electrodes located at regular intervals. The spline has a rectangular cross section, which is much wider than it is thick. It can be bent in one vertical plane passing through its longitudinal axis, but Multiple splines that cannot twist or bend in all other planes When,   A means to connect those splines to the distal end of the catheter, An electrode assembly comprising: 4. In the electrode support used for cardiac diagnosis and treatment in the ventricle,   A splatter with at least one electrode and a rectangular cross section that is much wider than it is thick. It is in and bendable in one vertical plane passing through its longitudinal axis. But cannot be twisted or bent in all other planes passing through the axis, Memory wire that can assume a predetermined shape when exposed to temperature conditions Spline made of An electrode support comprising: 5. In the electrode support used for cardiac diagnosis and treatment in the ventricle,   A spline with at least one electrode that is much wider than it is thick Bend in one vertical plane with a rectangular cross section and its longitudinal axis But it can be twisted or bent in all other planes through the axis. Flaw, having at least two regions of different flexural rigidity along its longitudinal axis spline An electrode support comprising: 6. In the electrode support used for cardiac diagnosis and treatment in the ventricle,   A spline with at least one electrode exposed to a temperature condition Sometimes consists of memory wires that can take a predetermined shape Spline An electrode support comprising: 7. In the electrode support used for cardiac diagnosis and treatment in the ventricle,   A spline having at least one electrode along its longitudinal axis , A spline having at least two regions of different flexural rigidity An electrode support comprising: 8. In an electrode support used for multi-electrode cardiac diagnosis and treatment in the ventricle,   Are multiple splines, each with multiple electrodes located at regular intervals. And can take a predetermined shape when exposed to a certain temperature condition Multiple splines composed of re-wires,   Means for connecting the spline to the distal end of the catheter; An electrode support comprising: 9. In an electrode assembly used for multi-electrode cardiac diagnosis and treatment in the ventricle ,   Each has a plurality of electrodes located at regular intervals and its longitudinal axis A plurality of splines having regions of different bending stiffness along   Means for connecting the spline to the distal end of the catheter; An electrode assembly comprising: