KR101572756B1 - Intracardiac defibrilation catheter system - Google Patents

Abstract

assignment
A defibrillation catheter system in which a DC voltage is applied in synchronization with an R wave of an electrocardiogram to perform a defibrillation only when abnormalities such as out-of-phase shrinkage are not occurring.
Solution
A defibrillation catheter 100, a power supply 700 and an electrocardiograph 800. The power supply includes a DC power supply 71, an external switch 74 including an energy application switch 744, And an arithmetic processing unit 75. The arithmetic processing unit sequentially senses an event estimated to be an R wave from the electrocardiogram input from the electrocardiograph and detects the polarity of the sensed event V _n after inputting the energy application switch , when matching the polarity of one of the events (V _{n -1)} polarity and the two events (V _{n -2)} sensed before the sensed before, in synchronization with the art events (V _n), the 1 DC The DC power supply unit is controlled so that the DC voltage is applied to the electrode group 31G and the second DC electrode group 32G.

Description

[0001] INTRACARDIAC DEFIBRILATION CATHETER SYSTEM [0002]

More particularly, the present invention relates to a defibrillation catheter inserted in the heart muscle, a power supply device for applying a direct current voltage to the electrode of the defibrillation catheter, and a catheter system having an electrocardiograph.

As a defibrillator to eliminate atrial fibrillation, an external defibrillator (AED) is known.

In the defibrillation treatment by the AED, an electrode pad is attached to the body surface of a patient and a direct current voltage is applied to give electrical energy to the patient's body. In this case, the electric energy flowing from the electrode pad into the body of the patient is usually 150 to 200 J, and some (usually about several% to 20%) of the electric energy flows to the heart and is supplied to the defibrillation therapy.

In addition, atrial fibrillation is prone to occur during cardiac catheterization, and electrical defibrillation is also necessary in this case.

However, it is difficult to supply effective electrical energy (for example, 10 to 30 J) to the heart causing fibrillation depending on the AED supplying the electric energy from the outside of the body.

That is, when the ratio of the electric energy supplied from the outside of the body to the heart is small (for example, about several%), sufficient defibrillation treatment can not be performed.

On the other hand, when the electrical energy supplied from the outside of the body flows into the heart at a high rate, the heart tissue may be damaged.

Further, in the defibrillation treatment by the AED, an image is likely to be generated on the body surface on which the electrode pad is mounted. And, when the ratio of the electric energy flowing to the heart is small as described above, the electric energy is repeatedly supplied, and the degree of the burning becomes serious, which is a considerable burden on the patient undergoing catheterization.

SUMMARY OF THE INVENTION In view of the above circumstances, the present inventors have found that a defibrillation catheter having a defibrillation catheter inserted in a deep-seated vessel for performing defibrillation, a power supply device for applying a direct current voltage to the electrode of the defibrillation catheter, A first DC electrode group composed of a plurality of ring-shaped electrodes mounted on the front end region of the tube member, and a second DC electrode group composed of a plurality of ring-shaped electrodes separated from the first DC electrode group toward the base end side and mounted on the tube member. A first lead line group composed of a plurality of lead wires each having a lead connected to each of the electrodes constituting the first DC electrode group and a plurality of leads connected to the electrodes constituting the second DC electrode group, And a second lead line group; A catheter connection connector connected to a base end side of a first lead wire group and a second lead wire group of a defibrillation catheter; an electrocardiograph connector connected to an input terminal of the electrocardiograph; An arithmetic processing section for controlling the power supply section and having an output circuit for a DC voltage from the DC power source section, and a changeover switch of one circuit for two contacts, the catheter connection connector being connected to the common contact, And a switching section to which a connector is connected and an arithmetic processing section is connected to the second contact; When the cardiac potential is measured by the electrode of the defibrillation catheter (the electrode constituting the first DC electrode group and / or the second DC electrode group), the first contact is selected in the switching portion, and the cardiac potential information from the defibrillation catheter Is input to the electrocardiograph via the catheter connection connector of the power supply unit, the switching unit and the ECG connection connector. When the defibrillation is performed by the defibrillation catheter, the contact of the switching unit is changed to the second contact by the calculation processing unit of the power supply unit, A catheter system in which voltages of different polarities are applied to the first DC electrode group and the second DC electrode group of the defibrillation catheter via the output circuit of the calculation processing unit, the switching unit, and the catheter connection connector from the DC power supply unit See Patent Document 1 below).

According to the defibrillation catheter system disclosed in Patent Document 1, it is possible to reliably supply sufficient electric energy necessary for defibrillation to the heart that has caused atrial fibrillation or the like during cardiac catheterization. In addition, there is no case of causing an image on the patient's body surface, and invasion is also small.

Further, when defibrillation therapy is not required, the defibrillation catheter constituting the present invention can be used as an electrode catheter for the measurement of the cardiac potential.

In the catheter system described in Patent Document 1, when an energy-applying switch as an external switch is input, the contact of the switching part is switched from the first contact to the second contact by the calculation processing part, The path is secured.

The first DC electrode group of the defibrillation catheter and the first DC electrode group of the defibrillation catheter via the output circuit of the arithmetic processing unit and the catheter connection connector from the DC power supply unit receiving the control signal from the operation processing unit after the contact point of the switching unit is switched to the second contact, DC voltages having different polarities are applied to the two DC electrode groups.

In this case, the arithmetic processing section synchronizes with the deep potential waveform input via the electrocardiogram input connector, performs arithmetic processing to apply a voltage, and sends a control signal to the DC power source section.

More specifically, one R wave (maximum peak) is detected in a deep potential waveform (electrocardiogram) input to the arithmetic processing unit, and the peak height is obtained. Next, the height of 80% of the peak height Level), a control signal is sent to the DC power source section to start application after a certain period of time (for example, a very short time of about 1/10 of the peak width of the R wave).

Japanese Patent Publication No. 4545216

Defibrillation (application of voltage) is usually performed in synchronization with the R wave so as not to adversely affect the ventricle while performing effective defibrillation therapy.

If defibrillation is performed synchronously with T wave, there is a high risk of causing critical ventricular fibrillation, and therefore, synchronization with T wave should be avoided.

Therefore, in the catheter system described in Patent Document 1, the peak reaching the trigger level immediately after the input of the energizing switch is recognized as the R wave, and the voltage is applied to the first electrode group and the second electrode group in synchronization with this peak .

However, in the case where the extracorporeal shrinkage occurs in the heart of a patient who is to undergo a shock therapy or a drift occurs in which the baseline (baseline) of the electrocardiogram inputted to the arithmetic processing unit occurs, The peak of the potential difference reached (the peak recognized as the R wave) may not actually be the peak of the R wave.

For example, when a single outpatient contraction occurs in the heart of a patient, an electrocardiogram (deep potential waveform) input to the arithmetic processing section is an R wave (the fourth R wave from the left in the figure) And the peak of the next T wave tends to increase.

As shown in the figure, when the switch for applying the electric energy is input immediately after the out-of-phase shrinkage occurs, the T wave that has been increased to reach the trigger level is mistaken as an R wave to sense (detect) So that the defibrillation is performed by applying the voltage.

In addition, when the baseline of the electrocardiogram fluctuates, it is conceivable to mistake a waveform that is not normally sensed as an R wave and sense it. For example, the height of a positive waveform, rather than an R wave, may be read higher than actually due to the rise of the baseline. 20 shows an electrocardiogram in which drift occurs and the base line descends and then the base line rises and returns to the original level. By inputting an electric energy application switch immediately before the base line rises, The rise of the line is mistaken for an R wave to sense (detect), and a voltage is applied in synchronization with this to perform defibrillation.

The present invention has been made based on the above-described circumstances.

SUMMARY OF THE INVENTION A first object of the present invention is to provide an electrocardiogram (ECG), which is inputted to an arithmetic processing unit when no external voltage is applied to an electrode of a defibrillation catheter and external shrinkage is not occurring, A defibrillation catheter system capable of performing a defibrillation by applying a DC voltage to an electrode of a defibrillation catheter in synchronization with a wave.

A second object of the present invention is to provide an electrocardiogram that is capable of correcting the R wave of the electrocardiogram when the baseline of the electrocardiogram is fluctuated without applying a voltage to the electrode of the defibrillation catheter, And a defibrillation catheter system capable of performing defibrillation by applying a DC voltage to an electrode of a defibrillation catheter in synchronism with the operation of the defibrillation catheter.

In order to achieve the above object, the inventors of the present invention have conducted intensive studies, and as a result, it has been found that when the out-of-phase shrinkage occurs in the patient's heart and the baseline of the electrocardiogram inputted to the arithmetic processing unit of the power supply apparatus fluctuates, When the polarity of the event (the waveform assumed to be the R wave) which is sensed in a sequential manner changes and the polarity of the event occurs in the same direction three times in succession, at the time of sensing at least the third event, And the third event (waveform) is a peak of the R wave reliably. When the polarity of the event presumed to be the R wave occurs three or more times in the same direction continuously (electric energy When the polarity of the event sensed after the input of the application switch of the previous event coincides with the polarity of the event sensed twice before) To find out synchronization in the tree that can be by applying a voltage, which conduct defibrillation reliably synchronized with the R wave, and accomplished the present invention based on this knowledge.

(1) That is, a defibrillation catheter system of the present invention includes a defibrillation catheter inserted into a deep-seated heart to perform a defibrillation, a power supply device for applying a direct-current voltage to the electrode of the defibrillation catheter, and a catheter system having an electrocardiograph,

The defibrillation catheter includes an insulating tube member,

A first electrode group (first DC electrode group) composed of a plurality of ring-shaped electrodes mounted on the front end region of the tube member,

A second electrode group (second DC electrode group) formed of a plurality of ring-shaped electrodes separated from the first DC electrode group toward the base end side and mounted on the tube member,

A first lead line group including a plurality of lead wires whose ends are connected to respective electrodes constituting the first DC electrode group,

And a second lead line group including a plurality of lead lines whose tips are connected to the respective electrodes constituting the second DC electrode group;

The power supply device includes a DC power source unit,

A catheter connection connector connected to the first lead wire group of the defibrillation catheter and the proximal end side of the second lead wire group,

An external switch including an electric energy application switch,

An arithmetic processing unit that has an output circuit for a DC voltage from the DC power supply unit and controls the DC power supply unit based on an input of the external switch,

And an electrocardiogram input connector connected to the operation processing unit and the output terminal of the electrocardiograph;

Wherein when the defibrillation is performed by the defibrillation catheter, the first DC electrode group of the defibrillation catheter and the second DC electrode group of the defibrillation catheter are connected to the DC power supply unit via the output circuit of the calculation processing unit and the catheter connection connector A voltage of a polarity different from that of the other (+/- is opposite) is applied;

The arithmetic processing unit of the power supply apparatus sequentially senses an event estimated to be an R wave from the electrocardiogram input from the electrocardiogram via the electrocardiogram input connector and outputs the sensed signal after the input of the electric energy applying switch when the polarity of the event (V _n), match the polarity of the event (V _{n -2)} sensing the polarity and the two prior to the event (V _{n -1)} sensing the at least one prior, art event (V _n ), a voltage is applied to the first DC electrode group and the second DC electrode group to control the DC power supply unit.

In the structure according to the simgang within defibrillation catheter system, such as, in the ECG input to the calculation processing of the power supply device, a continuously sensing the three events (V _{n -2),} of (V _n-1) and (V _n) If the polarities do not coincide with each other, it is likely that the patient's heart is undergoing contraction or that the baseline of the electrocardiogram is unstable due to drift or the like, and it is determined that the event (V _n ) The voltage is not applied in synchronization with the event V _n . When the polarities of the three events V _{n -2} , V _n-1 and V _n coincide with each other, it is determined that the third event V _n is a peak of the R wave, V _n ), it is possible to reliably perform defibrillation synchronized with the R wave.

(2) In the intra-abdominal shock defibrillation catheter system of the present invention, the arithmetic processing unit of the power supply device senses an event estimated to be an R wave, and then for a short period of 50 m, for a long period of 500 m, It is preferable to control the DC power supply unit so that no voltage is applied to the first DC electrode group and the second DC electrode group.

According to the intra-abdominal defibrillation catheter system configured as described above, since no voltage is applied to the first DC electrode group and the second DC electrode group for a short period of 50 ms after sensing an event estimated to be an R wave , It is possible to surely avoid defibrillation at the time when the next T wave appears when the sensed event is a peak of the R wave, that is, to mask a peak estimated to be a T wave.

(3) In the intra-abdominal defibrillation catheter system of (2), the arithmetic processing unit of the power supply device senses an event presumed to be an R wave and then for a short time of 10 m seconds, It is preferable not to newly detect an event estimated to be an R wave for 100 msec.

According to the intra-abdominal defibrillation catheter system configured as described above, since a new event is not sensed for 10 msec shortly after sensing an event presumed to be an R wave, the sensed event is a peak of the R wave, And the peak of the S wave appearing in the opposite direction is increased to reach the trigger level (this state is not particularly a problem in performing defibrillation), the peak of the S wave is sensed, and the polarity of the event It is possible to prevent that the continuity is inhibited (the count of the same polarity is reset).

(4) In the intra-abdominal defibrillation catheter system according to (2) or (3), the arithmetic processing unit of the power supply apparatus may be operated for 10 m short, 500 m long, Preferably, the DC power supply unit is controlled such that no voltage is applied to the first DC electrode group and the second DC electrode group for 260 msec.

According to the intra-abdominal defibrillation catheter system configured as described above, since no voltage is applied to the first DC electrode group and the second DC electrode group for 10 msec shortly after the input of the electric energy applying switch, It is possible to prevent the noise generated by the input of the switch (noise having the same polarity as the previous and previous event) as the R wave and sense it, and to perform the defibrillation in synchronization with this noise.

It is also possible to prevent the continuity of the polarity of the event (resetting the count of the same polarity) due to the noise generated by the input of the application switch (the noise of the polarity different from the previous and / or previous event) .

It is also possible to prevent the base line variation occurring immediately after the input of the application switch from being misinterpreted as the R wave and to perform the defibrillation synchronously with the sensing.

According to the intra-abdominal defibrillation catheter system of the present invention, when the out-of-phase contraction is occurring in the heart of the patient undergoing the defibrillation treatment, the voltage is not applied to the electrode of the defibrillation catheter, The defibrillation can be performed by applying a DC voltage to the electrodes of the defibrillation catheter in synchronization with the R wave of the defibrillation catheter.

When the baseline of the electrocardiogram input to the arithmetic processing unit is fluctuated, no voltage is applied to the electrodes of the defibrillation catheter, and when the baseline is stable, in synchronization with the R wave of the electrocardiogram, And the defibrillation can be performed.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a block diagram illustrating one embodiment of a deep-seated defibrillation catheter system of the present invention.
2 is a schematic plan view illustrating a defibrillation catheter constituting the catheter system shown in Fig.
3 is a explanatory plan view (a view for explaining dimensions and hardness) showing a defibrillation catheter constituting the catheter system shown in Fig. 1; Fig.
4 is a cross-sectional view showing the AA cross section in Fig.
Fig. 5 is a cross-sectional view showing the BB section, the CC section, and the DD section of Fig. 2;
FIG. 6 is a perspective view showing the internal structure of the handle of the embodiment of the defibrillation catheter shown in FIG. 2; FIG.
Fig. 7 is an enlarged view of the inside of the handle (tip side) shown in Fig. 6;
8 is a partially enlarged view of the inside of the handle (base end side) shown in Fig.
Fig. 9 is an explanatory view schematically showing the connection state of the connector of the defibrillation catheter and the catheter connection connector of the power supply unit in the catheter system shown in Fig. 1;
10 is a block diagram showing the flow of cardiac potential information when the cardiac potential is measured by the defibrillation catheter in the catheter system shown in Fig.
11A is a part (Step 1 to Step 6) of a flowchart showing the operation and operation of the power supply device in the catheter system shown in Fig.
FIG. 11B is a part (Step 7 to Step 14) of a flowchart showing the operation and operation of the power supply device in the catheter system shown in FIG.
11C is a part (Step 15 to Step 22) of a flowchart showing the operation and operation of the power supply device in the catheter system shown in Fig.
12 is a block diagram showing the flow of cardiac potential information in the cardiac potential measurement mode in the catheter system shown in Fig.
FIG. 13 is a block diagram showing the flow of psychomotor information and information related to the measured value of the resistance between the electrode groups in the defibrillation mode of the catheter system shown in FIG. 1; FIG.
FIG. 14 is a block diagram showing a state when a DC voltage is applied in the defibrillation mode of the catheter system shown in FIG. 1; FIG.
Fig. 15 is a potential waveform chart measured when predetermined electrical energy is applied by the defibrillation catheter constituting the catheter system shown in Fig. 1; Fig.
16A is an explanatory diagram showing the timing of the input (SW-ON) of the energizing switch and the application (DC) of the DC voltage in the electrocardiogram input to the arithmetic processing unit of the power supply unit.
16B is an explanatory diagram showing the timing of the input of the energizing switch and the application of the DC voltage in the electrocardiogram inputted to the arithmetic processing section of the power supply apparatus.
16C is an explanatory diagram showing the timing of the input of the energizing switch and the application of the DC voltage in the electrocardiogram input to the arithmetic processing unit of the power supply unit.
16D is an explanatory diagram showing the timing of the input of the energizing switch and the application of the DC voltage in the electrocardiogram inputted to the arithmetic processing unit of the power supply unit.
17A is an explanatory diagram showing the timing of the input of the energy application switch and the timing of application of the DC voltage in the electrocardiogram input to the operation processing unit of the power supply unit (electrocardiogram waveform when one-sided out-systole occurs in the patient's heart).
17B is an explanatory diagram showing the timing of the input of the energy application switch and the timing of application of the DC voltage in the electrocardiogram input to the arithmetic processing unit of the power supply apparatus (the deep potential waveform in the case where contiguous contraction of the patient is occurring in the heart) .
18 is an explanatory diagram showing the timing of the input of the energy application switch and the application of the DC voltage in the electrocardiogram (deep potential waveform) in which the baseline input to the operation processing unit of the power supply apparatus is varied.
FIG. 19 is a graph showing the relationship between the input of the energy application switch and the application of the direct current voltage in the electrocardiogram input to the operation processing unit of the power supply device constituting the conventional catheter system (the cardiac potential waveform in the case where one- Fig.
20 is an explanatory diagram showing the timing of the input of the energy application switch and the timing of application of the DC voltage in the electrocardiogram (deep potential waveform) in which the baseline input to the operation processing unit of the power supply device constituting the conventional catheter system is varied .

1, the defibrillation catheter system of the present embodiment includes a defibrillation catheter 100, a power supply device 700, an electrocardiograph 800, and a cardiac potential measuring means 900. [

2 to 5, a defibrillation catheter 100 constituting a defibrillation catheter system according to the present embodiment includes a multi-lumen tube 10, a handle 20, a first DC electrode group 31G, The first lead line group 41G, the second lead line group 42G and the third lead line group 43G are provided in the order from the first lead electrode group 32G to the second lead electrode group 32G, have.

4 and 5, the multi-lumen tube 10 (an insulating tube structure having a multi-lumen structure) constituting the defibrillation catheter 100 is provided with four lumens (first lumen 11, second lumen 11, The lumen 12, the third lumen 13, and the fourth lumen 14) are formed.

4 and 5, reference numeral 15 denotes a fluororesin layer for partitioning the lumen, reference numeral 16 denotes an inner (core) portion made of a nylon elastomer having a low hardness, reference numeral 17 denotes an outer (cell) portion made of a nylon elastomer having a high hardness, Reference numeral 18 in Fig. 4 is a stainless steel wire forming braided braid.

The fluororesin layer 15 for partitioning the lumens is made of a material having high insulating properties such as a perfluoroalkyl vinyl ether copolymer (PFA), polytetrafluoroethylene (PTFE), or the like.

The nylon elastomer constituting the outer portion 17 of the multi-lumen tube 10 has a different hardness depending on the axial direction. Thus, the multi-lumen tube 10 is structured such that its hardness is gradually increased stepwise from the tip end side to the base end side.

3, the hardness (hardness by the D type hardness meter) of the area indicated by L1 (length 52 mm) is 40, the hardness of the area indicated by L2 (length 108 mm) is 55, L3 The hardness of the region indicated by L5 (length: 500 mm) is 72, and the hardness of the region represented by L4 (having the length of 10 mm) is 68;

The braided blade constituted by the stainless steel strand 18 is formed only in the region indicated by L5 in Fig. 3 and is formed between the inner portion 16 and the outer portion 17 as shown in Fig.

The outer diameter of the multi-lumen tube 10 is, for example, 1.2 to 3.3 mm.

The method of manufacturing the multi-lumen tube 10 is not particularly limited.

The handle 20 constituting the defibrillation catheter 100 in the present embodiment is provided with the handle body 21, the handle 22, and the strain relief 24.

By rotating the knob 22, the distal end of the multi-lumen tube 10 can be deflected (adjusted in direction).

A first DC electrode group 31G, a second DC electrode group 32G and a proximal-side potential-measuring electrode group 33G are provided on the outer periphery of the multi-lumen tube 10 Respectively. In this case, the term " electrode group " refers to an aggregate of a plurality of electrodes mounted at the same interval (for example, 5 mm or less) with the same polarity or with the same polarity.

The first DC electrode group is constituted by a plurality of electrodes which are arranged at narrow intervals in the front end region of the multi-lumen tube so as to form the same pole (- pole or + pole). In this case, the number of electrodes constituting the first DC electrode group varies depending on the width and arrangement interval of the electrodes, but is, for example, 4 to 13, preferably 8 to 10.

In the present embodiment, the first DC electrode group 31G is composed of eight ring-shaped electrodes 31 mounted on the front end region of the multi-lumen tube 10.

The electrode 31 constituting the first DC electrode group 31G is connected to the catheter connection connector of the power supply device 700 through the lead wire (the lead wire 41 constituting the first lead wire group 41G) Respectively.

In this case, the width (axial length) of the electrode 31 is preferably 2 to 5 mm, and a preferable example is 4 mm.

If the width of the electrode 31 is too narrow, the amount of heat generated at the time of voltage application becomes excessive, and the surrounding tissues may be damaged. On the other hand, if the width of the electrode 31 is excessively wide, the flexibility and flexibility of the portion where the first DC electrode group 31G is formed in the multi-lumen tube 10 may be impaired.

It is preferable that the mounting interval (distance between adjacent electrodes) of the electrodes 31 is 1 to 5 mm, and a preferable example is 2 mm.

At the time of use of the defibrillation catheter 100 (when it is placed in the abdominal cavity), the first DC electrode group 31G is located, for example, in the coronary vein.

The second DC electrode group includes a plurality of electrodes which are separated from the mounting position of the first DC electrode group of the multi-lumen tube to the base end side and form a pole (positive pole or negative pole) opposite to the first DC electrode group And are mounted at narrow intervals. In this case, the number of electrodes constituting the second DC electrode group varies depending on the width and arrangement interval of the electrodes, and is, for example, 4 to 13, preferably 8 to 10.

The second DC electrode group 32G is constituted by eight ring electrodes 32 which are separated from the mounting position of the first DC electrode group 31G to the base end side and are mounted on the multi-lumen tube 10 .

The electrode 32 constituting the second DC electrode group 32G is connected to the catheter connection connector of the power supply device 700 through the lead wire (the lead wire 42 constituting the second lead wire group 42G) Respectively.

In this case, the width (axial length) of the electrode 32 is preferably 2 to 5 mm, and a preferable example is 4 mm.

If the width of the electrode 32 is too narrow, the amount of heat generated when the voltage is applied becomes excessive, and the surrounding tissues may be damaged. On the other hand, if the width of the electrode 32 is excessively wide, the flexibility and flexibility of the portion where the second DC electrode group 32G is formed in the multi-lumen tube 10 may be impaired.

It is preferable that the mounting interval (distance between adjacent electrodes) of the electrodes 32 is 1 to 5 mm, and 2 mm is preferable.

At the time of use of the defibrillation catheter 100 (when it is placed in the abdominal cavity), the second DC electrode group 32G is located, for example, in the right atrium.

In this embodiment, the proximal-side potential-measuring electrode group 33G is divided into four ring-shaped electrodes 33, which are separated from the mounting position of the second DC-electrode group 32G to the proximal end thereof, Consists of.

The electrode 33 constituting the proximal-side potential-measuring electrode group 33G is connected to the catheter-connecting connector 33C of the power-supply device 700 via the lead wire (the lead wire 43 constituting the third lead-wire group 43G) Respectively.

In this case, the width (axial length) of the electrode 33 is preferably 0.5 to 2.0 mm, and a preferable example is 1.2 mm.

If the width of the electrode 33 is excessively wide, the accuracy of measurement of the deep potential may decrease, or it may become difficult to specify the region where the abnormal potential is generated.

It is preferable that the mounting interval (distance between adjacent electrodes) of the electrode 33 is 1.0 to 10.0 mm, and if it is a preferable example, it is 5 mm.

When the defibrillation catheter 100 is used (when it is placed in the abdominal cavity), the proximal-side potential-measuring electrode group 33G is located, for example, in the superior vein in which an abnormal potential is likely to occur.

At the tip of the defibrillation catheter 100, a tip tip 35 is attached.

The leading end tip 35 is not connected to the lead wire and is not used as an electrode in the present embodiment. However, it is also possible to use it as an electrode by connecting a lead wire. The constituent material of the tip tip 35 is not particularly limited, such as a metallic material such as platinum, stainless steel, or various resin materials.

The distance d2 between the first DC electrode group 31G (the base electrode 31) and the second DC electrode group 32G (the electrode 32 on the tip side) is preferably 40 to 100 mm And a preferable example is 66 mm.

The distance d3 between the second DC electrode group 32G (the base end electrode 32) and the base end side potential measuring electrode group 33G (the electrode 33 on the tip end side) is 5 to 50 mm And a preferable example is 30 mm.

The electrodes 31, 32, and 33 constituting the first DC electrode group 31G, the second DC electrode group 32G, and the base-end side potential measurement electrode group 33G are made to have good contrast for X- For example, platinum or a platinum-based alloy.

The first lead 41G shown in Figs. 4 and 5 is an aggregate of eight lead wires 41 connected to each of the eight electrodes 31 constituting the first DC electrode group 31G.

Each of the eight electrodes 31 constituting the first DC electrode group 31G can be electrically connected to the power source device 700 by the first lead line group 41G (lead wire 41).

The eight electrodes 31 constituting the first DC electrode group 31G are connected to different lead wires 41, respectively. Each of the lead wires 41 is welded to the inner peripheral surface of the electrode 31 at the tip end thereof and enters the first lumen 11 from the side wall formed in the tube wall of the multi- The eight lead wires 41 that have entered the first lumen 11 extend to the first lumen 11 as the first lead wire group 41G.

The second lead line group 42G shown in Figs. 4 and 5 is an aggregate of eight lead lines 42 connected to each of the eight electrodes 32 constituting the second DC electrode group 32G.

Each of the eight electrodes 32 constituting the second DC electrode group 32G can be electrically connected to the power supply device 700 by the second lead line group 42G (lead wire 42).

The eight electrodes 32 constituting the second DC electrode group 32G are connected to different lead wires 42, respectively. Each of the lead wires 42 is welded to the inner circumferential surface of the electrode 32 at the tip end thereof and is welded to the second lumen 12 (the first lead wire group 41G) from the side wall formed in the tube wall of the multi- Lumen different from the extended first lumen 11). The eight lead wires 42 that have entered the second lumen 12 extend to the second lumen 12 as a second lead wire group 42G.

As described above, since the first lead line group 41G extends to the first lumen 11 and the second lead line group 42G extends to the second lumen 12, both extend to the multi lumen tube 10, Is completely isolated from inside Isolation. Therefore, when a voltage necessary for the defibrillation is applied, the potential difference between the first lead line group 41G (first DC electrode group 31G) and the second lead line group 42G (second DC electrode group 32G) A short circuit can surely be prevented.

The third lead line group 43G shown in Fig. 4 is an aggregate of four lead lines 43 connected to each of the electrodes 33 constituting the base-end side potential measuring electrode group 33G.

Each of the electrodes 33 constituting the proximal-side potential-measuring electrode group 33G can be electrically connected to the power-supply device 700 by the third lead-group 43G (lead 43).

The four electrodes 33 constituting the group 33 of potential measurement electrodes on the base end side are connected to different lead wires 43 respectively. Each of the lead wires 43 is welded to the inner circumferential surface of the electrode 33 at the tip end thereof and enters the third lumen 13 from the side wall formed in the tube wall of the multi- The four lead wires 43 that have entered the third lumen 13 extend to the third lumen 13 as the third lead wire group 43G.

As described above, the third lead-wire group 43G extended to the third lumen 13 is completely insulated and isolated from any of the first lead-wire group 41G and the second lead-wire group 42G. Therefore, when a voltage necessary for the defibrillation is applied, the third lead-wire group 43G (the base-end-side potential-measuring electrode group 33G) and the first lead-wire group 41G (the first DC-electrode group 31G) It is possible to reliably prevent a short circuit between the second lead line group 42G (second DC electrode group 32G).

The lead wire 41, the lead wire 42, and the lead wire 43 are both made of a resin sheath in which the outer circumferential surface of the metal wire is covered with a resin such as polyimide. In this case, the film thickness of the coating resin is about 2 to 30 mu m.

In Figs. 4 and 5, reference numeral 65 denotes a pull wire.

The pull wire 65 extends to the fourth lumen 14 and extends eccentrically to the central axis of the multi-lumen tube 10.

The distal end portion of the pull wire 65 is fixed to the distal tip 35 by a hinder. The pull wire 65 may have a large-diameter portion (slip-off preventing portion) formed at the distal end thereof. As a result, the tip tip 35 and the pull wire 65 are firmly coupled to each other to reliably prevent the tip tip 35 from falling off.

On the other hand, the proximal end portion of the pull wire 65 is connected to the handle 22 of the handle 20. By pulling the pull wire 65 by operating the pull 22, Is deflected.

The pull wires 65 are made of a stainless steel or a Ni-Ti superelastic alloy, but they are not necessarily made of metal. The pull wire 65 may be formed of, for example, a non-conductive wire having high strength.

In addition, the mechanism for deflecting the distal end of the multi-lumen tube is not limited to this, and for example, a plate spring may be provided.

Only the pull wire 65 is extended to the fourth lumen 14 of the multi-lumen tube 10, and the lead wire (group) is not extended. Thereby, it is possible to prevent the lead wire from being damaged (for example, abrasion) by the pull wire 65 moving in the axial direction during the deflection operation of the distal end portion of the multi-lumen tube 10.

The defibrillation catheter 100 according to the present embodiment is configured such that the first lead line group 41G, the second lead line group 42G and the third lead line group 43G are insulated from each other, .

Fig. 6 is a perspective view showing the internal structure of the handle of the defibrillation catheter 100 according to the present embodiment, Fig. 7 is a partially enlarged view of the inside of the handle (front end side) to be.

6, the proximal end of the multi-lumen tube 10 is inserted into the distal end opening of the handle 20, whereby the multi-lumen tube 10 and the handle 20 are connected.

6 and 8, a circular connector 50 (50) having a plurality of pin terminals (51, 52, 53) protruding in the tip direction is disposed on the distal end surface (50A) ).

6 to 8, three lead-wire groups (first lead-wire group 41G, second lead-wire group 42G, third lead-wire group 43G) are provided in the interior of the handle 20 (The first insulating tube 26, the second insulating tube 27, and the third insulating tube 28) are inserted and extended.

6 and 7, the distal end of the first insulative tube 26 (about 10 mm from the distal end) is inserted into the first lumen 11 of the multi-lumen tube 10, The tube 26 is connected to the first lumen 11 to which the first lead line group 41G extends.

The first insulated tube 26 connected to the first lumen 11 passes through the interior of the first protective tube 61 extending into the interior of the handle 20 and is inserted into the connector 50 (50A), thereby forming an insertion passage for guiding the proximal end portion of the first lead-wire group 41G to the vicinity of the connector 50. As shown in Fig. Thereby, the first lead-wire group 41G extending from the multi-lumen tube 10 (first lumen 11) is not kinked, and the inside of the handle 20 (the inside of the first insulating tube 26) can do.

The first lead wire group 41G extending from the base end opening of the first insulating tube 26 is divided into eight lead wires 41 constituting the first lead wire group 41G, And is connected and fixed to each of the pin terminals disposed on the base 50A by a hinder. In this case, the region where the pin terminal (pin terminal 51) to which the lead 41 constituting the first lead line group 41G is connected and fixed is referred to as a " first terminal group region ".

The distal end portion of the second insulative tube 27 is inserted into the second lumen 12 of the multi-lumen tube 10 so that the second insulative tube 27 is connected to the second lead- Is connected to the second lumen (12) where the second lumen (42G) extends.

The second insulative tube 27 connected to the second lumen 12 passes through the interior of the second protective tube 62 extending into the interior of the handle 20 and is inserted into the connector 50 (50A), thereby forming an insertion path for guiding the base end portion of the second lead-wire group 42G to the vicinity of the connector 50. As shown in Fig. Thereby, the second lead line group 42G extending from the multi-lumen tube 10 (second lumen 12) is not kinked, and the inside of the handle 20 (the inside of the second insulating tube 27) You can extend it.

The second lead wire group 42G extending from the base end opening of the second insulating tube 27 is divided into eight lead wires 42 constituting the second lead wire group 42G, And is connected and fixed to each of the pin terminals disposed on the base 50A by a hinder. In this case, the region where the pin terminal (pin terminal 52) to which the lead wire 42 constituting the second lead line group 42G is connected and fixed is referred to as a " second terminal group region ".

The distal end of the third insulating tube 28 is inserted into the third lumen 13 of the multi-lumen tube 10 so that the third insulating tube 28 is connected to the third lead- Is connected to the third lumen (13) where the second lumen (43G) extends.

The third insulative tube 28 connected to the third lumen 13 passes through the interior of the second protective tube 62 extending into the interior of the handle 20 and passes through the connector 50 (50A), thereby forming an insertion path for guiding the base end of the third lead-wire group 43G to the vicinity of the connector 50. [ As a result, the third lead-wire group 43G extending from the multi-lumen tube 10 (third lumen 13) is not kinked, and the inside of the handle 20 (the inside of the third insulating tube 28) can do.

The third lead wire group 43G extended from the base end opening of the third insulating tube 28 is decomposed into four lead wires 43 constituting the third lead wire group 43G, And is connected and fixed to each of the pin terminals disposed on the base 50A by a hinder. In this case, a region where the pin terminal (pin terminal 53) to which the lead wire 43 constituting the third lead line group 43G is connected and fixed is referred to as a " third terminal group region ".

In this case, as the constituent material of the insulating tube (the first insulating tube 26, the second insulating tube 27, and the third insulating tube 28), a polyimide resin, a polyamide resin, a polyamide- Can be exemplified. Among them, a polyimide resin which is high in hardness, easy to penetrate the lead-wire group, and capable of being thinned is particularly preferable.

The thickness of the insulating tube is preferably 20 to 40 占 퐉, and a preferable example is 30 占 퐉.

As the constituent material of the protective tubes (the first protective tube 61 and the second protective tube 62) into which the insulating tube is inserted, nylon-based elastomers such as "Pebax" (registered trademark of ARKEMA) Can be exemplified.

According to the defibrillation catheter 100 of the present embodiment having the above-described configuration, the first lead-wire group 41G is extended in the first insulating tube 26 and the second lead- The lead group 42G is extended and the third lead line group 43G is extended in the third insulating tube 28 so that the first lead line group 41G and the second lead line group 42G and the third lead line group 43G can be completely insulated from each other. As a result, when a voltage necessary for the defibrillation is applied, the short circuit between the first lead wire group 41G, the second lead wire group 42G, and the third lead wire group 43G inside the handle 20 (In particular, a short circuit between the lead-wire group extending in the vicinity of the opening of the lumen) can be reliably prevented.

The first insulating tube 26 is protected by the first protection tube 61 and the second insulating tube 27 and the third insulating tube 28 are protected by the second protection (Moving parts) of the handle 22 are contacted and rubbed during deflection operation of the distal end portion of the multi-lumen tube 10, for example, so that the insulating tube is damaged .

The defibrillation catheter 100 of the present embodiment is configured such that the distal end surface 50A of the connector 50 in which the plurality of pin terminals are disposed is divided into the first terminal group region, the second terminal group region, And a partition plate 55 separating the lead wire 41 and the lead wire 42 and the lead wire 43 from each other.

The partition plate 55 for partitioning the first terminal group region, the second terminal group region and the third terminal group region is formed by molding an insulating resin with a flat surface on both sides in general. The insulating resin constituting the partition plate 55 is not particularly limited, and a general-purpose resin such as polyethylene can be used.

The thickness of the partition plate 55 is, for example, 0.1 to 0.5 mm, and a preferable example is 0.2 mm.

The height of the partition wall plate 55 (the distance from the base end edge to the tip end edge) is set so that the distance between the distal end face 50A of the connector 50 and the insulating tube (the first insulating tube 26 and the second insulating tube 27) If the spacing distance is 7 mm, the height of the partition plate 55 is, for example, 8 mm. In the case of the partition plate having a height of less than 7 mm, the leading edge thereof can not be located at the tip side of the base end of the insulating tube.

The lead wire 41 constituting the first lead wire group 41G (the base end portion of the lead wire 41 extending from the base end opening of the first insulating tube 26) and the second lead wire group 42G The lead wire 42 (the base end portion of the lead wire 42 extending from the base end opening of the second insulating tube 27) constituting the base end portion of the second insulating tube 27 can be securely and evenly isolated.

When the partition plate 55 is not provided, the lead wires 41 and the lead wires 42 can not be isolated (divided) uniformly, and there is a fear that they are crossed.

The lead wires 41 constituting the first lead wire group 41G and the lead wires 42 constituting the second lead wire group 42G to which voltages of mutually different polarities are applied are connected by the barrier plates 55 Even if a voltage necessary for the defibrillation in the in-depth chamber is applied, the lead wire 41 (the first insulating tube (the first insulating tube) 41G) constituting the first lead- And the lead wire 42 constituting the second lead wire group 42G (the lead wire 42 extending from the base end opening of the second insulating tube 27) constituting the second lead wire group 42G, The short-circuit is not generated between the base end portion

When an error occurs when the lead wire is connected and fixed to the pin terminal at the time of manufacturing the defibrillation catheter, for example, the lead wire 41 constituting the first lead wire group 41G is connected to the terminal In the case of connecting to the pin terminal, since the lead wire 41 extends over the partition 55, a connection error can be easily found.

The lead wire 43 (pin terminal 53) constituting the third lead wire group 43G is connected to the lead wire 41 by the barrier plate 55 together with the lead wire 42 (the pin terminal 52) (The pin terminal 52) by the partition plate 55 together with the lead wire 41 (the pin terminal 51), but the present invention is not limited thereto. As shown in Fig.

The distal end edge of the partition plate 55 is located on the distal end side of either the base end of the first insulating tube 26 or the base end of the second insulating tube 27. [

Thereby, the lead wire (the lead wire 41 constituting the first lead wire group 41G) extending from the base end opening of the first insulating tube 26 and the lead wire (the lead wire 41 constituting the first lead wire group 41G) extending from the base end opening of the second insulating tube 27 The lead wires 42 constituting the lead wire group 42G are always present between the lead wires 41 and the lead wires 42 so that a short circuit due to contact between the lead wires 41 and the lead wires 42 can be reliably prevented.

8, eight leads 41 extending from the base end opening of the first insulating tube 26 and connected and fixed to the pin terminal 51 of the connector 50, the base end of the second insulating tube 27, Eight lead wires 42 extending from the openings and connected and fixed to the pin terminals 52 of the connector 50 and eight lead wires 42 extending from the base end openings of the third insulating tubes 28 and connected to the pin terminals 53 of the connector 50 The fixed four lead wires 43 are hardened by the resin 58 so that their respective shapes are held and fixed.

The resin 58 for retaining the shape of the lead wire is formed in a cylindrical shape having the same diameter as the connector 50. Pin terminals, lead wires, base ends of the insulating tubes, and the partition plate 55 are embedded in the resin- .

According to the constitution in which the proximal end portion of the insulating tube is embedded in the resin molded body, the entirety of the lead wire (proximal end portion) extending from the base end opening of the insulating tube to being connected and fixed to the pin terminal is connected to the resin 58 And the shape of the lead wire (base end portion) can be completely held and fixed.

It is preferable that the height of the resin molded body (distance from the base end face to the end face) is higher than the height of the partition plate 55. When the height of the partition plate 55 is 8 mm, for example, .

In this case, the resin 58 constituting the resin molded article is not particularly limited, but a thermosetting resin or a photocurable resin is preferably used. Specifically, urethane-based, epoxy-based, and urethane-epoxy-based curable resins can be exemplified.

The shape of the lead wire is held and fixed by the resin 58. As a result, when the defibrillation catheter 100 is manufactured (when the connector 50 is mounted in the handle 20) It is possible to prevent the lead wire extending from the base end opening of the insulating tube from being kinked or being damaged by contact with the edge of the pin terminal (for example, cracking occurs in the cover resin of the lead wire).

1, the power supply 700 constituting the defibrillation catheter system of the present embodiment includes a DC power supply 71, a catheter connection connector 72, an electrocardiograph connector 73, an external switch (not shown) A switching unit 76, an electrocardiogram input connector 77, and a display unit 78. The operation unit 75 is provided with an input unit 74, an operation processing unit 75, a switching unit 76,

A condenser is built in the DC power supply unit 71, and the built-in condenser is charged by the input of the external switch 74 (charge switch 743).

The catheter connection connector 72 is connected to the connector 50 of the defibrillation catheter 100 and electrically connects the proximal end side of the first lead line group 41G, the second lead line group 42G, Respectively.

9, the connector 50 of the defibrillation catheter 100 and the catheter connection connector 72 of the power supply device 700 are connected by the connector cable C1,

The pin terminals 51 (actually eight) and the terminals 721 (actually eight) of the catheter connector 72 are connected to the lead terminals 41 constituting the first lead line group,

Pin terminals 52 (actually eight) and eight terminals 722 (actually eight) of the catheter connector 72 are connected to the lead wires 42 constituting the second lead line group,

The pin terminals 53 (actually four terminals) and the terminals 723 (actually four terminals) of the catheter connecting connector 72 to which the four lead wires 43 constituting the third lead line group are connected and connected are connected .

In this case, the terminal 721 and the terminal 722 of the catheter connecting connector 72 are connected to the switching portion 76 and the terminal 723 is connected to the electrocardiograph connector 73 As shown in Fig.

Thereby, the deep potential information measured by the first DC electrode group 31G and the second DC electrode group 32G reaches the electrocardiograph connector 73 via the switching unit 76, The cardiac potential information measured by the electrode group 33G reaches the electrocardiograph connection connector 73 without passing through the switching portion 76. [

The electrocardiograph connection connector 73 is connected to an input terminal of the electrocardiograph 800. [

The external switch 74 as an input means is provided with a mode changeover switch 741 for switching between the electrocardiogram measurement mode and the defibrillation mode, an applied energy setting switch 742 for setting the electric energy to be applied at the time of defibrillation, And an energy application switch (discharge switch) 744 for applying electrical energy to perform defibrillation. All the input signals from these external switches 74 are sent to the arithmetic processing unit 75.

The operation processing section 75 controls the DC power source section 71, the switching section 76 and the display section 78 based on the input of the external switch 74.

The arithmetic processing unit 75 has an output circuit 751 for outputting the DC voltage from the DC power supply unit 71 to the electrode of the defibrillator catheter 100 through the switching unit 76.

The terminal 721 of the catheter connection connector 72 shown in Fig. 9 (finally the first DC electrode group 31G of the defibrillation catheter 100) and the catheter connection connector 72 ) Of the defibrillation catheter 100 are set such that the terminals 722 of the defibrillator catheter 100 (finally the second DC electrode group 32G of the defibrillation catheter 100) are of different polarities (when one electrode group is negative, Voltage can be applied.

The switching section 76 is connected to the catheter connecting connector 72 (the terminal 721 and the terminal 722) to the common contact, the electrocardiograph connector 73 to the first contact, (Single Pole Double Throw) switch to which the switch 75 is connected.

That is, when the first contact is selected (when the first contact is connected to the common contact), a path connecting the catheter connection connector 72 and the electrocardiograph connection connector 73 is secured, and the second contact is selected (When the second contact is connected to the common contact), a path for connecting the catheter connecting connector 72 and the arithmetic processing unit 75 is secured.

The switching operation of the switching section 76 is controlled by the operation processing section 75 based on the input of the external switch 74 (mode switching switch 741 and energy applying switch 744).

The electrocardiogram input connector 77 is connected to the calculation processing unit 75 and is also connected to the output terminal of the electrocardiograph 800.

The electrocardiogram input connector 77 can input the cardiac potential information (usually a part of the cardiac potential information input to the electrocardiograph 800) output from the electrocardiograph 800 to the operation processor 75, The processing section 75 can control the DC power source section 71 and the switching section 76 based on the deep potential information.

The display means 78 is connected to the arithmetic processing unit 75 and the display means 78 is connected to the arithmetic processing unit 75 by the electrocardiogram input connector 77 with the electrocardiographic information (mainly electrocardiogram And the operator can perform defibrillation therapy (input of an external switch, etc.) while monitoring the cardiac potential information (electrocardiogram) input to the operation processing section 75.

The electrocardiograph 800 (input terminal) constituting the defibrillation catheter system of the present embodiment is connected to the electrocardiograph connector 73 of the power supply 700 and the defibrillation catheter 100 (the first DC electrode group 31G) The DC electrode group 32G and the electrodes constituting the group of the proximal-side potential-measuring electrodes 33G) are input from the electrocardiograph connector 73 to the electrocardiograph 800. [

The electrocardiograph 800 (other input terminal) is also connected to the cardiac potential measuring means 900, and the cardiac potential information measured by the cardiac potential measuring means 900 is also inputted to the electrocardiograph 800.

In this case, the deep-potential measuring means 900 includes an electrode pad to be stuck to the body surface of the patient to measure 12-lead electrocardiogram, an electrode catheter (which is different from the defibrillation catheter 100) Electrode catheter).

The electrocardiograph 800 (output terminal) is connected to the electrocardiogram input connector 77 of the power supply 700 and outputs the psychoelectric potential information (the psycho potential information from the defibrillator 100 and the psycho potential A part of the heart rate information from the measurement means 900 can be sent to the calculation processing section 75 via the electrocardiogram input connector 77. [

The defibrillation catheter 100 according to the present embodiment can be used as an electrode catheter for measuring the deep potential when the defibrillation therapy is not required.

10 shows the flow of the cardiac potential information when the cardiac potential is measured by the defibrillation catheter 100 according to the present embodiment when cardiac catheterization (for example, high frequency treatment) is performed. At this time, the switching section 76 of the power supply apparatus 700 selects the first contact to which the electrocardiograph connection connector 73 is connected.

The diaphragm measured by the electrodes constituting the first DC electrode group 31G and / or the second DC electrode group 32G of the defibrillation catheter 100 is connected to the catheter connecting connector 72, the switch portion 76, And is input to the electrocardiograph 800 via the electrocardiograph connector 73. [

The cardiac potential measured by the electrodes constituting the proximal-side potential-measuring electrode group 33G of the defibrillator catheter 100 is directly transmitted from the catheter connecting connector 72 through the electrocardiograph connector (not shown) 73 to the electrocardiograph 800.

The cardiac potential information (electrocardiogram) from the defibrillation catheter 100 is displayed on a monitor (not shown) of the electrocardiograph 800.

A part of the cardiac potential information from the defibrillation catheter 100 (for example, a potential difference between the electrodes 31 (the first pole and the second pole) constituting the first DC electrode group 31G) 800 to the display means 78 via the electrocardiogram input connector 77 and the arithmetic processing unit 75 and display them.

As described above, when defibrillation therapy is not required during cardiac catheterization, the defibrillation catheter 100 can be used as an electrode catheter for the cardiac potential measurement.

When atrial fibrillation occurs during cardiac catheterization, the defibrillation catheter 100 used as an electrode catheter can immediately perform defibrillation treatment. As a result, when atrial fibrillation occurs, it is possible to reduce the trouble such as a new insertion of a catheter for defibrillation.

The arithmetic processing unit 75 sequentially senses an event (waveform) estimated to be an R wave of the electrocardiogram from a part (electrocardiogram) of the cardiac potential information sent from the electrocardiograph 800 via the electrocardiogram input connector 77 have.

The sensing of an event presumed to be an R wave is performed by, for example, detecting the maximum peak waveform in the cycle one cycle before the cycle (pulse) to be sensed and the maximum peak waveform in the cycles two cycles before, Calculating the average height of the peak waveform, and detecting that the potential difference reaches a height (trigger level) of 80% of the average height.

The calculation processing unit 75 recognizes the polarity (the direction of the peak indicated by the sign) in each of the sensed events, inputs the energy application switch 744, events have the polarities of (V _n), match the polarity of one of the previous polarity and the two events (V _{n -2)} sensed in the previous cycle of the event (V _{n -1)} in the sensing cycle time, the art in synchronization with the event (V _n), the catheter connector 72 of the terminal 721 (operation 1 DC electrode group (31G)), and a catheter connected to the connector 72, terminals 722 (a 2 DC of Electrode group 32G) so as to control the DC power supply unit 71. [0064]

In the electrocardiogram shown in Figs. 16A to 16D, the polarity of the third event from the left of the six events sensed and estimated as the R wave is negative (the peak waveform thereof is downward), and the polarity of the other five events is (+) (The peak waveform is upward).

16A, when the energy application switch 744 is inputted after sensing the second event (V ₀ ) from the left, the polarity (-) of the third event (V ₁ ) (+) Of the second event (V ₀ ) sensed in the event (V ₁ ), the voltage is not applied in synchronization with the event (V ₁ ).

In addition, the polarity (+) of the fourth event (V _2), the polarity of the third event (V ₁₎ sensing in the cycle immediately prior (-) because it differs, in synchronism with the event (V ₂₎ The voltage is not applied.

In addition, the polarity (+) of the fifth event (V _3), the polarity of the third event (V ₁₎ sensing in the cycle two before (-) because it differs, in synchronism with the event (V ₃₎ The voltage is not applied.

Sixth event (V _4), polarity (+) is the fourth event sensed in the 5 positive (+) and two previous cycle of the second event (V ₃₎ sensed in the cycle one before the (V ₂₎ because of the same as the polarity (+), it is in synchronization with the event (V _4), and the voltage to 1 DC electrode group (31G) and a 2 DC electrode group (32G) is applied.

16B, when the energy application switch 744 is input after sensing the third event (V ₀ ) from the left, the polarity (+) of the fourth event (V ₁ ) (-) of the third event (V ₀ ) sensed in the event (V ₁ ), the voltage is not applied in synchronization with the event (V ₁ ).

In addition, the polarity (+) of the fifth event (V _2), the polarity of the third event (V ₀₎ sensed in the cycle two before (-) because it differs, in synchronism with the event (V ₂₎ The voltage is not applied.

The polarity (+) of the sixth event (V ₃ ) is the polarity (+) of the fifth event (V ₂ ) sensed in the previous cycle and the fourth event (V ₁ ) because of the same as the polarity (+), it is in synchronization with the event (V _3), and the voltage to 1 DC electrode group (31G) and a 2 DC electrode group (32G) is applied.

16C, when the energy application switch 744 is inputted after sensing the fourth event (V ₀ ) from the left, the polarity (+) of the fifth event (V ₁ ) (-) of the third event (V _-1 ) sensed in the event (V ₁ ), the voltage is not applied in synchronization with this event (V ₁ ).

The polarity (+) of the sixth event (V ₂ ) is the polarity (+) of the fifth event (V ₁ ) sensed in the previous cycle and the fourth event (V ₀ ) because of the same as the polarity (+), it is in synchronization with the event (V _2), and the voltage to 1 DC electrode group (31G) and a 2 DC electrode group (32G) is applied.

16D, when the energy application switch 744 is input after sensing the fifth event (V ₀ ) from the left, the polarity (+) of the sixth event (V ₁ ) in the same as the polarity (+) of the sensed fifth event (V _0), the polarity (+) and the fourth event 2 _(-1 V) in the cycle before the sensing of the dog, and in this event (V ₁₎ In synchronism, a voltage is applied to the first DC electrode group 31G and the second DC electrode group 32G.

As described above, even when the energy applying switch 744 is input at any timing shown in Figs. 16A to 16D, the third event (the sixth event from the left) when the same polarity (+ The voltage is applied in synchronization with each other.

The arithmetic processing unit 75 senses an event presumed to be an R wave in the inputted electrocardiogram and then applies a voltage to the first DC electrode group 31G and the second DC electrode group 32G for 260 msec And controls the DC power supply unit 71 so as not to be applied.

Thereby, when the sensed event is the peak of the R wave, it is possible to reliably avoid defibrillation at the time when the next T wave appears, that is, to mask the peak estimated to be T wave, have.

Also, the period during which the DC voltage is not applied after sensing the event is not limited to 260 m seconds, but is short for 50 m seconds and long for 500 m seconds. If this period is shorter than 50 m seconds, it may become impossible to mask a peak estimated as a T wave. On the other hand, when this period is longer than 500 m seconds, the R wave in the next cycle (pulse) may not be able to be sensed.

The calculation processing unit 75 is programmed so as not to newly sense an event estimated to be an R wave for 100 ms after sensing an event estimated to be an R wave.

As a result, when the peak of the S wave appearing in the opposite direction (opposite polarity) to the R wave is increased following the R wave to reach the trigger level (this is not particularly a problem in defibrillation even in this state) It is possible to prevent the continuity of the polarity of the event (the reset of the count of the same polarity) by sensing the peak of the S wave.

In addition, the period (blanking period) during which no event is newly sensed after sensing the event is not limited to 100 m seconds, but is short for 10 m seconds and longer for 150 m seconds.

The arithmetic processing unit 75 controls the DC power source unit (not shown) so that the voltage is not applied to the first DC electrode group 31G and the second DC electrode group 32G for 260 m seconds after the energy application switch 744 is input 71).

Thereby, it is possible to prevent the noise generated by the input of the energy application switch 744 (noise having the same polarity as the previous and previous events) to be mistaken for R-shaped and sensing, and to perform defibrillation in synchronization with this noise .

It is to be noted that the continuity of the polarity of the event is inhibited (the count of the same polarity is reset) by the noise generated by the input of the energy application switch 744 (noise of polarity different from the previous and / or previous event) .

It is also possible to prevent the variation of the baseline occurring immediately after the input of the energizing switch 744 to be mistaken for an R wave and to sense the defibrillation in synchronization with this.

Also, after the input of the energizing switch 744, the period in which the DC voltage is not applied is not limited to 260 m seconds, but is short for 10 m seconds and 500 m seconds long.

Hereinafter, an example of the defibrillation therapy by the intra-abdominal defibrillation catheter system of the present embodiment will be described with reference to the flowchart shown in FIG.

(1) First, an X-ray image is taken of the electrodes of the defibrillation catheter 100 (the first DC electrode group 31G, the second DC electrode group 32G and the constituent electrodes of the group of the proximal-side potential-measuring electrodes 33G) And also selects a part of the cardiac potential information (12-lead electrocardiogram) input to the electrocardiograph 800 from the cardiac potential measuring means 900 (electrode pad attached to the body surface) 77 to the operation processing unit 75 of the power supply apparatus 700 (Step 1 in FIG. 11A). At this time, a part of the psycho-potential information input to the calculation processing section 75 is displayed on the display means 78 (see Fig. 12). The catheter connecting connector 72, the switching portion 76, the electrocardiograph connector 73 (first electrode group) and the second electrode group The catheter connection connector 72 and the electrocardiograph connection connector 73 are connected to the distal end side of the defibrillation catheter 100 from the constituent electrodes of the group of the proximal-side potential measurement electrodes 33G of the defibrillator catheter 100, And the cardiac potential information input to the electrocardiograph 800 is displayed on a monitor (not shown) of the electrocardiograph 800. [

(2) Next, the mode changeover switch 741 which is the external switch 74 is inputted. The power source apparatus 700 according to the present embodiment is in the " deep potential measurement mode " in the initial state, and the switching section 76 selects the first contact to disconnect the switching section 76 from the catheter connecting connector 72 And the path to the electrocardiograph connection connector 73 is secured.

The mode changeover switch 741 enters the " defibrillation mode " (Step 2).

(3) As shown in Fig. 13, when the mode changeover switch 741 is inputted and the mode is switched to the defibrillation mode, the contact of the switch 76 is switched to the second contact by the control signal of the operation processor 75, The path from the connector 72 to the arithmetic processor 75 is secured via the switch 76 and the path from the catheter connector 72 to the electrocardiograph connector 73 via the switch 76 is (Step 3). The cardiac potential information from the constituent electrodes of the first DC electrode group 31G and the second DC electrode group 32G of the defibrillation catheter 100 when the switching unit 76 is selecting the second contact is detected by the electrocardiograph 800) (therefore, it is not possible to send the sim cardinality information to the arithmetic processing unit 75). However, the cardiac potential information from the constituent electrodes of the group of the proximal-side potential-measuring electrodes 33G not passing through the switching unit 76 is input to the electrocardiograph 800. [

(4) The resistance between the first DC electrode group 31G of the defibrillation catheter 100 and the second DC electrode group 32G of the defibrillation catheter 100 is measured at the point when the contact point of the switching unit 76 is changed to the second contact point 4). The resistance value inputted from the catheter connecting connector 72 via the switching section 76 to the arithmetic processing section 75 is a part of the cardiac potential information from the cardiac potential measuring means 900 inputted to the arithmetic processing section 75 Together, they are displayed on the display means 78 (see Fig. 13).

(5) The contact of the switching portion 76 is changed to the first contact, and the path from the catheter connecting connector 72 to the electrocardiograph connector 73 via the switching portion 76 is returned (Step 5).

In addition, the time during which the contact of the switching unit 76 selects the second contact (the above Step 3 to Step 5) is, for example, one second.

(6) The arithmetic processing unit 75 determines whether or not the resistance measured in Step 4 exceeds a predetermined value. If the resistance does not exceed the predetermined value, the process proceeds to Step 7 (preparation for applying a DC voltage) If it is exceeded, return to Step 1 (check the position of the electrode of the defibrillation catheter 100) (Step 6).

In this case, when the resistance exceeds a predetermined value, the first DC electrode group and / or the second DC electrode group are reliably and uniformly applied to a predetermined region (for example, the inner wall of the tubular wall of the coronary vein and the inner wall of the right atrium) It means that the electrodes are not brought into contact with each other. Therefore, it is necessary to return to Step 1 and readjust the position of the electrodes.

Thus, only when the first DC electrode group and the second DC electrode group of the defibrillation catheter 100 are reliably in contact with a predetermined region (for example, the inner wall of the coronary vein, the inner wall of the right atrium) It is possible to perform effective defibrillation treatment.

(7) An applied energy setting switch 742, which is an external switch 74, is input to set the applied energy at the time of defibrillation (Step 7 of FIG. 11B).

According to the electrode device 700 of the present embodiment, the applied energy can be set at intervals of 1 J from 1 J to 30 J.

(8) A charging switch 743, which is an external switch 74, is input to charge the built-in capacitor of the DC power supply unit 71 (Step 8).

(9) After the charging is completed, the energy switch 744 which is the external switch 74 is inputted (Step 9).

(10) The present event (V _n ) sensed in Step 12 to be described later generates "1" as the number n indicating how many times it is sensed after the energy application switch 744 is input 10).

(11) The arithmetic processing unit 75 senses a previous event (V _{n -1} ) (an event sensed immediately before the input of the energy applying switch 744), and then performs a new sensing as a blanking period for 100 m seconds (Step 11).

(12) After the lapse of the blanking period, the operation processing unit 75 senses the event V _n (Step 12).

13, the calculation processing unit 75, the polarity of the event (V _n) sensing at Step 12, it is judged whether or not the match the polarity of the event (V _{n -1)} of the previously (before the sensing 1) , The process proceeds to Step 14, and if not, the process proceeds to Step 10 to add 1 to the number (n) in Step 10 'and to return to Step 11 (Step 13).

14 determines whether or not coincides with the polarity of the calculation processing unit 75, the polarity of the event (V _n) sensing at Step 12, before last time event (V _{n -2)} of (sensed two before) If they do not coincide with each other, the process proceeds to Step 15. If they do not coincide with each other, Step 10 'adds 1 to the number (n) and returns to Step 11 (Step 14).

(15) The arithmetic processing unit 75 determines whether or not the time from when the previous event (V _{n -1} ) is sensed to when the event (V _n ) is sensed exceeds 260 m seconds, The process proceeds to Step 16, and in Step 10 ', the number (n) is incremented by 1 and the process returns to Step 11 (Step 15 in FIG. 11C).

(16) The arithmetic processing unit 75 determines whether or not the time from when the energy application switch 744 is input until the event V _n is sensed exceeds 260 m seconds, , The process proceeds to Step 17, and in Step 10 ', if it is not exceeded, 1 is added to the number (n) and the process returns to Step 11 (Step 16).

(17) The contact of the switching portion 76 is switched to the second contact by the calculation processing portion 75 and a path from the catheter connecting connector 72 to the calculation processing portion 75 via the switching portion 76 is secured , The path from the catheter connecting connector 72 to the electrocardiograph connector 73 via the switching portion 76 is blocked (Step 17).

The output circuit 751 of the arithmetic processing unit 75 and the switching unit 751 of the arithmetic processing unit 75 receive the control signal from the arithmetic processing unit 75 after the contact of the switching unit 76 is switched to the second contact, A DC voltage of a different polarity is applied to the first DC electrode group and the second DC electrode group of the defibrillation catheter 100 via the catheter connector 76 and the catheter connection connector 72 (see Step 18, Fig. 14).

In this case, the arithmetic processing unit 75 synchronizes with the event V _n sensed in Step 12, performs arithmetic processing to apply the DC voltage to the first DC electrode group and the second electrode group, and supplies the DC voltage to the DC power source unit 71 As shown in Fig.

Concretely, from a point of time when the event V _n is sensed (when the next R wave rises), a predetermined time (for example, a very short time of about 1/10 of the peak width of the R wave that is the event V _n ) After the elapse of the predetermined period of time.

FIG. 15 is a diagram showing a potential waveform measured when predetermined electrical energy (for example, setting output = 10 J) is applied by the defibrillation catheter 100 according to the present embodiment. In the figure, the horizontal axis represents time and the vertical axis represents electric potential.

First, after the elapse of a predetermined time (t ₀ ) after the event processing unit 75 senses the event V _n , the first DC electrode group 31G becomes _negative and the second DC electrode group 32G becomes negative (E ₁ is the peak voltage at this time), and the measurement potential is increased by supplying the electric energy. After the lapse of a predetermined time (t _1), of claim 1 DC electrode group (31G) the + pole, the 2 DC electrode group (32G) is - by applying a DC voltage obtained by inverting the ± so that the poles between both the electrical energy (E ₂ is the peak voltage at this time).

In this case, the time t ₀ from the sensing of the event V _n to the start of application is 0.01 to 0.05 seconds, for example 0.01 second, and the time t = t ₁ + t ₂ ) is, for example, 0.006 to 0.03 seconds, and 0.02 seconds if a preferable example is given. This makes it possible to apply a voltage by taking the synchronization with the R pine event (V _n), it may be subjected to an effective defibrillation therapy.

The measured peak voltage (E ₁ ) is, for example, 300 to 600 V.

19, the application of voltage from the event (V _n) and then sensing the predetermined time (t ₀ + t) has elapsed after, the calculation processing unit (75) DC power supply unit 71 receives the control signal from the stops (Step 19).

(20) The application of the voltage is stopped, and the applied recording (deep potential waveform at the time of application as shown in Fig. 15) is displayed on the display means 78 (Step 20). The display time is, for example, 5 seconds.

The contact of the switching unit 76 is switched to the first contact so that the path from the catheter connecting connector 72 to the electrocardiograph connector 73 via the switching unit 76 is returned and the defibrillation catheter 100, The electrocardiograph information from the electrodes constituting the first DC electrode group 31G and the second DC electrode group 32G of the electrocardiograph 800 is input to the electrocardiograph 800 (Step 21).

(First DC electrode group 31G, second DC electrode group 32G, and proximal-side potential-measuring electrode group 33G) of the defibrillator catheter 100, which are displayed on the monitor of the electrocardiograph 800, (12-lead ECG) from the cardiac potential measuring means 900, and if it is "normal", it is terminated, and if it is not "normal" (atrial fibrillation Is not calm ", the process returns to Step 2 (Step 22).

According to the catheter system of the present embodiment, the first DC electrode group 31G and the second DC electrode group 32G of the defibrillation catheter 100 can directly supply electrical energy to the heart that has caused firings, It is necessary for defibrillation therapy and can also give enough electrical stimulation (electric shock) to heart only.

In addition, since electric energy can be directly applied to the heart, it does not cause burns on the patient's body surface.

The cardiac potential information measured by the constituent electrode 33 of the proximal-side potential-measuring electrode group 33G is transmitted from the catheter connecting connector 72 through the electrocardiograph connector 73 via the switching portion 76, The electrocardiograph 800 is connected to the electrocardiograph 800 so that the first DC electrode group 31G of the defibrillation catheter 100 and the second DC electrode group 300 of the defibrillator catheter 100 are connected to the electrocardiograph 800, The diaphragm from the catheter connector 32G is switched from the catheter connector 72 to the diaphragm connection via the switching portion 76 in the defibrillation therapy The electrocardiograph 800 can acquire the cardiac potential information measured by the group of the base-end-side potential-measuring electrode group 33G and the cardiac potential-measuring unit 900 even when the path to the connector 73 is blocked, The electrocardiograph 800 monitors (monitors) the cardiac potential while defibrillating Treatment can be performed.

The arithmetic processing unit 75 of the power supply 700 synchronizes with the electrocardiogram waveform input via the electrocardiogram input connector 77 and performs arithmetic processing to apply a voltage to control the DC power supply unit 71 The first DC electrode group 31G of the defibrillation catheter 100 and the second DC electrode group 31B of the defibrillator catheter 100 are electrically connected to each other, The voltage can be applied to the group of electrodes 32G by synchronizing with the deep-potential waveform and effective defibrillation treatment can be performed.

When the resistance between the electrode groups of the defibrillation catheter 100 does not exceed a predetermined value, that is, when the first DC electrode group 31G and the second DC electrode group 32G are in a predetermined (For example, a vessel wall of a coronary vein, an inner wall of a right atrium) of the coronary artery, it is possible to perform an effective defibrillation treatment.

The arithmetic processing unit 75 sequentially senses an event estimated to be an R wave in the electrocardiogram input from the electrocardiograph 800 via the electrocardiogram input connector 77, , when the polarity of the event (V _n) to the n-th sensing, match the polarity of the polarity and the two events (V _n-2) before sensing in the event that one (V _{n -1)} before sensing , The voltage is applied to the first DC electrode group 31G and the second DC electrode group 32G in synchronism with the event V _n to control the DC power source unit 71 so that three consecutively sensed event _{(V n -2), (V} n -1) , and if (V _n) is not matched polarity, in synchronism with the event (V _n) without applying a voltage, the three events (V _{n -2)} , The voltages are applied in synchronization with the third event (V _n ) only when the polarities of (V _{n -1} ) and (V _n ) match, It is possible to perform defibrillation synchronized with the G wave.

17A is an electrocardiogram (electrocardiogram waveform same as that shown in Fig. 19) input to the arithmetic processing unit 75 when a single outpatient shrinkage occurs in the heart of the patient. 17A, the polarity of the fourth R wave [event (V ₀ )] from the left is negative (-), the peak of the T wave following this is increased, and this T wave is sensed as the event (V ₁ ) .

Polarity (+) of the in. As shown in the figure, after a sensed event (V _0), if the input energy applied to the switch 744, sensing that immediately after the event (V ₁₎ is the one the polarity of the sensed event (V ₀₎ before (-) because it differs from, it does not occur that synchronization with the voltage application to this event (V _1). Thereby, it is possible to avoid the input of the voltage in synchronization with the T wave that is increased in peak and is mistaken for the R wave.

The event (V _1), and then the event (V ₂₎ sensing a is, although the R-wave peak, the polarity (+) is, the two before the polarity of the sensed event (V ₀₎ - because different from the () , there is no case that a voltage is applied in synchronism with the event (V _2).

And, in the event (V _3), the event (V ₁₎ sensing the polarity (+), the polarity (+) and (2) of the event (V ₂₎ sensing one before the one before the sensing to the event (V ₂₎ The voltage is applied to the first DC electrode group 31G and the second DC electrode group 32G in synchronization with the event V ₃ which can be assured as the peak of the R wave.

17B is an electrocardiogram inputted to the arithmetic processing unit 75 when the out-of-phase contraction is continuously occurring in the patient's heart.

As shown in the figure, when the energy application switch 744 is input after sensing the event (V ₀ ) in which the polarity is inverted by the out-of-phase shrinkage (-), the sensed event V ₁₎ the polarity (+), the polarity of the next event (V ₂₎ sensing for the (-), the polarity of the next event (V ₃₎ sensing in the (+), an event sensed in the next ( the polarity of V ₄₎ is (-), it is in the polarity of the next event (V ₅₎ for sensing the (+), and changes the polarity of the event in turn. Therefore, in a state where the polarities of the three events continuously sensed in this manner do not coincide with each other, it is determined that each of these events may not be the peak of the R wave, and the voltage is not applied in synchronization with the event.

In addition, the polarity of the event (V _5), the event (V ₄₎ sensing the polarity (+) of the following events (V ₆₎ sensing a is, although the R-wave peak, the polarity (+), and two before (- ) and because different, it does not occur that the voltage applied to the synchronous event (V _6).

And, the same as the polarity (+), the polarity (+) of a polarity (+) and event (V ₅₎ of the event (V ₆₎ of the event (V ₆₎ the event (V _7), sensing in the following, events (V ₇₎ at the time of sensing gioe it has been determined that the shrinkage is certainly true, in synchronization with the event (V ₇₎ that can be sure of the R-wave peak, the 1 DC electrode group (31G) and a 2 DC of A voltage is applied to the electrode group 32G.

Fig. 18 shows the electrocardiogram (electrocardiogram waveform shown in Fig. 20) in which the drift occurs and the base line descends, and then the base line rises and returns to the original level. it is misleading, as each event is sensed (V _-1) and event (V _1).

18, the polarity (+) of the event (V ₁ ) sensed immediately thereafter when the energy application switch 744 is input immediately before the rise of the base line, (-) polarity of the event (V _0), the polarity (+) and the same, an event (V _-1) sensing the two before because it differs from, in the case where voltage is applied in synchronism with the event (V ₁₎ So that it is possible to avoid the voltage being applied in synchronization with the rise of the baseline, which is mistaken for the R wave.

And, in the event (V ₁₎ of the event (V ₂₎ the polarity (+) is the event (V _1), the polarity (+) and two events (V ₀₎ sensed before the sensed one before the sensing in the following is the same as the polarity (+), it is determined that that is the base line is stable when the sensing of the event (V _2), in synchronism with the event (V ₂₎ can be sure of the R wave peak claim 1 DC electrode group A voltage is applied to the second DC electrode group 31G and the second DC electrode group 32G.

The DC voltage is applied to the first DC electrode group 31G and the second DC electrode group 32G for 260 m seconds after sensing the event that is supposed to be an R wave, It is possible to reliably avoid the defibrillation at the time when the next T wave appears when the sensed event is the peak of the R wave.

Since the arithmetic processing unit 75 is programmed not to newly sense an event estimated to be an R wave for 100 ms after sensing an event estimated to be an R wave, the sensed event is a peak of the R wave , And when the peak of the S wave appearing in the opposite direction is increased to reach the trigger level, the peak of this S wave is sensed to prevent the count of the same polarity from being reset.

The DC power source unit 75 is controlled such that DC voltage is not applied to the first DC electrode group 31G and the second DC electrode group 32G for 260 m seconds after the energy application switch 744 is input, The noise generated by the input of the energy applying switch 744 is mistaken for the R wave and is sensed and the defibrillation is performed in synchronization with this noise or the count of the same polarity is reset by the noise Can be prevented.

Although the embodiment of the present invention has been described above, the defibrillation catheter system of the present invention is not limited thereto, and various modifications are possible.

For example, the arithmetic processing unit of the power supply apparatus may be configured such that the polarity of the event (V _n ) sensed after the input of the energizing switch is the polarity of the previously sensed event (V _{n -1} ) event polarity, and in that when matching the polarity of the event (V _{n -3)} sensing three before (when the same polarity is continuously four times), the fourth event of the _{(n -2} V) (V _n) The first DC electrode group and the second DC electrode group may be subjected to arithmetic processing to control the DC power source unit.

100: Defibrillation catheter
10: Multi-lumen tube
11: First lumen
12: second lumen
13: Third lumen
14: fourth lumen
15: Fluorine resin layer
16: Inner (core) part
17: Outer (cell) part
18: Stainless steel wire
20: Handle
21:
22: Handle
24: Strain Relief
26: first insulating tube
27: Second insulating tube
28: Third insulating tube
31G: first DC electrode group
31: Ring-shaped electrode
32G: second DC electrode group
32: ring-shaped electrode
33G: Proximal-end potential measurement electrode group
33: ring-shaped electrode
35: tip tip
41G: First lead line group
41: Lead wire
42G: Second lead soldier
42: Lead wire
43G: Third Lead Soldier
43: Lead wire
50: Connector of defibrillation catheter
51, 52, 53: Pin terminal
55: Bulkhead plate
58: Resin
61: first protection tube
62: second protection tube
65: full wire
700: Power supply
71: DC power supply
72: catheter connection connector
721, 722, 723: terminal
73: ECG connection connector
74: external switch (input means)
741: Mode select switch
742: Applied energy setting switch
743: Charging switch
744: Energy-applying switch (discharge switch)
75:
751: Output circuit
76:
77: ECG input connector
78: Display means
800: electrocardiograph
900: Shim Pot measurement means

Claims (4)

A catheter system having an electrocardiograph, comprising: a defibrillation catheter inserted into a deep-seated heart to perform a defibrillation; a power supply for applying a direct current voltage to an electrode of the defibrillation catheter;
The defibrillation catheter includes:
An insulating tube member,
A first electrode group composed of a plurality of ring-shaped electrodes mounted on the front end region of the tube member,
A second electrode group formed of a plurality of ring-shaped electrodes separated from the first electrode group toward the base end side and mounted on the tube member,
A first lead-wire group including a plurality of lead wires whose ends are connected to respective electrodes constituting the first electrode group,
And a second lead line group including a plurality of lead lines whose ends are connected to the respective electrodes constituting the second electrode group;
The power supply device includes:
DC power supply unit,
A catheter connection connector connected to the first lead wire group of the defibrillation catheter and the proximal end side of the second lead wire group,
An external switch including an electric energy application switch,
An arithmetic processing unit that has an output circuit for a DC voltage from the DC power supply unit and controls the DC power supply unit based on an input of the external switch,
And an electrocardiogram input connector connected to the operation processing unit and the output terminal of the electrocardiograph;
Wherein when the defibrillation is performed by the defibrillation catheter, the first electrode group and the second electrode group of the defibrillation catheter are connected to each other via the output circuit of the arithmetic processing unit and the catheter connection connector, A voltage of a polarity is applied;
The arithmetic processing unit of the power supply apparatus sequentially senses an event estimated to be an R wave from the electrocardiogram input from the electrocardiograph via the electrocardiogram input connector and detects an event (V _n ) sensed after the input of the electric energy applying switch, After the time of the polarity, consistent with the polarity of at least a first polarity of the event (V _{n -1)} one before the sensing and the two events (V _n-2) before sensing in synchronization with the art events (V _n) And the DC power supply unit is controlled by performing a calculation process so that a voltage is applied to the first electrode group and the second electrode group. The method according to claim 1,
The arithmetic processing unit of the power supply apparatus senses an event presumed to be an R wave so that the voltage is not applied to the first electrode group and the second electrode group for as short as 50 msec and as long as 500 msec, DC power supply unit is controlled by the control unit. 3. The method of claim 2,
Wherein the arithmetic processing unit of the power supply unit does not newly sense an event estimated to be an R wave for a duration of 10 m for a short time or 150 m for a long time after sensing an event estimated to be an R wave, Catheter system. The method according to claim 2 or 3,
The operation processing unit of the power supply unit may be configured such that a voltage is applied to the first electrode group and the second electrode group for a short time of 10 msec and a long time of 500 msec after the input of the electric energy application switch, Wherein the control unit controls the power supply unit.

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