WO2018008250A1

WO2018008250A1 - Electrode catheter

Info

Publication number: WO2018008250A1
Application number: PCT/JP2017/017735
Authority: WO
Inventors: 拓也桝田; 佐々木　卓也
Original assignee: 日本ライフライン株式会社
Priority date: 2016-07-06
Filing date: 2017-05-10
Publication date: 2018-01-11
Also published as: JP2018000713A; JP6512611B2

Abstract

The purpose of the present invention is to provide an electrode catheter wherein even if a basket-shaped electrode assembly is expanded, proximal and distal portions thereof can be sufficiently irrigated with a liquid. This electrode catheter is provided with a catheter shaft (10), an electrode assembly (30), and a pipe (60). The pipe (60) has an irrigation lumen (60L) formed therein, and a distal irrigation opening group (61G) comprising openings (61) for irrigating the distal portion of the electrode assembly (30) and a proximal irrigation opening group (62G) comprising openings (62) for irrigating the proximal portion of the electrode assembly (30) are formed on the outer circumferential surface of the pipe (60). By pulling the pipe (60), the electrode assembly (30) is expanded and a part of the region in which the proximal irrigation opening group (62G) is formed is withdrawn into the catheter shaft (10) so that a liquid is jetted from the irrigation lumen through the openings (62) which are not withdrawn into the catheter shaft (10) and the openings (61) of the distal irrigation opening group (61G).

Description

Electrode catheter

The present invention relates to an electrode catheter in which a basket-like electrode assembly is connected to the tip of a catheter shaft.

Conventionally, in an electrophysiological examination of the heart, as an electrode catheter that facilitates insertion into the left atrial pulmonary vein and maintenance of the electrode position and suppresses the formation of a thrombus that may clog peripheral blood vessels, Patent Document 1 listed below Is a catheter shaft (flexible tube) and a plurality of spines (vertebral columns) each having a proximal end fixed to the distal end of the catheter shaft and electrodes attached to the outer periphery thereof. An electrode assembly (aggregate) formed in a basket shape by being joined, and extends in the axial direction inside the catheter shaft, and extends from the tip of the catheter shaft to the inside (center) of the electrode assembly. ), The distal end of which is fixed to the distal end of the electrode assembly, and the proximal end of which is capable of pulling operation (aggregate pulling wire); An operation wire (tube pulling wire) that extends axially within the tell shaft and whose distal end is fixed to the distal end of the catheter shaft and whose proximal end can be pulled, and an operation wire (collection) A control handle connected to the proximal end of each of the body pulling wire and the tube pulling wire), and a branch portion provided between the proximal end of the catheter shaft and the control handle and connected to the water injection tube. An electrode catheter has been introduced in which liquid supplied from a tube is ejected from the distal end of the catheter shaft (the base end of the electrode assembly) through the inside of the catheter shaft.

JP 2013-81526 A

In the electrode assembly formed in a basket shape as described in Patent Document 1, the tip end portion (joint portion between the tip ends of a plurality of spines and the vicinity thereof) and the base end portion (plural spines) The blood tends to stay at the joint between the proximal ends of the two and the vicinity thereof, and a thrombus is easily generated. For this reason, it is necessary to sufficiently irrigate the distal end portion and the proximal end portion of the basket-shaped electrode assembly.

However, in the electrode catheter described in Patent Document 1, the liquid ejected from the distal end of the catheter shaft reaches the distal end portion of the basket-shaped electrode assembly (the joint portion between the distal ends of a plurality of spines and the vicinity thereof). Therefore, it is difficult to sufficiently irrigate the tip of the electrode assembly, and thrombus formation at the tip of the electrode assembly cannot be sufficiently suppressed.

In addition, since the liquid ejected from the distal end of the catheter shaft in the distal direction flows in the basket-shaped electrode assembly along the operation wire (aggregate pulling wire) in the distal direction, the proximal end of the electrode assembly It is not possible to sufficiently irrigate the portion (joint portion between the proximal ends of a plurality of spines and the vicinity thereof).

In particular, when the basket-shaped electrode assembly is expanded in the radial direction of the manipulation wire by pulling the manipulation wire (the assembly pulling wire), the distance from the liquid outlet to the vicinity of the proximal end of the spine is Since it becomes longer than the distance before expansion (the vicinity of the proximal end of the spine moves away from the radial direction of the operation wire), it becomes more difficult to irrigate the liquid to the proximal end portion of the electrode assembly. .

When expanding the electrode assembly, it is conceivable to increase the amount of liquid supplied from the water injection tube, but not only is the operation complicated and impractical, but if the amount of liquid supplied is increased, Since the momentum of the applied liquid increases and does not spread in the radial direction of the operation wire, it is not possible to increase the irrigation amount to the proximal end portion of the electrode assembly only by increasing the supply amount of the liquid. .

The present invention has been made based on the above situation.
The first object of the present invention is to sufficiently irrigate the tip of the basket-shaped electrode assembly and sufficiently suppress the formation of thrombus at the tip of the electrode assembly. It is to provide an electrode catheter that can be used.
The second object of the present invention is to sufficiently irrigate the liquid even to the base end portion of the basket-shaped electrode assembly, and sufficiently suppress the formation of thrombus at the base end portion of the electrode assembly. It is an object of the present invention to provide an electrode catheter that can be used.
The third object of the present invention is that the basket-shaped electrode assembly is expanded with respect to the end portions (the base end portion and the front end portion) of the electrode assembly even when the basket-shaped electrode assembly is expanded in the radial direction of the operation wire. An object of the present invention is to provide an electrode catheter capable of sufficiently irrigating a liquid.
A fourth object of the present invention is to provide an electrode catheter capable of reducing a difference in irrigation amount between a proximal end portion and a distal end portion of a basket-shaped electrode assembly.

The electrode catheter of the present invention includes a catheter shaft,
A plurality of spines each having a proximal end fixed to the distal end of the catheter shaft and having at least one ring electrode mounted on the outer periphery thereof are joined to each other at the distal end to form a basket shape. An electrode assembly;
A conducting wire connected to the ring-shaped electrode;
A handle connected to the proximal end of the catheter shaft;
The catheter shaft extends movably in the axial direction of the catheter shaft, extends from the distal end of the catheter shaft and extends into the electrode assembly, and the distal end of the distal end of the electrode assembly And a cylindrical pipe whose proximal end is capable of pulling operation,
The conductive wire is connected to the ring-shaped electrode by being joined to the inner peripheral surface of the ring-shaped electrode at the tip thereof, and extends inside the spine and the catheter shaft,
In the pipe, an irrigation lumen serving as a liquid flow path is formed, and at the outer periphery of the pipe, there are joints between the tips of the plurality of spines and the vicinity thereof (tips of the electrode assembly). A distal side irrigation opening group comprising a plurality of side hole openings formed in the pipe wall of the pipe so as to reach the irrigation lumen, and a joint portion between the proximal ends of the plurality of spines, and A proximal-side irrigation opening group consisting of a plurality of side-hole openings formed in a pipe wall of the pipe so as to reach the irrigation lumen for irrigation in the vicinity (the proximal end portion of the electrode assembly) And
By pulling the proximal end of the pipe, each of the plurality of spines is bent to expand the electrode assembly in the radial direction of the pipe, and the formation region of the proximal-side irrigation opening group in the pipe A portion of the irrigation lumen is drawn into the interior of the catheter shaft, and the liquid constituting the irrigation lumen forms a proximal irrigation opening group in the remaining portion of the formation region that is not drawn into the catheter shaft. It is injected from the opening which comprises the opening group for the tip side irrigation.

According to the electrode catheter having such a configuration, the liquid supplied to the irrigation lumen of the pipe constitutes the distal-side irrigation opening group formed on the outer periphery of the pipe extending inside the electrode assembly. Since the pipe can be sprayed in the radial direction of the pipe toward the joint between the tips of the plurality of spines and the vicinity thereof, the liquid can be sufficiently irrigated to the tip of the electrode assembly. .

Further, the liquid supplied to the irrigation lumen of the pipe is supplied to the proximal ends of the plurality of spines from the openings constituting the proximal-side irrigation opening group formed on the outer periphery of the pipe extending inside the electrode assembly. Since the pipe can be sprayed in the radial direction toward the joints and the vicinity thereof, the liquid can be sufficiently irrigated also to the base end of the electrode assembly.

In addition, by pulling the proximal end of the pipe, the electrode assembly expands in the radial direction of the pipe, and when the vicinity of the proximal end and the vicinity of the distal end of the spine constituting the electrode assembly are moved away from the pipe, A part of the formation region of the end irrigation opening group is drawn into the catheter shaft, and the opening in the undrawn region (the remaining part of the formation region of the proximal irrigation opening group) and the distal irrigation opening group The injection pressure of the liquid from the opening which comprises is raised. This makes it possible to irrigate the liquid also in the vicinity of the proximal end and the distal end of the spine away from the pipe (the proximal end side irrigation opening group and the distal end side irrigation opening group).
Thus, in the electrode catheter of the present invention, as the electrode assembly is expanded, the ejection pressure of the liquid from the openings constituting the proximal irrigation opening group and the distal irrigation opening group increases. Even when the assembly is expanded, the liquid can be sufficiently irrigated to the end portions (the base end portion and the front end portion) of the electrode assembly.

In the electrode catheter of the present invention, it is preferable that the outer peripheral surface of the pipe is liquid-tightly covered with an inner wall (constituent resin) in at least the distal end region of the catheter shaft.
According to the electrode catheter having such a configuration, the opening in a part of the formation region of the proximal-side irrigation opening group drawn into the catheter shaft is reliably blocked, and the liquid flows out from the opening. While being able to suppress reliably, it can prevent that a liquid infiltrates into the inside of a catheter shaft from the front end side of a catheter shaft.

In the electrode catheter of the present invention, the total area of the openings constituting the distal irrigation opening group is S61,
When the proximal end of the pipe is pulled and the electrode assembly is most expanded in the radial direction of the pipe, the formation region of the proximal irrigation opening group that is not drawn into the catheter shaft When the total area of the injectable opening in the remaining portion is S621, and the total area of the non-injectable opening in a part of the formation region of the proximal irrigation opening group drawn into the catheter shaft is S622 ,
It is preferable that (S61 + S621) / (S61 + S621 + S622) is 0.7 or less.

In this electrode catheter, S61 / (S621 + S622 / 2) is preferably 1.2 to 2.0.
According to the electrode catheter having such a configuration, when the electrode assembly is in a predetermined expanded state (standard state), the difference in irrigation amount between the proximal end portion and the distal end portion of the electrode assembly is reduced. can do.

It is a side view which shows the electrode catheter which concerns on one Embodiment of this invention. It is a side view which shows the front-end | tip part of the electrode catheter shown in FIG. FIG. 3 is a transverse sectional view (III-III sectional view) of the electrode catheter shown in FIG. FIG. 4 is a transverse sectional view (IV-IV sectional view) of the electrode catheter shown in FIG. 1. FIG. 5 is a cross-sectional view (VV cross-sectional view) of a spine that constitutes the electrode assembly of the electrode catheter shown in FIG. 2. It is a longitudinal cross-sectional view which shows the front-end | tip part of the electrode catheter shown in FIG. It is a perspective view which shows the front-end | tip part of the electrode assembly of the electrode catheter shown in FIG. It is a side view which shows the anchor which comprises the front-end | tip part of an electrode assembly. It is a perspective view which shows the anchor which comprises the front-end | tip part of an electrode assembly. It is a side view which shows the pipe which comprises the electrode catheter shown in FIG. It is a side view (XIA part enlarged view) which shows the formation area of the opening group for front end side irrigation in the pipe shown in FIG. It is a side view (XIB part enlarged view) which shows the formation area of the opening group for proximal end irrigation in the pipe shown in FIG. It is a front view (XIC part enlarged view) of the pipe shown in FIG. In the electrode catheter shown in FIG. 1, it is a side view which shows the shape change of the electrode assembly accompanying the pipe pulling operation.

The electrode catheter 100 of this embodiment shown in FIGS. 1 to 7 has a catheter shaft 10, each proximal end fixed to the distal end of the catheter shaft 10, and twelve ring-shaped electrodes 20 attached to each outer periphery. 10 spines 31 are joined to each other at their distal ends, connected to the electrode assembly 30 formed in a basket shape, the conductive wire 40 connected to the ring electrode 20, and the proximal end of the catheter shaft 10. The handle 50 and the catheter shaft 10 extend movably in the axial direction of the catheter shaft 10, extend from the distal end of the catheter shaft 10, and extend into the electrode assembly 30. A cylindrical pipe 60 fixed to an anchor 33 which is a distal end portion of the assembly 30 and having a proximal end capable of being pulled. Ri,
The conducting wire 40 is connected to the ring-shaped electrode 20 by being joined to the inner peripheral surface of the ring-shaped electrode 20 at the distal end thereof, and extends inside the spine 31 and the catheter shaft 10.
The pipe 60 is formed with an irrigation lumen 60 L that serves as a liquid flow path, and on the outer periphery of the pipe 60, there is a joint between the tips of the spine 31 that is the tip of the electrode assembly 30 and the vicinity thereof. A distal side irrigation opening group 61G formed of a plurality of side hole openings 61 formed in the tube wall of the pipe 60 so as to reach the irrigation lumen 60L for irrigation, and a spine 31 which is a proximal end portion of the electrode assembly 30 A proximal end side irrigation opening group 62G comprising a plurality of side hole openings 62 formed in the pipe wall of the pipe 60 so as to reach the irrigation lumen 60L in order to irrigate the joint portion between the proximal ends thereof and the vicinity thereof. Formed,
By pulling the proximal end of the pipe 60, each of the plurality of spines 31 bends and the electrode assembly 30 expands in the radial direction of the pipe 60, and the formation region of the proximal end side irrigation opening group 62G in the pipe 60 Is partially pulled into the catheter shaft 10 and the liquid from the irrigation lumen 60L is not drawn into the catheter shaft 10, and the opening 62 and the distal end of the remaining region of the proximal irrigation opening group 62G are formed. It is comprised so that it may inject from the opening 61 which comprises the opening group 61G for side irrigation.

In FIG. 1, reference numeral 70 denotes an electrode connector incorporating a plurality of terminals to which the respective base ends of the conducting wire 40 are connected, and 71 denotes a single lumen structure including the conducting wire 40 extending from the handle 50 toward the electrode connector 70. 81 is a fixed valve connected to the

handle

50, 82 is a fixed valve hub for holding the fixed

valve

81, 83 is a connecting tube for connecting the handle 50 and the fixed

valve hub

82, 85 is a perfusion connector, 86 is a perfusion tube having a lumen that connects the pipe 60 and the perfusion connector 85 and communicates with the irrigation lumen 60 L of the pipe 60.

As shown in FIG. 4, a central lumen 11 is formed inside a catheter shaft 10 constituting the electrode catheter 100, and ten sub-lumens 13 having a rectangular cross section around it are equiangularly spaced. Is formed.

The length of the catheter shaft 10 is usually 800 to 1300 mm, and is 1100 mm if a suitable example is shown.
The outer diameter of the catheter shaft 10 is usually 2.4 to 4.0 mm, and is 2.8 mm as a suitable example.
The inner diameter of the catheter shaft 10 (the diameter of the central lumen 11) is usually 0.4 to 1.0 mm, and 0.7 mm if a suitable example is shown.

As a constituent material of the catheter shaft 10, synthetic resins such as polyolefin, polyamide, polyether polyamide, polyurethane, nylon, polyether block amide (PEBAX) can be used, and among these, it is preferable to use PEBAX. .

The catheter shaft 10 may have the same hardness over its entire length, but preferably has different hardness along the length direction. For example, the catheter shaft 10 changes (decreases) from 72D to 40D in the tip direction. ) Can be preferably used.

Further, the catheter shaft 10 may be a blade tube reinforced by braiding. Here, as a constituent material of the braid, a resin capable of exhibiting a reinforcing effect by being embedded can be exemplified, and a PEEK resin can be exemplified as a suitable resin.

An electrode assembly 30 is connected to the distal end of the catheter shaft 10.
The electrode assembly 30 constituting the electrode catheter 100 is formed in a basket shape by ten spines 31.
As the constituent material of the spine 31, the same material as the constituent material of the catheter shaft 10 can be used, and it is preferable to use PEBAX.

As shown in FIGS. 2 and 6, each proximal end of the spine 31 is fixed to the distal end of the catheter shaft 10.
The proximal end of the spine 31 and the distal end of the catheter shaft 10 are fixed by fusion of the constituent resins. As shown in FIGS. 3 and 6, in the fusion range of both (for example, 5 to 15 mm), The central lumen 11 of the catheter shaft 10 is filled with a fusion resin. The fusion resin constituting the distal end region of the catheter shaft 10 covers the outer peripheral surface of the pipe 60 extending to the central lumen 11 of the catheter shaft 10 in a liquid-tight manner, whereby the central lumen 11 extends from the distal end of the catheter shaft 10. It is possible to prevent the liquid from entering the glass.

On the other hand, as shown in FIGS. 2 and 7, the tips of the spines 31 are joined to each other by being fixed to the anchor 33.
Examples of the constituent material of the anchor 33 include metals such as stainless steel.

As shown in FIGS. 5 and 6, a core wire 35 made of a shape memory alloy extends inside the spine 31.
The core wire 35 stores the bending shape of the spine 31 as shown in FIG. 2, and is easily deformed (for example, linearly deformed) by applying a force, but returns to the original bending shape when the force is removed. . An example of the constituent material of the core wire 35 is a Ni—Ti alloy.

As shown in FIGS. 8 and 9, ten holes 335 are formed on the outer peripheral surface of the anchor 33 constituting the electrode assembly 30 so as to be spirally arranged. By inserting the tip of 35, the tip of the spine 31 from which the core wire 35 extends is fixed to the anchor 33.

3 and 6, the proximal end of the core wire 35 is inserted into the sub-lumen 13 at the distal end portion of the catheter shaft 10 (for example, a portion about 100 mm from the distal end of the shaft).

Twelve ring-shaped electrodes 20 are attached to the outer periphery of each of the spines 31 constituting the electrode assembly 30, so that the number of electrodes of the electrode assembly 30 is 120.
As a constituent material of the ring-shaped electrode 20, for example, a metal having good electrical conductivity such as platinum, gold, silver, aluminum, copper, and stainless steel can be used. From the viewpoint of improving the contrast properties for X-rays, platinum, gold, silver, and alloys containing these as main components are preferable.

A conductive wire 40 is connected to each of the ring electrodes 20.
As shown in FIG. 5, the conductive wire 40 constituting the electrode catheter 100 is connected to the ring-shaped electrode 20 by being joined to the inner peripheral surface of the ring-shaped electrode 20 at the distal end thereof, and the ring-shaped electrode. The spine 31 enters the inside of the spine 31 from the side hole 315 formed in the tube wall of the spine 31 corresponding to the mounting position of the spine 31, and extends inside the spine 31.

As shown in FIG. 3, FIG. 4, and FIG. 6, the lead wire 40 extending inside the spine 31 enters the inside (central lumen 11) of the catheter shaft 10 and extends inside the catheter shaft 10. .
As shown in FIG. 3, the lead wire 40 at the distal end portion of the catheter shaft 10 extends inside the catheter shaft 10 in a state of being included in each of the polyimide tubes 37 arranged corresponding to each of the spines 31. Exist.

The conducting wire 40 extending inside the catheter shaft 10 enters the inside of the handle 50 connected to the proximal end of the catheter shaft 10, and further extends out of the handle 50 so as to pass through the lumen of the conducting wire protection tube 71. It passes through and is inserted into the electrode connector 70. Each of the base end portions of the conducting wire 40 is connected to each of a plurality of terminals built in the electrode connector 70. Via this electrode connector 70, the electrode catheter 100 of this embodiment is connected to a medical measurement device.

The pipe 60 constituting the electrode catheter 100 extends inside the catheter shaft 10 (central lumen 11) so as to be movable in the axial direction of the catheter shaft 10 and extends from the distal end of the catheter shaft 10 to the electrode assembly 30. It extends inside.

The distal end of the pipe 60 is fixed to the distal end portion of the electrode assembly 30 by being inserted into a hole 337 formed in the proximal end surface of the anchor 33.

A pipe 60 extending inside the catheter shaft 10 extends from the proximal end of the catheter shaft 10 to enter the handle 50, and further extends from the handle 50 to connect the connection tube 83 and the fixed valve hub 82. It extends inside. The proximal end of the pipe 60 is connected to the perfusion connector 85 via the perfusion tube 86.

Examples of the constituent material of the pipe 60 include metals such as Ni—Ti and stainless steel, but materials other than metals (for example, hard resin) may be used.
The outer diameter of the pipe 60 is normally 0.5 to 1.2 mm, and 0.8 mm if a suitable example is shown.
The inner diameter of the pipe 60 (the diameter of the irrigation lumen 60L) is usually 0.4 to 1.0 mm, and 0.7 mm if a suitable example is shown.

The proximal end of the pipe 60 can be pulled, and the pipe 60 acts as a pulling wire for expanding the electrode assembly 30.
By pulling the perfusion connector 85 connected to the proximal end of the pipe 60, the pipe 60 moves to the proximal side inside the catheter shaft 10.

When the pipe 60 moves to the proximal end side with respect to the catheter shaft 10, a part of the pipe 60 extending from the distal end of the catheter shaft 10 is drawn into the catheter shaft 10. The distal end portion of the electrode assembly 30 to which the distal end of the electrode assembly 30 is fixed is pulled in the proximal direction, and each of the spines 31 is bent to expand the electrode assembly 30.

The fusion resin filled in the central lumen 11 of the catheter shaft 10 and liquid-tightly covering the outer peripheral surface of the pipe 60 at the fusion portion between the proximal end of the spine 31 and the distal end of the catheter shaft 10 is the pipe 60. It does not impede movement. The pipe 60 can move inside the catheter shaft 10 while sliding with the fusion resin on the outer periphery thereof.

FIG. 12 shows a state in which the shape of the electrode assembly 30 is changed by pulling the perfusion connector 85 connected to the proximal end of the pipe 60.
FIG. 1A shows a state in which the electrode assembly 30 is most contracted, and is a suitable shape when the electrode catheter 100 is inserted into the sheath.
FIG. 3 (3) shows a state in which the electrode assembly 30 is most expanded by the pulling operation, and is a suitable shape when measuring the potential of the atrial septum (left atrial side).
FIG. 2B is an intermediate state (standard state), and the bending shape of the spine 31 at this time is stored by the core wire 35.

As shown in FIGS. 10 and 11C, the pipe 60 is formed with an irrigation lumen 60L serving as a liquid flow path.
Also, as shown in FIGS. 10 and 11A, a plurality of sides are formed on the outer periphery of the pipe 60 so as to irrigate the joint between the tips of the spine 31 and the vicinity thereof (the tip of the electrode assembly 30). A distal-side irrigation opening group 61 G composed of hole openings 61 is formed. Also, as shown in FIGS. 10 and 11B, a plurality of pipes 60 are formed on the outer periphery of the pipe 60 for irrigation at the joint between the proximal ends of the spine 31 and the vicinity thereof (the proximal end of the electrode assembly 30). A proximal end irrigation opening group 62 G composed of the side hole openings 62 is formed.

Here, the diameters of the opening 61 and the opening 62 are, for example, 0.03 to 0.1 mm, and preferably 0.04 to 0.06 mm.
The total area of the openings 61 constituting the distal-side irrigation opening group 61G is, for example, 1.5 to 8 mm ² .
The total area of the openings 62 constituting the proximal irrigation opening group 62G is, for example, 3 to 20 mm ² .

In the electrode catheter 100 of the present embodiment, a part of the proximal end side irrigation opening group 62 G in the pipe 60 is drawn into the catheter shaft 10 by pulling the proximal end (perfusion connector 85) of the pipe 60. It is.

Here, in the state where the electrode assembly 30 is most contracted as shown in FIG. 12 (1), the entire formation region of the proximal irrigation opening group 62 G extends from the distal end of the catheter shaft 10. ing.
In this case, liquid can be ejected from all the openings 62 constituting the proximal end side irrigation opening group 62G and the openings 61 constituting the distal end side irrigation opening group 61G.

On the other hand, in the state in which the electrode assembly 30 is most expanded as shown in FIG. 12 (3), a part of the formation region of the proximal irrigation opening group 62G (for example, the proximal region in FIG. 11B). 622A) is retracted into the catheter shaft 10.
As described above, the outer peripheral surface of the pipe 60 extending to the central lumen 11 of the catheter shaft 10 is liquid-tightly covered with the fusion resin constituting the distal end region of the catheter shaft 10. The opening 62 in a part of the formation region of the proximal-side irrigation opening group 62G (the proximal-side region 622A) that is drawn into is blocked by the fusion resin, and the liquid cannot be ejected.
In this case, the liquid is ejected from the opening 62 in the remaining part of the formation region of the proximal end side irrigation opening group 62G (the distal side region 621A in FIG. 11B) and the opening 61 constituting the distal side irrigation opening group 61G.

Further, in the intermediate state (standard state) as shown in FIG. 12B, a part of the formation region of the proximal end irrigation opening group 62G (for example, the proximal end side of the proximal end region 622A in FIG. 11B). About half of the region) is drawn into the catheter shaft 10, and approximately half of the openings 62 in the proximal region 622 A are blocked by the fusion resin that forms the distal region of the catheter shaft 10, thereby allowing liquid to flow. It becomes impossible to inject.
In this case, the opening 62 and the distal-side irrigation opening group 61G in the remaining part of the formation region of the proximal-side irrigation opening group 62G (the distal-side region 621A and the proximal-side region 622A in FIG. 11B). A liquid is ejected from the opening 61 which comprises.

The total area of the openings 62 in the distal end region 621A shown in FIG. 11B is S621, the total area of the openings 62 in the proximal region 622A is S622, and the openings 61 constituting the distal irrigation opening group 61G shown in FIG. When the total area is S61, the total area of the

injectable openings

61 and 62 in the state where the electrode assembly 30 is most contracted as shown in FIG. 12A is S61 + S621 + S622, and FIG. The total area of the

injectable openings

61 and 62 in the state in which the electrode assembly 30 is most expanded as shown in FIG. 3 is S61 + S621, and the

injectable openings

61 and 62 are able to be injected as the electrode assembly 30 is expanded. The total area of the fuel is reduced, and the injection pressure increases accordingly.
This makes it possible to irrigate the liquid near the proximal end and the distal end of the spine 31 away from the pipe 60 (the proximal end irrigation opening group 62G and the distal irrigation opening group 61G).

Here, the total area (S61 + S621) of the

injectable openings

61 and 62 in the state in which the electrode assembly 30 is most expanded [the state shown in FIG. 12 (3)], and the electrode assembly 30 is most contracted. The ratio [(S61 + S621) / (S61 + S621 + S622)] to the total area (S61 + S621 + S622) of the

injectable openings

61 and 62 in the state [the state shown in FIG. 12 (1)] is 0.7 or less It is preferable that

Since the ratio [(S61 + S621) / (S61 + S621 + S622)] is 0.7 or less, the rate of increase of the injection pressure from the

openings

61 and 62 accompanying the expansion of the electrode assembly 30 can be increased to some extent. Even when the assembly 30 is expanded and the proximal end portion and the distal end portion thereof are moved away from the pipe 60 (the proximal end side irrigation opening group 62G and the distal end side irrigation opening group 61G), the electrode assembly 30 The liquid can be sufficiently irrigated to the proximal end portion and the distal end portion.

The ratio [S61 / (S621 + S622 / 2)] is preferably 1.2 to 2.0.
Here, (S621 + S622 / 2) is substantially equal to the total area of the injectable opening 62 in the intermediate state (standard state) as shown in FIG. 12 (2), and the ratio [S61 / (S621 + S622 / 2). )] Is set to 1.2 to 2.0 to reduce the difference in irrigation amount between the proximal end portion and the distal end portion of the electrode assembly 30 when in the intermediate state (standard state). it can.

When this ratio [S61 / (S621 + S622 / 2)] is less than 1.2, the irrigation amount with respect to the distal end portion of the electrode assembly 30 is too small as compared with the irrigation amount with respect to the proximal end portion.
On the other hand, when this ratio exceeds 2.0, the irrigation amount with respect to the proximal end portion of the electrode assembly 30 is too small compared with the irrigation amount with respect to the distal end portion.

According to the electrode catheter 100 of the present embodiment, the liquid supplied to the irrigation lumen 60L of the pipe 60 causes the distal-side irrigation opening group 61G formed on the outer periphery of the pipe 60 extending inside the electrode assembly 30. Can be sprayed in the radial direction of the pipe 60 toward the joint portion between the tips of the spine 31 and the vicinity thereof, so that the liquid is sufficiently irrigated with respect to the tip portion of the electrode assembly 30. can do.

In addition, the liquid supplied to the irrigation lumen 60L of the pipe 60 is supplied from the opening 62 constituting the proximal irrigation opening group 62G formed on the outer periphery of the pipe 60 extending inside the electrode assembly 30 to the spine. Since the pipe 60 can be sprayed in the radial direction toward the joint portion between the proximal ends of 31 and the vicinity thereof, the liquid can be sufficiently irrigated also to the proximal end portion of the electrode assembly 30.

Further, by pulling the proximal end (perfusion connector 85) of the pipe 60, the electrode assembly 30 expands in the radial direction of the pipe 60, and the vicinity of the proximal end and the distal end of the spine 31 constituting the electrode assembly 30. Is moved away from the pipe 60, a part of the formation region of the proximal end side irrigation opening group 62 G in the pipe 60 is drawn into the catheter shaft 10, and a region that is not retracted (the proximal end irrigation opening group 62 G of the proximal end side irrigation opening group 62 G). Since the ejection pressure of the liquid from the opening 62 constituting the opening 62 and the distal irrigation opening group 61G in the remaining portion of the formation region increases, the pipe 60 (the proximal irrigation opening group 62G and the distal irrigation opening group) 61G), it is possible to irrigate the liquid also in the vicinity of the proximal end and the vicinity of the distal end of the spine 31 that is far from 61G).

As described above, in the electrode catheter 100 of the present embodiment, as the electrode assembly 30 is expanded, from the opening 62 constituting the proximal end side irrigation opening group 62G and the opening 61 constituting the distal end side irrigation opening group 61G. Therefore, even when the electrode assembly 30 is expanded, the liquid is sufficiently irrigated with respect to the end portions (the base end portion and the front end portion) of the electrode assembly 30. Can do.

As mentioned above, although one Embodiment of this invention was described, this invention is not limited to these, A various change is possible.
For example, in the above embodiment, when the electrode assembly 30 is most contracted as shown in FIG. 12A, the distal end side region 621A and the proximal end region 622A extend from the distal end of the catheter shaft 10. In the intermediate state as shown in FIG. 12 (2), a substantially half region of the proximal side region 622A is drawn into the catheter shaft 10, and as shown in FIG. 12 (3). In the state where the electrode assembly 30 is most expanded, the proximal region 622A is drawn into the catheter shaft 10, but in the intermediate state as shown in FIG. 12 (2), the distal region 621A and The proximal end region 622A extends from the distal end of the catheter shaft 10, and in the most expanded state as shown in FIG. 12 (3), the entire proximal end region 622A or Area parts may be configured to be drawn into the catheter shaft 10.

DESCRIPTION OF SYMBOLS 100 Electrode catheter 10 Catheter shaft 11 Center lumen 13 Sublumen 20 Ring-shaped electrode 30 Electrode assembly 31 Spine 315 Side hole 33 Anchor 335 Hole 337 Hole 37 Polyimide tube 40 Conductor 50 Handle 60 Pipe 60L Irrigation lumen 61G Tip side irrigation opening Group 61 opening 62G proximal end irrigation opening group 62 opening 621A distal end side region 622A proximal end side region 70 electrode connector 71 conductor protection tube 81 fixed valve 82 fixed valve hub 83 connecting tube 85 perfusion connector 86 perfusion tube

Claims

A catheter shaft;
A plurality of spines each having a proximal end fixed to the distal end of the catheter shaft and having at least one ring electrode mounted on the outer periphery thereof are joined to each other at the distal end to form a basket shape. An electrode assembly;
A conducting wire connected to the ring-shaped electrode;
A handle connected to the proximal end of the catheter shaft;
The catheter shaft extends movably in the axial direction of the catheter shaft, extends from the distal end of the catheter shaft and extends into the electrode assembly, and the distal end of the distal end of the electrode assembly And a cylindrical pipe whose proximal end is capable of pulling operation,
The conductive wire is connected to the ring-shaped electrode by being joined to the inner peripheral surface of the ring-shaped electrode at the tip thereof, and extends inside the spine and the catheter shaft,
In the pipe, an irrigation lumen serving as a liquid flow path is formed, and on the outer periphery of the pipe, there are joints between the tips of the plurality of spines, which are the tips of the electrode assembly, and the vicinity thereof. A distal end side irrigation opening group consisting of openings of a plurality of side holes formed in a pipe wall of the pipe so as to reach the irrigation lumen, and the plurality of the plurality of base electrode end portions. A proximal-side irrigation opening group consisting of a plurality of side-hole openings formed in the pipe wall of the pipe so as to reach the irrigation lumen in order to irrigate the joint between the proximal ends of the spine and the vicinity thereof And
By pulling the proximal end of the pipe, each of the plurality of spines is bent to expand the electrode assembly in the radial direction of the pipe, and the formation region of the proximal-side irrigation opening group in the pipe A portion of the irrigation lumen is drawn into the interior of the catheter shaft, and the liquid constituting the irrigation lumen forms a proximal irrigation opening group in the remaining portion of the formation region that is not drawn into the catheter shaft. An electrode catheter sprayed from an opening constituting the distal irrigation opening group.
2. The electrode catheter according to claim 1, wherein an outer peripheral surface of the pipe is liquid-tightly covered with an inner wall in at least a distal end region of the catheter shaft.
The total area of the openings constituting the distal irrigation opening group is S61,
When the proximal end of the pipe is pulled and the electrode assembly is most expanded in the radial direction of the pipe, the formation region of the proximal irrigation opening group that is not drawn into the catheter shaft When the total area of the injectable opening in the remaining portion is S621, and the total area of the non-injectable opening in a part of the formation region of the proximal irrigation opening group drawn into the catheter shaft is S622 ,
The electrode catheter according to claim 1 or 2, wherein (S61 + S621) / (S61 + S621 + S622) is 0.7 or less.
The electrode catheter according to claim 3, wherein S61 / (S621 + S622 / 2) is 1.2 to 2.0.