WO2021187154A1 - Système cathéter - Google Patents

Système cathéter Download PDF

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Publication number
WO2021187154A1
WO2021187154A1 PCT/JP2021/008618 JP2021008618W WO2021187154A1 WO 2021187154 A1 WO2021187154 A1 WO 2021187154A1 JP 2021008618 W JP2021008618 W JP 2021008618W WO 2021187154 A1 WO2021187154 A1 WO 2021187154A1
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WIPO (PCT)
Prior art keywords
electrode
pacing
ablation
ablation electrode
timing
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PCT/JP2021/008618
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English (en)
Japanese (ja)
Inventor
拓 周
大久保　到
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テルモ株式会社
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Publication of WO2021187154A1 publication Critical patent/WO2021187154A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators

Definitions

  • the present invention relates to a catheter system including an ablation catheter that is inserted into a living body and treats a living tissue by ablation.
  • pulmonary vein isolation may be performed to treat the junction between the pulmonary vein and the left atrium and destroy the myocardial cells.
  • Pulmonary vein isolation involves generating energy (eg, high frequency) from the tip of an ablation catheter to circularly necrotize the myocardium at the inflow of the pulmonary vein and isolate the pulmonary vein.
  • Ablation catheters can also be used for other renal sympathetic denervation.
  • ablation catheters output a high-voltage pulse from the ablation electrode to the living tissue and destroy cardiomyocytes non-thermally.
  • This high voltage pulse excites the myocardium and can disrupt the transmission pattern of the original myocardial excitement.
  • a pacing catheter having pacing electrodes is inserted into the atrium and the ventricle, respectively, and a pacing signal, which is a weak electric signal, is output to put the myocardium into a refractory period, and during this refractory period. It is known to output a high voltage pulse to the heart.
  • a catheter system that performs such control is described in, for example, Patent Document 1.
  • the catheter system of Patent Document 1 outputs a high voltage pulse with a delay of a certain period of time from the output of the pacing signal. This allows the catheter system to output high voltage pulses with both the atrium and ventricle in the refractory period.
  • pacing electrodes and ablation electrodes can be therapeutically placed throughout the heart. The timing at which the myocardium at the position where the ablation electrode is placed becomes refractory depends on the distance between the pacing electrode and the ablation electrode.
  • the high-voltage pulse when a high-voltage pulse is output after a certain period of time from the output of the pacing signal, the high-voltage pulse may be output at the position of the ablation electrode before the myocardium enters the refractory period, depending on the arrangement of each electrode. ..
  • the present invention has been made to solve the above-mentioned problems, and provides a catheter system capable of outputting a high voltage pulse in a state where the myocardium has entered the refractory period regardless of the arrangement of the pacing electrode and the ablation electrode.
  • the purpose is.
  • the catheter system according to the present invention that achieves the above object includes an ablation catheter having an ablation electrode and an ablation catheter. It has a control unit that controls the power supply to the ablation electrode.
  • the control unit has a timing of power supply to a pacing electrode arranged at a position different from that of the ablation electrode, and a value of a transmission time required for transmitting an electric signal from the pacing electrode to the position of the ablation electrode.
  • the receiving means to receive It has adjusting means for adjusting the timing of power supply to the ablation electrode based on the timing of power supply to the pacing electrode and the value of the transmission time received by the receiving means.
  • the timing of electrode supply to the ablation electrode is adjusted in consideration of the transmission time required for the electrical signal to be transmitted from the pacing electrode arranged in the living body to the position of the ablation electrode. Therefore, it is possible to output a high voltage pulse in a state where the myocardium at the position where the ablation electrode is arranged is surely entered into the refractory period. This allows the catheter system to prevent the occurrence of intraoperative arrhythmias due to the output of high voltage pulses.
  • the catheter system may have a pacing catheter having a pacing electrode arranged at a position different from the ablation electrode, and a second control unit for controlling the power supply to the pacing electrode.
  • the catheter system can measure the transmission time required for transmitting the electric signal from the pacing electrode to the position of the ablation electrode from the information held by the control unit and the second control unit.
  • the catheter system may have a measuring unit for measuring the transmission time required for transmitting the electric signal from the pacing electrode to the ablation electrode. This allows the catheter system to easily obtain transmission time.
  • the ablation electrode may detect an electric signal from the pacing electrode, and the measuring unit may measure the time until the electric signal is transmitted from the pacing electrode to the ablation electrode. good.
  • the catheter system does not need to be provided with electrodes for measuring the transmission time, and the procedure can be simplified.
  • the adjusting means is the ablation electrode after the lapse of the transmission time from the timing of power supply to the pacing electrode and within the time when the biological tissue becomes refractory due to the electric signal from the pacing electrode.
  • the timing may be adjusted so as to supply power to the device. This allows the catheter system to output high voltage pulses reliably in the refractory period at both the pacing electrode position and the ablation electrode position.
  • the pacing electrode has a first pacing electrode arranged in the atrium and a second pacing electrode arranged in the ventricle, and the adjusting means is described from the timing of power supply to the pacing electrode.
  • the atrioventricular refractory period in which the atriosphere becomes refractory due to the electrical signal from the first pacing electrode and the ventricle in which the ventricle becomes refractory due to the electrical signal from the second pacing electrode The timing may be adjusted so as to supply power to the ablation electrode within a time overlapping with the refractory time. This allows the catheter system to output high voltage pulses reliably in the refractory period at all locations where the atrium, ventricles and ablation electrodes are located.
  • the transmission time received by the receiving means is the time required for the electric signal to be transmitted from the first pacing electrode and the second pacing electrode farther from the ablation electrode to the ablation electrode. It may be.
  • the catheter system can output a high voltage pulse while ensuring that the myocardium at the position where the ablation electrode is arranged is in the refractory period.
  • the catheter system of the present embodiment is percutaneously inserted into the living space, contacts the living tissue of the target site, applies an electric current, and performs ablation.
  • the target of the catheter system of the present embodiment is a treatment in which pulmonary vein isolation is performed by ablating the entrance of the pulmonary vein over the entire circumference.
  • the catheter system can also be applied to other treatments.
  • the catheter system includes one ablation catheter 10 having an ablation electrode 21 and two pacing catheters 12 and 13 having a first pacing electrode 41 and a second pacing electrode 45, respectively. doing.
  • a control unit 14 that controls power supply to the ablation electrode 21 is connected to the ablation catheter 10.
  • the pacing catheters 12 and 13 are connected to a second control unit 16 that controls power supply to the first pacing electrode 41 and the second pacing electrode 45.
  • a measuring unit 18 for measuring the transmission time required for transmitting an electric signal from the first pacing electrode 41 or the second pacing electrode 45 to the ablation electrode 21 is connected to the control unit 14 and the second control unit 16. Will be done.
  • the control unit 14 is connected to the second control unit 16.
  • the control unit 14 has a receiving means 50 that receives the timing of power supply from the second control unit 16 to the first pacing electrode 41 and the second pacing electrode 45.
  • the receiving means 50 also receives the transmission time from the measuring unit 18. Further, the control unit 14 determines the timing of power supply to the ablation electrode 21 based on the timing of power supply to the first pacing electrode 41 and the second pacing electrode 45 and the value of the transmission time received by the receiving means 50. It has an adjusting means 51 for adjusting.
  • the control unit 14 and the second control unit 16 can be configured by a computer or the like having a CPU, a memory, or the like. Further, although the measurement unit 18 is provided independently of the control unit 14 and the second control unit 16, the control unit 14 may have the function of the measurement unit 18.
  • the ablation catheter 10 will be described. As shown in FIGS. 2 and 3, the ablation catheter 10 has an ablation electrode 21 and a balloon 22 at the tip of a long tubular shaft portion 20. In FIG. 2 and the like, for simplification, only two ablation electrodes 21 are shown, but a large number of ablation electrodes 21 are provided depending on the circumferential direction.
  • a hub 23 is provided at the base end of the shaft portion 20.
  • the shaft portion 20 has an outermost pipe 30, an outer pipe 31 inserted into the outermost pipe 30, and an inner pipe 32 inserted into the outer pipe 31 and having a protruding tip portion.
  • a base end member 36 for fixing the base end portion of the ablation electrode 21 is provided at the tip end portion of the outermost tube 30. Further, a tip member 35 for fixing the tip of the ablation electrode 21 is provided at the tip of the inner tube 32.
  • the ablation electrode 21 can be expanded in the radial direction as the balloon 22 expands. As shown in FIG. 4, the ablation electrode 21 can be expanded in the radial direction with the expansion of the balloon 22.
  • the shaft portion 20 has a connecting wire 38 for applying a voltage to the ablation electrode 21 along the length direction.
  • the connection line 38 is connected to the control unit 14.
  • An expansion lumen 33 is formed between the outer pipe 31 and the inner pipe 32. Further, a guide wire lumen 34 is formed inside the inner pipe 32.
  • the inner pipe 32 projects further to the tip side than the tip of the outer pipe 31.
  • the base end side end of the balloon 22 is fixed to the outer tube 31, and the tip end side end is fixed to the inner tube 32.
  • the balloon 22 can be expanded by injecting an expansion fluid into the balloon 22 via the expansion lumen 33.
  • the expansion fluid may be a gas or a liquid, and for example, a gas such as helium gas, CO 2 gas, O 2 gas, or laughing gas, or a liquid such as physiological saline, a contrast medium, or a mixture thereof can be used.
  • the outermost pipe 30, the outer pipe 31 and the inner pipe 32 are preferably formed of a material having a certain degree of flexibility.
  • a material having a certain degree of flexibility include polyolefins such as polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof, and a soft polyvinyl chloride resin.
  • fluororesins such as polyamide, polyamide elastomer, polyester, polyester elastomer, polyurethane and polytetrafluoroethylene, silicone rubber and latex rubber.
  • the balloon 22 is formed of a thin-film balloon film, and is formed of a flexible material like the outer tube 31 and the inner tube 32. Further, the strength required to surely spread the ablation electrode 21 is also required. As the material of the balloon 22, the ones mentioned above for the outer tube 31 and the inner tube 32 can be used, or other materials may be used. In particular, when ablating the surface of the heart chamber at the base of a blood vessel (pulmonary vein), the blood vessel may contract due to spasm or the like if the inside of the blood vessel is ablated. Therefore, in order to ablate the heart chamber surface at the root of the blood vessel without ablating the inside of the blood vessel, the balloon expansion diameter is set to about 15 mm to 30 mm.
  • the pacing catheter 12 has a long shaft portion 40.
  • a hub 42 is provided at the base end of the shaft portion 40, and a first pacing electrode 41 is provided at the tip end of the shaft portion 40.
  • the material of the shaft portion 40 is the same as that of the shaft portion 20 of the ablation catheter 10.
  • the other pacing catheter 13 has the same configuration as the pacing catheter 12, and has a second pacing electrode 45 at the tip of the shaft portion 40.
  • an introducer (not shown) is percutaneously punctured into a blood vessel by the Seldinger method or the like.
  • the guide wire is projected toward the tip side, and then the tip of the guiding catheter is inserted into the tip of the introducer. Insert into the blood vessel through the opening.
  • the guiding catheter is gradually pushed to the target site while leading the guide wire.
  • the surgeon forms a through hole in the atrial septum by penetrating a predetermined puncture device from the right atrium Ra side toward the left atrium La side.
  • a device such as a wire with a sharp tip can be used. Delivery of the puncture device can be via a guiding catheter.
  • the puncture device can also, for example, remove the guide wire from the guiding catheter and then deliver it to the atrial septum in place of the guide wire.
  • the specific structure of the puncture device used for penetrating the interatrial septum, the specific procedure for forming the through hole, and the like are not particularly limited.
  • the through hole is expanded by using a dilator, a guiding catheter is passed through the through hole, and a guide wire is used to push the through hole to a target site (for example, near a pulmonary vein).
  • the guiding catheter may have a mechanism for moving the tip of the guiding catheter.
  • the end of the guide wire is inserted into the opening at the tip of the guide wire lumen 34, and the guide wire is taken out from the hub 23.
  • the ablation catheter 10 is inserted from the tip into the guiding catheter inserted into the blood vessel, and the ablation catheter 10 is pushed along the guide wire.
  • the tip of the ablation catheter 10 having the ablation electrode 21 is delivered to the left atrium La.
  • the tip of the pacing catheter 12 having the first pacing electrode 41 is delivered to the right atrium Ra.
  • the tip of the pacing catheter 13 having the second pacing electrode 45 is delivered to the right ventricle Rv.
  • the first pacing electrode 41 of the pacing catheter 12 is arranged in the high right atrium or the coronary sinus of the right atrium Ra. However, the first pacing electrode 41 may be arranged at a portion other than that.
  • the second pacing electrode 45 is located in the right ventricle Rv, which is easily accessible via the femoral vein, but may be located in the left ventricle Lv. In the example of FIG. 6, the distance L2 between the pacing electrode 41 arranged in the right ventricle Rv and the ablation electrode 21 is larger than the distance L1 between the pacing electrode 41 arranged in the right atrium Ra and the ablation electrode 21. ..
  • an expansion fluid is supplied into the balloon 22 via the expansion lumen 33 to expand the balloon 22.
  • the ablation electrode 21 expands in the radial direction and comes into close contact with the living tissue.
  • the measuring unit 40 measures the transmission time ⁇ t at which the electric signal from the first pacing electrode 41 or the second pacing electrode 45 is transmitted to the ablation electrode 21.
  • the second control unit 16 outputs an electric signal from the second pacing electrode 45 arranged in the right ventricle Rv, which has a large distance from the ablation electrode 21.
  • the control unit 14 can cause the ablation electrode 21 to detect an electric signal from the second pacing electrode 45.
  • the measuring unit 40 transmits the electric signal from the timing when the electric signal is output from the second pacing electrode 45 by the second control unit 16 and the timing when the electric signal is detected by the ablation electrode 21 by the control unit 14.
  • the required transmission time ⁇ t is measured.
  • the measuring unit 18 transmits the transmission time value to the control unit 14, and the control unit 14 receives the transmission time value ⁇ t at the receiving means 50.
  • the second control unit 16 outputs a pacing signal at a constant cycle from the first pacing electrode 41 arranged in the right atrium Ra and the second pacing electrode 45 arranged in the right ventricle Rv.
  • V1 is the voltage applied to the first pacing electrode 41 arranged in the right atrium Ra
  • V2 is the voltage applied to the second pacing electrode 45 arranged in the right ventricle Rv
  • V3 is the voltage applied to the second pacing electrode 45.
  • the voltage applied to the ablation electrode 21 is represented by each. As shown in FIG. 7, both are applied simultaneously and at the same period.
  • the pacing signal from the first pacing electrode 41 and the second pacing electrode 45 is output at a cycle earlier than the normal heartbeat, preferably 1.3 to 1.5 times the normal heartbeat.
  • the pacing signal has a voltage set in the range of 3V to 5V.
  • the pulse width of the pacing signal is set in the range of 1 to 300 ⁇ s.
  • the myocardium of the atrium is in a refractory period from the output of the pacing signal to the time of Ta.
  • the ventricular myocardium is in a refractory state for the Tv time from the output of the pacing signal.
  • Ta is around 150 ms and Tv is around 300 ms.
  • the atrium is in the refractory period from time t1 to time t3, and the ventricle is in the refractory period from time t1 to time t4.
  • the receiving means 50 of the control unit 14 receives the timing of power supply from the second control unit 16 to the first pacing electrode 41 and the second pacing electrode 45, and is after the transmission time ⁇ t has elapsed from this timing.
  • a high voltage pulse is output to the ablation electrode 21 within the time when both the atrium and the ventricle are in the refractory period.
  • the high voltage pulse is output at the time t5, which is between the time t2 when ⁇ t has elapsed from the output of the pacing signal and the time t3 when the refractory period of the atrium ends.
  • the high voltage pulse is output multiple times at the timing after the intermittently output pacing signal.
  • the control unit 14 outputs a high voltage pulse to the pair of ablation electrodes 21 and 21 adjacent to each other in the circumferential direction.
  • a current flows between the pair of ablation electrodes 21 and 21 adjacent to each other in the circumferential direction.
  • a high voltage pulse is output to the other pair of ablation electrodes 21 and 21 adjacent in the circumferential direction.
  • the output of the high voltage pulse is sequentially performed on all the paired ablation electrodes 21 and 21 adjacent in the circumferential direction.
  • An example of the voltage of the high voltage pulse is given below.
  • the electric field strength output by the control unit 14 is 400 to 800 V / cm, and has a bipolar voltage waveform.
  • Its pulse width is 100 ⁇ sec, and 10 to 200 bals is output at one time at 100 ⁇ sec intervals.
  • the voltage application is repeated between each electrode at a timing of once every 0.5 to 2 seconds. This causes the cells at the entrance of the pulmonary vein to die all around.
  • the high voltage referred to here refers to a voltage capable of achieving an electric field strength of 400 V / cm or more between the electrodes to which the voltage is applied.
  • the balloon 22 is contracted.
  • the ablation electrode 21 also contracts in the radial direction. Then, all the instruments inserted into the blood vessels are removed to complete the procedure.
  • the catheter system measures the transmission time ⁇ t required for the electric signal to be transmitted from the first pacing electrode 41 or the second pacing electrode 45 to the ablation electrode 21, and the transmission time ⁇ t is calculated from the output of the pacing signal.
  • a high voltage pulse is output from the ablation electrode 21 within the time when both the atrium and the ventricle are in a refractory period due to the pacing signal.
  • the catheter system can output a high voltage pulse from the ablation electrode 21 in a state where the atrium, the ventricle, and the site where the ablation electrode 21 is arranged are surely entered into the refractory period. Therefore, the catheter system can prevent the occurrence of intraoperative arrhythmia due to the output of high voltage pulses.
  • the catheter system includes an ablation catheter 10 having an ablation electrode 21 and a control unit 14 for controlling the power supply to the ablation electrode 21, and the control unit 14 is the ablation electrode 21.
  • the catheter system determines the timing of electrode supply to the ablation electrode 21 in consideration of the transmission time required for the electrical signal to be transmitted from the pacing electrodes 41 and 45 arranged in the living body to the position of the ablation electrode 21. Since the adjustment is performed, the high voltage pulse can be output in a state where the myocardium at the position where the ablation electrode 21 is arranged is surely entered into the refractory period. This allows the catheter system to prevent the occurrence of intraoperative arrhythmias due to the output of high voltage pulses.
  • the catheter system has a pacing catheters 12 and 13 having pacing electrodes 41 and 45 arranged at positions different from the ablation electrode 21, and a second control unit 16 for controlling power supply to the pacing electrodes 41 and 45. It may be. Thereby, the catheter system can measure the transmission time required for transmitting the electric signal from the pacing electrodes 41 and 45 to the position of the ablation electrode 21 from the information held by the control unit 14 and the second control unit 16.
  • the measuring unit 18 for measuring the transmission time required for transmitting the electric signal from the pacing electrodes 41 and 45 to the ablation electrode 21 may be provided. This allows the catheter system to easily obtain transmission time.
  • the ablation electrode 21 detects an electric signal from the pacing electrodes 41 and 45, and the measuring unit 18 measures the time until the electric signal is transmitted from the pacing electrodes 41 and 45 to the ablation electrode 21. It may be. As a result, the catheter system does not need to be provided with electrodes for measuring the transmission time, and the procedure can be simplified.
  • the adjusting means 51 is after the lapse of the transmission time from the timing of power supply to the pacing electrodes 41 and 45, and within the time when the living tissue becomes refractory due to the electric signal from the pacing electrodes 41 and 45.
  • the timing may be adjusted so as to supply power to the ablation electrode 21.
  • the catheter system can output high voltage pulses reliably in the refractory period at both the positions where the pacing electrodes 41 and 45 are arranged and the positions where the ablation electrodes 21 are arranged.
  • the pacing electrodes 41 and 45 have a first pacing electrode 41 arranged in the atrium and a second pacing electrode 45 arranged in the ventricle, and the adjusting means 51 with respect to the pacing electrodes 41 and 45.
  • the ventricle becomes refractory due to the electrical signal from the first pacing electrode 41 and the ventricle due to the electrical signal from the second pacing electrode 45.
  • the timing may be adjusted so as to supply power to the ablation electrode 21 within a time overlapping with the ventricular refractory period, which is the refractory period. This allows the catheter system to output high voltage pulses reliably in the refractory period at all positions where the atrium, ventricle and ablation electrode 21 are located.
  • the transmission time received by the receiving means 50 is the time required for the electric signal to be transmitted from the far side of the first pacing electrode 41 and the second pacing electrode 45 to the ablation electrode 21. It may be.
  • the catheter system can output a high voltage pulse after ensuring that the myocardium at the position where the ablation electrode 21 is arranged is in the refractory period.
  • the treatment method according to the present embodiment includes a step of inserting the pacing catheter 12 having the first pacing electrode 41 into the atrium and the pacing catheter 13 having the second pacing electrode 45 into the ventricle.
  • a step of outputting a pacing signal from the first pacing electrode 41 and the second pacing electrode 45 From the ablation electrode 21 at the timing after the lapse of the transmission time from the timing at which the pacing signal is output, before the end of the refractory period of the atriosphere due to the pacing signal, and at the timing before the end of the refractory period of the ventricle due to the pacing signal. Outputs a high voltage pulse. As a result, the high-voltage pulse is output in the refractory period at any of the positions where the atrium, the ventricle, and the ablation electrode 21 are arranged, so that the induction of arrhythmia by the high-voltage pulse can be prevented.
  • the output of the pacing signal from the first pacing electrode 41 and the second pacing electrode 45 may be simultaneous.
  • a high voltage pulse can be reliably output with the position of the ablation electrode 21 in the refractory period simply by measuring the transmission time from the pacing electrode that is farther from the ablation electrode 21.
  • the second control unit 16 outputs the pacing signal from the first pacing electrode 41 and the second pacing electrode 45 at the same time, but the output timing of the pacing signal may be shifted.
  • the ablation catheter 10 has the balloon 22, but it does not have to have the balloon 22 as shown in FIG.
  • the ablation electrode 21 has a base end fixed to the outermost pipe 30 and a tip end fixed to the inner pipe 32, and the outermost pipe 30 is moved with respect to the inner pipe 32 in the length direction. Can be expanded and contracted in the radial direction.
  • the ablation catheter may have a configuration as shown in FIG. As shown in FIG. 9A, the ablation catheter 60 has a long tubular shaft portion 61. A long electrode support 62 is arranged inside the shaft portion 61. The electrode support 62 can move in the length direction with respect to the shaft portion 61. When the shaft portion 61 is inserted into the living body 100, the electrode support 62 is housed inside the shaft portion 61.
  • the electrode support 62 is exposed to the tip end side of the shaft portion 61 at the treatment site.
  • the electrode support 62 has a plurality of ablation electrode portions 63 along the length direction.
  • the ablation electrode unit 63 is connected to the control unit 14 to control the power supply.
  • Adjusting means Ra Right ventricle Rv Right ventricle La Left ventricle Lv Left ventricle

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Abstract

La présente invention concerne un système cathéter apte à produire une impulsion de haute tension dans un état dans lequel le muscle cardiaque se trouve dans une période réfractaire quelle que soit la relation d'agencement d'une électrode de stimulation ou d'une électrode d'ablation.　Ce système cathéter présente : un cathéter d'ablation (10) ayant une électrode d'ablation (21); et une unité de commande (14) pour réguler l'alimentation électrique au niveau de l'électrode d'ablation (21). L'unité de commande (14) présente : un moyen de réception (50) pour recevoir une synchronisation d'alimentation électrique au niveau des électrodes de stimulation (41), (45) disposées à des positions différentes de celle de l'électrode d'ablation (21) et la valeur du temps requis pour transmettre un signal électrique depuis les électrodes de stimulation (41), (45) à la position de l'électrode d'ablation (21); et un moyen d'ajustement (51) pour ajuster la synchronisation de l'alimentation électrique au niveau de l'électrode d'ablation (21) sur la base de la synchronisation de l'alimentation électrique au niveau des électrodes de stimulation (41), (45) et de la valeur du temps de transmission reçue par l'unité de réception (50).
PCT/JP2021/008618 2020-03-17 2021-03-05 Système cathéter WO2021187154A1 (fr)

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JP2020046033A JP2023056552A (ja) 2020-03-17 2020-03-17 カテーテルシステム
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12076071B2 (en) 2020-08-14 2024-09-03 Kardium Inc. Systems and methods for treating tissue with pulsed field ablation

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020120304A1 (en) * 2001-02-28 2002-08-29 Mest Robert A. Method and system for treatment of tachycardia and fibrillation
JP2009511214A (ja) * 2005-10-14 2009-03-19 ナノスティム・インコーポレイテッド リードレス心臓ペースメーカー及びシステム
WO2018200800A1 (fr) * 2017-04-27 2018-11-01 Farapulse, Inc. Systèmes, dispositifs, et procédés de génération de signal
JP2019500170A (ja) * 2016-01-05 2019-01-10 ファラパルス，インコーポレイテッド 組織へのアブレーションエネルギーの送達のためのシステム、装置及び方法

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020120304A1 (en) * 2001-02-28 2002-08-29 Mest Robert A. Method and system for treatment of tachycardia and fibrillation
JP2009511214A (ja) * 2005-10-14 2009-03-19 ナノスティム・インコーポレイテッド リードレス心臓ペースメーカー及びシステム
JP2019500170A (ja) * 2016-01-05 2019-01-10 ファラパルス，インコーポレイテッド 組織へのアブレーションエネルギーの送達のためのシステム、装置及び方法
WO2018200800A1 (fr) * 2017-04-27 2018-11-01 Farapulse, Inc. Systèmes, dispositifs, et procédés de génération de signal

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US12076071B2 (en) 2020-08-14 2024-09-03 Kardium Inc. Systems and methods for treating tissue with pulsed field ablation

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