WO2022180046A1

WO2022180046A1 - Catheter

Info

Publication number: WO2022180046A1
Application number: PCT/EP2022/054420
Authority: WO
Inventors: Bart KOOTTE; Benjamin BURG; Maik Gräfe; Thorsten Göttsche
Original assignee: Osypka Ag
Priority date: 2021-02-23
Filing date: 2022-02-22
Publication date: 2022-09-01
Also published as: DE102021104315A1

Abstract

The invention relates to improvements in the technical field of electromedical catheters. In order to improve known cathethers, the invention provides a catheter (1) which has at least one catheter arm (2) connected to a joint (18).

Description

catheter

The invention relates to catheters with at least one catheter arm on which at least one or more, for example at least two or more, poles of one or more electrodes are arranged.

Such catheters are known from practice and are used, for example, for the electromedical measurement and/or correction of electrical activities in human heart tissue. In this case, the catheters are introduced with their catheter arms to a target site of an electromedical measurement in the heart in order to record the electrical activities in the heart tissue there. The recording of the electrical activities serves to gain an overview of the electrical conduction patterns that is as precise as possible, to recognize potential conduction disorders and ultimately to identify optimal starting points for carrying out treatments to eliminate or reduce the conduction disorders. In order to eliminate or limit possibly disturbed stimulus conduction in the heart tissue, the so-called ablation is carried out, for example, in which specific tissue areas are desolate in a targeted manner.

The success of an ablation treatment also depends on the accuracy with which the stimulus conduction pattern can be recorded. The exact recording of the stimulus output pattern can be made more difficult by the topography of the tissue to be examined. In particular when highly curved or uneven surfaces are to be examined, it is often difficult to carry out a meaningful measurement, for example because a sufficient number of poles cannot be brought into contact with the target tissue. This can complicate the handling of such catheters. The object of the invention is therefore to provide catheters of the type mentioned at the outset, the handling of which is simplified.

To solve the problem, a catheter with the features of the first independent claim directed to such a catheter is first proposed. In order to achieve the object, it is therefore particularly proposed in a catheter of the type mentioned at the outset that at least one catheter arm has at least one joint. The at least one joint can have a degree of freedom of one and/or be designed as a rotary joint.

During use, the catheter arms of such catheters can be stretched out from an initial position, which can promote their application in the target tissue. The purpose of this is to adapt the catheter, in particular a basket formed from the catheter arms, as well as possible in terms of its shape to the topography of the target tissue to be examined and/or treated. The catheter arms can be exposed to comparatively high alternating loads, which in the worst case can lead to the catheter arms breaking. In order to reduce the loads on the catheter arms, it is proposed according to the invention that at least one catheter arm of the catheter has at least one joint.

The catheter preferably has several catheter arms. Electrode poles can be arranged on all catheter arms. Several catheter arms or also all catheter arms of the catheter can have at least one joint. This favors the mobility of the catheter arms if the shape of the catheter is adapted to the topography of the is to be adapted to the target tissue to be examined and/or treated.

In one embodiment of the catheter it is provided that at least one catheter arm has a joint which is arranged between a distal end and a proximal end of the catheter arm. This can reduce stress in the middle section of a catheter arm.

In particular in connection with the catheter described above, which is the subject of the independent claim, it is advantageous if at least one catheter arm has a joint at its distal end. The catheter arm can be connected at least indirectly to at least one other catheter arm and/or also to a holder of the catheter via the joint. In this way, the mobility of the catheter arms can be promoted and the catheter arms can be protected from overloading.

Here, too, several catheter arms or all catheter arms are preferably provided with joints at their distal ends.

In one embodiment of the catheter, it is provided that the catheter arms are each connected via a joint to a holder, which is designed, for example, as a retaining plate and/or retaining ring.

In one embodiment of the catheter it is provided that at least one catheter arm has a joint at its proximal end. The catheter arm can be connected at least indirectly to at least one other catheter arm via this joint at the proximal end. It is also possible for several catheter arms or all catheter arms to have joints at their proximal ends, via which they can be connected at least indirectly to at least one other catheter arm. The joints favor, the catheter arms below as less as possible To bring the load into different positions, thereby forming baskets of catheter arms that have different geometries.

If at least one catheter arm of the catheter has a joint at its distal end and at its proximal end, this favors the formation of a spherical basket of catheter arms. A spherical basket can be formed particularly easily if several or all of the catheter arms have a joint at their distal ends and at their proximal ends.

At least one joint of the catheter can have a degree of freedom of one and/or be designed as a film hinge or as a rotating joint. Because the at least one joint has a degree of freedom of one, the catheter arm equipped with the joint can obtain sufficient stability against a load that is aligned laterally to the direction of movement that is specified by the at least one joint. This can favor the stability of a basket of the catheter stretched out from the catheter arms of the catheter against undesired deformation.

A joint designed as a film hinge can have a material weakening running along its pivot axis. It is possible for the at least one joint to consist at least partially of plastic and/or metal.

In one embodiment of the catheter it is provided that at least one joint has a joint pin. The joint pin can be arranged in a joint recess of the joint, in particular it can be rotatably mounted. The mobility of the at least one catheter arm provided with the at least one joint can result from the interaction between the joint pin and joint recess. At this point it should be mentioned that the joint pin of the at least one joint can be connected at least indirectly to a catheter arm. The joint recess can serve as a bearing shell of the joint, in which the joint pin can rotate in order to allow mobility of the catheter arm connected at least indirectly to the joint.

In one embodiment of the catheter, it is provided that at least one catheter arm has a joint head, in particular at its distal end and/or at its proximal end, which is movably mounted in a joint recess of the joint. Here, too, the joint recess can serve as a bearing shell for the joint. The joint head can be made of metal. The joint head can thus be resilient and also withstand a large number of alternating loads.

In one embodiment of the catheter, the condyle is T-shaped. Thus, the joint head and with it the catheter arm connected to the joint head can be hung in the joint recess of the joint and be movably, namely rotatably, mounted there.

In a further embodiment of the catheter, at least one catheter arm has, in particular at its distal end and/or at its proximal end, a joint head of the joint which includes a receptacle in which a joint pin of the joint is arranged. The joint head and the joint pin can be connected to one another in a rotationally fixed manner. Here, too, the joint head of the joint can be made of metal. This can improve the stability and resilience of the joint head. The joint pin connected to the joint head can be rotatably mounted in a joint recess, which can then assume the function of a bearing shell of the joint. In one embodiment of the joint head, it is provided that it is formed from a strip, in particular from a metal strip, which is twisted and/or bent by 90° around its longitudinal axis, for example. In this case, the receptacle for the joint head can be arranged or formed in the section of the strip that is twisted and/or bent by 90°, for example. A joint head formed from such a strip can be connected particularly easily to the catheter arm on which it is to be arranged. By torsion and/or bending of the strip it is possible to bring the socket formed in the strip for the hinge pin into the required orientation for connection to the hinge pin. The joint head can be rotatably mounted on the joint pin arranged in its receptacle.

In one embodiment of the catheter it is provided that at least one joint has a joint sleeve. In this case, the joint sleeve can be at least part of a joint head or itself represent a joint head. The articulating sleeve can be connected to a catheter arm. The joint sleeve can accommodate a joint pin of the joint, for example the joint pin already mentioned above. The articulation sleeve means that the catheter arm can thus be rotatably movable relative to the articulation pin and/or a holder in which the articulation pin is arranged.

The previously mentioned joint recess of the at least one joint can be arranged or formed in or on a holder, in particular in or on a holding plate of the catheter, via which the catheter arms of the catheter are at least indirectly connected to one another. The joint recess acts as a bearing shell for a joint head and/or joint pin of the joint movably mounted therein. In one embodiment of the catheter, it is provided that it has a holder, in particular a holding plate, via which the catheter arms of the catheter are at least indirectly connected to one another. The holder can have at least one extension on which at least one catheter arm of the catheter is hung for attachment to the holder. The at least one extension can preferably be arranged on a side of the holder that faces away from the catheter arms when the holder is in the position of use. This side of the holder can form a distal end face of the catheter.

The catheter arm, which is hooked onto the extension of the holder, can have a hook-in opening for this purpose. In this embodiment of the catheter, the at least one joint of at least one catheter arm can preferably be designed as a film hinge.

The catheter can have a cover for the holder, with which the at least one catheter arm suspended on the at least one extension can be attached to the holder when the cover is in the covering position on the holder.

In this way, the at least one catheter arm suspended on the at least one extension of the holder can be fixed to the holder in a particularly simple and yet secure manner.

In all of the above-described embodiments of catheters, it can be provided that at least one catheter arm is at least partially formed from a flexible printed circuit board material. On the flexible circuit board material of the at least one catheter arm, both the lines of the electrodes and the poles can be or can be applied comparatively easily. At least one catheter arm can have a preferably metallic carrier layer onto which at least one pole and/or one, for example the previously mentioned, flexible printed circuit board material of the catheter arm can be applied. The carrier layer can give the catheter arm its required stability and also a certain spring elasticity. A strip of material, preferably a strip of metal, can serve as the carrier layer, for example. Circuit board foil can be used as circuit board material.

In one embodiment of the catheter, it is set up to open the catheter arms from an initial position into at least two different clamping positions and to keep them open. In a first clamping position, distal ends and/or distal sections of the catheter arms span an angle of 0° to 90° and in a second clamping position an angle of 90° to 180° with a longitudinal axis of the catheter. In the second clamped position, the distal ends and/or distal sections of the catheter arms can thus be aligned, for example, parallel to the longitudinal axis of the catheter. It is also possible for the distal ends and/or distal sections of the catheter arms to be aligned at an angle of between 90° and 180° to the longitudinal axis of the catheter in the second clamping position, for example at an angle of 120° or at an angle of 178°.

The catheter arms can thus be clamped and kept clamped in at least two different clamped positions or configurations in order to carry out different examinations and/or treatments. This allows two fundamentally different basic geometric shapes of the catheter with one single catheter design. This allows an anatomy-dependent individual choice of a basic catheter shape with a specific distribution and/or arrangement of poles of the catheter and thus a targeted adaptation of the catheter arms to the topography of the tissue to be examined without replacing the catheter with another catheter. This can simplify the examination and lead to more accurate examination results.

In one embodiment of the catheter, it is provided that the at least two clamping positions of the catheter arms are each defined at least indirectly by a holding position and/or a stop. The holding position and/or the stop allows the person operating and guiding the catheter during the treatment to receive feedback on the position of the catheter arms. In addition, the holding position and/or the stop makes it possible to bring the catheter arms into the at least two different clamping positions in a comparatively simple and targeted manner.

In one embodiment of the catheter, it is set up to stretch the catheter arms between the two different stretched positions in intermediate stretched positions and to keep them stretched. The previously mentioned two clamping positions of the catheter arms can be extreme positions beyond which the catheter cannot be deformed for an examination and/or treatment. It is preferably possible to open the catheter arms steplessly between the two different clamping positions in intermediate clamping positions and to keep them open. In this way, the persons using the catheter are given even greater freedom of action and an even better adaptation of the catheter to the topography of the tissue to be examined is made possible. In order to open the catheter arms and keep them open, the catheter can have a clamping device. The catheter arms can be at least indirectly connected to one another at their distal ends to form a basket. For this purpose, the catheter can have, for example, a retaining plate or a retaining ring to which the catheter arms are attached with their distal ends.

Corresponding to the at least two different clamping positions, the basket formed from the catheter arms can assume corresponding and different shapes. Thus, the catheter can also be set up to form its basket formed from the catheter arms in at least two different shapes.

The catheter can have a locking device for at least indirectly locking the catheter arms in the at least two different clamping positions. The catheter arms brought into the clamped position can be fixed and kept clamped with the locking device. The locking device of the catheter can be part of the previously mentioned tensioning device of the catheter.

The catheter can have a traction means, for example a traction wire and/or a traction rope. The pulling means can be connected at least indirectly to the catheter arms, in particular to the distal ends of the catheter arms. In this case, the pulling means can be part of the previously mentioned tensioning device of the catheter. By pulling on the pulling means, it is thus possible to bring the catheter arms from a non-tensioned initial position into one of the at least two different tensioned positions. If the catheter arms have a holder, for example the holder already mentioned above, are connected to each other, it may be useful to attach the traction means to the holder.

In one embodiment of the catheter it is provided that the pulling means is arranged within a space delimited by the catheter arms. The traction means is thus positioned between the catheter arms, where it does not impair the applications and/or measurements carried out with the catheter and can also be well protected from external influences.

In particular when the catheter arms are elastic or spring-elastic and can generate a restoring force when they are tensioned, it is possible for the catheter arms to automatically return from their tensioned positions to their starting position. If a restoring force possibly applied by the catheter arms is not sufficient to automatically move the catheter arms from one of the at least two clamped positions back to their starting position, it is also possible to use a tension/compression means as the tension means, which not only works on tension but also on can be subjected to pressure. The catheter arms can then be reset from one of the at least two clamped positions back into their starting position with the aid of the tension/pressure means.

The catheter can have a clamping means with which the traction means can be fixed in at least two traction positions and/or in intermediate positions located between the at least two traction positions, preferably steplessly.

The aim is to keep the catheter arms stretched in the at least two different stretched positions and/or in the intermediate stretched positions located between them.

The clamping means may be part of those already mentioned Tensioning device and/or part of the previously mentioned locking device of the catheter.

In order to adjust the catheter arms into the at least two different clamping positions, the catheter can have at least one operating element. This operating element can be used to operate a clamping device, for example the one already mentioned above, and/or a locking device, for example the one already mentioned above.

The at least one operating element is preferably arranged and/or formed on a proximal end and/or on a handle part of the catheter.

The at least one joint can have a pivoting range of up to 180°. This can favor the movement of the distal ends and/or sections of the catheter arms into the previously described angular positions of 0° to 90° in the first clamped position and from 90° to 180° in the second clamped position relative to the longitudinal axis of the catheter.

The invention will now be described in more detail using exemplary embodiments, but is not limited to these exemplary embodiments. Further exemplary embodiments result from combining the features of individual or multiple claims with one another and/or with one or more features of the exemplary embodiments. Show it:

Fig. 1: a side view of an end portion of a

Catheter with catheter arms in a relaxed initial position,

FIG. 2: a perspective view of that shown in FIG

end section,

Figure 3 is a side view of the one shown in the previous figures shown end section with catheter arms located in a first clamped position,

Figure 4 is a perspective view of the end portion shown in Figure 3;

5 shows a side view of the end section shown in the previous figures with catheter arms in a second clamped position,

Figure 6 is a perspective view of the end portion shown in Figure 5,

7 shows a side view, greatly simplified in parts, of a catheter equipped with the end section shown in the previous figures,

8 and 9 show a sectional side view and a plan view of a first embodiment of a catheter, the catheter arms of which are connected to one another at their distal ends via a common holder, each catheter arm having an articulation pin at its distal end which is inserted in an articulation recess, formed in the holder

10 to 12 different views of another

Embodiment of a catheter, in which case the catheter arms are equipped at their distal ends with T-shaped joint heads made of metal, which are hooked into joint recesses formed in the holder in order to promote mobility of the catheter arms relative to the holder, 13 is a side view of a further embodiment of a catheter, the catheter arms of which are connected at their distal ends to articulated heads made of metal strips, the metal strips each being provided with a receptacle in which a pivot pin of the joint is arranged, the metal strips according to FIG are twisted 90°,

14 and 15 different views of another

Embodiment of a catheter, the catheter arms of which are connected to joint pins at their distal ends, the material of the catheter arms being connected to the joint pins in a cohesive manner and the joint pins being rotatably mounted in joint recesses of a holder of the catheter shown,

16 to 18 different views of another

Embodiment of a catheter, the catheter arms of which are provided at their distal ends with joint heads in the form of joint sleeves which receive joint pins which are inserted into joint recesses which are formed in a holder of the catheter, and

19 and 20 different views of another

Embodiment of a catheter in which a holder has an extension for each catheter arm on its side facing away from the catheter arms, the catheter arms having suspension openings at their distal ends with which they are suspended from the extensions of the holder. In the following description of various embodiments of the invention, elements that have the same function are given the same reference numbers, even if the design or shape differs. If not specifically pointed out, the following explanations can relate to all exemplary embodiments shown.

All of the figures show at least parts of a catheter designated 1 as a whole. The catheter 1 is set up to carry out electromedical measurements in the human heart in order to monitor electrical activities in the heart tissue and to identify any conduction disturbances that may be present.

The catheter 1 has a plurality of catheter arms 2 on which poles 3 of electrodes are arranged. With the help of the poles 3, the electrical activities in the human heart tissue can be recorded and transmitted to an evaluation unit.

The catheter 1 is set up to open the catheter arms 2 from an initial position shown in FIGS. 1 and 2 into at least two different clamping positions and to keep them open.

FIGS. 1 and 2 show the catheter 1 with its catheter arms 2 in an initial position in which the catheter arms 2 are relaxed, or at least almost relaxed. In this position, the catheter arms 2 can be guided through a shaft 4 of the catheter 1 to a target location, for example into a human heart. The starting position, which the catheter arms 2 assume according to FIG. 1, is not a clamping position within the meaning of the invention. The at least two different clamping positions can also be used as two different positions of use of the catheter arms 2 are designated.

In the first clamping position according to FIG. 3, the distal ends 6 and the distal sections 14 span an angle of 0° to 90°, here an angle of 90°, with a longitudinal axis L of the catheter 1 . In the second clamping position according to FIG. 5, the distal ends 6 and the distal sections 14 span an angle of 90° to 180°, here an angle β of 180° with the longitudinal axis L of the catheter 1. In the first clamping position, the distal ends 6 and the distal sections 14 of the catheter arms 2 are thus aligned at a right angle and in the second clamping position parallel to the longitudinal axis L.

The at least two clamping positions of the catheter arms 2 are each defined at least indirectly by a holding position and/or a stop.

The catheter 1 is set up to stretch the catheter arms 2 steplessly between the two different stretched positions into intermediate stretched positions and to keep them stretched in these intermediate stretched positions.

Depending on which intermediate clamping position or which clamping position the catheter arms 2 assume, the end section of the catheter 1, which can also be referred to as the catheter tip, has different shapes.

In order to open the catheter arms 2 and keep them open in the different positions, the catheter 1 is equipped with a clamping device 5 .

The catheter arms 2 are at their distal ends 6 to form a basket 7 via a holder 8 indirectly one below the other tied together. The basket 7 is shown in Figures 3 and 4 in a first form and in Figures 5 and 6 in a second form. The holder 8 of the catheter 1 shown in the figures is a retaining ring. In an exemplary embodiment of the catheter 1 not shown in the figures, the holder 8 is a holding plate.

In FIGS. 3 and 4, the catheter 1 is shown with its catheter arms 2 in the first clamped position. The basket 7 formed by the catheter arms 2 thus has a corresponding first shape.

In FIGS. 5 and 6, the catheter arms 2 are shown in their second clamped position, in which the basket 7 of the catheter 1 has assumed a corresponding second form or shape.

The catheter 1 also includes a locking device 9 which is part of the tensioning device 5 . The locking device 9 is used for at least indirect locking of the catheter arms 2 in the at least two different clamping positions. The catheter arms 2 can be moved from their initial position shown in FIGS. 1, 2 and 7 into the clamping positions shown in FIGS.

The pulling means 10 is attached to the holder 8 and is thereby at least indirectly connected to the distal ends 6 of the catheter arms. The pulling means 10 runs through a space delimited by the catheter arms 2 and is thus arranged between the catheter arms 2 . By pulling on the pulling means 10 in the direction of the arrow A, the catheter arms 2 can be moved from the starting position into the clamping positions. The catheter arms 2 are reset in the opposite direction of arrow A. The locking device 9 of the catheter 1 comprises a clamping means 11 with which the traction means 10 can be continuously fixed in different traction positions. In this way, the catheter arms 2 can be kept clamped in their different clamped positions and also in the intermediate clamped positions located between them.

To operate its tensioning device 5 and also its locking device 9, the catheter 1 has at least one corresponding operating element 12, which is arranged or formed in or on a handle part 13 of the catheter 1 and is shown in highly schematic form in FIG.

FIGS. 3 and 4 make it clear that the distal ends 6 of the catheter arms 2 form a distal end of the catheter 1 in the first clamped position. In the first clamping position, distal sections 14 of the catheter arms 2 are clamped parallel or almost parallel to a cross-sectional plane oriented at right angles to the longitudinal axis L of the catheter 1, in the embodiment described here in such a way that no design and/or construction elements of the catheter 1 from this cross-sectional plane in Direction of the longitudinal axis L of the catheter 1 protrude. In the first clamped position, the distal sections 14 of the catheter arms 2 can span an angle of between 0° and 20° with the aforementioned cross-sectional plane. In the first clamping position, however, they preferably span an angle with the cross-sectional plane that is less than 20°, for example between 0° and 5°, preferably between 0° and 2°.

FIGS. 5 and 6 make it clear that the distal ends 6 and also the distal sections 14 of the catheter arms 2 are drawn in between the central sections 15 and/or also the proximal sections 16 of the catheter arms 2 in the second clamped position are arranged. While the outer sides of the distal sections 14 of the catheter arms 2 face away from the longitudinal axis L of the catheter 1 in the initial position and also in the first clamped position of the catheter arms 2, they are turned inside out in the second clamped position and the longitudinal axis L of the catheter 1 faces.

In the second clamped position, at least parts of the central sections 15 of the catheter arms 2 form the distal end of the catheter 1. Seen in absolute terms, a higher number of poles 3 is arranged on a front side of the catheter 1 when the catheter arms 2 are in the first clamped position than on the front side of the catheter 1 with catheter arms in the second clamping position 2.

An end face of the catheter 1, which is formed by the distal sections 14 when the catheter arms 2 are in the first clamped position according to Figures 3 and 4, is flatter and also larger than an end face of the catheter 1, which according to Figures 5 and 6 is at in second clamping position located catheter arms 2 is formed by parts of the middle sections 15 of the catheter arms 2.

In one embodiment of the catheter 1, each of the catheter arms 2 can have at least two sections in which different pole densities are realized. The same pole density is then realized in the distal sections 14 and in the proximal sections 16 of the catheter arms 2, but a lower pole density than in the middle sections 15 of the catheter arms 2. Thus higher pole densities are available in the middle sections 15 than in the other sections 14 and 16 of the catheter arms 2.

The result of this is that on one end face of the catheter 1 when the catheter arms 2 are in the second clamping position higher pole density is formed than on the front side of the catheter 1 when the catheter arms 2 are in the first clamping position.

The catheter arms 2 each have at least one ablation pole 17 of an ablation electrode in their central sections 15 . It is possible via the ablation pole 17 to emit electrical impulses for the ablation of an area of tissue. In the second clamped position of the catheter arms 2, the ablation poles 17 reach the distal end face of the catheter 1 and are there ready for the ablation of a tissue area requiring treatment.

In order to promote mobility of the catheter arms 2 and to protect the catheter arms 2 from damage when they are moved back and forth between the different clamping positions, each of the catheter arms 2 has a joint 18 at its distal end 6 .

The catheter arms 2 are at least indirectly connected to the other catheter arms 2 via their joints 18 , namely here via the respective holder 8 . Each of the catheter arms 2 is connected to the holder 8 via its joint 18 located at its distal end 6 .

The exemplary embodiments of catheters 1 shown in FIGS. 8 to 20 also make it clear that all catheter arms 2 each have a joint 18 . They are at least indirectly connected to the holder 8 via the joint 18 .

The joints 18 of the catheter 1 each have a degree of freedom of one and are designed as film hinges (Figures 19 and 20) or as rotary joints (compare the other figures). educated. Depending on the embodiment, the joints 18 are at least partially made of plastic and/or metal.

In the case of those shown in Figures 1 to 7, 8 and 9, 13 and 14 to 18, the joints 18 each have a joint pin 22 which is arranged in a joint recess 23 of the respective joint 18 and, in the case of the catheter 1 according to Figures 8 and 9 and 14 and 15 is also rotatably mounted there. The joint recesses

23 can thus also be referred to as bearing shells. In the case of the catheters 1 shown in FIGS. 8 and 9 as well as 14 and 15, the joint pins 22 are connected directly and firmly to the catheter arms 2. This is done, for example, by the material of the catheter arms 2 being fused to the joint pins 22, which can be made of metal, or being bonded in some other way.

In the exemplary embodiment of a catheter 1 shown in FIGS. 10 to 12, the catheter arms 2 each have a metal, T-shaped joint head 24 at their distal ends 6 . The joint heads 24 are rotatably mounted in corresponding joint recesses 23 of the joints 18 . These joint recesses 23 also act as bearing shells within which the joint heads 24 can move. The joint recesses 23 are designed as a half-shell and/or semi-cylindrical holder 8 of the catheter 1 designed as a holding plate.

The catheters 1 shown in FIGS. 14 and 15 as well as 16 to 18 also have catheter arms 2 which are provided with articulated heads 24 at their distal ends 6 . In these exemplary embodiments of catheters 1, the joint heads

24 each have a receptacle 25, in which a joint pin 22 of the respective joint 18 is arranged, via which the respective catheter arm 2 is rotatably connected to the holder 8 of the catheter 1. In the catheter 1 shown in FIG. 13, the joint heads 24, which are arranged on the distal ends 6 of the catheter arms 2, are formed from strips, namely from metal or sheet metal strips. Each strip is twisted 90° about its longitudinal axis. As a result, receptacles 25 in the strip-shaped joint heads of the catheter 1 shown in FIG Catheter arms 2 can be used with the holder 8 of the catheter 1. The receptacles 25 of the catheter 1 shown in FIG. 13 can be in the form of holes punched into the strips.

The catheter 1 shown in FIGS. 16 to 18 has catheter arms 2 whose joint heads 24 are designed as joint sleeves 26 . The joint sleeves 26 serve as receptacles 25 for the joint pins 22. In the position of use of the joint sleeves 26, the joint pins 22 of the joints 18 are arranged in the joint sleeves 26. The hinge pins 22 of this catheter 1 are fixed in the holder 8 of the catheter, as shown in particular in the plan view from FIG.

In all of the catheters 1 shown in the figures, the catheter arms 2 are connected to one another at least indirectly at their distal ends 6 to form a basket, namely via the holders 8 already mentioned above.

The catheter 1 shown in FIGS. 19 and 20 comprises a holder 8 which has an extension 27 for each catheter arm 2 on its side facing away from the catheter arms 2 . The catheter arms 2 are provided at their distal ends 6 with suspension openings 28, with the help of which they can be attached to the Extensions 27 of the holder 8 are mounted for attachment to the holder 8.

In order to fix the catheter arms 2 suspended on the extensions 27 in this position on the holder 8 , the catheter 1 has a cover 29 for the holder 8 . With this cover 29, the catheter arms 2 suspended on the extensions 27 can be fastened to the holder 8 when the cover 29 is in the covering position on the holder 8.

The joints 18 of the catheter arms 2 of the catheter 1 shown in FIGS. 19 and 20 are designed as film hinges.

In an exemplary embodiment of the catheter 1 not shown in the figures, it is provided that at least one of the catheter arms 2 has at least one joint 18 which is arranged between the distal end 6 and a proximal end 19 of the catheter arm 2 . The joints 18 can be designed as film hinges and/or consist at least partially of plastic and/or metal. The joints 18 each have a pivoting range of up to 180°, which facilitates the adjustment of the catheter arms 2 into and between the clamped positions.

In one embodiment of the catheter 1 it is provided that at least one further joint is also attached to the proximal end 19 of the catheter arms 2 . Thus, at least one of the catheter arms 2 can be mounted with two joints 18, for example in the form of film hinges. This allows the catheter arms 2 to be oriented at the proximal end 19 as well as at the distal end 6 - for example in a cross-sectional plane which is oriented perpendicular to the longitudinal axis L of the catheter 1. Joints 18 at the proximal ends 19 of the catheter arms 2 favor arranging the catheter arms 2 so that their proximal ends 19 and thereon adjoining proximal sections can be spanned at an angle of 0° to 90° in a first clamping position and at an angle of 90° to 180° with the longitudinal axis L of the catheter 1 in a second clamping position.

The catheter arms 2 of the catheters 1 shown in the figures consist at least in part of a flexible printed circuit board material. The flexible conductor material forms a carrier layer 20 of the catheter arms 2 that faces away from the longitudinal axis L of the catheter 1 in the initial position of the catheter arms 2.

The carrier layer 20 made of printed circuit board material is reinforced on the inside by an inner or outer carrier layer 21, which consists of metal in the exemplary embodiment of the catheter 2 shown. The metallic carrier layer 21 makes the catheter arms 2 spring-elastic, so that they automatically move from their clamped positions shown in FIGS. 3 to 6 back to their starting position shown in FIGS and/or held.

The invention addresses improvements in the art of electromedical catheters. Among other things, a catheter 1 is proposed as an improvement, which has at least one catheter arm 2 which is connected to a joint 18 so that the catheter arm 2 can be moved gently, for example to open a basket 7 of the catheter 1 . reference list

1 catheter

2 catheter arm

3 pin

4 shaft

5 clamping device

6 distal end of 2

7 basket

8 holders

9 locking device

10 traction means

11 clamping means

12 control element

13 handle part

14 distal section of 2

15 middle section of 2

16 proximal section of 2

17 ablation pole

18 joint

19 proximal end of 2

20 backing layer of 2

21 backing layer

22 pivot pin

23 joint recess

24 rod end

25 recording in 24

26 joint sleeve

27 extension

28 hanging opening

29 cover

Claims

Expectations

1. Catheter (1), in particular for the electromedical measurement and/or correction of electrical activities in human heart tissue, having at least one catheter arm

(2) on which at least one or more poles (3) of one or more electrodes are arranged, characterized in that at least one catheter arm (2) has at least one joint (18).

2. Catheter (1) according to the preceding claim, wherein the catheter (1) has a plurality of catheter arms (2) and/or wherein a plurality of catheter arms (2) or all catheter arms (2) have at least one joint (18).

3. catheter (1) according to any one of the preceding claims, wherein at least one catheter arm (2) at its distal end (6) has a joint (18) via which it is connected to a holder (8) of the catheter (1) and / or connected at least indirectly to at least one other catheter arm (2), or wherein several catheter arms (2) or all catheter arms (2) have joints (18) at their distal ends (6) via which they can be connected to a holder (8) of the catheter (1) and/or are at least indirectly connected to at least one other catheter arm (2).

4. Catheter (1) according to one of the preceding claims, wherein at least one catheter arm (2) has a joint (18) at its proximal end (19), in particular via which it is at least indirectly connected to at least one other catheter arm (2), or wherein several catheter arms (2) or all catheter arms (2) have joints (18) at their proximal ends (6), in particular via which they are at least indirectly connected to at least one other catheter arm (2).

5. Catheter (1) according to one of the preceding claims, wherein at least one catheter arm (2) has a joint (18) at its distal end (6) and at its proximal end (19), or wherein several or all catheter arms (2 ) each have a joint (18) at their distal ends (6) and at their proximal ends (19).

6. Catheter (1) according to one of the preceding claims, wherein at least one catheter arm (2) has a joint (18) which is arranged between a proximal end (6) and a distal end (19) of the catheter arm (2).

7. Catheter (1) according to one of the preceding claims, wherein at least one joint (18) has a degree of freedom of one and/or is designed as a film hinge or as a rotary joint.

8. Catheter (1) according to one of the preceding claims, wherein at least one joint (18) consists at least partially of plastic and/or metal.

9. Catheter (1) according to one of the preceding claims, wherein at least one joint (18) has a joint pin (22) which is arranged, in particular rotatably mounted, in a joint recess (23), in particular in a bearing shell, of the joint (18). , and / or at least indirectly connected to a catheter arm (2).

10. Catheter (1) according to any one of the preceding claims, wherein at least one catheter arm (2), in particular at its distal end (6) and / or its proximal end (19), preferably made of metal and / or T-shaped Having joint head (24) which is rotatably mounted in a joint recess (23) of the joint (18). is.

11. Catheter (1) according to one of the preceding claims, wherein at least one catheter arm (2), in particular at its distal end (6) and/or its proximal end (19), has a joint head (24), made of metal, for example, of the Joint (18), wherein the joint head (24) comprises a receptacle (25) in which a joint pin (22) of the joint (18) is arranged.

12. Catheter (1) according to one of the two preceding claims, wherein the joint head (24) is formed from a strip, in particular from a metal strip, which is twisted and/or bent in particular by 90° about its longitudinal axis.

13. Catheter (1) according to one of the preceding claims, wherein at least one joint (18) has a joint sleeve (26), in particular as a joint head (24), in particular one or the joint pin (22) of the joint (18) inside the Joint sleeve (26) is arranged.

14. Catheter (1) according to one of the preceding claims, wherein the catheter arms (2) are at least indirectly connected to one another at their distal ends (6) to form a basket (7), in particular via a holder (8), for example a holding plate or a retaining ring.

15. Catheter (1) according to one of the preceding claims, wherein the joint recess (23) of the at least one joint (18) is arranged or formed in or on a holder (8), in particular in or on a holding plate.

16. Catheter (1) according to one of the preceding claims, wherein the catheter (1) has a holder (8) which, in particular on its side facing away from the catheter arms (2), has at least one extension (27) on which at least one catheter arm (2) of the catheter (1) is suspended for attachment to the holder (8), preferably with the catheter arm (2) having a suspension opening (28) for this purpose.

17. Catheter (1) according to the preceding claim, wherein the catheter (1) has a cover (29) for the holder (8), with which the at least one catheter arm (2) suspended on the at least one extension (27) at in Cover position on the holder (8) located cover

(29) on the holder (8) can be fixed.

18. Catheter (1) according to one of the preceding claims, wherein at least one catheter arm (2) is formed at least partially from a flexible printed circuit board material and/or wherein at least one catheter arm (2) comprises a preferably metallic carrier layer (21).

19. Catheter (1) according to one of the preceding claims, wherein at least one joint (18) has a pivoting range of up to 180°.