WO2023026346A1 - Système de cathéter - Google Patents

Système de cathéter Download PDF

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Publication number
WO2023026346A1
WO2023026346A1 PCT/JP2021/030896 JP2021030896W WO2023026346A1 WO 2023026346 A1 WO2023026346 A1 WO 2023026346A1 JP 2021030896 W JP2021030896 W JP 2021030896W WO 2023026346 A1 WO2023026346 A1 WO 2023026346A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrode group
electrode
power supply
electrodes
defibrillation
Prior art date
Application number
PCT/JP2021/030896
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English (en)
Japanese (ja)
Inventor
久生 宮本
一樹 中神
Original Assignee
日本ライフライン株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 日本ライフライン株式会社 filed Critical 日本ライフライン株式会社
Priority to JP2023543508A priority Critical patent/JPWO2023026346A1/ja
Priority to PCT/JP2021/030896 priority patent/WO2023026346A1/fr
Publication of WO2023026346A1 publication Critical patent/WO2023026346A1/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
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators

Definitions

  • the present applicant has proposed a defibrillation catheter inserted into the heart chamber for defibrillation,
  • the defibrillation catheter comprises a power supply for applying a DC voltage to the electrodes of the defibrillation catheter, and an electrocardiograph;
  • the defibrillation catheter comprises a plurality of ring-shaped electrodes attached to the tip region of an insulating tube member.
  • the first electrode group of the defibrillation catheter and the second electrode are sent from the DC power supply unit that receives the control signal from the arithmetic processing unit via the output circuit of the arithmetic processing unit, the switching unit, and the catheter connection connector.
  • DC voltages of polarities different from each other are applied to the groups.
  • the intracardiac defibrillation catheter system of the present invention comprises a defibrillation catheter inserted into a heart chamber for defibrillation, and a power supply for applying a DC voltage to electrodes of the defibrillation catheter.
  • a catheter system comprising: The defibrillation catheter includes an insulating tube member, a first DC electrode group including a plurality of first electrodes attached to a distal region of the tube member, and spaced apart proximally from the first DC electrode group.
  • a second DC electrode group consisting of a plurality of second electrodes attached to the distal end region of the tube member, and a plurality of first leads each having a distal end connected to each of the first electrodes constituting the first DC electrode group.
  • the first DC electrode group is composed of n first electrodes (n is an integer equal to or greater than 2)
  • the second DC electrode group is composed of n composed of the second electrodes
  • the arithmetic processing unit of the power supply device includes a first electrode that is the k-th electrode from the tip of the first DC electrode group (k is any integer from 1 to n) and a first electrode that is the k-th electrode from the tip of the second DC electrode group. It is preferable to control (the switch group) such that the impedance between the two electrodes is measured (by the impedance measuring circuit) n times.
  • the arithmetic processing unit of the power supply device may be configured to detect the first electrode and/or the second electrode that caused the impedance exceeding a predetermined value to be measured.
  • an electrode is identified and the display means is controlled to display the electrode.
  • the two electrodes selected from the first DC electrode group and the second DC electrode group are adjacent electrodes (first electrode and/or second electrode). According to the intracardiac defibrillation catheter system with such a configuration, the distance between the electrodes where the impedance is measured can be minimized, and the effect (error) on the measurement value due to the increased distance between the electrodes ) can be eliminated.
  • part of the arithmetic processing unit including the impedance measurement circuit may be arranged outside the power supply device.
  • the arithmetic processing unit of the power supply device measures the impedance between two electrodes selected from the electrode group for all electrodes constituting the electrode group by the impedance measurement circuit. It is characterized by controlling to be measured by
  • FIG. 2 is an explanatory view schematically showing a connection state between a connector of a defibrillation catheter and a catheter connection connector of a power supply device in the catheter system shown in FIG. 1;
  • 2 is a flow chart showing the operation and operation of the power supply in the catheter system shown in FIG. 1;
  • 2 is a block diagram showing the flow of electrocardiographic information in the electrocardiographic measurement mode after the main power switch is turned on in the catheter system shown in FIG. 1;
  • FIG. 2 is a block diagram showing a state in which a DC voltage is applied after an application execution switch is input in the catheter system shown in FIG. 1; It is a circuit diagram for switching between impedance measurement and DC voltage application, and shows a state in which the impedance between the first electrode and the second electrode can be measured. It is a circuit diagram for switching between impedance measurement and DC voltage application, and shows a state in which the impedance between the first DC electrode group and the second DC electrode group can be measured.
  • FIG. 4 is a circuit diagram for switching between impedance measurement and DC voltage application, and shows a state in which a DC voltage can be applied to the first DC electrode group and the second DC electrode group.
  • a distal tip 35 is attached to the distal end of the defibrillation catheter 100 .
  • No lead wire is connected to the distal tip 35, and it is not used as an electrode in this embodiment.
  • the eight first electrodes 31 forming the first DC electrode group 31G are connected to different first lead wires 41, respectively.
  • Each of the first lead wires 41 is welded to the inner peripheral surface of the first electrode 31 at its distal end portion and enters the first lumen 11 through a side hole formed in the tube wall of the multi-lumen tube 10 .
  • the eight first lead wires 41 entering the first lumen 11 extend to the first lumen 11 as a first lead wire group 41G.
  • the first lead wire group 41G extends to the first lumen 11 and the second lead wire group 42G extends to the second lumen 12, so that both of them can be used in the multi-lumen tube 10. Completely insulated. Therefore, when a voltage required for defibrillation is applied, a short circuit between the first lead wire group 41G (first DC electrode group 31G) and the second lead wire group 42G (second DC electrode group 32G) can be reliably prevented.
  • the distal end of the second insulating tube 27 is inserted into the second lumen 12 of the multi-lumen tube 10, whereby the second insulating tube 27 is inserted into the second lumen 12 through which the second lead wire group 42G extends. Concatenated.
  • the second insulating tube 27 extends to the vicinity of the connector 50 through the inner hole of the second protective tube 62 extending inside the handle 20, and connects the proximal ends of the second lead wire group 42G to the connector 50.
  • the first A first lead wire group 41G extends in the insulating tube 26
  • a second lead wire group 42G extends in the second insulating tube 27
  • a third lead wire group 43G extends in the third insulating tube 28.
  • the first lead wire group 41G, the second lead wire group 42G, and the third lead wire 43G can be completely insulated and isolated even inside the handle 20.
  • the DC power supply unit 71 has a built-in capacitor.
  • the terminals 721 and 722 of the catheter connector 72 are connected to the first ON/OFF switch 761, and the terminal 723 is directly connected to the electrocardiograph connector 73 without going through the first ON/OFF switch 761.
  • the electrocardiographic information measured by the first DC electrode group 31G and the second DC electrode group 32G reaches the electrocardiograph connector 73 via the first ON/OFF switch 761, and reaches the proximal side potential measuring electrode group.
  • Electrocardiogram information measured by 33G reaches the electrocardiograph connection connector 73 without passing through the first ON/OFF switch 761 .
  • the first ON/OFF switch 761 is turned “OFF” and the second ON/OFF switch 762 is turned “ON”.
  • the first DC electrode group 31G of the defibrillation catheter 100 is supplied from the DC power supply unit 71 via the output circuit 751 of the arithmetic processing unit 75, the switching unit 754, the second ON/OFF switch 762 and the catheter connector 72. and the second DC electrode group 32G (defibrillation/impedance measurement mode).
  • the IMP measurement circuit 752 can measure the impedance between the first DC electrode group 31G and the second DC electrode group 32G of the defibrillation catheter 100 (between the electrode groups), and constitutes the first DC electrode group 31G.
  • the impedance between the first electrode 31 and the second electrode 32 constituting the second DC electrode group 32G (interelectrode) can also be measured.
  • the ON/OFF switches 791-798 are ON/OFF switches provided between each of the second electrodes 321 to 328 and the changeover switch 799 .
  • the ON/OFF switches 791-798 are connected to the proximal end of each of the eight second lead wires whose distal ends are connected to the respective second electrodes 321-328. can be connected to the output circuit 751 or the IMP measurement circuit 752 via the switch 799 .
  • the electrocardiogram input connector 77 is connected to the arithmetic processing unit 75 and to the output terminal of the electrocardiograph 800 . Through this electrocardiogram input connector 77, the electrocardiographic information output from the electrocardiograph 800 (usually, part of the electrocardiographic information input to the electrocardiograph 800) can be input to the arithmetic processing unit 75, and arithmetic processing is performed.
  • the unit 75 can control the DC power supply unit 71, the first ON/OFF switch 761 and the second ON/OFF switch 762 based on this electrocardiographic information.
  • the defibrillation catheter 100 of this embodiment can be used as an electrode catheter for cardiac potential measurement when defibrillation treatment is not required.
  • the electrocardiographic information measured by the constituent electrodes of the proximal side potential measuring electrode group 33G is input to the electrocardiograph 800 via the catheter connector 72 and the electrocardiograph connector 73 .
  • the electrocardiogram information input to the electrocardiograph 800 is input to the arithmetic processing unit 75 via the electrocardiogram input connector 77 .
  • the electrocardiographic information (12-lead electrocardiogram) measured by the electrocardiographic measuring means 900 is also input to the electrocardiograph 800, and the electrocardiographic information obtained by the electrocardiographic measuring means 900 is also input to the electrocardiogram input connector.
  • 77 to the arithmetic processing unit 75 .
  • the IMP measurement circuit 752 and the internal resistance 753 are connected via the switching unit 754. At this stage, the IMP measurement circuit 752 measures the resistance value of the internal resistance 753. can be tested to see if it matches a known resistance value.
  • the electrocardiographic information from the constituent electrodes of the first DC electrode group 31G and the second DC electrode group 32G of the defibrillation catheter 100 cannot be input to the electrocardiograph 800 (therefore, this electrocardiographic information cannot be sent to the arithmetic processing unit 75). cannot be sent). However, electrocardiographic information from the constituent electrodes of the proximal side potential measuring electrode group 33 ⁇ /b>G that does not pass through the first ON/OFF switch 761 is input to the electrocardiograph 800 .
  • the influence (error ) can be eliminated.
  • the application of DC voltage (defibrillation) is not performed, so that the occurrence of tissue damage due to disconnection of the lead wire can be reliably avoided. can be done.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Plasma & Fusion (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Cardiology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Electrotherapy Devices (AREA)

Abstract

La présente invention vise à proposer un système de cathéter qui est capable de détecter rapidement et avec précision une déconnexion d'un fil de dérivation d'une électrode qui constitue un cathéter de défibrillation. La présente invention concerne un système de cathéter qui comprend un cathéter de défibrillation (100) et un dispositif de source d'alimentation (700), dans lequel le cathéter de défibrillation comprend un premier groupe d'électrodes à courant continu (31G) constitué d'une pluralité de premières électrodes (31) et un second groupe d'électrodes à courant continu (32G) constitué d'une pluralité de secondes électrodes (32) ; le dispositif de source d'alimentation comprend une unité d'alimentation en courant continu (71) et une unité de traitement de calcul (75) ; l'unité de traitement de calcul comprend un circuit de sortie (751) pour une tension continue et un circuit de mesure d'IMP (752) pour mesurer l'IMP entre des groupes d'électrodes ou l'IMP entre des électrodes ; et l'unité de traitement de calcul commande le circuit de mesure d'IMP de façon à effectuer, sur l'ensemble des premières électrodes et des secondes électrodes, la mesure d'IMP entre une première électrode et une seconde électrode avant que la défibrillation ne soit effectuée.
PCT/JP2021/030896 2021-08-24 2021-08-24 Système de cathéter WO2023026346A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP2023543508A JPWO2023026346A1 (fr) 2021-08-24 2021-08-24
PCT/JP2021/030896 WO2023026346A1 (fr) 2021-08-24 2021-08-24 Système de cathéter

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2021/030896 WO2023026346A1 (fr) 2021-08-24 2021-08-24 Système de cathéter

Publications (1)

Publication Number Publication Date
WO2023026346A1 true WO2023026346A1 (fr) 2023-03-02

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PCT/JP2021/030896 WO2023026346A1 (fr) 2021-08-24 2021-08-24 Système de cathéter

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WO (1) WO2023026346A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004065529A (ja) * 2002-08-06 2004-03-04 Takayuki Sato 血圧制御装置
JP2019080792A (ja) * 2017-10-31 2019-05-30 日本ライフライン株式会社 筋電位信号判定装置、除細動システムおよびアブレーションシステム
WO2019200127A1 (fr) * 2018-04-11 2019-10-17 Eximis Surgical Inc. Dispositif, système et procédé de retrait d'échantillon tissulaire
WO2020136798A1 (fr) * 2018-12-27 2020-07-02 日本ライフライン株式会社 Système de cathéter de défibrillation intracardiaque

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004065529A (ja) * 2002-08-06 2004-03-04 Takayuki Sato 血圧制御装置
JP2019080792A (ja) * 2017-10-31 2019-05-30 日本ライフライン株式会社 筋電位信号判定装置、除細動システムおよびアブレーションシステム
WO2019200127A1 (fr) * 2018-04-11 2019-10-17 Eximis Surgical Inc. Dispositif, système et procédé de retrait d'échantillon tissulaire
WO2020136798A1 (fr) * 2018-12-27 2020-07-02 日本ライフライン株式会社 Système de cathéter de défibrillation intracardiaque

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