CN1147964A - Composition electrode connecting conduct - Google Patents
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- CN1147964A CN1147964A CN 95116790 CN95116790A CN1147964A CN 1147964 A CN1147964 A CN 1147964A CN 95116790 CN95116790 CN 95116790 CN 95116790 A CN95116790 A CN 95116790A CN 1147964 A CN1147964 A CN 1147964A
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Abstract
The combined high-frequency medical electrode catheter is composed of sheathing tube, branch electrode catheters on which the electrodes are inlaid and track electrode catheter, guider and conducting wires. Those branch electrode catheters and track electrode catheter are respectively inserted into the cavity of the sheathing tube, and the guider is inserted into the guiding cavity of the track electrode, and the electrodes are connected with conducting wires. Said sheathing tube has a central cavity with circular cross section in its interior, and its periphery is equipped with symmetrically-distributed branch electrode catheter cavities with oval cross-section. Said device can be introduced into cardiac chamber through femoral venous puncture, and all branch electrode catheters are fed into their correspondent positions, and one electrode is closed to the focal region to make elimination. Said device is stable in contact, safe and high in therapeutic effect.
Description
Composition electrode connecting conduct is a kind of device that utilizes frequency electromagnetic waves that the human body tachy-arrhythmia is treated, and especially integrates the high frequency medical-treatment electrode conduit of many electrode catheters and guider.
Electrode catheter is the crux parts of the RF ablation device of treatment tachy-arrhythmia, at present general electrode catheter be that major part electrode catheter and common multipolar electrode catheter [see also " ARR radio frequency ablation therapy " (national natural science fund subsidy project), yellow from new chief editor such as grade, scientific and technical literature publishing house publishes, in April, 1994 front page].Its method is when carrying out radio-frequency (RF) ablation, and the peripheral blood vessel that at first punctures under X line perspective, is inserted along lumen of vessels and to be sent many electrode catheters different position to the chambers of the heart, and so that heart is carried out electrophysiologic study, mapping lesions position (being target spot) carries out ablation again.This Therapeutic Method had both made patient avoid opening the hardship of breast, again can radical curing of disease, and do not stay any severe complication, be that a kind for the treatment of irregular heart pulse that is described as is learned the desirable therapy that goes up epoch-making progress.Its curative effect depends primarily on limitation damage to cardiac tissue kitchen range that accuracy that target spot demarcates and radio-frequency (RF) energy the caused level of coverage to target spot, and the size of damage kitchen range depends on the size of radio-frequency (RF) energy, size and the electrode slice and the endocardial exposure level of electrode slice surface area.Because existing defective is gone up in existing electrode catheter parts design, and operation and curative effect aspect are remained in following problem: the first, the fixing difficulty in electrode catheter target spot position in the chambers of the heart.In the radio-frequency ablation procedure of the right side chambers of the heart, the target spot multidigit is near tricuspid orifice, because the particularity on this position dissection and the hemodynamics, electrode and the endocardial instability that contacts are easy to dislocation, are difficult to reach expected effect.The second, the radio-frequency (RF) energy utilization rate is low.Because electrode structure makes it less with the endocardium contact surface, effective contact surface between the two is lower than 50% of electrode slice surface area, and promptly the radio-frequency (RF) energy utilization rate also is lower than 50%.Unemployed radio-frequency (RF) energy acts in the blood, makes electrode surface form blood coagulation layer and easily carbonization, and impedance is also corresponding increases, and not only can not reach the curative effect that melts, and the danger that causes ventricular fibrillation is arranged on the contrary.The 3rd, because the fixing difficulty of electrode, may dislocate and impedance is increased, the placement of electrode catheter needs carry out repeatedly under X line perspective, thereby has prolonged operating time, has increased the radiation injury of X line to patient and surgical doctor.Above defective is that surgical doctor rely on to improve subjectivity such as operating technology and makes great efforts institute and cannot or hardly overcome, and " pace-making and heart " magazine the 7th is rolled up the 2nd phase of rolling up the 2nd phase and the 8th all report to this.
The objective of the invention is to radio frequency ablation therapy for tachy-arrhythmia a kind of supporting ﹠ stablizing, safe and reliable, compound electrode fulgurite that curative effect is higher are provided.
The claimed technical scheme of the present invention is as follows:
Composition electrode connecting conduct is made of sheath pipe (1), sub-electrode conduit (2), track electrode catheter (3), guider (4) and lead (5).Be provided with a cross section and be circular central chamber (6) on the axis of sheath pipe (1), track electrode catheter (3) inserts wherein.Being provided with some cross sections at the periphery of sheath pipe (1) is oval-shaped sub-electrode catheter lumen (7), and sub-electrode conduit (2) inserts wherein.The sub-electrode catheter lumen is the center with the center of circle of sheath pipe, the symmetric periphery that is distributed in the sheath pipe.The axis of track electrode catheter (3) is provided with a cross section and is circular directed cavity (8), and guider (4) inserts wherein.Be inlaid with pellet electrode (9) and ring electrode (10) on the sub-electrode conduit (2), be inlaid with ring electrode (10) and termination electrode (11) on the track electrode catheter (3).Pellet electrode, ring electrode and termination electrode connect with corresponding lead (5) respectively, and each lead passes through catheter body and caudad extends to outside the catheter body.
(BC, C ' are D), turn section (CC ') and rear (DE) constitute by electrode section (AB), linkage section for sub-electrode conduit (2).Electrode section (AB) is positioned at extremely first, its cross section is oval, be loose fit between the sub-electrode chamber (7) in electrode section (AB) and the sheath pipe (1), rear (DE) is positioned at the end of sub-electrode conduit (2), its cross section is oval, between the sub-electrode catheter lumen (7) in rear (DE) and the sheath pipe (1) is tight fit, turn section (CC ') is positioned at two linkage section (BC, C ' D), its cross section is circular, its diameter is identical with the minor axis of electrode section cross section ellipse, turn section (CC ') is by linkage section (BC, C ' D) respectively with electrode section (AB), rear (DE) links, and two linkage sections and turn section (CC ') link the cross section at place for circular.And link the cross section at place for oval with electrode section (AB), rear (DE).Two linkage sections are that circle is connected mutually with turn section (CC ') with the cross section, and progressively to carry out the transition to cross section respectively with the form of gradual change be ellipse, be connected mutually with electrode section (AB), the rear (DE) of cross section ovalize, rear (DE) is provided with markings (12) and (13).
Below in conjunction with embodiment, and the contrast accompanying drawing, composition electrode connecting conduct is further described.
Fig. 1 is that master with 4 sub-electrode composition electrode connecting conducts looks sketch map (in 4 sub-electrodes is blocked).
Fig. 2 is the right view (the track electrode catheter that is positioned at central chamber is removed) with 4 sub-electrode composition electrode connecting conducts,
Fig. 3 is the vertical sectional structure sketch map with sheath pipe of 4 sub-electrode catheter lumen.
Fig. 4 is the horizontal sectional structure sketch map with sheath pipe of 4 sub-electrode catheter lumen.
Fig. 5 is that the master of I type sub-electrode conduit looks sketch map.
Fig. 6 is the vertical view of I type sub-electrode conduit.
Fig. 7 is that the master of II type sub-electrode conduit looks sketch map.
Fig. 8 is the vertical view of II type sub-electrode conduit.
Now the parts to the sign among above-mentioned each figure are described as follows:
1---the sheath pipe, make by polyethylene or polyurethane, length 80-100cm, overall diameter 5-8mm, cross section are circular, and sub-electrode catheter lumen (7), its oval major diameter that sheath pipe inner rim is provided with four cross section ovalizes are 2mm, and minor axis is 1.3mm.In the cross section of same vertical vertical central axis, the line in the symmetrical centre of major diameter and ellipse and the center of circle of sheath pipe is orthogonal, and the line in the symmetrical centre of two adjacent ellipses and the sheath pipe center of circle is orthogonal.Like this design constraints the sub-electrode conduit in of any rotation of sub-electrode intracavity around its vertical central axis, thereby after making each sub-electrode conduit stretch out the sheath head end, adjacent two sub-electrode conduits keep being mutually the duty (as shown in Figure 2) of 90 ° of angles.Have a cross section and be circular central chamber (6) on the axis of sheath pipe, its diameter is 2mm.
2---the sub-electrode conduit, main body is that polyethylene or polyurethane are made, it be divided into electrode section (AB), linkage section (BC, C ' D), turn section (CC ') and rear (DE), total length is than the long 5-15cm of sheath pipe (1), and electrode section (AB) can be along being moulded any radian in the angle plane of the projection line of the minor axis of its non-circular cross-section and its horizontal direction or vertical direction.Be inlaid with each one piece of pellet electrode (9) and ring electrode (10) on the electrode section (AB), pellet electrode (9) is positioned on the side of electrode section (AB), according to the position at pellet electrode (9) place, sub-electrode conduit (2) is divided into I type (seeing Fig. 5 and Fig. 6) and II type (seeing Fig. 7 and Fig. 8).With the cross section of each sub-electrode catheter insertion sheath pipe (1) respective perimeter is in the oval-shaped sub-electrode catheter lumen (7).
3---track electrode catheter, main body are that polyethylene or polyurethane are made, and length is than the long 8-15cm of sub-electrode conduit, and cross section is circular, and this electrode front portion can be moulded any radian along any direction.It is inserted in the central chamber (6) of sheath pipe (1).
4---guider, to make by rustless steel or extraordinary steel wire, tail end is circlewise tortuous, i.e. control loops (14), guider (4) inserts in the directed cavity (8) of track electrode catheter (3).Guider length (being not counted in the control loops girth) is than the long 1-4cm of directed cavity (8).
5---lead, each electrode slice all link with a lead.
6---central chamber, be positioned on the axis of sheath pipe (1), cross section is circular, track electrode catheter (3) or major part electrode catheter insert in it.
7---the sub-electrode catheter lumen, they are the center with the center of circle of sheath pipe, the symmetric periphery that is distributed in sheath pipe (1), its cross section are oval, wherein insert sub-electrode conduit (2).
8---directed cavity, the axis cross section of its axis and track electrode catheter (3) is rounded, and its front portion is a cecum, and this cecum is 0.5-1cm apart from track electrode catheter (3) top.Guider (4) inserts intracavity.
9---pellet electrode, be embedded on the side of electrode section (AB) of sub-electrode conduit (2), in endocardial mapping, each pellet electrode links by respective wire and polygraph.After mapping was finished, the one piece of pellet electrode and the radio-frequency signal generator that are positioned at the target spot place linked, and a radio-frequency (RF) energy piece pellet electrode thus is emitted to target spot.
10---ring electrode, be embedded on the electrode section (AB) of sub-electrode conduit (2), with pellet electrode (9) at a distance of 2-5mm, track electrode catheter (3) top also is inlaid with ring electrode, with termination electrode (11) at a distance of 2-5mm.Ring electrode also links by respective wire and polygraph, only participates in endocardial mapping.
11---termination electrode, be wrapped in the top of track electrode catheter (3), link by lead and polygraph, only participate in endocardial mapping.
12,13---be located at two markings on the rear (DE) of sub-electrode conduit (2).When markings (12) and sheath pipe (1) when end coincides, then the front end of the front end of sub-electrode conduit (2) and sheath pipe (1) also coincides; When markings (13) and sheath pipe (1) when end coincides, then the electrode section (AB) of sub-electrode conduit (2) all stretches out in sheath pipe (1).Head end from markings (12) to sub-electrode conduit (2) is loose fit between sub-electrode conduit (2) and the sheath pipe (1), markings (12) locate then to be the gradually changeable tight fit to markings (13).She Ji purpose is like this: the electrode section (AB) that prevents sub-electrode conduit (2) arrives at slip before and after the generation behind the predetermined position in the heart, moreover has avoided blood to leak outside along sub-electrode catheter lumen (7).
14---control loops is positioned at guider (4) end.
15---cecum, be positioned at the front portion of directed cavity (8), with the distance on the top of track electrode catheter (3) be 0.5-1cm.
Be example with the operational approach of composition electrode connecting conduct in the accessory atrioventricular pathways ablation of right side below, operation sequence of the present invention be described with 4 sub-electrode conduits:
One, sub-electrode conduit and track electrode catheter or major part electrode catheter are inserted respectively in the corresponding chamber of sheath pipe, the markings (12) on each sub-electrode rear are overlapped with the sheath pipe is terminal, promptly each sub-electrode front end is concordant with sheath pipe front end; Track electrode head end is also held level with both hands with the sheath tube head together.At this moment, this device main body outward appearance is cylindric, is convenient to move in the blood vessel and the chambers of the heart.
Two, after the success of puncture femoral vein, composition electrode connecting conduct is inserted femoral vein, and it is advanced along blood vessel, make its front end enter right atrium.At this moment, guider is inserted in the directed cavity of track electrode catheter, hand-held sheath pipe, preceding guider and the track electrode catheter of pushing away makes the track electrode catheter stride across tricuspid orifice, arrives at the endocardium of right ventricle.
Three, hand-held sheath pipe, preceding each sub-electrode conduit that pushes away, make they separately the markings (13) on the rear overlap with sheath pipe end, promptly the electrode section of each electrode catheter (AB) all stretches out the sheath pipe and enters right atrium.Hand-held track electrode catheter pushes away sheath pipe and each sub-electrode conduit before the track electrode catheter, and makes (AB) section of each electrode arrive near the endocardium of tricuspid orifice.Operational approach during more than for use I type sub-electrode conduit in step 3.If use II type sub-electrode conduit, then hand-held track electrode catheter pushes away sheath pipe and sub-electrode conduit before the track electrode catheter, make them stride across tricuspid orifice and arrive in the right ventricle.At this moment, hand-held sheath pipe, preceding each sub-electrode conduit that pushes away makes each electrode catheter all stretch out the sheath pipe and enters right ventricle.Then, hand-held track electrode catheter is dropped back sheath pipe and each sub-electrode conduit together along the track electrode catheter, and near the endocardium of each electrode catheter and tricuspid orifice is pasted mutually.
Four, handle guider, and move the sub-electrode conduit, make each electrode section be in tricuspid orifice along the sub-electrode catheter lumen.Thereby the wherein one piece of pellet electrode on 4 electrodes (AB) section is pasted mutually with lesions position (being target spot), lead and polygraph with this pellet electrode disconnects then, and be connected with radio-frequency signal generator, radio-frequency (RF) energy to the target spot by this pellet electrode granting melts immediately.
Five, after melting successfully, in each sub-electrode conduit and track electrode catheter income sheath pipe, withdraw from external.
In sum, owing to be subjected to being in the sheath pipe strangulation in oval cross section and sub-electrode chamber, after the electrode section of each sub-electrode conduit stretches out sheath tube head end, keep being mutually certain angle and stretch out and can not draw close mutually, each electrode section (AB) can support after arriving at endocardium mutually.Be not subject to the ballistic influence of heartbeat and blood flow and dislocate, thereby stably be supported in tricuspid orifice.Because pellet electrode is positioned at a side of electrode section, electrode is closely contacted with endocardium, effectively contact surface is near the electrode slice surface area, therefore the radio-frequency (RF) energy utilization rate greatly improves, make the radio-frequency (RF) energy that runs off in blood reduce to bottom line, reduced to cause the danger of ventricular fibrillation, improved the safety of operation because of the carbonization of electrode surface blood coagulation layer.Because the composition electrode connecting conduct supporting ﹠ stablizing, shortened operating time, from and reduced the radiation injury of X line to patient and surgical doctor.In addition, the sub-electrode number of composition electrode connecting conduct should be between 2-6 props up, and institute's loading electrode sheet is also unsuitable many on the electrode section, so that reduce total external diameter of composition electrode connecting conduct, alleviates peripheral vascular damage.
Claims (8)
1, a kind of composition electrode connecting conduct comprises plastic catheter, electrode, it is characterized in that:
A. composition electrode connecting conduct is made of the sheath pipe (1) that contains central chamber and sub-electrode catheter lumen, the sub-electrode conduit (2) that is inlaid with electrode slice, the track electrode catheter (3) that contains directed cavity, guider (4) and lead (5),
B. track electrode catheter (3) and sub-electrode conduit (2) insert respectively in the central chamber (6) and sub-electrode catheter lumen (7) of sheath pipe (1), guider (4) inserts in the directed cavity (8) of track electrode, directed cavity is positioned at the center of track electrode catheter, the electrode section (AB) of sub-electrode conduit (2) and the head of track electrode catheter (3) are inlaid with electrode slice respectively, and electrode slice links with corresponding lead.
2, composition electrode connecting conduct according to claim 1 is characterized in that; Be provided with a central chamber (6) and 2-6 sub-electrode catheter lumen (7) in the sheath pipe (1), the cross section of central chamber (6) is rounded, the cross section ovalize of sub-electrode catheter lumen (7), and they are the center with the center of circle of sheath pipe, the symmetric periphery that is distributed in the sheath pipe,
3, according to right 1 described composition electrode connecting conduct, it is characterized in that: sub-electrode conduit (2) is by electrode section (AB), linkage section (BC, C ' D), turn section (CC ') and rear (DE) constitute, electrode section (AB) is positioned at the head of sub-electrode conduit (2), its cross section is oval, cross section in electrode section (AB) and the sheath pipe (1) is to be loose fit between the oval-shaped sub-electrode catheter lumen (7), rear (DE) is positioned at sub-electrode conduit (2) afterbody, its cross section is oval, cross section in rear (DE) and the sheath pipe (1) is to be tight fit between the oval-shaped sub-electrode catheter lumen (7), turn section (CC ') is positioned at linkage section (BC, C ' D) between, its cross section is circular, it is measure-alike that the cross section of its diameter dimension and electrode section (AB) is oval minor axis, turn section (CC ') is by linkage section (BC, C ' D) respectively with electrode section (AB), rear (DE) links, it is transversal for circular that two linkage sections and turn section (CC ') link and locate, and progressively to carry out the transition to cross section with the form of gradual change be ellipse, with electrode section (AB), rear (DE) links, and rear (DE) is provided with markings (12) and (13).
4, composition electrode connecting conduct according to claim 1, it is one that the central axis that it is characterized in that sheath pipe (1), central chamber (6), directed cavity (8) and guider (4) four coincides.
5, composition electrode connecting conduct according to claim 1, the length that it is characterized in that sheath pipe (1) is 80-100cm, overall diameter is 5-8mm, cross section is circular, the length of sub-electrode conduit (2) than the length of the long 5-15cm of sheath pipe (1), track electrode catheter (3) than the long 8-15cm of sub-electrode conduit (2).
6, composition electrode connecting conduct according to claim 1, it is characterized in that the tortuous control loops (14) circlewise of guider (4) tail end, under the situation that is not counted in the control loops girth, the length of guider self is than the long 1-4cm of directed cavity (8), the front portion of directed cavity (8) is provided with cecum (15), and the distance on the top of cecum and track electrode catheter (3) is 0.5-1cm.
7, composition electrode connecting conduct according to claim 1, it is characterized in that on the electrode section (AB) of sub-electrode conduit (2), being inlaid with pellet electrode (9) and ring electrode (10), apart from 2-5mm, the top of track electrode catheter (3) is inlaid with ring electrode (10) and termination electrode (11) between the two.
8, composition electrode connecting conduct according to claim 1 each pellet electrode (9), each ring electrode (10) and the termination electrode (11) that it is characterized in that being embedded on sub-electrode conduit (2) and the track electrode catheter (3) links with lead (5) respectively.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 95116790 CN1147964A (en) | 1995-10-17 | 1995-10-17 | Composition electrode connecting conduct |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 95116790 CN1147964A (en) | 1995-10-17 | 1995-10-17 | Composition electrode connecting conduct |
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| Publication Number | Publication Date |
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| CN1147964A true CN1147964A (en) | 1997-04-23 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 95116790 Pending CN1147964A (en) | 1995-10-17 | 1995-10-17 | Composition electrode connecting conduct |
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