CN201223445Y - Radio frequency ablation catheter - Google Patents
Radio frequency ablation catheter Download PDFInfo
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- CN201223445Y CN201223445Y CNU2008201087820U CN200820108782U CN201223445Y CN 201223445 Y CN201223445 Y CN 201223445Y CN U2008201087820 U CNU2008201087820 U CN U2008201087820U CN 200820108782 U CN200820108782 U CN 200820108782U CN 201223445 Y CN201223445 Y CN 201223445Y
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Abstract
The utility model relates to a radiofrequency ablation catheter, which belongs to a medical appliance. The radiofrequency ablation catheter mainly comprises an ablation umbrella at the top end of the radiofrequency ablation catheter, and a delivery catheter at the somatic part, wherein the ablation umbrella at the top end presents a conical double-umbrella with the same bottom, and comprises a front end umbrella net, a rear end umbrella net, a guide head, a radio-frequency discharge planar girdle, thermocouples and a fixed connecting piece, wherein the radio-frequency discharge planar girdle is arranged at the juncture between the front end umbrella net and the rear end umbrella net, the thermocouples are symmetrically installed on the surface of the radio-frequency discharge planar girdle, and the fixing and connecting piece is installed at the end part of the rear end umbrella net; the delivery catheter mainly comprises a medium tube, a sheath tube, a connecting piece, a steel wire for controlling the curved top end of the catheter, a handle, a sliding bar and an electrode plate socket, wherein the medium tube can slide relative to the sheath tube; and the ablation umbrella at the top end is fixed with the delivery catheter through a fastening part. The utility model has the advantages of reasonable structure, secure use, convenient operation and wide application range.
Description
Technical field
This utility model relates to a kind of novel basket shape atrial fibrillation radio-frequency (RF) ablation conduit, belongs to a kind of interventional medical device.
Background technology
Atrial fibrillation is called for short atrial fibrillation, is one of common arrhythmia in clinic.About 0.77%, but along with the age increases, the atrial fibrillation sickness rate increases gradually at general crowd's total prevalence rate, and the sickness rate of old people's atrial fibrillation of over-65s reaches 5%, and the crowd can reach 10% more than 75 years old.The present patients with atrial fibrillation of China is near 1,000 ten thousand according to estimates, and this shows that atrial fibrillation has become a kind of " epidemic diseases " in China.
The hazardness of atrial fibrillation is very big, and the main harm of atrial fibrillation has: apoplexy and bring out heart failure.Studies show that: pulmonary vein and pulmonary vein vestibular portion are the key positions that atrial fibrillation takes place and keeps, and ring pulmonary vein linear ablation is the foundation stone of atrial fibrillation ablation.If can thorough electric isolation of pulmonary veins, the conductivity between blocking-up left atrium and the pulmonary vein then can be cured the patients with atrial fibrillation more than 90%.In recent years, the basis of atrial fibrillation and clinical research confirmation pulmonary vein vestibular portion be important atrial fibrillation starting and keep the position after, different energy sources such as radio frequency, freezing and microwave occurred the pulmonary vein vestibular portion carried out the technology of ablative surgery, purpose is to effect a radical cure atrial fibrillation.Wherein ripe with radio-frequency ablation technique.
Radio-frequency ablation procedure is to grow up the late nineteen eighties, in the operation, conduit is inserted into heart inside from patient's blood vessel, through electrophysiologic study, behind the target area, mapping location, pass to the radio-frequency current of certain energy, certain time, make target area pathological tissues heat production, coagulation necrosis, reach and melt focus, cure ARR purpose.This operation has not open breast, danger is little, recovery is fast, the painless advantage of waiting bitterly for of patient.In America and Europe's large-scale therapeutic community, radio-frequency catheter ablation has become the common method of atrial fibrillation therapy at present, and success rate reaches 80-90%.But there is following shortcoming in Gong Ying ablation catheter in the market: the annular electro isolation of pulmonary veins is to utilize shaft-like radiofrequency catheter to cut open under mapping instructs in three-dimensional electrolysis at present, piecemeally melts formation, as the perforation of playing stamp.Operating time is long, the process complexity, and potential risk increases.An operating time needs 3～5 hours, X line exposure time 30～60 minutes usually.Present used ablation catheter and material are import, cost an arm and a leg.Every conduit price is about 30,000, and an atrial fibrillation ablative surgery expense is about 6～80,000, and general patient is difficult to bear.Complicated operation, expensive instrument and conduit, expensive costs constraints atrial fibrillation melt carrying out at home.
Summary of the invention
The purpose of this utility model provides a kind of novel radio-frequency (RF) ablation conduit, and the pulmonary vein vestibular portion is carried out circumferential ablation, thorough electric isolation of pulmonary veins, the conductivity between blocking-up left atrium and the pulmonary vein.
For achieving the above object, the treatment atrial fibrillation of the present invention design mainly melts umbrella and delivery conduit two parts are formed by vertical with the radio-frequency (RF) ablation conduit, the top is melted umbrella shape and is the conical two umbrellas with the bottom, mainly comprise front end umbrella net, rear end umbrella net, seeker, radio-frequency discharge plane endless belt, thermocouple, fixed connecting piece, front end umbrella net and rear end umbrella net are formed by the memory alloy wire braiding, its surface-coated insulating barrier, the seeker that is used for the closing in of front end umbrella net is fixed in the top of front end umbrella net, intersection outward flange at front end umbrella net and rear end umbrella net has radio-frequency discharge plane endless belt, radio-frequency discharge plane endless belt is equipped with thermocouple for exposed metal gauze at radio-frequency discharge planar rings belt surface; The end of rear end umbrella net is equipped with fixed connecting piece, fixed connecting piece comprises dead ring and porous casing, thermocouple, memory alloy wire import delivery conduit by thermocouple lead, radio frequency seal wire lead-in wire by porous casing, and the top is melted umbrella and fixed by securing member and delivery conduit; Delivery conduit mainly comprises middle pipe, epitheca pipe, connector, the steel wire of control catheter tip bending, handle, slide bar, battery lead plate socket, the epitheca pipe box is in middle pipe outside, middle pipe can slide with respect to the epitheca pipe, the top is melted umbrella and is fixed in middle pipe front end by securing member, pipe front end inboard during porous casing is fixed in, in the pipe, it was connected with the battery lead plate socket by handle during thermocouple lead, radio frequency seal wire lead-in wire were penetrated by porous casing; The end of epitheca pipe is fixed with the hands handle by clamp nut; Middle pipe end is with slide bar, slide bar is equipped with handle outward, spacer pin is installed on the handle, correspondence has stopper slot on slide bar, and spacer pin and stopper slot cooperatively interact, and has stretch bending fixation with steel wire pin in handle end, the stretch bending steel wire is offset in the middle pipe, the front end of pipe during the one end is fixed in, the other end is connected with stretch bending fixation with steel wire pin, and the battery lead plate socket is positioned at handle end.
The umbrella that melts of described radio-frequency (RF) ablation conduit is formed by the braiding of Ultimum Ti silk.
The radical of described Ultimum Ti silk is in 16-32 root scope, and the silk footpath is 0.13-0.2mm.
The described umbrella umbrella cover maximum gauge that melts is in the 20-30mm scope, and the width of discharge plane endless belt is in the 2-3mm scope.
Melting the material that umbrella is coated with insulating layer coating part is polyurethane, polyethylene, politef, xylylene po1ymer (Pa rylene) or bioceramic, and repaste prevents thrombosis with the heparin layer insulating barrier outside.
Melt porous casing welding in umbrella rear end umbrella net afterbody and the securing member, draw 1-4 root radio frequency seal wire lead-in wire, the seal wire diameter is 0.1-0.16mm, and radio frequency seal wire lead-in wire front end is connected with memory alloy wire, and radio frequency seal wire lead-in wire rear end links to each other with electrode socket.
Constituting the porous casing of securing member and the material of dead ring is rustless steel or titanium or titanium alloy.
Uniform distribution is provided with 1-4 thermocouple on the radio-frequency discharge plane endless belt of umbrella melting.
The middle pipe of delivery conduit and epitheca be effective to have that elasticity, hardness and rigidity nylon and politef are made preferably.
This utility model is when using, and the electrode socket of the rear end of treatment radio-frequency (RF) ablation conduit is connected with external control instrument.Its operation is identical with the ablation catheter of using at present, sends into process by external control instrument control ablation catheter.Wherein melt umbrella with thermocouple be used for perception and measure tissue temperature when melting, the power of regulating radio-frequency discharge plane endless belt according to the Temperature Feedback control instrument discharges.It is softer yielding about 10 ℃ to melt umbrella, can be positioned over the front end of epitheca pipe very freely by relatively moving of pipe in the control, melting umbrella is imported in the body by delivery conduit, enter the back and control its off-position by steel wire, under human body temperature, revert to umbrella, make the planar annular position be close to the pulmonary vein vestibule, circumferential ablation is carried out to the pulmonary vein vestibular portion in the energising back.
This method can be simplified the ablative surgery process, shortens to melt the time, and melting 1-2 time just can complete isolation of pulmonary veins current potential.Method is simple, practical, can reduce operation risk, improves curative effect.
Advantage of the present utility model:
1, the double cone shape of radio-frequency (RF) ablation catheter proximal end is melted umbrella and is the basket shape, expand when front end umbrella net enters the pulmonary vein blood vessel, moulding, make the pulmonary vein opening be garden shape, be convenient to ablation catheter ring-shaped platform position and be close to the pulmonary vein vestibular portion fully, reach the circumferential ablation of pulmonary vein vestibular portion when melting, melt rapidly, accurately, can improve the effect that melts.
2, this utility model is a ring discharge, shortens greatly and melts the time, only needs 1-2 time, 1～2 minute, just can isolate a pulmonary vein current potential fully, 4 pulmonary vein melt 4 ~ 8 times, just can reach the purpose that melts, improve the success rate of operation, reduce doctor and patient and be subjected to the radiating time of x-ray.Method is simple, safety.
3, adopt ti-ni shape memory alloy to make and melt umbrella, have memory performance and elastic performance.Softer yielding below 10 ℃, can very freely in delivery conduit, become the umbrella net to the internal energy automatic expansion of body, easy to operate.
4, material that this utility model adopts is relatively cheap, simplifies the ablative surgery process simultaneously again greatly, reduces surgery cost, and therefore the operation subject range also will relax.Make more common patients with atrial fibrillation obtain this treatment.
Description of drawings
Fig. 1 is the frequency ablation catheter structural representation in this utility model room.
Fig. 2 melts the umbrella enlarged drawing.
Fig. 3 is the side diagrammatic sketch of Fig. 2.
Fig. 4 melts umbrella afterbody closing in place internal anatomy.
Fig. 5 is the sketch map that melts in the umbrella net income epitheca pipe.
Fig. 6 is the use sketch map of radio-frequency (RF) ablation catheter ablation pulmonary vein vestibular portion of the present utility model.
Fig. 7 is the guiding-tube bend sketch map.
Specific embodiment
In conjunction with specific embodiments the structure and the occupation mode of the designed atrial fibrillation radio-frequency (RF) ablation conduit of this utility model is described further with reference to the accompanying drawings below.
Atrial fibrillation radio-frequency (RF) ablation conduit shown in Fig. 1,2,3,4, mainly melt umbrella and delivery conduit two parts are formed by vertical, the top is melted umbrella shape and is the conical two umbrellas with the bottom, mainly comprise seeker 1, front end umbrella net 2, rear end umbrella net 3, radio-frequency discharge plane endless belt 19, thermocouple 14, fixed connecting piece, front end umbrella net 2 and rear end umbrella net 3 directly are that the braiding of 0.13mm Ultimum Ti silk forms by 16 rhizoids, its surface-coated polyurethane insulating barrier, repaste covers the heparin layer.The seeker 1 that is used for 2 closing ins of front end umbrella net is fixed in the top of front end umbrella net 2, intersection maximum gauge at front end umbrella net 2 and rear end umbrella net 3 is 20mm, it keeps to the side and has the wide radio-frequency discharge plane endless belt 19 of 2mm, radio-frequency discharge plane endless belt 19 is exposed metal gauze, be symmetrically installed with four thermocouples 14 on endless belt 19 surfaces, radio-frequency discharge plane, correspondence is drawn four thermocouple leads 20, the end of rear end umbrella net 3 is equipped with fixed connecting piece, fixed connecting piece is made by titanium alloy material, comprises dead ring 15 and porous casing 18.16 memory alloy wires and a radio frequency seal wire go between and 16 fixedly connected, and thermocouple lead 20, radio frequency seal wire lead-in wire 16 import delivery conduits by porous casing 18, and it is fixing with the middle pipe 4 of delivery conduit by dead ring 15 that umbrella is melted on the top, as shown in Figure 2; Pipe 4, epitheca pipe 5, connector, the steel wire 17 of control catheter tip bending, handle 7,10, slide bar 9, battery lead plate socket 13 during delivery conduit mainly comprises, in pipe 4 and epitheca pipe 5 make by nylon material, the outside of pipe 4 during epitheca pipe 5 is placed in, middle pipe 4 can slide with respect to epitheca pipe 5; Pipe 4 front end inboards during porous casing 18 is fixed in, thermocouple lead 20, during penetrating by porous casing 18, radio frequency seal wire lead-in wire 16 manages in 4, be connected with battery lead plate socket 13 by handle 10, the end of epitheca pipe 5 is fixed with handle 7 by clamp nut 6, middle pipe 4 ends are with slide bar 9, the slide bar 9 outer handles 10 that are equipped with, spacer pin 11 is installed on the handle 10, correspondence has stopper slot 21 on slide bar 9, spacer pin 11 cooperatively interacts with stopper slot 21, has stretch bending fixation with steel wire pin 12 at handle 10 ends, and stretch bending steel wire 17 is arranged in pipe 4, the front end of pipe 4 during one end of steel wire 17 is offset to, the other end is connected with stretch bending fixation with steel wire pin 12.The operation principle of steel wire 17 is: steel wire 17 is positioned at porous casing 18 1 eccentric orfices, and in the pipe 4, during pull steel wire 17, middle pipe 4 drove and melts umbrella to one-sided bending during invar silk 17 was offset to; When pushing steel wire 17, middle pipe 4 drives are melted umbrella and are stretched to opposite direction.Electrode socket 13 is installed in handle 10 tail ends, is connected with control instrument by connecting line.
Its operating procedure is as follows during use:
1, the clamp nut 8 of radio-frequency (RF) ablation conduit is tightened, pipe 4, slide bar 9, handle 10 are integral in making, and pull back by handle 10, will melt in the umbrella income epitheca pipe 5, as shown in Figure 5;
2, the radio-frequency (RF) ablation conduit is sent into pulmonary vein, when the radio-frequency (RF) ablation conduit when the patient vessel delivers to the heart change position, unclamp clamp nut 8, promoting slide bar 9 moves forward, when slide bar 9 reaches, steel wire 17 works, and catheter head bends, be convenient to insert target site, sliding distance is by 11 controls of slide bar spacer pin.Tighten clamp nut 7, epitheca pipe 5 and middle pipe 4 are integral, be convenient to ablation catheter is sent in the left atrium, perspective is sent front end into pulmonary vein down, unclamps clamp nut 7, and the epitheca pipe 5 of drawing back makes and melts umbrella automatic expansion under body temperature and become umbrella netted, sees Fig. 7; Meanwhile the front end tapering is aimed at pulmonary vein and is expanded into regular circular, and pulmonary vein vestibular portion 22 places then are close at the position, plane, as Fig. 6.
3, discharge radio-frequency (RF) energy by the external control instrument and melt the pulmonary vein vestibular portion, melt 1 ~ 2 time, 1～2 minute, just can isolate a pulmonary vein current potential fully, 4 pulmonary vein melt 4 ~ 8 times.
5, in therapeutic process, the tissue temperature that thermocouple 14 is measured when melting, the power of regulating the external control instrument according to Temperature Feedback discharges.
6, after treatment finishes, tighten clamp nut 8, the relative motion by handle 7,10 makes and melts in the umbrella income epitheca pipe 5, then ablation catheter is withdrawn from external.
7, whether thoroughly can observe the isolation of pulmonary veins current potential after melting.If any leak source, can mend a little again by above-mentioned steps and melt.
Can find out by said process, the umbrella that melts of radio-frequency (RF) ablation catheter proximal end is the basket shape, make when front end umbrella net enters the pulmonary vein blood vessel tapered, and the pulmonary vein opening is garden shape, the very convenient ablation catheter ring-shaped platform position that makes is close to pulmonary vein vestibular portion 22 fully, reach when melting and melt rapidly, accurately, can improve the effect that melts.
Present embodiment is rational in infrastructure, and cost is low, but wide popularization and application.
Embodiment 2
In the radio-frequency (RF) ablation conduit shown in the embodiment 1, vertical front end umbrella net 2 and the rear end umbrella net 3 that melts umbrella can directly be that the braiding of 0.2mm Ultimum Ti silk forms by 32 rhizoids also, and its surface can apply the bioceramic insulating barrier, and repaste covers the heparin layer.Intersection maximum gauge at front end umbrella net 2 and rear end umbrella net 3 can be 30mm, and it keeps to the side and has the wide radio-frequency discharge plane endless belt 19 of 3mm, on endless belt 19 surfaces, radio-frequency discharge plane a thermocouple 14 is installed, and correspondence is drawn a thermocouple lead 20; 32 Ultimum Ti silks are equally divided into four groups, are connected with four radio frequency seal wire lead-in wires 16 respectively.The end fixed connecting piece of rear end umbrella net 3 is made by Titanium, comprises dead ring 15 and porous casing 18, and thermocouple lead 20, radio frequency seal wire lead-in wire 16 imports delivery conduits by porous casing 18, and the top is melted umbrella and fixed by dead ring 15 and delivery conduit; Epitheca pipe 5 during delivery conduit mainly comprises is made by polytetrafluoroethylmaterial material.
Other structures of present embodiment are identical with embodiment 1, and above-mentioned difference is only arranged, and have with embodiment 1 just as advantage and using method.
Claims (9)
1, a kind of radio-frequency (RF) ablation conduit, it is characterized in that: mainly melt umbrella and delivery conduit two parts are formed by vertical, the top is melted umbrella shape and is the conical two umbrellas with the bottom, mainly comprise front end umbrella net, rear end umbrella net, seeker, radio-frequency discharge plane endless belt, thermocouple, fixed connecting piece, front end umbrella net and rear end umbrella net are formed by the memory alloy wire braiding, its surface-coated insulating barrier, the seeker that is used for the closing in of front end umbrella net is fixed in the top of front end umbrella net, intersection outward flange at front end umbrella net and rear end umbrella net has radio-frequency discharge plane endless belt, radio-frequency discharge plane endless belt is exposed metal gauze, be symmetrically installed with thermocouple at radio-frequency discharge planar rings belt surface, the end of rear end umbrella net is equipped with fixed connecting piece, fixed connecting piece comprises securing member and porous casing, thermocouple, memory alloy wire passes through thermocouple lead, radio frequency seal wire lead-in wire imports delivery conduit by porous casing, and the top is melted umbrella and fixed by securing member and delivery conduit; Delivery conduit mainly comprises middle pipe, epitheca pipe, connector, the steel wire of control catheter tip bending, handle, slide bar, battery lead plate socket, and the epitheca pipe box is in middle pipe outside, and middle pipe can slide with respect to the epitheca pipe; The top is melted umbrella and is fixed in middle pipe front end by securing member, pipe front end inboard during porous casing is fixed in, thermocouple lead, radio frequency seal wire lead-in wire is penetrated in the middle pipe by porous casing, be connected with the battery lead plate socket by handle, the end of epitheca pipe is fixed with handle by clamp nut, middle pipe end is with slide bar, slide bar is equipped with handle outward, and spacer pin is installed on the handle, and correspondence has stopper slot on slide bar, spacer pin and stopper slot cooperatively interact, have stretch bending fixation with steel wire pin in handle end, in the pipe, the one end was fixed in the front end of middle pipe during the stretch bending steel wire was offset to, the other end is connected with stretch bending fixation with steel wire pin, and the battery lead plate socket is positioned at handle end.
2, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: melt umbrella and formed by the braiding of Ultimum Ti silk.
3, radio-frequency (RF) ablation conduit according to claim 2, its feature also is: the radical of Ultimum Ti silk is in 16-32 root scope, and the silk footpath is 0.13-0.2mm.
4, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: the described umbrella umbrella cover maximum gauge that melts is in the 20-30mm scope, and the width of discharge plane endless belt is in the 2-3mm scope.
5, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: melting the material that umbrella is coated with insulating layer coating part is polyurethane, polyethylene, politef, xylylene po1ymer or bioceramic, repaste is with the heparin layer outside insulating barrier.
6, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: melt porous casing welding in umbrella rear end umbrella net afterbody and the securing member, draw 1-4 root radio frequency seal wire lead-in wire, the seal wire diameter is 0.1-0.16mm, radio frequency seal wire lead-in wire front end is connected with memory alloy wire, and radio frequency seal wire lead-in wire rear end links to each other with electrode socket.
7, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: constituting the porous casing of securing member and the material of dead ring is rustless steel or titanium or titanium alloy.
8, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: uniform distribution is provided with 1-4 thermocouple on the radio-frequency discharge plane endless belt of umbrella melting.
9, radio-frequency (RF) ablation conduit according to claim 1, its feature also is: the middle pipe and the epitheca pipe of delivery conduit are made by nylon or politef.
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| CNU2008201087820U CN201223445Y (en) | 2008-06-23 | 2008-06-23 | Radio frequency ablation catheter |
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| CNU2008201087820U CN201223445Y (en) | 2008-06-23 | 2008-06-23 | Radio frequency ablation catheter |
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