JP4943343B2 - 皮下電極挿入装置および方法 - Google Patents
皮下電極挿入装置および方法 Download PDFInfo
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- JP4943343B2 JP4943343B2 JP2007544346A JP2007544346A JP4943343B2 JP 4943343 B2 JP4943343 B2 JP 4943343B2 JP 2007544346 A JP2007544346 A JP 2007544346A JP 2007544346 A JP2007544346 A JP 2007544346A JP 4943343 B2 JP4943343 B2 JP 4943343B2
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- shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
- A61M25/0668—Guide tubes splittable, tear apart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
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- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
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- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Cardiology (AREA)
- Radiology & Medical Imaging (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Pulmonology (AREA)
- Vascular Medicine (AREA)
- Biophysics (AREA)
- Electrotherapy Devices (AREA)
- Surgical Instruments (AREA)
- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
Description
どの解剖学的構造の選択した部分の形状にユーザがシャフトを適応させることができるように形成可能である。
本明細書で使用される「リード」および「リード電極アセンブリ」という用語は、別個の意味を持っており、リード電極アセンブリはリードと電極とが互いに結合されたものであることに留意すべきである。バーディー(Bardy)らの米国特許出願第09/940,377号明細書を引用によって本明細書に援用する。バーディーらは、皮下キャニスタおよび1つ以上の電極を含む除細動装置の挿入のためのいくつかの方法を提案し、皮下除細動装置および方法の追加の詳細を説明している。
必須ではない。屈曲用具100は、挿入用具20,40の形状を調節するのに使用することができるが、これも必須ではない。これらの要素の各々の特性を以下に説明する。
ャフト42に固定することができる。この結合の機械強度を向上させる1つの方法は、ハンドル46の下のシャフト42にオフセット屈曲部56を含めることである。
支柱102は間隙104によって分離されている。図2A〜2Bまたは3A〜3Bに示す挿入用具20,40のシャフトなどの装置を屈曲させるため、選択した装置のシャフトは間隙104を通され、屈曲用具100に対して曲げられて、支柱102には装置が異なる湾曲を有するように再成形することが可能となる。これは、選択した挿入用具をより正確に患者の解剖学的構造に一致させるように行われてよい。支柱102は、間隙104を通じる装置シャフトを保持し、滑り出るのを防ぐように、キャップ、切欠き、溝、フック、オーバーハングなどを含めることによって、変更され得る。
第1の切開部206および第2の切開部208を形成した後の第1のステップを示す。なお、患者200の皮下領域内には嚢207が画定されている。嚢207は、第2の切開部を通じてトロカールを挿入し、トロカールで組織層を分離して皮下嚢207を画定することによって、または移植可能な装置を受けるために手動で鈍的切開を行うことによって形成されてよい。挿入用具210(その上に分割可能なシース218を備えるように示す)は、第1の開口部206を通して挿入されるところである。図11Bに示すように、挿入用具210は第1の開口部206から第2の開口部に向かい、第2の開口部を通して進行されて、途中、皮下組織を通じて経路を形成する。第2の切開部208を通じる先端212の進行を示すが、この範囲の挿入は必須ではない。挿入用具210が、取付機構にアクセスするため切開部208の外側から挿入用具210の先端212までのアクセスを提供するのに充分なだけ遠くへ進行されれば充分である。例示的な目的では、図11Bに示す取付機構は縫合糸孔216を含むように示す。このような挿入および経路形成中、リドカインなどの局部麻酔薬を、ルアー・ハブ214を通した注入および挿入用具210の管腔を通した通過によって供給することができる。
そのように画定された経路の両端部を厳密に制御することができる。したがって、定置の不正確性が避けられる。
ad signal sensing)の問題が生じ得る。
Claims (10)
- リード電極アセンブリを皮下挿入するための用具であって、
ハンドルと、
基端および先端を有するシャフトと、を備え、
シャフトはその基端近くでハンドルに対し固定されており、
シャフトはシャフト中に先端注入ポートまで延びる管腔を画定しており、
シャフトはリード電極アセンブリへの取付のための取付機構をその先端近くに備え、取付機構はそれを通して縫合糸を受けるようになっている縫合糸孔であり、先端注入ポートは縫合糸孔へ開口しており、
先端は組織を通じて進行するように成形されている、用具。 - シャフトはハンドルから先端に直線状である請求項1に記載の用具。
- シャフトはハンドルの先端に湾曲部を備えており、シャフトの先端の軸方向はハンドルの軸方向に対して30度〜90度のある角度をなす請求項1に記載の用具。
- 前記角度は75度である請求項3に記載の用具。
- シャフトは、その基端近くにオフセット湾曲部を有する長尺状の金属管状部材からなり、ハンドルはオフセット湾曲部の上に固定されている請求項1に記載の用具。
- 取付機構は縫合糸孔を含む請求項1に記載の用具。
- 取付機構は溝を含む請求項1に記載の用具。
- 溝はシャフトの周りに延びる外径溝である請求項7に記載の用具。
- 取付機構はフックを含む請求項1に記載の用具。
- 請求項1に記載の用具と、
長手方向分割線を有し、用具を受ける寸法の管腔を画定している分割可能なシースと、からなるリード電極アセンブリ挿入キット。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/006,291 | 2004-12-06 | ||
US11/006,291 US7655014B2 (en) | 2004-12-06 | 2004-12-06 | Apparatus and method for subcutaneous electrode insertion |
PCT/US2005/037759 WO2006062590A1 (en) | 2004-12-06 | 2005-10-19 | Apparatus and method for subcutaneous electrode insertion |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2008522655A JP2008522655A (ja) | 2008-07-03 |
JP2008522655A5 JP2008522655A5 (ja) | 2008-12-04 |
JP4943343B2 true JP4943343B2 (ja) | 2012-05-30 |
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Application Number | Title | Priority Date | Filing Date |
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JP2007544346A Expired - Fee Related JP4943343B2 (ja) | 2004-12-06 | 2005-10-19 | 皮下電極挿入装置および方法 |
Country Status (10)
Country | Link |
---|---|
US (4) | US7655014B2 (ja) |
EP (1) | EP1830918B1 (ja) |
JP (1) | JP4943343B2 (ja) |
CN (1) | CN101072601B (ja) |
AT (1) | ATE469669T1 (ja) |
AU (2) | AU2005314611B2 (ja) |
CA (1) | CA2588024C (ja) |
DE (1) | DE602005021695D1 (ja) |
ES (1) | ES2346551T3 (ja) |
WO (1) | WO2006062590A1 (ja) |
Cited By (1)
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US8801729B2 (en) | 2004-12-06 | 2014-08-12 | Cameron Health, Inc. | Apparatus and method for subcutaneous electrode insertion |
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-
2004
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2005
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- 2005-10-19 EP EP05810131A patent/EP1830918B1/en active Active
- 2005-10-19 AT AT05810131T patent/ATE469669T1/de active
- 2005-10-19 AU AU2005314611A patent/AU2005314611B2/en not_active Ceased
- 2005-10-19 ES ES05810131T patent/ES2346551T3/es active Active
- 2005-10-19 CN CN200580041756XA patent/CN101072601B/zh not_active Expired - Fee Related
- 2005-10-19 JP JP2007544346A patent/JP4943343B2/ja not_active Expired - Fee Related
- 2005-10-19 CA CA2588024A patent/CA2588024C/en active Active
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8801729B2 (en) | 2004-12-06 | 2014-08-12 | Cameron Health, Inc. | Apparatus and method for subcutaneous electrode insertion |
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EP1830918B1 (en) | 2010-06-02 |
US20120191106A1 (en) | 2012-07-26 |
AU2011202081A1 (en) | 2011-05-26 |
AU2005314611B2 (en) | 2011-02-24 |
WO2006062590A1 (en) | 2006-06-15 |
US7655014B2 (en) | 2010-02-02 |
CN101072601B (zh) | 2012-08-29 |
AU2005314611A1 (en) | 2006-06-15 |
US20100137879A1 (en) | 2010-06-03 |
EP1830918A1 (en) | 2007-09-12 |
US8157813B2 (en) | 2012-04-17 |
AU2011202081B2 (en) | 2013-04-04 |
US20060122676A1 (en) | 2006-06-08 |
CN101072601A (zh) | 2007-11-14 |
CA2588024C (en) | 2014-04-22 |
US20140324068A1 (en) | 2014-10-30 |
CA2588024A1 (en) | 2006-06-15 |
ATE469669T1 (de) | 2010-06-15 |
DE602005021695D1 (de) | 2010-07-15 |
ES2346551T3 (es) | 2010-10-18 |
JP2008522655A (ja) | 2008-07-03 |
US8801729B2 (en) | 2014-08-12 |
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