JP5490235B2 - マップ及び切除のための開放洗浄ハイブリッドカテーテル - Google Patents
マップ及び切除のための開放洗浄ハイブリッドカテーテル Download PDFInfo
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Description
〔1〕マッピング機能及び切除機能を実行するための開放洗浄カテーテルシステムであって、 先端部分内に開放内部領域を形成する外壁を有する先端部分であって、該外壁が、マッピング電極開口部と洗浄ポートとを含み、該外壁が、RF切除手順のための無線周波数(RF)エネルギを送出するために導電性であり、該洗浄ポートが、流体が該開放内部領域から該洗浄ポートを通って流れることを可能にするために該開放内部領域と流体連通している上記先端部分と、
上記開放領域を遠位流体リザーバと近位流体リザーバに分離するために上記先端部分に位置決めされた遠位インサートと、
上記先端部分の上記マッピング電極開口部に位置決めされたマッピング電極と、を含むことを特徴とするシステム。
〔3〕熱電対を更に含み、
上記遠位インサートは、上記遠位流体リザーバから上記近位流体リザーバまで延びる熱電対開口部を形成し、該熱電対開口部は、該熱電対を受け入れるように構成される、
ことを特徴とする上記〔1〕に記載のシステム。
〔4〕上記遠位インサートは、上記遠位流体リザーバから上記近位流体リザーバまで延びる流体導管を形成することを特徴とする上記〔1〕に記載のシステム。
〔5〕電気絶縁体で製作されたノイズアーチファクトアイソレータを更に含み、
上記マッピング電極は、上記ノイズアーチファクトアイソレータによって上記先端部分の上記外壁から電気的に隔離される、
ことを特徴とする上記〔1〕に記載のシステム。
〔7〕上記ノイズアーチファクトアイソレータは、略環状形を有することを特徴とする上記〔5〕に記載のシステム。
〔8〕上記マッピング電極は、上記先端部分の外周に沿って互いにほぼ等間隔に離間した3つのマッピング電極を含むことを特徴とする上記〔1〕に記載のシステム。
〔9〕上記マッピング電極は、上記先端部分の外周に沿って互いにほぼ等間隔に離間した4つのマッピング電極を含むことを特徴とする上記〔1〕に記載のシステム。
〔11〕上記開放領域と流体連通する上記洗浄ポートは、上記近位流体リザーバと流体連通する近位洗浄ポートを含むことを特徴とする上記〔1〕に記載のシステム。
〔12〕上記開放領域と流体連通する上記洗浄ポートは、上記遠位流体リザーバと流体連通する遠位洗浄ポートと上記近位流体リザーバと流体連通する近位洗浄ポートの両方を含むことを特徴とする上記〔1〕に記載のシステム。
〔14〕上記先端部分は、近位部分と遠位部分を含み、該近位部分は、遠位側面を含み、該遠位部分は、近位側面を含み、
上記遠位インサートは、該遠位インサートの近位端上に近位リップ及び該遠位インサートの遠位端上に遠位リップを含み、
上記遠位部分の上記近位側面は、上記遠位リップの上に適合し、
上記近位部分の上記遠位側面は、上記近位リップの上に適合する、ことを特徴とする上記〔1〕に記載のシステム。
〔16〕上記先端部分の上記外壁は、所定の距離だけ上記洗浄ポートから分離した遠位端を有し、
上記遠位インサートは、遠位チャンネル端部で終了する遠位に延びる部材を含み、該遠位に延びる部材は、該遠位チャンネル端部が上記外壁の上記遠位端に当接する時に該遠位インサートを上記洗浄ポートの近位側の上記先端部分に位置決めするために第1の所定の長さを用いて構成される、ことを特徴とする上記〔1〕に記載のシステム。
上記主本体部分は、上記外壁の内径に対してほぼ相補的な外周を有し、かつ上記マッピング電極を受け入れる大きさの開口部を備えた周囲面を有し、
上記遠位チャンネル端部は、上記先端部分の上記遠位壁に当接し、上記主本体は、上記洗浄ポートの近位側に位置決めされ、上記近位チャンネル端部は、近接して隣接する構造に接続され、上記チャンネルは、上記近位流体リザーバから隔離された内部通路を有し、
システムが、上記チャンネルの上記内部通路を通って上記遠位インサートの上記主本体部分に入り、上記マッピング電極まで延びるワイヤを含む、ことを特徴とする上記〔1〕に記載のシステム。
〔19〕上記主本体部分は、上記周囲面から離れる方向に延びる周方向戻り止めを含み、該周方向戻り止めは、上記遠位インサートと上記外壁の間にシールを設けるように構成されることを特徴とする上記〔17〕に記載のシステム。
〔20〕上記主本体部分は、上記周囲面上に形成された周方向ガスケットを含み、該周方向ガスケットは、上記遠位インサートと上記外壁の間にシールを設けるように構成されることを特徴とする上記〔17〕に記載のシステム。
〔22〕上記流体通路は、上記主本体部分の上記周囲面にチャンネルを含むことを特徴とする上記〔21〕に記載のシステム。
〔23〕上記流体通路は、上記主本体部分の上記周囲面に流体管腔を含むことを特徴とする上記〔21〕に記載のシステム。
〔24〕上記チャンネルを通って延びて上記外壁の上記遠位端と接触する熱電対を更に含み、
上記熱電対は、上記遠位流体リザーバの流体から隔離される、ことを特徴とする上記〔17〕に記載のシステム。
上記遠位チャンネル端部は、上記遠位流体リザーバからの流体が上記熱電対に接触することを可能にするように構成される、
ことを特徴とする上記〔17〕に記載のシステム。
〔26〕上記先端部分の上記外壁と作動可能に接続され、かつ該先端部分の該外壁を用いて組織を切除するように構成されたRF発生器と、
流体リザーバ及びポンプ、及び該流体リザーバ及びポンプから上記先端部分に延びる管腔と、
電気活動をマップするために上記先端部分の上記マッピング電極と作動可能に接続したマッピング信号プロセッサと、を更に含むことを特徴とする上記〔1〕に記載のシステム。
先端部分内に開放内部領域を形成する外壁を有する先端部分であって、該外壁が、少なくとも3つのマッピング電極開口部と複数の洗浄ポートとを含み、該外壁が、RF切除手順のための無線周波数(RF)エネルギを送出するために導電性であり、該洗浄ポートが、流体を該開放内部領域から該洗浄ポートを通って流すために該開放内部領域と流体連通している上記先端部分と、
上記開放領域を遠位流体リザーバと近位流体リザーバに分離するために上記先端部分に位置決めされ、該遠位流体リザーバから該近位流体リザーバまで延びる流体導管を形成する遠位インサートと、
上記少なくとも3つのマッピング電極開口部に位置決めされた少なくとも3つのマッピング電極であって、上記遠位インサートが、該マッピング電極を受け入れる大きさの開口部を備えた周囲面を有する上記少なくとも3つのマッピング電極と、
電気絶縁体で製作された少なくとも3つのノイズアーチファクトアイソレータであって、上記マッピング電極が、該ノイズアーチファクトアイソレータによって上記先端部分の上記外壁と電気的に絶縁される上記少なくとも3つのノイズアーチファクトアイソレータと、を含むことを特徴とするシステム。
〔29〕上記開放領域と流体連通する上記洗浄ポートは、上記遠位流体リザーバと流体連通する遠位洗浄ポートを含むことを特徴とする上記〔27〕に記載のシステム。
〔30〕上記開放領域と流体連通する上記洗浄ポートは、上記近位流体リザーバと流体連通する近位洗浄ポートを更に含むことを特徴とする上記〔29〕に記載のシステム。
〔31〕開放洗浄カテーテル先端を形成する方法であって、
遠位インサートの遠位リップを遠位先端部分の近位端に挿入する段階と、
上記遠位インサートの外周の周りでマッピング開口部にマッピング電極を着座させる段階と、
上記遠位インサートの近位リップにわたって近位先端部分の遠位端を挿入する段階と、を含むことを特徴とする方法。
〔33〕マッピング及び切除機能を実行するためのカテーテルシステムであって、
切除機能を目的としたRFエネルギを送出する際に用いるように構成され、マッピング電極開口部を備えた導電性外壁と、
上記マッピング電極開口部に位置決めされたマッピング電極と、
上記マッピング電極開口部に位置決めされたノイズアーチファクトアイソレータであって、上記マッピング電極が、該ノイズアーチファクトアイソレータによって上記外壁と電気的に絶縁される上記ノイズアーチファクトアイソレータと、を含むことを特徴とするシステム。
〔35〕電極の側面を形成する外周部、第1の面、及び該第1の面に対向する第2の面を有する電極と、
上記電極の上記第2の面から延びて該電極と電気的に導通する電極シャフトと、
上記電極の側面と接触して該電極の上記外周部を取り囲むノイズアーチファクトアイソレータと、を含むことを特徴とする電極アセンブリ。
〔37〕上記ノイズアーチファクトアイソレータは、ポリマーベース材料であることを特徴とする上記〔35〕に記載の電極アセンブリ。
遠位先端部分内に遠位インサートを挿入する段階であって、該遠位インサートが、遠位延長部を含み、該遠位先端部分が、遠位端と所定の距離だけ該遠位端から分離した洗浄ポートとを含み、該遠位インサートを挿入する段階が、該遠位延長部が該遠位先端部分の該遠位端に接触して該遠位インサートを該洗浄ポートの近くに自己位置決めするまで該遠位インサートを該遠位先端部分内に移動する段階を含む上記挿入する段階と、
上記遠位先端部分を近接して隣接する構造に接続する段階と、
を含み、
上記遠位インサートは、上記遠位先端部分を該遠位インサートと上記遠位端の間の遠位流体リザーバと、該遠位インサートと上記近接して隣接する構造との間の近位流体リザーバとに分割し、
上記遠位インサートは、上記遠位及び近位流体リザーバ間の流体連通をもたらす、
ことを特徴とする方法。
上記遠位インサートを上記遠位先端部分内に挿入する段階は、該遠位インサートのマッピング電極開口を該遠位先端部分のマッピング電極開口と整列させる段階を含み、
方法が、マッピング電極を上記マッピング電極開口内に着座させる段階を更に含み、
上記マッピング電極に接続したワイヤが、上記遠位インサートの上記チャンネルを貫通する、ことを特徴とする上記〔38〕に記載の方法。
101 カテーテル先端本体
102 先端部分
103 マッピング電極
108 ノイズアーチファクトアイソレータ
Claims (14)
- マッピング機能及び切除機能を実行するための開放洗浄カテーテルシステムであって、
先端部分内に開放内部領域を形成する外壁を有する先端部分であって、該外壁が、マッピング電極開口部と洗浄ポートとを含み、該外壁が、RF切除手順のための無線周波数(RF)エネルギを送出するために導電性であり、該洗浄ポートが、流体が該開放内部領域から該洗浄ポートを通って流れることを可能にするために該開放内部領域と流体連通している前記先端部分と、
前記開放領域を遠位流体リザーバと近位流体リザーバに分離するために前記先端部分に位置決めされた遠位インサートと、
前記先端部分の前記マッピング電極開口部に位置決めされたマッピング電極と、を含み、
前記遠位インサートは、前記マッピング電極を受け入れる大きさの開口部を備えた周囲面を有することを特徴とする開放洗浄カテーテルシステム。 - 熱電対を更に含み、
前記遠位インサートは、前記遠位流体リザーバから前記近位流体リザーバまで延びる熱電対開口部を形成し、該熱電対開口部は、該熱電対を受け入れるように構成されることを特徴とする請求項1に記載の開放洗浄カテーテルシステム。 - 前記遠位インサートは、前記遠位流体リザーバから前記近位流体リザーバまで延びる流体導管を形成することを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 電気絶縁体で製作されたノイズアーチファクトアイソレータを更に含み、
前記マッピング電極は、前記ノイズアーチファクトアイソレータによって前記先端部分の前記外壁から電気的に隔離されることを特徴とする請求項1に記載の開放洗浄カテーテルシステム。 - 前記マッピング電極は、前記先端部分の外周に沿って互いにほぼ等間隔に離間した3つのマッピング電極を含むことを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 前記開放領域と流体連通する前記洗浄ポートは、前記遠位流体リザーバと流体連通する遠位洗浄ポートを含むことを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 前記開放領域と流体連通する前記洗浄ポートは、前記近位流体リザーバと流体連通する近位洗浄ポートを含むことを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 前記開放領域と流体連通する前記洗浄ポートは、前記遠位流体リザーバと流体連通する遠位洗浄ポートと前記近位流体リザーバと流体連通する近位洗浄ポートの両方を含むことを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 流体を前記遠位流体リザーバに送出するために前記遠位インサートを通って延びる流体冷却管腔を更に含み、該流体冷却管腔は、流体を前記近位流体リザーバに送出するため開口部を備えた壁を有することを特徴とする請求項1に記載の開放洗浄カテーテルシステム。
- 前記先端部分は、近位部分と遠位部分を含み、該近位部分は、遠位側面を含み、該遠位部分は、近位側面を含み、
前記遠位インサートは、該遠位インサートの近位端上に近位リップ及び該遠位インサートの遠位端上に遠位リップを含み、
前記遠位部分の前記近位側面は、前記遠位リップの上に適合し、
前記近位部分の前記遠位側面は、前記近位リップの上に適合する、ことを特徴とする請求項1に記載の開放洗浄カテーテルシステム。 - 前記先端部分の前記外壁は、所定の距離だけ前記洗浄ポートから分離した遠位端を有し、
前記遠位インサートは、遠位チャンネル端部で終了する遠位に延びる部材を含み、該遠位に延びる部材は、該遠位チャンネル端部が前記外壁の前記遠位端に当接する時に該遠位インサートを前記洗浄ポートの近位側の前記先端部分に位置決めするために第1の所定の長さを用いて構成されることを特徴とする請求項1に記載の開放洗浄カテーテルシステム。 - マッピング機能及び切除機能を実行するための開放洗浄カテーテルシステムであって、
先端部分内に開放内部領域を形成する外壁を有する先端部分であって、該外壁が、マッピング電極開口部と洗浄ポートとを含み、該外壁が、RF切除手順のための無線周波数(RF)エネルギを送出するために導電性であり、該洗浄ポートが、流体が該開放内部領域から該洗浄ポートを通って流れることを可能にするために該開放内部領域と流体連通している前記先端部分と、
前記開放領域を遠位流体リザーバと近位流体リザーバに分離するために前記先端部分に位置決めされた遠位インサートと、
前記先端部分の前記マッピング電極開口部に位置決めされたマッピング電極と、を含み、
前記先端部分の前記外壁は、所定の距離だけ前記洗浄ポートから分離した遠位端を有し、
前記遠位インサートは、主本体部分と、近位チャンネル端部から該主本体部分を通って遠位チャンネル端部まで延びるチャンネルとを含み、
前記主本体部分は、前記外壁の内径に対してほぼ相補的な外周を有し、かつ前記マッピング電極を受け入れる大きさの開口部を備えた周囲面を有し、
前記遠位チャンネル端部は、前記先端部分の前記遠位壁に当接し、前記主本体は、前記洗浄ポートの近位側に位置決めされ、前記近位チャンネル端部は、近接して隣接する構造に接続され、
前記チャンネルは、前記近位流体リザーバから隔離された内部通路を有し、
システムが、前記チャンネルの前記内部通路を通って前記遠位インサートの前記主本体部分に入り、前記マッピング電極まで延びるワイヤを含む、開放洗浄カテーテルシステム。 - マッピング及び切除機能を実行するための開放洗浄カテーテルシステムであって、
切除機能を目的としたRFエネルギを送出する際に用いるように構成され、マッピング電極開口部を備えた導電性外壁とを有し、この導電性外壁は開放内部領域を形成し、且つ、前記開放内部領域と流体連通している洗浄ポートを有していて、流体が前記開放内部領域から前記洗浄ポートを通って流れ、
更に、前記マッピング電極開口部に位置決めされたマッピング電極と、
前記マッピング電極開口部に位置決めされたノイズアーチファクトアイソレータであって、前記マッピング電極が、該ノイズアーチファクトアイソレータによって前記外壁と電気的に絶縁される前記ノイズアーチファクトアイソレータと、を含み、
前記遠位インサートは、前記マッピング電極を受け入れる大きさの開口部を備えた周囲面を有する、開放洗浄カテーテルシステム - 前記マッピング電極は、前記外壁から出る方向に向く外面を有し、前記ノイズアーチファクトアイソレータは、該マッピング電極の該外面を超えて該外壁から外向きに延びるリップを有することを特徴とする請求項4又は13に記載の開放洗浄カテーテルシステム。
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EP3391845A3 (en) | 2018-11-28 |
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EP2448510A1 (en) | 2012-05-09 |
US8414579B2 (en) | 2013-04-09 |
WO2011008444A1 (en) | 2011-01-20 |
KR20120046209A (ko) | 2012-05-09 |
CA2766640C (en) | 2016-01-05 |
EP3391845A2 (en) | 2018-10-24 |
EP3106116A1 (en) | 2016-12-21 |
US20100331658A1 (en) | 2010-12-30 |
US20130197507A1 (en) | 2013-08-01 |
EP2448510B1 (en) | 2016-08-31 |
CA2766640A1 (en) | 2011-01-20 |
KR101358498B1 (ko) | 2014-02-05 |
US8740900B2 (en) | 2014-06-03 |
JP2012531967A (ja) | 2012-12-13 |
EP3391845B1 (en) | 2020-02-12 |
US20140288548A1 (en) | 2014-09-25 |
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