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ITBA20070049A1 - Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare - Google Patents

Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare Download PDF

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Publication number
ITBA20070049A1
ITBA20070049A1 IT000049A ITBA20070049A ITBA20070049A1 IT BA20070049 A1 ITBA20070049 A1 IT BA20070049A1 IT 000049 A IT000049 A IT 000049A IT BA20070049 A ITBA20070049 A IT BA20070049A IT BA20070049 A1 ITBA20070049 A1 IT BA20070049A1
Authority
IT
Italy
Prior art keywords
radiofrequency
catheters
ablation
arithmia
transcateter
Prior art date
Application number
IT000049A
Other languages
English (en)
Inventor
Massimo Grimaldi
Original Assignee
Massimo Grimaldi
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 Massimo Grimaldi filed Critical Massimo Grimaldi
Priority to IT000049A priority Critical patent/ITBA20070049A1/it
Priority to JP2010511787A priority patent/JP5368434B2/ja
Priority to PCT/IT2008/000397 priority patent/WO2008152674A1/en
Priority to CA2689279A priority patent/CA2689279C/en
Priority to US12/663,962 priority patent/US9033980B2/en
Priority to EP08789986.0A priority patent/EP2155097B1/en
Publication of ITBA20070049A1 publication Critical patent/ITBA20070049A1/it
Priority to US14/712,344 priority patent/US9333030B2/en

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Classifications

    • 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
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/0016—Energy applicators arranged in a two- or three dimensional array
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00357—Endocardium
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
    • 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
    • A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Radiation-Therapy Devices (AREA)

Description

Descrizione
Dell’Invenzione Industriale dal Titolo: Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare
La radiofrequenza bipolare, erogata attraverso ì cateteri disegnati negli allegati Y eZ, questo tipo di complicanza grazie al fatto che l’energia si concentra fra i poli dei catetere stesso dunque la lesione non può interessare le strutture paracardiache. L’esofago non subirebbe dunque pericolosi aumenti di temperatura e questo, oltre ad evitare la fistola atrio-esofagea, evita anche che il paziente avverta dolore. Un altro vantaggio della radiofrequenza bipolare è dato dal minor tempo necessario per eseguire la lesione. Sono sufficienti pochissimi secondi per ottenere lesioni complete. In questo modo diventa più semplice eseguire le lesioni in aree di instabilità e si abbreviano notevolmente i tempi delle procedure.
11 catetere disegnato nell’allegato Z presenta gli elettrodi eroganti curvi al fine di ottenere lesioni complete qualsiasi sia l’area di contatto della punta del catetere con il tessuto. 1 quattro elettrodi curvi sono composti da due poli negativi e due positivi, posizionati in modo alterno. I due poli positivi sono poi uniti tra loro internamente nel catetere. Anche ì poli negativi sono uniti internamente nel catetere. La radiofrequenza è erogata dai due poli negativi ai positivi.
L’irrigazione riduce la temperatura locale; permette un miglior passaggio della radiofrequenza nel tessuto; riduce rischio di formazione di trombi o di carbonizzazione del sangue. II dipolo prossimale è utilizzato solo per il sensing.
Il catetere disegnato nell’allegato Y è formato da un elettrodo distale sferico che rappresenta il polo positivo per l’erogazione di radiofrequenza. Gli altri elettrodi di forma semicilindrica rappresentano i poli negativi per l’erogazione di radiofrequenza bipolare. Questi possono essere utilizzati con il tirante aperto, come se fosse un normale catetere che eroghi di lato (o di dorso). Richiamando il tirante il catetere assume una particolare forma tipo un fiore con quattro petali dove ogni petalo possiede un elettrodo erogante (polo negativo che chiude il circuito con l’elettrodo positivo sferico centrale) ed un elettrodo più piccolo e prossimale che serve per il sensing (chiude il dipolo con il vicino elettrodo erogante). La radiofrequenza può essere erogata da uno o da più elettrodi contemporaneamente. I poli eroganti sono scelti mediante swìteh box dedicata. Il richiede una irrigazione dagli elettrodi eroganti e dal foro di uscita del tirante.
IA creazione di una lesione lineare dell’istmo cavo-tricuspidalico, nell’ablazione del flutter atriale tipico, eseguita mediante radiofrequenza unipolare, spesso presenta difficoltà tecniche dovute alla presenza di angusti recessi in quest’area o ad un elevato spessore del miocardio. L’utilizzo della radiofrequenza bipolare, erogata mediante un catetere come quello illustrato nell’allegato X, permetterebbe di ottenere in pochi secondi una lesione lineare continua e transmurale. I,a radiofrequenza bipolare sarebbe erogata dalPelettrodo distale (polo negativo) all’elettrodo prossimale (polo positivo). Gli elettrodi 2 e 3 servono per il sensing e formano un dipolo rispettivamente con gli elettrodi 1 e 4 (gli stessi poli eroganti la radiofrequenza). Il catetere richiede una irrigazione dagli elettrodi eroganti
Sempre sfruttando il concetto di radiofrequenza bipolare, la lesione dell'istmo tra anulus mitralico e vena polmonare inferiore sinistra si potrebbe ottenere formando un dipolo di radiofrequenza tra un catetere in seno coronarico posterolaterale ed uno in atrio sinistro il più vicino possibile al catetere in seno coronarico. La lesione viene poi completata da un catetere che eroga radiofrequenza in atrio sinistro fino all'ostio della vena polmonare inferiore sinistra.

Claims (1)

  1. RiVENDICAZJONI: La presente domanda di brevetto industriale e di modello di utilità è finalizzata a rivendicare la paternità intellettuale della seguente idea: eseguire ablazioni di aritmie cardiache, in particolare flutter atriale tipico ed atipico e fibrillazione atriale, utilizzando cateteri percutanei che utilizzano radiofrequenza bipolare anziché unipolare.
IT000049A 2007-06-14 2007-06-14 Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare ITBA20070049A1 (it)

Priority Applications (7)

Application Number Priority Date Filing Date Title
IT000049A ITBA20070049A1 (it) 2007-06-14 2007-06-14 Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare
JP2010511787A JP5368434B2 (ja) 2007-06-14 2008-06-13 双極高周波を使用する心臓不整脈の経皮経カテーテルアブレーション用のカテーテル
PCT/IT2008/000397 WO2008152674A1 (en) 2007-06-14 2008-06-13 Catheter for percutaneous transcatheter ablation of cardiac arrhythmias using bipolar radiofrequency
CA2689279A CA2689279C (en) 2007-06-14 2008-06-13 Catheter for percutaneous transcatheter ablation of cardiac arrhythmias using bipolar radiofrequency
US12/663,962 US9033980B2 (en) 2007-06-14 2008-06-13 Catheter for percutaneous transcatheter ablation of cardiac arrhythmias using bipolar radiofrequency
EP08789986.0A EP2155097B1 (en) 2007-06-14 2008-06-13 Catheter for percutaneous transcatheter ablation of cardiac arrhythmias using bipolar radiofrequency
US14/712,344 US9333030B2 (en) 2007-06-14 2015-05-14 Catheter for percutaneous transcatheter ablation of cardiac arrhythmias using bipolar radiofrequency

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
IT000049A ITBA20070049A1 (it) 2007-06-14 2007-06-14 Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare

Publications (1)

Publication Number Publication Date
ITBA20070049A1 true ITBA20070049A1 (it) 2008-12-15

Family

ID=39884260

Family Applications (1)

Application Number Title Priority Date Filing Date
IT000049A ITBA20070049A1 (it) 2007-06-14 2007-06-14 Cateteri per ablazione transcatetere per via percutanea di aritmie cardiache mediante radiofrequenza bipolare

Country Status (6)

Country Link
US (2) US9033980B2 (it)
EP (1) EP2155097B1 (it)
JP (1) JP5368434B2 (it)
CA (1) CA2689279C (it)
IT (1) ITBA20070049A1 (it)
WO (1) WO2008152674A1 (it)

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Also Published As

Publication number Publication date
US20100174280A1 (en) 2010-07-08
EP2155097B1 (en) 2016-10-12
CA2689279C (en) 2017-04-18
CA2689279A1 (en) 2008-12-18
WO2008152674A1 (en) 2008-12-18
JP5368434B2 (ja) 2013-12-18
JP2010528804A (ja) 2010-08-26
US9033980B2 (en) 2015-05-19
US20150245869A1 (en) 2015-09-03
US9333030B2 (en) 2016-05-10
EP2155097A1 (en) 2010-02-24

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