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WO2013058088A1 - Cathéter à électrodes - Google Patents

Cathéter à électrodes Download PDF

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Publication number
WO2013058088A1
WO2013058088A1 PCT/JP2012/075319 JP2012075319W WO2013058088A1 WO 2013058088 A1 WO2013058088 A1 WO 2013058088A1 JP 2012075319 W JP2012075319 W JP 2012075319W WO 2013058088 A1 WO2013058088 A1 WO 2013058088A1
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WO
WIPO (PCT)
Prior art keywords
electrode
ring
lead wire
catheter shaft
tip
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/JP2012/075319
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English (en)
Japanese (ja)
Inventor
謙二 森
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Japan Lifeline Co Ltd
Original Assignee
Japan Lifeline Co Ltd
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 Japan Lifeline Co Ltd filed Critical Japan Lifeline Co Ltd
Publication of WO2013058088A1 publication Critical patent/WO2013058088A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • 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
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • 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
    • A61B2018/00315—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
    • 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

Definitions

  • the present invention relates to an electrode catheter in which a plurality of ring electrodes are fixed to the outer peripheral surface of the distal end portion of the catheter shaft.
  • electrode catheters are used as medical instruments for diagnosing or treating cardiac arrhythmias.
  • an electrode catheter one in which a distal end portion of a catheter shaft can be bent and a plurality of ring electrodes are fixed to the distal end portion has been introduced (see Patent Document 1).
  • the electrode catheter described in Patent Document 1 includes a catheter shaft 110, a control handle 116, a tip electrode 138, a plurality (three) of ring-shaped electrodes 140, and a connector 118. ing.
  • a tension wire and a flexible structure for bending the distal end portion 114 of the catheter shaft 110 are disposed inside the electrode catheter.
  • FIG. 10 is a cross-sectional view showing the distal end portion 114 of the catheter shaft 110 constituting the electrode catheter shown in FIG. 9, in which 120 is a side hole formed in the tube wall of the distal end portion 114, and 117 is a deflection.
  • a structure (a leaf spring having a rectangular cross section), 130 is a lead wire connected to each of the tip electrode 138 and the plurality of ring electrodes 140, 126 and 127 are lumens of the catheter shaft 110, and 129 is an injection tube.
  • the tip electrode 138 and the plurality of ring electrodes 140 are each connected to a separate lead wire 130.
  • the lead wire 130 connected to the ring-shaped electrode 140 is welded to the inner peripheral surface of the ring-shaped electrode 140 at each tip portion, and the tube wall of the tip portion 114 of the catheter shaft 110 (the lead wire 130 is connected).
  • the lumen 126 enters the lumen 126 from the side hole 120 formed at the fixed position of the ring-shaped electrode 140, and extends to the lumen 126 and the inner hole of the control handle 116, and is connected to the connector 118 at each rear end portion. Has been.
  • the lead wire 130 is passed through the side hole 120 formed in the tube wall of the distal end portion 114. Then, the tip of the lead wire 130 is welded to the inner peripheral surface of the ring-shaped electrode 138, and then the ring-shaped electrode 138 is slidably fitted to the outer periphery of the tip portion 114 to open the opening of the side hole 120.
  • a method of sliding (sliding) along the axial direction of the tip portion 114 to a position where it can be closed, and fixing with a polyurethane adhesive or the like at that position can be given (see paragraph 0029 of Patent Document 1). .
  • a plurality of (three) side holes 120 for allowing the lead wire 130 to enter are linearly arranged along the axial direction of the catheter shaft 110,
  • the lead wire 130 connected to each of the plurality of ring-shaped electrodes 140 enters one lumen (lumen 126) from the corresponding side hole 120, and extends through the lumen 126.
  • FIG. 6 shows the shape of the distal end portion of such an electrode catheter
  • FIG. 7 shows the cross-sectional shape of the distal end portion.
  • FIG. 8 schematically shows an arrangement state of lead wires extending to the lumen of the catheter shaft of the electrode catheter shown in FIGS. 6 and 7.
  • the tip electrode 301 is fixed to the tip of the catheter shaft 10 and 19 ring electrodes 302 to 320 are fixed to the outer peripheral surface of the tip portion of the shaft 10. Yes.
  • reference numerals 101 to 106 denote lumens (first lumen to sixth lumen) of the shaft 10 arranged along the circumferential direction of the catheter shaft 10.
  • Reference numerals 61 and 62 denote tension wires for bending the tip portion of the shaft 10 in both directions. The tension wires 61 and 62 extend to the fifth lumen 105 and the sixth lumen 106, respectively.
  • Reference numeral 50 denotes a leaf spring as a flexible structure.
  • the lead wire 401 connected to the distal electrode 301 extends to the first lumen 101 of the catheter shaft 10 (see FIGS. 7 (1) to (4)). . Only the lead wire 401 extends to the first lumen 101, and the lead wires 402 to 420 connected to the ring electrode do not extend.
  • the lead wires 402 to 408 connected to the first to seventh ring-shaped electrodes 302 to 308 from the tip end are respectively arranged on the seven sides arranged linearly on the tube wall of the shaft 10.
  • Each of the holes (S1 to S7 in FIG. 8) enters the second lumen 102 and extends to the second lumen 102 (see FIGS. 7 (2) to (4) and FIG. 8).
  • the seven side holes for allowing the lead wires 402 to 408 to enter the second lumen 102 are formed corresponding to the arrangement position of the second lumen 102 (position in the circumferential direction of the shaft 10).
  • the lead wires 409 to 414 connected to the eighth to thirteenth ring-shaped electrodes 309 to 314 from the tip are respectively arranged on the six sides arranged linearly on the tube wall of the shaft 10.
  • Each of the holes (S8 to S13 in FIG. 8) enters the third lumen 103 and extends to the third lumen 103 (see FIGS. 7 (3) to (4) and FIG. 8).
  • the six side holes (S8 to S13) for allowing the lead wires 409 to 414 to enter the third lumen 103 correspond to the arrangement positions of the third lumen 103, that is, the lead wires 402 to 408 are inserted.
  • the seven side holes (S1 to S7) for this purpose are formed by shifting the positions in the circumferential direction.
  • the lead wires 415 to 420 connected to the fourteenth to nineteenth ring-shaped electrodes 315 to 320 from the tip are respectively arranged on the six sides arranged in a straight line on the tube wall of the shaft 10.
  • Each of the holes (S14 to S19 in FIG. 8) enters the fourth lumen 104 and extends to the fourth lumen 104 (see FIGS. 7 (4) and 8).
  • the six side holes (S14 to S19) for allowing the lead wires 415 to 420 to enter the fourth lumen 104 correspond to the arrangement positions of the fourth lumen 104, that is, the lead wires 409 to 414 are inserted.
  • the six side holes (S8 to S13) for this purpose are formed by shifting the positions in the circumferential direction.
  • a plurality of arrays of side holes are formed while shifting the positions in the circumferential direction (for example, as shown in FIG. 1 to S7 to form a leading end arrangement, S8 to S13 intermediate arrangement, and S14 to S19 rear end arrangements), and lead wires that have entered from the side holes of the same arrangement are extended to the same lumen Can be considered.
  • a first object of the present invention is to provide an electrode catheter that does not cause breakage at a joint portion between a ring-shaped electrode and a lead wire even when the distance between electrodes in adjacent ring-shaped electrodes is small.
  • a second object of the present invention is to provide an electrode catheter that can be bent in the same plane even if it has a distal end portion of a catheter shaft to which a large number of ring electrodes are fixed. It is to provide.
  • the lead wire is distributed to a plurality of lumens, and can be a plurality of side holes (adhesive entrance paths) communicating with the same lumen.
  • side holes adheresive entrance paths
  • a large number of ring electrodes are fixed to the distal end portion of the catheter shaft.
  • the electrode catheter of the present invention includes a catheter shaft in which a plurality of lumens are arranged along the circumferential direction and the tip portion can be bent; In order to bend the distal end portion of the catheter shaft, an operation wire extending inside the catheter shaft and capable of pulling the rear end thereof, A control handle connected to the proximal side of the catheter shaft; A plurality of ring-shaped electrodes, each of which is axially spaced apart and fixed by an adhesive on the outer peripheral surface of the distal end portion of the catheter shaft; A plurality of lead wires connected to each of the plurality of ring-shaped electrodes, In the tube wall of the catheter shaft, a side hole extending from the outer peripheral surface of the catheter shaft to any one of the plurality of lumens is formed corresponding to the fixed positions of the plurality of ring electrodes.
  • Each of the plurality of lead wires is connected to the ring-shaped electrode by being joined to the inner peripheral surface of the ring-shaped electrode at the distal end thereof, and is formed on the side formed on the tube wall of the catheter shaft
  • An electrode catheter that extends from a hole into any one of a plurality of lumens of the catheter shaft and extends to the lumen and an inner hole of the control handle, Two lead wires connected to each of adjacent ring-shaped electrodes respectively extend to different lumens of the catheter shaft.
  • the electrode catheter having such a configuration a plurality of lead wires are distributed to at least two lumens, and two lead wires connected to each of adjacent ring-shaped electrodes extend to the same lumen. Therefore, the arrangement interval of the side holes communicating with one lumen (the side hole that can serve as an adhesive entry path) is at least twice the arrangement interval of the side holes in the conventional electrode catheter having the same interelectrode distance. As a result, the movement (elongation) of the extending lead wire is ensured in the one lumen, and breakage at the joint portion between the ring-shaped electrode and the lead wire can be prevented.
  • the ubiquitous state of the lead wire in the circumferential direction of the catheter shaft is alleviated, so that the flatness of the shape change can be ensured.
  • the number of ring electrodes is preferably 4 or more, particularly preferably 9 or more.
  • the structure of this invention is especially effective.
  • a lead wire connected to the nth electrode (where n is an integer of 1 or more) from the distal end, A lead wire connected to the (n + 1) -th ring electrode from the tip; It is preferable that lead wires connected to the (n + 2) th ring-shaped electrode from the distal end respectively extend to different lumens of the catheter shaft.
  • a plurality of lead wires are distributed to at least three lumens and connected to each of the nth, (n + 1) th and (n + 2) th ring electrodes. Since the three lead wires thus formed do not extend to the same lumen, the distance between the electrodes is the same as the arrangement interval of the side holes communicating with one lumen (side holes that can serve as an adhesive entry path).
  • the distance between the side holes in the conventional electrode catheter can be expanded to at least about three times, thereby sufficiently ensuring the movement (extension) of the lead wire extending in the one lumen, and the ring electrode and the lead Breakage at the joint with the wire can be prevented.
  • the ubiquitous state of the lead wire in the circumferential direction of the catheter shaft can be further alleviated, so that the flatness of the shape change can be sufficiently ensured.
  • the lead wire connected to the (n + 3) th ring electrode from the tip is the same as the lead wire connected to the nth ring electrode from the tip. It preferably extends to the lumen.
  • the arrangement interval of the side holes communicating with one lumen is set to be equal to that of the side holes in the conventional electrode catheter having the same inter-electrode distance. It can be expanded to about three times the arrangement interval.
  • a tip electrode attached to the tip of the catheter shaft;
  • the lead wire connected to the tip electrode enters one of a plurality of lumens of the catheter shaft and extends to the lumen and the inner hole of the control handle.
  • the lead wire connected to the ring electrode does not extend in the lumen in which the lead wire connected to the tip electrode extends. .
  • a plurality of side holes communicating with the same lumen of the catheter shaft are linearly arranged along the axial direction, and the arrangement interval of the side holes is 0.7 mm or more. Is preferred.
  • the electrode catheter of the present invention it is possible to prevent the occurrence of breakage at the joint portion between the ring electrode and the lead wire even when the separation distance between adjacent ring electrodes is narrow. Moreover, even if it has the front-end
  • FIG. 10 is a cross-sectional view showing a distal end portion of the electrode catheter shown in FIG. 9.
  • the electrode catheter 100 according to an embodiment of the present invention is used, for example, for diagnosis or treatment of arrhythmia in the heart.
  • 1 to 5 showing the electrode catheter of this embodiment, the same reference numerals are used for the same or corresponding components as those shown in FIGS.
  • the catheter shaft 10 that can bend the distal end portion 10A and the distal end portion 10A of the catheter shaft 10 are bent.
  • the operation wires 61 and 62 that extend inside the catheter shaft 10 (the fifth lumen 105 and the sixth lumen 106) and can pull the rear ends of the catheter shaft 10 and the control handle connected to the proximal end side of the catheter shaft 10 70, a tip electrode 301 attached to the tip of the catheter shaft 10, and nineteen ring-shaped electrodes 302 to 30 which are axially spaced apart and fixed by an adhesive on the outer peripheral surface of the tip portion 10A of the catheter shaft 10.
  • a lead wire 401 connected to the tip electrode 301, and ring electrodes 302 to 32 It includes a lead wire 402 to 420 of each connected nineteen, and a leaf spring 50 as bending structures,
  • side holes (S 1 to S 19) extending from the outer peripheral surface of the catheter shaft 10 to any one of the lumens 102 to 104 corresponding to the fixing positions of the 19 ring electrodes 302 to 320.
  • Each of the 19 lead wires 402 to 420 is connected to each of the ring electrodes 302 to 320 by being welded to the inner peripheral surface of the ring electrode at the tip thereof, and From each of the side holes (S 1 to S 19) formed in the tube wall of the catheter shaft 10, it enters any one of the lumens 102 to 104 of the catheter shaft 10 and extends to the lumen and the inner hole of the control handle 70.
  • a lead wire 401 connected to the tip electrode 301 extends to the first lumen 101 of the catheter shaft 10
  • a lead 420 connected to the third ring electrode 320 extends to the third lumen 103 of the catheter shaft 10;
  • a lead wire 412 connected to the eleventh ring electrode 312, a lead wire 415 connected to the fourteenth ring electrode 315, and a lead wire 418 connected to the seventeenth ring electrode 318 include a
  • a lead wire 419) connected to 19 extends to the fourth lumen 104 of the catheter shaft 10.
  • the electrode catheter 100 of the present embodiment includes a catheter shaft 10, a tip electrode 301 fixed to the tip thereof, and 19 rings fixed to the tip portion 10 ⁇ / b> A of the catheter shaft 10.
  • the control handle 70 connected to the proximal end of the catheter shaft 10.
  • the distal end portion 10A of the catheter shaft 10 can be bent (bent) by pulling the operation wire (the first operation wire 61 or the second operation wire 62).
  • the outer diameter of the catheter shaft 10 is usually 0.6 to 3 mm, preferably 1.3 to 2.4 mm.
  • the length of the catheter shaft 10 is usually 400 to 1500 mm, preferably 700 to 1200 mm.
  • the length of the tip portion 10A that can be bent is, for example, 30 to 400 mm, and preferably 100 to 300 mm.
  • a control handle 70 is attached to the proximal end side of the catheter shaft 10.
  • a connector (not shown) having a plurality of terminals is provided in the control handle 70, and lead wires connected to each of the tip electrode 301 and the ring electrodes 302 to 320 are connected to the terminals of the connector (FIG. 1). And a rear end portion thereof (not shown in FIG. 2).
  • the control handle 70 is equipped with a knob 75 for performing an operation of bending the distal end portion 10A of the catheter shaft 10.
  • the catheter shaft 10 has a multi-lumen structure at least at the distal end portion 10A. As shown in FIGS. 3A and 3B, the distal end portion 10A of the catheter shaft 10 covers an inner (core) portion 18 that divides six lumens 101 to 106 arranged along the circumferential direction, and covers the inner portion 18. An outer (shell) portion 19 is formed.
  • the first operation wire 61 and the second operation wire 62 are inserted through the fifth lumen 105 and the sixth lumen of the tip portion 10A, respectively.
  • the outer portion 19 of the tip portion 10 ⁇ / b> A is made of a resin material that covers the inner portion 18.
  • the outer portion 19 may be composed of tubes having the same physical properties along the axial direction, but it is preferable that the rigidity (hardness) increases stepwise toward the rear end side.
  • the thickness of the outer portion 19 is preferably about 3 to 15% of the outer diameter of the catheter shaft 10.
  • a distal electrode 301 is fixed to the distal end of the catheter shaft 10.
  • Nineteen ring-shaped electrodes 302 to 320 are fixed to the outer peripheral surface of the distal end portion 10A of the catheter shaft 10 so as to be spaced apart in the axial direction.
  • the tip electrode 301 and the ring-shaped electrodes 302 to 320 are made of a metal having good electrical conductivity, such as aluminum, copper, stainless steel, gold, or platinum.
  • a metal having good electrical conductivity such as aluminum, copper, stainless steel, gold, or platinum.
  • the electrode width (the length in the axial direction of the catheter shaft 10) of the ring-shaped electrodes 302 to 320 varies depending on the purpose of the electrode, but is, for example, 0.5 to 8.0 mm, preferably 0.7 to 6. 0 mm.
  • the electrode catheter 100 includes a first operation wire 61 for bending the distal end portion 10A of the catheter shaft 10 in the first direction (direction indicated by arrow A) and the distal end portion 10A in the second direction (direction indicated by arrow B).
  • a second operation wire 62 is provided for bending the wire.
  • the first operation wire 61 constituting the electrode catheter 100 is inserted inside the catheter shaft 10 (fifth lumen 105) so as to be movable in the axial direction.
  • the tip of the first operation wire 61 is connected and fixed to the tip electrode 301 by, for example, solder. Further, the rear end of the first operation wire 61 is connected to a knob 75 of the control handle 70 so that it can be pulled.
  • the second operation wire 62 constituting the electrode catheter 100 is inserted inside the catheter shaft 10 (sixth lumen 106) so as to be movable in the axial direction.
  • the tip of the second operation wire 62 is connected and fixed to the tip electrode 301 by soldering, for example, in the same manner as the first operation wire 61.
  • the rear end of the second operation wire 62 is connected to a knob 75 of the control handle 70 so that it can be pulled.
  • the knob 75 of the control handle 70 when the knob 75 of the control handle 70 is rotated in the A1 direction shown in FIG. 1, the rear end of the first operation wire 61 is pulled and moved to the proximal end side, and the distal end portion 10A is moved in the first direction ( 1 in the direction indicated by arrow A), and the shape thereof can be continuously changed.
  • the knob 75 of the control handle 70 is rotated in the B1 direction shown in FIG. 1, the rear end of the second operation wire 62 is pulled and moved to the proximal end side, and the distal end portion 10A is moved in the second direction (FIG. 1 in the direction indicated by the arrow B), and the shape thereof can be continuously changed.
  • the control handle 70 is rotated around the axis, the directions of the first direction and the second direction with respect to the catheter 150 can be freely set while being inserted into the body cavity.
  • Examples of the constituent material of the first operation wire 61 and the second operation wire 62 include metals such as stainless steel and a Ni—Ti superelastic alloy.
  • the outer diameters of the first operation wire 61 and the second operation wire 62 are not particularly limited, but are preferably 0.10 to 0.30 mm, and more preferably 0.21 to 0.28 mm. A preferable example is 0.26 mm.
  • the lead wire 401 connected to the tip electrode 301 is connected and fixed to the tip electrode 301 with solder, and is shown in FIGS. 3A (1) to (8) and FIGS. 3B (9) to (10).
  • the first lumen 101 of the catheter shaft 10 and the inner hole of the control handle 70 are extended, and the rear end thereof is connected to the connector in the control handle 70.
  • Side holes S2, S5, S8, S11, S14 and S17 corresponding to the fixed positions of the electrode (312), the fourteenth ring electrode (315) and the seventeenth ring electrode (318) are: Each is linearly arranged so as to communicate with the second lumen 102 of the catheter shaft 10.
  • Side holes S1, S4, S7, S10, S13, S16 corresponding to the fixing positions of the thirteenth ring electrode (314), the sixteenth ring electrode (317) and the nineteenth ring electrode (320), and S19 is arranged in a straight line so as to communicate with the third lumen 103 of the catheter shaft 10, respectively.
  • the side holes S3, S6, S9, S12, S15, and S18 corresponding to the fixing positions of the 18th ring electrode (316) and the 18th ring electrode (319) are the fourth lumen 104 of the catheter shaft 10, respectively. Are linearly arranged so as to communicate with each other.
  • ... S16, S17, S18, and S19 are arranged in a spiral shape.
  • Each of the lead wires 402 to 420 shown in FIG. 3A, FIG. 3B and FIG. 4 is connected to each of the ring electrodes 302 to 320 by resistance welding to the inner peripheral surface of the ring electrode at the tip. Yes.
  • each of the lead wires 402 to 420 enters one of the lumens 102 to 104 of the catheter shaft 10 from a side hole formed in the tube wall of the catheter shaft 10, and the lumen and the control handle 70. It extends to the inner hole.
  • the lead wire 402 connected to the first ring-shaped electrode 302 from the tip enters the third lumen 103 from the side hole S1 formed in the tube wall of the catheter shaft 10 and enters the third lumen 103. It extends (see FIGS. 3A (2) to (8), FIG. 3B and FIG. 4).
  • FIG. 5 shows that the lead wire 402 is connected to the ring-shaped electrode 302 by resistance-welding the distal end portion of the lead wire 402 to the inner peripheral surface of the ring-shaped electrode 302, and the lead wire 402 is connected to the catheter shaft.
  • 10 shows a state in which it enters the third lumen 103 of the catheter shaft 10 from the side hole S1 formed in the tube wall 10 (the same applies to the other lead wires 403 to 420).
  • 402a is a metal core wire constituting the lead wire 402
  • 402b is a coating resin constituting the lead wire 402
  • W is a welded portion
  • 351 and 352 are curable resins that function as an adhesive.
  • the diameter of the metal core wire 402a constituting the lead wire 402 is, for example, 0.1 mm
  • the thickness of the coating resin 402b made of, for example, polyamideimide resin is, for example, 10 ⁇ m. Since the lead wire 402 is resistance-welded to the inner peripheral surface of the ring-shaped electrode 302 at the tip, the coating resin 402b at the tip of the lead wire 402 is peeled off to expose the metal core wire 402a.
  • the lead wire 403 connected to the second ring-shaped electrode 303 from the distal end enters the second lumen 102 from the side hole S2 formed in the tube wall of the catheter shaft 10 and extends to the second lumen 102. (See FIGS. 3A (3) to (8), FIG. 3B and FIG. 4).
  • a lead wire 404 connected to the third ring-shaped electrode 304 from the distal end enters the fourth lumen 104 from the side hole S3 formed in the tube wall of the catheter shaft 10 and extends to the fourth lumen 104. (See FIGS. 3A (4) to (8), FIG. 3B and FIG. 4).
  • the lead wire 405 connected to the fourth ring-shaped electrode 305 from the tip enters the third lumen 103 from the side hole S4 formed in the tube wall of the catheter shaft 10, and enters the third lumen 103 together with the lead wire 402. It extends (see FIGS. 3A (5) to (8), FIG. 3B and FIG. 4).
  • the lead wire 406 connected to the fifth ring-shaped electrode 306 from the tip enters the second lumen 102 from the side hole S5 formed in the tube wall of the catheter shaft 10, and enters the second lumen 102 together with the lead wire 403. It extends (see FIGS. 3A (6) to (8), FIG. 3B and FIG. 4).
  • the lead wire 407 connected to the sixth ring-shaped electrode 307 from the tip enters the fourth lumen 104 from the side hole S6 formed in the tube wall of the catheter shaft 10, and enters the fourth lumen 104 together with the lead wire 404. It extends (see FIGS. 3A (7) to (8), FIG. 3B and FIG. 4).
  • the lead wire 408 connected to the seventh ring-shaped electrode 308 from the tip enters the third lumen 103 through the side hole S7 formed in the tube wall of the catheter shaft 10, and together with the lead wire 402 and the lead wire 405, the lead wire 408 enters the third lumen 103. 3 lumens 103 (see FIGS. 3A (8), 3B and 4).
  • a lead wire 411 connected to each of the tenth ring electrode 311, the thirteenth ring electrode 314, the sixteenth ring electrode 317, and the nineteenth ring electrode 320 from the tip, and the lead
  • the wire 414, the lead wire 417, and the lead wire 420 enter the third lumen 103 from each of the side holes S10, S13, S16, and S19, and extend to the third lumen 103 together with the lead wire 402, the lead wire 405, and the lead wire 408. (See FIG. 3B and FIG. 4).
  • a lead wire 409 connected to each of the eighth ring electrode 309, the eleventh ring electrode 312, the fourteenth ring electrode 315, and the seventeenth ring electrode 318 from the tip, the lead
  • the wire 412, the lead wire 415, and the lead wire 418 enter the second lumen 102 from each of the side holes S8, S11, S14, and S17, and extend to the third lumen 103 together with the lead wire 403 and the lead wire 406. (See FIG. 3B and FIG. 4).
  • the lead wire 401 connected to the distal electrode 301 extends to the first lumen 101 of the catheter shaft 10, and the lead wire 403 extends to the second lumen 102.
  • the lead wire 406, the lead wire 409, the lead wire 412, the lead wire 415, and the lead wire 418 extend, and the third lumen 103 has a lead wire 402, a lead wire 405, a lead wire 408, a lead wire 411, and a lead wire.
  • a lead wire 414, a lead wire 417, and a lead wire 420 extend, and a lead wire 404, a lead wire 407, a lead wire 410, a lead wire 413, a lead wire 416, and a lead wire 419 extend to the four lumen 104.
  • the electrode catheter 100 of the present embodiment having such a configuration, 19 lead wires are distributed to three lumens (second lumen 102, third lumen 103, and fourth lumen 104), and the nth Since the three lead wires connected to each of the (n + 1) -th and (n + 2) -th ring electrodes do not extend to the same lumen, the three lumens ( Disposition interval of side holes communicating with each of second lumen 102, third lumen 103, and fourth lumen 104) (for example, disposition interval between side hole S6 communicating with fourth lumen 104 and side hole S9 in FIG. 4) the (D 1)], the arrangement interval of the side holes in the electrode catheter shown in FIGS. 6 to 8 [e.g., 8, the side hole S6 and the side communicating with the second lumen 102 It can be extended to 3 times the arrangement spacing (D 2)] and S7.
  • the three lumens Disposition interval of side holes communicating with each of second lumen 102, third lumen 103, and fourth lumen 104) (for example
  • the ring-shaped electrodes It is possible to reliably prevent breakage at the joint portion (welded portion W) between 301 to 320 and the lead wires 402 to 420.
  • the arrangement interval of the side holes communicating with each of the three lumens (the second lumen 102, the third lumen 103, and the fourth lumen 104) of the catheter shaft 10 (the (D 1 )) is 0.7 mm or more. It is preferable that it is 1.0 mm or more. When the distance between the side holes is 0.7 mm or more, it is possible to reliably prevent the occurrence of breakage at the joint portion between the ring electrode and the lead wire.
  • lead wires extend to the fourth lumen 104 and the third lumen 103 also on the distal end side of the distal end portion 10A of the catheter shaft 10 (see FIG. 3A).
  • the electrode catheter 100 according to the present embodiment is clear from the comparison between the lead wire density shown in FIGS. 3A, 3B, and 4 and the lead wire density shown in FIGS.
  • the ubiquitous state in the circumferential direction of the lead wires 402 to 420 in the tip portion 10A can be sufficiently relaxed. Thereby, the flatness of the shape change when bending the distal end portion 10A of the catheter shaft 10 can be sufficiently ensured.
  • the catheter shaft 10 has a large number (19) of ring-shaped electrodes 302 to 320 and a large number of lead wires extend inside the catheter shaft 10, the catheter shaft 10
  • the tip portion 10A can be bent in the same plane.
  • the number of ring-shaped electrodes fixed to the distal end portion of the catheter shaft can be changed as appropriate.
  • the number of ring-shaped electrodes is preferably large to some extent. Specifically, the number is preferably 4 to 47, and more preferably 9 to 19.
  • the number of lumens through which lead wires (lead wires connected to each of the tip electrode and the ring electrode) extend is not limited to four, for example, 2 to 12, preferably 4 to 8 Lead wires can be distributed to the lumens.
  • the electrode catheter of the present invention may be of a type (single direction type) in which the distal end portion of the shaft of the catheter shaft is bent in one direction.

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Abstract

L'invention concerne un cathéter à électrodes comprenant : une tige (10) dans laquelle plusieurs lumières sont positionnées le long de la direction de la circonférence, et avec laquelle il est possible de courber la partie d'extrémité avant (10A); des fils (61, 62) de fonctionnement destinés à courber la partie d'extrémité avant (10A) de la tige (10); plusieurs électrodes annulaires (302-320) qui sont liées en place séparément les unes des autres le long de la face de circonférence externe de la partie d'extrémité avant (10A) de la tige (10); et plusieurs lignes annulaires (402-420) qui sont connectées à chacune des électrodes annulaires (302-320). La ligne conductrice qui est connectée à la nième électrode annulaire à partir de l'extrémité avant, la ligne conductrice qui est connectée à la (n+1)ième électrode annulaire à partir de l'extrémité avant et la ligne conductrice qui est connectée à la (n+2)ième électrode annulaire à partir de l'extrémité avant s'étendent respectivement jusqu'à différentes lumières. Grace à ce cathéter à électrodes, il est possible, même si la distance entre les électrodes annulaires est courte, de courber la partie d'extrémité avant dans un plan donné sans provoquer de rupture dans la partie de liaison entre les électrodes annulaires et les lignes conductrices.
PCT/JP2012/075319 2011-10-21 2012-10-01 Cathéter à électrodes Ceased WO2013058088A1 (fr)

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JP2011231966A JP5875175B2 (ja) 2011-10-21 2011-10-21 電極カテーテル
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WO2019156059A1 (fr) * 2018-02-06 2019-08-15 株式会社カネカ Cathéter et son procédé de production
US20230310851A1 (en) * 2013-11-22 2023-10-05 Lungpacer Medical Inc. Apparatus and methods for assisted breathing by transvascular nerve stimulation

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JP5697273B2 (ja) * 2013-07-25 2015-04-08 日本ライフライン株式会社 先端偏向操作可能カテーテル
JP6570123B2 (ja) * 2016-02-29 2019-09-04 日本ライフライン株式会社 心腔内除細動カテーテル
JP5976973B1 (ja) * 2016-03-28 2016-08-24 インター・ノバ株式会社 多極電極を有する末梢血管用ガイドカテーテル
US11426575B2 (en) * 2018-07-06 2022-08-30 Sorin Crm Sas Connection method for connecting an isolated micro-conductor
JP6876091B2 (ja) * 2019-05-09 2021-05-26 日本ライフライン株式会社 心腔内除細動カテーテル
US11305108B2 (en) * 2019-12-05 2022-04-19 Medtronic, Inc. Implantable medical lead devices and systems having balanced clocked conductor positions

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WO2010083308A1 (fr) * 2009-01-14 2010-07-22 Spinal Modulation, Inc. Électrodes de stimulation, systèmes de pose, et procédés d'utilisation
JP2011072782A (ja) * 2009-09-29 2011-04-14 Biosense Webster Inc 付勢された平面的な偏向を有するカテーテル
WO2011121931A2 (fr) * 2010-03-30 2011-10-06 日本ライフライン株式会社 Cathéter

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JP2010063886A (ja) * 2008-09-09 2010-03-25 Biosense Webster Inc 接合された中心支柱を備えた偏向可能なカテーテルおよびその製造方法
JP2010063708A (ja) * 2008-09-11 2010-03-25 Japan Lifeline Co Ltd 除細動カテーテル
WO2010083308A1 (fr) * 2009-01-14 2010-07-22 Spinal Modulation, Inc. Électrodes de stimulation, systèmes de pose, et procédés d'utilisation
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WO2011121931A2 (fr) * 2010-03-30 2011-10-06 日本ライフライン株式会社 Cathéter

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US20230310851A1 (en) * 2013-11-22 2023-10-05 Lungpacer Medical Inc. Apparatus and methods for assisted breathing by transvascular nerve stimulation
US12239838B2 (en) * 2013-11-22 2025-03-04 Lungpacer Medical Inc. Apparatus and methods for assisted breathing by transvascular nerve stimulation
WO2019156059A1 (fr) * 2018-02-06 2019-08-15 株式会社カネカ Cathéter et son procédé de production
JPWO2019156059A1 (ja) * 2018-02-06 2021-01-14 株式会社カネカ カテーテルおよびその製造方法
JP7261183B2 (ja) 2018-02-06 2023-04-19 株式会社カネカ カテーテルおよびその製造方法

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