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WO2025115280A1 - Electrode catheter - Google Patents

Electrode catheter Download PDF

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Publication number
WO2025115280A1
WO2025115280A1 PCT/JP2024/025672 JP2024025672W WO2025115280A1 WO 2025115280 A1 WO2025115280 A1 WO 2025115280A1 JP 2024025672 W JP2024025672 W JP 2024025672W WO 2025115280 A1 WO2025115280 A1 WO 2025115280A1
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WO
WIPO (PCT)
Prior art keywords
splines
shaft
electrode
spline
electrode catheter
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.)
Pending
Application number
PCT/JP2024/025672
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French (fr)
Japanese (ja)
Inventor
航平 榊
亮 石田
誠 加藤
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 WO2025115280A1 publication Critical patent/WO2025115280A1/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor

Definitions

  • This disclosure relates to an electrode catheter.
  • a catheter is a type of medical device that is inserted into the body for diagnosis or treatment.
  • an electrode catheter is known that includes a shaft and a basket electrode assembly connected to the tip of the shaft (see, for example, Patent Document 1).
  • the basket electrode assembly includes a number of splines.
  • the basket electrode assembly is configured to be deformed from a contracted shape to an expanded shape by deforming the splines.
  • the electrode catheter described above has difficulty in simultaneously contacting most of the inner circumference of tubular body tissue. For this reason, for example, when cauterizing the boundary between the pulmonary vein and the left atrium to treat atrial fibrillation, it is necessary to cauterize multiple times while changing the position of the spline.
  • the present disclosure has been made in consideration of the above circumstances, and its purpose is to provide an electrode catheter that can be simultaneously contacted over most of the inner circumference of tubular body tissue.
  • the electrode catheter comprises a shaft that is inserted into the body and an electrode assembly provided at the tip of the shaft.
  • the electrode assembly comprises a plurality of splines, each having at least one electrode, and a tip member connected to the tip side of the plurality of splines.
  • Each of the plurality of splines can be deformed into a fan shape having an arc-shaped region along a common imaginary circle when viewed from the axial direction of the shaft, and when each of the plurality of splines is fan-shaped, the plurality of arc-shaped regions formed by the plurality of splines collectively occupy 80% or more of the circumference of the imaginary circle.
  • the electrode catheter of the present disclosure can simultaneously contact most of the inner circumference of tubular body tissue.
  • FIG. 1 is an explanatory diagram relating to a usage scene of the electrode catheter according to the first embodiment.
  • FIG. 2 is a side view showing a schematic view of the vicinity of the tip of the electrode catheter shown in FIG. 1.
  • FIG. 2 is a view of the electrode catheter shown in FIG. 1 as seen from the tip side in the axial direction of the shaft.
  • FIG. 2 is a schematic diagram showing the boundary between the pulmonary vein and the left atrium cauterized by the electrode catheter shown in FIG. 1 .
  • FIG. 2 is a side view showing a schematic example of the overall configuration of the electrode catheter shown in FIG. 1 .
  • 13 is a side view showing a schematic view of the vicinity of the tip of an electrode catheter according to a second embodiment.
  • FIG. FIG. 7 is a view of the electrode catheter shown in FIG. 6 as seen from the tip side in the axial direction of the shaft.
  • FIG. 1 is an explanatory diagram of a usage scene of the electrode catheter 10 according to the first embodiment of the present disclosure.
  • the electrode catheter 10 is used for treatment of a living body.
  • treatment refers to an action related to medical treatment or examination of a living body.
  • the electrode catheter 10 of this embodiment is used for treatment of atrial fibrillation by PFA (Pulsed Field Ablation). Atrial fibrillation is often caused by the transmission of abnormal electrical signals generated in the pulmonary vein 112 to the left atrium 114. This treatment is usually performed by cauterizing the boundary between the pulmonary vein 112 and the left atrium 114 using the electrode assembly 16 of the electrode catheter 10.
  • the ablation range Sa by the electrode catheter 10 is hatched.
  • the method of current application using the electrode assembly 16 can be a monopolar method in which current is applied between the electrode assembly 16 and a return electrode plate placed outside the body, or a bipolar method in which current is applied between the electrode assembly 16 and another electrode placed inside the body.
  • 1 shows an annular ablation area Sa, but the ablation area Sa indicates an approximate area to be ablated by the electrode catheter 10, and the actual ablation area does not necessarily have to coincide with the ablation area Sa. The details of the ablation area Sa will be described later.
  • FIG. 2 is a side view showing the tip of the electrode catheter 10.
  • the electrode catheter 10 includes a shaft 20 that is inserted into the body and an electrode assembly 16 that is provided at the tip of the shaft 20.
  • FIG. 3 is a view of the electrode catheter 10 as seen from the tip side in the axial direction of the shaft 20.
  • the side of the electrode catheter 10 that is inserted into the body is referred to as the "tip side” and the side that is placed outside the body is referred to as the "base side”.
  • the same side as the tip side of the electrode catheter 10 is referred to as the "tip side” of that member
  • the same side as the base side of the electrode catheter 10 is referred to as the "base side” of that member.
  • "viewed from the tip side in the axial direction” means that the electrode catheter 10 is viewed toward the base side from a viewpoint located on the tip side of the electrode catheter 10 along the axial direction of the shaft 20.
  • the shaft 20 may be a long, tubular member.
  • the length of the shaft 20 is, for example, 800 mm to 1800 mm.
  • the outer diameter of the shaft 20 is, for example, 2.0 mm to 5.0 mm.
  • the material constituting the shaft 20 may be any material that is flexible and biocompatible.
  • the shaft 20 is made of a known resin such as polyolefin or polyamide elastomer.
  • the electrode assembly 16 comprises a plurality of splines 24a-24f and a tip member 22 that is connected to the tip side of the plurality of splines 24a-24f by attachment or the like.
  • descriptions common to each of the plurality of splines 24a-24f will also be simply referred to as spline 24.
  • descriptions common to those reference numerals will be written without the alphabetical character added as appropriate.
  • the spline 24 is a member that connects the shaft 20 and the tip member 22.
  • the spline 24 may be a cylindrical member, similar to the shaft 20.
  • the length of the spline 24 when extended in a straight line is, for example, 20 mm to 70 mm.
  • the outer diameter of the spline 24 is, for example, 0.5 mm to 2.0 mm.
  • the material that constitutes the spline 24 may be any material that is flexible and biocompatible.
  • the spline 24, similar to the shaft 20, is made of a known resin such as polyolefin or polyamide elastomer.
  • the electrode catheter 10 has six splines 24a to 24f.
  • the splines 24a to 24f are arranged adjacent to each other in the stated order in a clockwise direction along the circumferential direction when viewed from the tip side. That is, spline 24a and spline 24b, spline 24b and spline 24c, spline 24c and spline 24d, spline 24d and spline 24e, spline 24e and spline 24f, and spline 24f and spline 24a are adjacent to each other.
  • the splines 24 are arranged spaced apart from each other in a plane perpendicular to the central axis of the shaft 20.
  • the base end side of the spline 24 is connected to the shaft 20.
  • a part including the base end of the spline 24 (hereinafter referred to as the "base end") is inserted into the tip side of the shaft 20 and bundled.
  • the base end side of the spline 24 and the shaft 20 are then joined to each other by a known joining method such as welding or bonding with an adhesive.
  • the tip member 22 may cover and bundle a portion (hereinafter referred to as the "tip portion") including the tip of each of the multiple splines 24a to 24f.
  • the tip portions of the multiple splines 24a to 24f may be covered with the tip member 22.
  • the tip member 22 may be in any shape, and is cap-shaped as an example.
  • the tip member 22 may be made of any material, and is made of known resins such as polyamide, polyamide elastomer, polycarbonate, etc., or known metals such as stainless steel, etc.
  • the inside of the tip member 22 may be filled with adhesive. In this case, the multiple splines 24a to 24f are likely to be firmly fixed to each other by the adhesive.
  • the shape of the splines 24 changes in response to a deformation operation, which will be described later.
  • the splines 24 are configured to be deformable.
  • the shape of each spline 24 changes between a non-deployed or contracted shape in which the splines 24 are not deployed along the central axis of the shaft 20, and an expanded or expanded shape in which the splines 24 are deployed from the contracted shape along the central axis of the shaft 20. Details will be described later, but an example of a contracted shape is a "petal shape.”
  • an example of an expanded shape is a "basket shape" in which the splines 24 are deployed from the petal shape along the central axis of the shaft 20.
  • Both Figures 2 and 3 show the state in which each spline 24 is deformed into the expanded shape.
  • Each of the multiple splines 24a to 24f has at least one electrode 26.
  • the electrode 26 is, for example, a ring-shaped electrode provided on the outer peripheral surface of the spline 24.
  • the electrodes 26 of the same spline 24 are arranged at a distance from each other along the longitudinal direction of the spline 24. In this case, the distance between adjacent electrodes 26 may be constant or may be different. Also, the number of electrodes 26 that each spline 24 has may be the same or may be different. In this embodiment, the distance between adjacent electrodes 26 is constant, and all of the electrodes 26 are arranged within a certain area that includes the longitudinal center of each spline 24.
  • Each of the multiple splines 24a to 24f according to this embodiment has four electrodes 26.
  • the electrode 26 is made of a conductive material.
  • the electrode 26 is made of a metal with good electrical conductivity, such as aluminum (Al), copper (Cu), stainless steel, gold (Au), or platinum (Pt).
  • the length of the electrode 26 along the longitudinal direction of the spline 24 is, for example, 0.5 mm to 2.0 mm.
  • the outer diameter of the electrode 26 may be the same as the outer diameter of the spline 24, and is, for example, 0.5 mm to 2.0 mm.
  • the electrodes 26 are individually and electrically connected to conductors.
  • the conductors pass from inside the spline 24 through the shaft 20 and the handle 8 (described below), and are connected to an external power supply device via the handle 8.
  • the splines 24a to 24f form a plurality of arc-shaped regions 28a to 28f along a common imaginary circle 50 as viewed from the axial direction of the shaft 20.
  • the spline 24a forms the arc-shaped region 28a along a portion of the imaginary circle 50.
  • the splines 24b to 24f each form an arc-shaped region 28b to 28f along a portion of the imaginary circle 50.
  • the formation of the arc-shaped regions 28a to 28f along the common imaginary circle 50 by the splines 24a to 24f is not limited to when the splines 24a to 24f are in an expanded shape.
  • each of the splines 24a to 24f has an arc-shaped region 28 along the common imaginary circle 50 is also called a sector shape.
  • each of the multiple splines 24a to 24f can be deformed into a sector shape having an arc-shaped region 28 that is aligned with a common imaginary circle 50 when viewed from the axial direction of the shaft 20.
  • the arc-shaped region 28 that is aligned with the imaginary circle 50 when viewed from the axial direction of the shaft 20 means that the arc-shaped region 28 overlaps with the imaginary circle 50 when viewed from the axial direction of the shaft 20, and the longitudinal direction of the spline 24 in the arc-shaped region 28 approximately coincides with the circumferential direction of the imaginary circle 50 when viewed from the axial direction of the shaft 20.
  • the center of the virtual circle 50 is located at the center of the tip member 22 when viewed from the axial direction of the shaft 20.
  • the arc-shaped region 28 constitutes a certain region including the center of the spline 24 in the longitudinal direction.
  • the spline 24 when the spline 24 is fan-shaped, the spline 24 includes the arc-shaped region 28, a region extending from the tip member 22 in the radial direction of the virtual circle 50 and connecting to one end of the arc-shaped region 28, and a region extending from the shaft 20 in the radial direction of the virtual circle 50 and connecting to the other end of the arc-shaped region 28.
  • the arc-shaped region 28 constitutes the region of the spline 24 that is the farthest from the center of the virtual circle 50 when viewed from the axial direction of the shaft 20. That is, in this embodiment, the virtual circle 50 is a virtual circle that can be drawn on the outermost periphery of the spline 24 when viewed from the axial direction of the shaft 20.
  • the arc-shaped regions 28a to 28f formed by the splines 24a to 24f occupy 80% or more of the circumference of the virtual circle 50 as a whole.
  • the ratio of the arc-shaped regions 28a to 28f to the circumference of the virtual circle 50 as a whole is 80% or more of the circumference of the virtual circle 50. Therefore, the splines 24a to 24f can be simultaneously contacted over most of the circumferential direction of the inner wall of the tubular body tissue, such as the boundary between the pulmonary vein 112 and the left atrium 114 shown in FIG. 1.
  • the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be blocked by a single cauterization without changing the positions of the splines 24a to 24f.
  • the arc-shaped regions 28a to 28f overlap with the virtual circle 50 over almost the entire circumference of the virtual circle 50 as viewed from the axial direction of the shaft 20.
  • each of the splines 24a to 24f is fan-shaped, at least two adjacent splines of the splines 24a to 24f, for example, spline 24a and spline 24b, have an overlap region 30 where they overlap when viewed from the axial direction of the shaft 20.
  • spline 24a and spline 24b cross each other in the overlap region 30 when viewed from the axial direction of the shaft 20.
  • the overlap region 30 is also included in the arc-shaped region 28. Therefore, adjacent splines 24 are arranged without any gaps when viewed from the axial direction of the shaft 20, so that the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be blocked more reliably.
  • not only spline 24a and spline 24b but all adjacent splines 24 have the overlap region 30.
  • each of the multiple splines 24a to 24f is fan-shaped, only adjacent splines 24 have a common overlap region 30 where they overlap when viewed in the axial direction of the shaft 20.
  • non-adjacent splines 24 do not overlap when viewed in the axial direction of the shaft 20 and do not have an overlap region 30. Therefore, it is not necessary for the splines 24 to have a shape that is excessively twisted around the central axis of the shaft 20.
  • the tip member 22 fixes at least two adjacent splines 24, for example, spline 24a and spline 24b, among the plurality of splines 24, at a predetermined angular interval ⁇ around the central axis of the shaft 20.
  • the shaft 20 also fixes the at least two adjacent splines 24, for example, spline 24a and spline 24b, at a position rotated relative to the tip member 22 by an angle between 1 and 3 times the angular interval ⁇ around the central axis of the shaft 20.
  • the twist angle ⁇ is the clockwise angle at the position where the spline 24a is fixed to the shaft 20, based on the position where the spline 24a is fixed to the tip member 22.
  • the spline 24b is fixed to the shaft 20 at a position rotated clockwise by the twist angle ⁇ from the position where the spline 24b is fixed to the tip member 22.
  • the twist angle ⁇ is 1 to 3 times the angle interval ⁇ .
  • the above-mentioned relationship between the angular interval ⁇ and the twist angle ⁇ is satisfied not only for spline 24a and spline 24b but also for all adjacent splines 24.
  • the angular interval ⁇ may be approximately 60°.
  • the twist angle ⁇ may be approximately 60° or more and approximately 180° or less.
  • each of the splines 24a to 24f when each of the splines 24a to 24f is fan-shaped, the electrodes 26 of the splines 24a to 24f that are located in the arc-shaped regions 28a to 28f are arranged at equal intervals on the circumference of the imaginary circle 50.
  • each of the splines 24a to 24f has four electrodes 26, which are arranged at equal intervals along the longitudinal direction of each spline 24 as viewed from the axial direction of the shaft 20.
  • the electrodes 26 that are closest to each other on adjacent splines 24 are arranged at approximately the same intervals as the electrodes 26 of each spline 24 as viewed from the axial direction of the shaft 20.
  • the electrodes 26 being evenly spaced means that the difference between the interval between any two adjacent electrodes 26 and the average interval between all adjacent electrodes 26 on a plane viewed from the axial direction of the shaft 20 as shown in FIG. 3 is less than 10%, for example.
  • each of the multiple splines 24a-24f may have one or more electrodes 26 arranged in an area other than the arc-shaped area 28.
  • the multiple electrodes 26 of the multiple splines 24a to 24f may be disposed at positions corresponding to multiple imaginary points that are equally spaced around the circumference of an imaginary circle 50, as viewed in the axial direction of the shaft 20.
  • the electrodes 26 being disposed at positions corresponding to the imaginary points means that at least a portion of the electrodes 26 is disposed at a position that overlaps with the imaginary points as viewed in the axial direction of the shaft 20.
  • each of the multiple splines 24a to 24f when each of the multiple splines 24a to 24f is fan-shaped, the arc-shaped region 28 of each spline 24 is located in a region that includes the center of the spline 24 in the axial direction.
  • the arc-shaped region 28 of each spline 24 is located in a region that is within 90% of the total axial length of the electrode assembly 16, and preferably within 80%.
  • Each spline 24 tends to be largest in the radial direction perpendicular to the axial direction near the center in the axial direction.
  • the arc-shaped region 28 is located in such a region, it is easy to reliably bring the arc-shaped region 28 into contact with the inner circumference of tubular body tissue, such as the boundary between the pulmonary vein 112 and the left atrium 114 shown in FIG. 1.
  • the electrode catheter 10 according to the first embodiment has been described as having six splines 24a to 24f.
  • the number of splines 24 provided on the electrode catheter 10 is not limited to six, and may be four or more.
  • FIG. 4 is a schematic diagram showing the boundary 116 between the pulmonary vein 112 and the left atrium 114, which is cauterized by the electrode catheter 10.
  • the electrode catheter 10 enters the boundary 116 from inside the left atrium 114, with the tip of the electrode catheter 10 facing the pulmonary vein 112.
  • each of the multiple splines 24a to 24f is deformed into a fan shape, and the multiple splines 24a to 24f are brought into contact with the inner wall of the boundary 116.
  • the boundary 116 is cauterized at multiple cauterization points 130.
  • the multiple cauterization points 130 are included in the cauterization range Sa also shown in FIG. 1.
  • the ablation points 130 correspond to the locations where the splines 24a-24f contact the boundary 116.
  • the locations where the splines 24a-24f contact the boundary 116 are mainly the arc-shaped regions 28. That is, the ablation points 130 are formed to correspond to the shapes and arrangement of the arc-shaped regions 28.
  • the transmission path 118 of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 associated with atrial fibrillation tends to be a straight path from the pulmonary vein 112 to the left atrium 114 along the myocardial sleeve formed at the boundary 116, as shown in FIG. 4. Therefore, the ablation points 130 formed to correspond to the shapes and arrangement of the arc-shaped regions 28 can block the transmission path 118 of abnormal electrical signals.
  • the multiple splines 24a-24f are in contact with the inner wall of the boundary 116 between the pulmonary vein 112 and the left atrium 114, and an electrical pulse is applied through the multiple electrodes 26, thereby cauterizing the electrical transmission pathway 118 of atrial fibrillation so as to block it all at once.
  • FIG. 5 is a side view showing a schematic example of the overall configuration of the electrode catheter 10.
  • the electrode catheter 10 may include a handle 8 connected to the base end side of the shaft 20.
  • the handle 8 is a part that an operator such as a doctor grasps or holds when using the electrode catheter 10.
  • the handle 8 may include a handle main body 11 attached to the base end side of the shaft 20, a rotation operation unit 12, and a slide member 13.
  • the handle body 11 corresponds to the part that the operator actually grips.
  • the handle body 11 may have any shape.
  • the handle body 11 has a shape that extends along the central axis of the shaft 20.
  • the handle body 11 is made of a known resin, such as polycarbonate, polyacetal, ABS, etc.
  • the rotation operation unit 12 is the part that is operated by rotation operation and the like when bending or flexing the vicinity of the tip of the shaft 20 in both directions.
  • the base ends of a pair of pull wires are fixed to the rotation operation unit 12 within the handle body 11.
  • the tips of the pair of pull wires pass from inside the handle body 11 through the shaft 20 and are fixed to the tip side of the shaft 20. Therefore, when the rotation operation unit 12 is operated, the pull wires are pulled toward the base end, and the tip side of the shaft 20 to which the tips of the pull wires are fixed bends or flexes.
  • the slide member 13 is a part that is deformed by an operator, such as by sliding, when changing the shape of the multiple splines 24 between the undeployed or contracted shape and the deployed or expanded shape described above.
  • the slide member 13 is slidable along the central axis of the shaft 20 in the handle body 11.
  • the base end of the deformation member 14 is fixed to the slide member 13.
  • the tip of the deformation member 14 passes from inside the handle body 11 through the shaft 20 and is fixed in the tip member 22.
  • the slide member 13 can be moved to any position along the central axis of the shaft 20 in the handle body 11. Therefore, depending on the position of the slide member 13, the shape of the multiple splines 24 can be deformed to the previously described non-expanded shape or contracted shape, the expanded shape or expanded shape, or any intermediate shape between the non-expanded shape and the expanded shape.
  • the deformation member 14 may be of any shape, structure, or material as long as it is long.
  • the deformation member 14 is a wire.
  • FIG. 6 is a side view showing the vicinity of the tip of the electrode catheter 10A according to the second embodiment.
  • Figure 7 is a view of the electrode catheter 10A as seen from the tip side in the axial direction of the shaft 20.
  • the electrode catheter 10A of this embodiment differs from the electrode catheter 10 of the first embodiment in the arrangement of the electrodes 26 of each of the splines 24a to 24f. That is, when each of the splines 24a to 24f is fan-shaped, at least a portion of the electrode 26 of one of at least two adjacent splines 24, for example, spline 24a and spline 24b, overlaps with at least a portion of the electrode 26 of the other spline 24 when viewed from the axial direction of the shaft 20. Specifically, as shown in FIG. 7, the electrode 261 of the spline 24a and the electrode 262 of the spline 24b overlap with each other when viewed from the axial direction of the shaft 20. As a result, by cauterizing using these electrodes 26, the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be more reliably blocked.
  • the electrode 261 located closest to the spline 24b among the electrodes 26 of the spline 24a and the electrode 262 located closest to the spline 24a among the electrodes 26 of the spline 24b overlap each other when viewed from the axial direction of the shaft 20.
  • This configuration can minimize the number of overlapping electrodes 26 while still achieving the effect of blocking the transmission of abnormal electrical signals.
  • the multiple electrodes 26 of the multiple splines 24a to 24f do not have to be equally spaced on the circumference of the virtual circle 50 when viewed in the axial direction of the shaft 20.
  • the overlapping electrodes 26 of adjacent splines 24 are considered to be one electrode 26, it is also possible to arrange the electrodes 26 at equal intervals on the circumference of the virtual circle 50 when viewed in the axial direction of the shaft 20.
  • the embodiment may be specified by the items described below.
  • the electrode assembly (16) includes a plurality of splines (24) each having at least one electrode (26) and a tip member (22) connected to a tip side of the plurality of splines (24);
  • Each of the plurality of splines (24) is deformable into a sector shape having an arc-shaped region (28) along a common imaginary circle (50) when viewed in the axial direction of the shaft (20);
  • the plurality of arc-shaped regions (28) formed by the plurality of splines (24) occupy 80% or more of the circumference of the imaginary circle (50) as a whole.
  • the multiple arc-shaped regions (28) formed by the multiple splines (24) occupy 80% or more of the circumference of the virtual circle (50) as a whole. Therefore, the multiple splines (24) can be simultaneously brought into contact with most of the circumferential direction of the inner wall of tubular body tissue, such as the boundary between the pulmonary vein and the left atrium. Therefore, the transmission of abnormal electrical signals from the pulmonary vein to the left atrium can be blocked with a single cauterization without changing the position of the multiple splines (24).
  • each of the plurality of splines (24) is fan-shaped, at least two adjacent splines (24) of the plurality of splines (24) have overlapping regions (30) that overlap each other when viewed in the axial direction.
  • Item 1 An electrode catheter (10) as described in item 1.
  • the electrode catheter (10) according to the second item has at least two adjacent splines (24) arranged so that there is no gap between them when viewed in the axial direction, so that the transmission of abnormal electrical signals from the pulmonary vein to the left atrium can be blocked more reliably.
  • At least two adjacent splines (24) have at least two electrodes (26) that overlap when viewed in the axial direction, so that cauterization using these electrodes (26) can more reliably block the transmission of abnormal electrical signals from the pulmonary vein to the left atrium.
  • non-adjacent splines (24) do not have overlapping regions (30), so there is no need for the splines (24) to be excessively twisted around the central axis of the shaft (20), making it easier to handle.
  • the tip member (22) fixes at least two adjacent splines (24) of the plurality of splines (24) so as to be spaced at a predetermined angle around the central axis of the shaft (20);
  • the shaft (20) has at least two adjacent splines (24) fixed at positions rotated relative to the tip member (22) by an angle between 1 and 3 times the angular interval around the central axis. 5.
  • An electrode catheter (10) according to any one of claims 1 to 4.
  • the electrode catheter (10) can block the transmission of abnormal electrical signals from the pulmonary vein to the left atrium while avoiding the spline (24) from being excessively twisted around the central axis of the shaft (20).
  • the electrode catheter (10) allows the inner circumference of the boundary between the pulmonary vein and the left atrium to be cauterized uniformly at once using multiple electrodes (26) arranged at equal intervals around the circumference of an imaginary circle (50).
  • each of the plurality of splines (24) is fan-shaped, the arcuate region (28) of each spline (24) includes the center of the spline (24) in the axial direction and is located in a region within 90% of the total axial length of the electrode assembly (16); 7.
  • An electrode catheter (10) according to any one of claims 1 to 6.
  • the arc-shaped region (28) is located in a region including the axial center where the electrode assembly (16) is most likely to become large in the radial direction perpendicular to the axial direction, making it easier to reliably bring the arc-shaped region (28) into contact with the inner circumference of the tubular body tissue.
  • This disclosure can be used in electrode catheters.

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Abstract

This electrode catheter comprises: a shaft to be inserted into the body; and an electrode assembly 16 provided at the leading end of the shaft. The electrode assembly 16 is provided with a plurality of splines 24a-24f each having at least one electrode 26, and a leading end member connected to the leading end sides of the plurality of splines 24a-24f. The plurality of splines 24a-24f can be deformed into a circular sector shape having arc-shaped regions 28a-28f along a common virtual circle 50 as viewed in the axial direction of the shaft. When the plurality of splines 24a-24f are in the circular sector shape, the plurality of arc-shaped regions 28a-28f formed by the plurality of splines 24a-24f account for a total of at least 80% of the circumference of the virtual circle 50.

Description

電極カテーテルElectrode Catheter

 本開示は、電極カテーテルに関する。 This disclosure relates to an electrode catheter.

 カテーテルは、診断または治療のために体内に挿入される医療機器の一種である。一例として、シャフトと、シャフトの先端に結合されたバスケット電極組立体と、を備える電極カテーテルが知られている(例えば特許文献1参照)。ここで、バスケット電極組立体は、複数のスプラインを含んでいる。そして、スプラインを変形させることで、バスケット電極組立体が収縮形状から拡張形状に変形するように構成されている。 A catheter is a type of medical device that is inserted into the body for diagnosis or treatment. As an example, an electrode catheter is known that includes a shaft and a basket electrode assembly connected to the tip of the shaft (see, for example, Patent Document 1). Here, the basket electrode assembly includes a number of splines. The basket electrode assembly is configured to be deformed from a contracted shape to an expanded shape by deforming the splines.

特表2016-507349号公報Special Publication No. 2016-507349

 上述した電極カテーテルは、管状の体組織の内周の大部分に亘って同時に接触させることは困難であった。そのため、例えば心房細動の治療のために、肺静脈と左心房との境界部を焼灼する場合においては、スプラインの位置を変えながら複数回に亘って焼灼する必要があった。 The electrode catheter described above has difficulty in simultaneously contacting most of the inner circumference of tubular body tissue. For this reason, for example, when cauterizing the boundary between the pulmonary vein and the left atrium to treat atrial fibrillation, it is necessary to cauterize multiple times while changing the position of the spline.

 本開示は上述の事情を鑑みてなされたものであり、その目的は、管状の体組織の内周の大部分に亘って同時に接触させることが可能な電極カテーテルを提供することにある。 The present disclosure has been made in consideration of the above circumstances, and its purpose is to provide an electrode catheter that can be simultaneously contacted over most of the inner circumference of tubular body tissue.

 本開示のある態様は、電極カテーテルである。この電極カテーテルは、体内に挿入されるシャフトと、シャフトの先端に設けられた電極アセンブリと、を備える。電極アセンブリは、それぞれ少なくとも1つの電極を有する複数のスプラインと、複数のスプラインの先端側に接続された先端部材と、を備える。複数のスプラインのそれぞれは、シャフトの軸方向から見て、共通の仮想円に沿う円弧状領域を有する扇形状に変形可能であり、複数のスプラインのそれぞれが扇形状であるとき、複数のスプラインによって形成される複数の円弧状領域は、全体として仮想円の円周の80%以上を占める。 One aspect of the present disclosure is an electrode catheter. The electrode catheter comprises a shaft that is inserted into the body and an electrode assembly provided at the tip of the shaft. The electrode assembly comprises a plurality of splines, each having at least one electrode, and a tip member connected to the tip side of the plurality of splines. Each of the plurality of splines can be deformed into a fan shape having an arc-shaped region along a common imaginary circle when viewed from the axial direction of the shaft, and when each of the plurality of splines is fan-shaped, the plurality of arc-shaped regions formed by the plurality of splines collectively occupy 80% or more of the circumference of the imaginary circle.

 本開示の他の態様は、電極カテーテルである。この電極カテーテルは、体内に挿入されるシャフトと、シャフトの先端に設けられた電極アセンブリと、を備える。電極アセンブリは、それぞれ少なくとも1つの電極を有する複数のスプラインと、複数のスプラインの先端側に接続された先端部材と、を備える。複数のスプラインが肺静脈と左心房との境界部の内壁に接触した状態で、複数の電極を通じて電気パルスが印加されることで、心房細動の電気的な伝達経路を一度に遮断するように焼灼可能である。 Another aspect of the present disclosure is an electrode catheter. This electrode catheter comprises a shaft that is inserted into the body and an electrode assembly provided at the tip of the shaft. The electrode assembly comprises a number of splines, each having at least one electrode, and a tip member connected to the tip side of the number of splines. With the number of splines in contact with the inner wall of the boundary between the pulmonary vein and the left atrium, an electrical pulse can be applied through the number of electrodes, thereby cauterizing the electrical transmission pathway of atrial fibrillation so as to block it all at once.

 以上の構成要素の任意の組合せ、本開示の表現を方法、装置、システムなどの間で変換したものもまた、本開示の態様として有効である。 Any combination of the above components, or any conversion of the expressions of this disclosure between methods, devices, systems, etc., are also valid aspects of this disclosure.

 本開示の電極カテーテルは、管状の体組織の内周の大部分に亘って同時に接触させることができる。 The electrode catheter of the present disclosure can simultaneously contact most of the inner circumference of tubular body tissue.

第1実施形態に係る電極カテーテルの利用シーンに関する説明図である。FIG. 1 is an explanatory diagram relating to a usage scene of the electrode catheter according to the first embodiment. 図1に示す電極カテーテルの先端付近を模式的に示す側面図である。FIG. 2 is a side view showing a schematic view of the vicinity of the tip of the electrode catheter shown in FIG. 1. 図1に示す電極カテーテルをシャフトの軸方向の先端側から見た図である。FIG. 2 is a view of the electrode catheter shown in FIG. 1 as seen from the tip side in the axial direction of the shaft. 図1に示す電極カテーテルによって焼灼される肺静脈と左心房との境界部を模式的に示す図である。FIG. 2 is a schematic diagram showing the boundary between the pulmonary vein and the left atrium cauterized by the electrode catheter shown in FIG. 1 . 図1に示す電極カテーテルの全体構成の一例を模式的に示す側面図である。FIG. 2 is a side view showing a schematic example of the overall configuration of the electrode catheter shown in FIG. 1 . 第2実施形態に係る電極カテーテルの先端付近を模式的に示す側面図である。13 is a side view showing a schematic view of the vicinity of the tip of an electrode catheter according to a second embodiment. FIG. 図6に示す電極カテーテルをシャフトの軸方向の先端側から見た図である。FIG. 7 is a view of the electrode catheter shown in FIG. 6 as seen from the tip side in the axial direction of the shaft.

 以下、本開示を好適な実施の形態をもとに図面を参照しながら説明する。実施の形態は、本開示を限定するものではなく例示であって、実施の形態に記述されるすべての特徴やその組み合わせは、必ずしも本開示の本質的なものであるとは限らない。各図面に示される同一または同等の構成要素、部材、処理には、同一の符号を付するものとし、適宜重複した説明を省略する。また、各図に示す各部の縮尺や形状は、説明を容易にするために便宜的に設定されており、特に言及がない限り限定的に解釈されるものではない。また、本明細書または請求項中に「第1」、「第2」等の用語が用いられる場合には、特に言及がない限りこの用語はいかなる順序や重要度を表すものでもなく、ある構成と他の構成とを区別するためのものである。また、各図面において実施の形態を説明する上で重要ではない部材の一部は省略して表示する。 Below, the present disclosure will be described with reference to the drawings based on preferred embodiments. The embodiments are illustrative and do not limit the present disclosure, and all features and combinations thereof described in the embodiments are not necessarily essential to the present disclosure. The same or equivalent components, members, and processes shown in each drawing will be given the same reference numerals, and duplicated descriptions will be omitted as appropriate. In addition, the scale and shape of each part shown in each drawing are set for convenience to facilitate explanation, and are not to be interpreted as being limiting unless otherwise specified. In addition, when terms such as "first" and "second" are used in this specification or claims, unless otherwise specified, these terms do not indicate any order or importance, but are intended to distinguish one configuration from another. In addition, some of the members that are not important in explaining the embodiments in each drawing are omitted.

[第1実施形態]
 図1は、本開示の第1実施形態に係る電極カテーテル10の利用シーンに関する説明図である。電極カテーテル10は、生体の処置に用いられる。ここでの「処置」とは、生体の治療又は検査に関する行為をいう。本実施形態の電極カテーテル10は、PFA(パルス電界アブレーション:Pulsed Field Ablation)による心房細動の治療に用いられる。心房細動は、多くの場合、肺静脈112で生じた異常な電気信号の左心房114への伝達に起因して生じる。この治療は、通常、電極カテーテル10の電極アセンブリ16を用いて肺静脈112と左心房114の境界部を焼灼することでなされる。ここでは電極カテーテル10による焼灼範囲Saにハッチングを付す。これにより、肺静脈112から左心房114への異常な電気信号の伝達が遮断される。電極アセンブリ16を用いた通電方式は、体外に配置される対極板との間で通電するモノポーラ方式の他、体内に配置した他の電極との間で通電するバイポーラ方式等を採用できる。図1では、環状の焼灼範囲Saを示すが、焼灼範囲Saは電極カテーテル10によって焼灼されるおおよその範囲を示すものであり、実際に焼灼される箇所は焼灼範囲Saと必ずしも一致しなくてよい。焼灼範囲Saの詳細は後述する。
[First embodiment]
FIG. 1 is an explanatory diagram of a usage scene of the electrode catheter 10 according to the first embodiment of the present disclosure. The electrode catheter 10 is used for treatment of a living body. Here, "treatment" refers to an action related to medical treatment or examination of a living body. The electrode catheter 10 of this embodiment is used for treatment of atrial fibrillation by PFA (Pulsed Field Ablation). Atrial fibrillation is often caused by the transmission of abnormal electrical signals generated in the pulmonary vein 112 to the left atrium 114. This treatment is usually performed by cauterizing the boundary between the pulmonary vein 112 and the left atrium 114 using the electrode assembly 16 of the electrode catheter 10. Here, the ablation range Sa by the electrode catheter 10 is hatched. This blocks the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114. The method of current application using the electrode assembly 16 can be a monopolar method in which current is applied between the electrode assembly 16 and a return electrode plate placed outside the body, or a bipolar method in which current is applied between the electrode assembly 16 and another electrode placed inside the body. 1 shows an annular ablation area Sa, but the ablation area Sa indicates an approximate area to be ablated by the electrode catheter 10, and the actual ablation area does not necessarily have to coincide with the ablation area Sa. The details of the ablation area Sa will be described later.

 図2は、電極カテーテル10の先端付近を模式的に示す側面図である。電極カテーテル10は、体内に挿入されるシャフト20と、シャフト20の先端に設けられた電極アセンブリ16とを備える。図3は、電極カテーテル10をシャフト20の軸方向の先端側から見た図である。以下では適宜、電極カテーテル10の体内に挿入される側を「先端側」といい、体外に配置される側を「基端側」という。また、電極カテーテル10を構成する各部材についても、電極カテーテル10の先端側と同じ側をその部材の「先端側」といい、電極カテーテル10の基端側と同じ側をその部材の「基端側」という。本明細書において、「軸方向の先端側から見る」とは、シャフト20の軸方向に沿って電極カテーテル10よりも先端側に位置する視点から、基端側に向かって電極カテーテル10を見ることを意味する。 2 is a side view showing the tip of the electrode catheter 10. The electrode catheter 10 includes a shaft 20 that is inserted into the body and an electrode assembly 16 that is provided at the tip of the shaft 20. FIG. 3 is a view of the electrode catheter 10 as seen from the tip side in the axial direction of the shaft 20. In the following, the side of the electrode catheter 10 that is inserted into the body is referred to as the "tip side" and the side that is placed outside the body is referred to as the "base side". In addition, for each member that constitutes the electrode catheter 10, the same side as the tip side of the electrode catheter 10 is referred to as the "tip side" of that member, and the same side as the base side of the electrode catheter 10 is referred to as the "base side" of that member. In this specification, "viewed from the tip side in the axial direction" means that the electrode catheter 10 is viewed toward the base side from a viewpoint located on the tip side of the electrode catheter 10 along the axial direction of the shaft 20.

 シャフト20は、長尺の円管状部材であってもよい。シャフト20の長さは、例えば800mm~1800mmである。シャフト20の外径は、例えば2.0mm~5.0mmである。シャフト20を構成する材料は、可撓性および生体適合性を有する材料であればよい。例えば、シャフト20は、ポリオレフィンまたはポリアミドエラストマー等といった公知の樹脂から構成される。 The shaft 20 may be a long, tubular member. The length of the shaft 20 is, for example, 800 mm to 1800 mm. The outer diameter of the shaft 20 is, for example, 2.0 mm to 5.0 mm. The material constituting the shaft 20 may be any material that is flexible and biocompatible. For example, the shaft 20 is made of a known resin such as polyolefin or polyamide elastomer.

 電極アセンブリ16は、複数のスプライン24a~24fと、複数のスプライン24a~24fの先端側に装着等により接続された先端部材22と、を備える。以下、複数のスプライン24a~24fそれぞれについて共通する説明については、単にスプライン24とも記載する。末尾にアルファベットが付加されたその他の符号についても、それらの符号に共通する説明については、適宜アルファベットを付加せずに記載する。 The electrode assembly 16 comprises a plurality of splines 24a-24f and a tip member 22 that is connected to the tip side of the plurality of splines 24a-24f by attachment or the like. In the following, descriptions common to each of the plurality of splines 24a-24f will also be simply referred to as spline 24. For other reference numerals with an alphabetical character added to the end, descriptions common to those reference numerals will be written without the alphabetical character added as appropriate.

 スプライン24は、シャフト20と先端部材22との間を繋ぐ部材である。スプライン24は、シャフト20と同様に円管状部材であってもよい。スプライン24を直線状に伸ばした際の長さは、例えば20mm~70mmである。スプライン24の外径は、例えば0.5mm~2.0mmである。スプライン24を構成する材料は、可撓性および生体適合性を有する材料であればよい。例えば、スプライン24は、シャフト20と同様に、ポリオレフィンまたはポリアミドエラストマー等といった公知の樹脂から構成される。 The spline 24 is a member that connects the shaft 20 and the tip member 22. The spline 24 may be a cylindrical member, similar to the shaft 20. The length of the spline 24 when extended in a straight line is, for example, 20 mm to 70 mm. The outer diameter of the spline 24 is, for example, 0.5 mm to 2.0 mm. The material that constitutes the spline 24 may be any material that is flexible and biocompatible. For example, the spline 24, similar to the shaft 20, is made of a known resin such as polyolefin or polyamide elastomer.

 本実施形態に係る電極カテーテル10は、6つのスプライン24a~24fを備える。スプライン24a~24fは、先端側から見て周方向に沿って時計回りにこの順番で隣り合うように配置されている。すなわち、スプライン24aおよびスプライン24b、スプライン24bおよびスプライン24c、スプライン24cおよびスプライン24d、スプライン24dおよびスプライン24e、スプライン24eおよびスプライン24f、スプライン24fおよびスプライン24aがそれぞれ隣り合っている。また、シャフト20の軸方向におけるスプライン24の中心付近では、シャフト20の中心軸と直交する面内において、各スプライン24は互いに離隔して配置されている。 The electrode catheter 10 according to this embodiment has six splines 24a to 24f. The splines 24a to 24f are arranged adjacent to each other in the stated order in a clockwise direction along the circumferential direction when viewed from the tip side. That is, spline 24a and spline 24b, spline 24b and spline 24c, spline 24c and spline 24d, spline 24d and spline 24e, spline 24e and spline 24f, and spline 24f and spline 24a are adjacent to each other. In addition, near the center of the splines 24 in the axial direction of the shaft 20, the splines 24 are arranged spaced apart from each other in a plane perpendicular to the central axis of the shaft 20.

 スプライン24の基端側は、シャフト20に接続されている。一例として、スプライン24の基端を含む一部(以下、「基端部」という)が、シャフト20の先端側に挿入されて束ねられている。そして、スプライン24の基端部とシャフト20とが、溶着または接着剤による接着等の公知の接合方法によって互いに接合されている。 The base end side of the spline 24 is connected to the shaft 20. As an example, a part including the base end of the spline 24 (hereinafter referred to as the "base end") is inserted into the tip side of the shaft 20 and bundled. The base end side of the spline 24 and the shaft 20 are then joined to each other by a known joining method such as welding or bonding with an adhesive.

 先端部材22は、複数のスプライン24a~24fそれぞれの先端を含む一部(以下、「先端部」という)を覆って束ねていてもよい。換言すれば、複数のスプライン24a~24fの先端部には、先端部材22が被せられていてもよい。先端部材22は、どのような形状であっても構わないが、一例としてキャップ状である。また、先端部材22は、どのような材料で構成されていても構わないが、一例として、ポリアミド、ポリアミドエラストマー、ポリカーボネート等といった公知の樹脂、もしくはステンレススチール等といった公知の金属から構成される。先端部材22の内部は、接着剤により充填されていてもよい。この場合、複数のスプライン24a~24fが接着剤によりそれぞれ強固に固定されやすい。 The tip member 22 may cover and bundle a portion (hereinafter referred to as the "tip portion") including the tip of each of the multiple splines 24a to 24f. In other words, the tip portions of the multiple splines 24a to 24f may be covered with the tip member 22. The tip member 22 may be in any shape, and is cap-shaped as an example. The tip member 22 may be made of any material, and is made of known resins such as polyamide, polyamide elastomer, polycarbonate, etc., or known metals such as stainless steel, etc. The inside of the tip member 22 may be filled with adhesive. In this case, the multiple splines 24a to 24f are likely to be firmly fixed to each other by the adhesive.

 スプライン24は、後述する変形操作に応じて形状が変化する。すなわち、スプライン24は変形可能に構成されている。具体的には、シャフト20の中心軸に沿って各スプライン24を展開していない非展開形状もしくは収縮形状と、収縮形状からシャフト20の中心軸に沿って各スプライン24を展開させた展開形状もしくは拡張形状との間で、各スプライン24の形状が変化するようになっている。詳細は後述するが、収縮形状の一例としては、「花弁形状」が挙げられる。一方、拡張形状の一例としては、花弁形状から各スプライン24がシャフト20の中心軸に沿って展開された「バスケット形状」が挙げられる。図2および図3は、いずれも各スプライン24が拡張形状に変形した状態を示す。 The shape of the splines 24 changes in response to a deformation operation, which will be described later. In other words, the splines 24 are configured to be deformable. Specifically, the shape of each spline 24 changes between a non-deployed or contracted shape in which the splines 24 are not deployed along the central axis of the shaft 20, and an expanded or expanded shape in which the splines 24 are deployed from the contracted shape along the central axis of the shaft 20. Details will be described later, but an example of a contracted shape is a "petal shape." On the other hand, an example of an expanded shape is a "basket shape" in which the splines 24 are deployed from the petal shape along the central axis of the shaft 20. Both Figures 2 and 3 show the state in which each spline 24 is deformed into the expanded shape.

 複数のスプライン24a~24fは、それぞれ少なくとも1つの電極26を有する。電極26は、スプライン24の外周面に設けられた、例えばリング状の電極である。同一のスプライン24が有する各電極26は、スプライン24の長手方向に沿って、互いに離隔して配置されている。この場合、隣り合う電極26同士の間隔は一定であってもよく、異なっていてもよい。また、各スプライン24が有する電極26の個数は同じであってもよく、異なっていてもよい。本実施形態では、隣り合う電極26同士の間隔は一定であり、全ての電極26が各スプライン24の長手方向の中心を含む一定領域内に配置されている。本実施形態に係る複数のスプライン24a~24fは、それぞれ4つの電極26を有する。 Each of the multiple splines 24a to 24f has at least one electrode 26. The electrode 26 is, for example, a ring-shaped electrode provided on the outer peripheral surface of the spline 24. The electrodes 26 of the same spline 24 are arranged at a distance from each other along the longitudinal direction of the spline 24. In this case, the distance between adjacent electrodes 26 may be constant or may be different. Also, the number of electrodes 26 that each spline 24 has may be the same or may be different. In this embodiment, the distance between adjacent electrodes 26 is constant, and all of the electrodes 26 are arranged within a certain area that includes the longitudinal center of each spline 24. Each of the multiple splines 24a to 24f according to this embodiment has four electrodes 26.

 電極26は、導電性を有する材料で構成されている。例えば、電極26は、アルミニウム(Al)、銅(Cu)、ステンレス、金(Au)、白金(Pt)等の電気伝導性が良好な金属により構成されている。電極26のスプライン24の長手方向に沿う長さは、例えば0.5mm~2.0mmである。電極26の外径は、スプライン24の外径と同等であればよく、例えば0.5mm~2.0mmである。 The electrode 26 is made of a conductive material. For example, the electrode 26 is made of a metal with good electrical conductivity, such as aluminum (Al), copper (Cu), stainless steel, gold (Au), or platinum (Pt). The length of the electrode 26 along the longitudinal direction of the spline 24 is, for example, 0.5 mm to 2.0 mm. The outer diameter of the electrode 26 may be the same as the outer diameter of the spline 24, and is, for example, 0.5 mm to 2.0 mm.

 電極26には、導線が個別に電気的に接続されている。また、導線は、スプライン24内からシャフト20内および後述するハンドル8内を通り、ハンドル8を介して外部の給電装置に接続される。 The electrodes 26 are individually and electrically connected to conductors. The conductors pass from inside the spline 24 through the shaft 20 and the handle 8 (described below), and are connected to an external power supply device via the handle 8.

 図3に示すように、複数のスプライン24a~24fが拡張形状であるとき、シャフト20の軸方向から見て、複数のスプライン24a~24fは共通の仮想円50に沿う複数の円弧状領域28a~28fを形成する。具体的に、スプライン24aは、仮想円50の一部に沿う円弧状領域28aを形成する。同様に、複数のスプライン24b~24fは、それぞれ、仮想円50の一部に沿う円弧状領域28b~28fを形成する。複数のスプライン24a~24fが共通の仮想円50に沿う複数の円弧状領域28a~28fを形成するのは、複数のスプライン24a~24fが拡張形状であるときには限定されない。複数のスプライン24a~24fのそれぞれが共通の仮想円50に沿う円弧状領域28を有するときの形状を、扇形状ともいう。換言すると、複数のスプライン24a~24fのそれぞれは、シャフト20の軸方向から見て、共通の仮想円50に沿う円弧状領域28を有する扇形状に変形可能である。ここで、シャフト20の軸方向から見て円弧状領域28が仮想円50に沿うとは、シャフト20の軸方向から見て円弧状領域28が仮想円50と重なり、かつ、シャフト20の軸方向から見てスプライン24の長手方向が円弧状領域28において仮想円50の周方向と略一致することをいう。 3, when the splines 24a to 24f are in an expanded shape, the splines 24a to 24f form a plurality of arc-shaped regions 28a to 28f along a common imaginary circle 50 as viewed from the axial direction of the shaft 20. Specifically, the spline 24a forms the arc-shaped region 28a along a portion of the imaginary circle 50. Similarly, the splines 24b to 24f each form an arc-shaped region 28b to 28f along a portion of the imaginary circle 50. The formation of the arc-shaped regions 28a to 28f along the common imaginary circle 50 by the splines 24a to 24f is not limited to when the splines 24a to 24f are in an expanded shape. The shape when each of the splines 24a to 24f has an arc-shaped region 28 along the common imaginary circle 50 is also called a sector shape. In other words, each of the multiple splines 24a to 24f can be deformed into a sector shape having an arc-shaped region 28 that is aligned with a common imaginary circle 50 when viewed from the axial direction of the shaft 20. Here, the arc-shaped region 28 that is aligned with the imaginary circle 50 when viewed from the axial direction of the shaft 20 means that the arc-shaped region 28 overlaps with the imaginary circle 50 when viewed from the axial direction of the shaft 20, and the longitudinal direction of the spline 24 in the arc-shaped region 28 approximately coincides with the circumferential direction of the imaginary circle 50 when viewed from the axial direction of the shaft 20.

 本実施形態では、仮想円50の中心は、シャフト20の軸方向から見て、先端部材22の中心に位置する。本実施形態では、円弧状領域28は、スプライン24の長手方向における中心を含む一定領域を構成する。具体的に、スプライン24が扇形状であるとき、スプライン24は、円弧状領域28と、先端部材22から仮想円50の径方向に延在して円弧状領域28の一端に繋がる領域と、シャフト20から仮想円50の径方向に延在して円弧状領域28の他端に繋がる領域と、を含む。また、本実施形態では、円弧状領域28は、シャフト20の軸方向から見て、スプライン24の領域のうち、仮想円50の中心から最も離隔した領域を構成する。すなわち、本実施形態では、仮想円50は、シャフト20の軸方向から見て、スプライン24の最外周部に描画できる仮想的な円である。 In this embodiment, the center of the virtual circle 50 is located at the center of the tip member 22 when viewed from the axial direction of the shaft 20. In this embodiment, the arc-shaped region 28 constitutes a certain region including the center of the spline 24 in the longitudinal direction. Specifically, when the spline 24 is fan-shaped, the spline 24 includes the arc-shaped region 28, a region extending from the tip member 22 in the radial direction of the virtual circle 50 and connecting to one end of the arc-shaped region 28, and a region extending from the shaft 20 in the radial direction of the virtual circle 50 and connecting to the other end of the arc-shaped region 28. In addition, in this embodiment, the arc-shaped region 28 constitutes the region of the spline 24 that is the farthest from the center of the virtual circle 50 when viewed from the axial direction of the shaft 20. That is, in this embodiment, the virtual circle 50 is a virtual circle that can be drawn on the outermost periphery of the spline 24 when viewed from the axial direction of the shaft 20.

 複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fによって形成される複数の円弧状領域28a~28fは、全体として仮想円50の円周の80%以上を占める。すなわち、複数の円弧状領域28a~28fの全体が仮想円50の円周に占める割合は、仮想円50の円周全体のうちの80%以上である。そのため、複数のスプライン24a~24fを、図1に示した肺静脈112と左心房114との境界部などの管状の体組織の内壁の周方向の大部分に亘って同時に接触させることができる。よって、複数のスプライン24a~24fの位置を変えなくても、一度の焼灼で肺静脈112から左心房114への異常な電気信号の伝達を遮断することができる。本実施形態では、図3に示すように、複数の円弧状領域28a~28fは、シャフト20の軸方向から見て仮想円50の円周の略全域において仮想円50と重なっている。 When each of the splines 24a to 24f is fan-shaped, the arc-shaped regions 28a to 28f formed by the splines 24a to 24f occupy 80% or more of the circumference of the virtual circle 50 as a whole. In other words, the ratio of the arc-shaped regions 28a to 28f to the circumference of the virtual circle 50 as a whole is 80% or more of the circumference of the virtual circle 50. Therefore, the splines 24a to 24f can be simultaneously contacted over most of the circumferential direction of the inner wall of the tubular body tissue, such as the boundary between the pulmonary vein 112 and the left atrium 114 shown in FIG. 1. Therefore, the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be blocked by a single cauterization without changing the positions of the splines 24a to 24f. In this embodiment, as shown in FIG. 3, the arc-shaped regions 28a to 28f overlap with the virtual circle 50 over almost the entire circumference of the virtual circle 50 as viewed from the axial direction of the shaft 20.

 図3に示すように、複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fのうちの少なくとも2つの隣り合うスプライン、例えばスプライン24aおよびスプライン24bは、シャフト20の軸方向から見て互いに重なり合う重複領域30を有する。具体的に、スプライン24aおよびスプライン24bは、シャフト20の軸方向から見て重複領域30において互いに交差している。また、重複領域30は円弧状領域28に含まれる。そのため、隣り合うスプライン24同士が、シャフト20の軸方向から見て隙間なく配置されるので、肺静脈112から左心房114への異常な電気信号の伝達をより確実に遮断することができる。本実施形態では、スプライン24aおよびスプライン24bに限らず、全ての隣り合うスプライン24同士が、重複領域30を有する。 As shown in FIG. 3, when each of the splines 24a to 24f is fan-shaped, at least two adjacent splines of the splines 24a to 24f, for example, spline 24a and spline 24b, have an overlap region 30 where they overlap when viewed from the axial direction of the shaft 20. Specifically, spline 24a and spline 24b cross each other in the overlap region 30 when viewed from the axial direction of the shaft 20. The overlap region 30 is also included in the arc-shaped region 28. Therefore, adjacent splines 24 are arranged without any gaps when viewed from the axial direction of the shaft 20, so that the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be blocked more reliably. In this embodiment, not only spline 24a and spline 24b but all adjacent splines 24 have the overlap region 30.

 本実施形態では、複数のスプライン24a~24fのそれぞれが扇形状であるとき、隣り合うスプライン24同士のみがシャフト20の軸方向から見て互いに重なり合う共通の重複領域30を有する。すなわち、隣り合わないスプライン24同士は、シャフト20の軸方向から見て互いに重なり合うことはなく、重複領域30を有さない。そのため、スプライン24がシャフト20の中心軸周りで過剰に捻られた形状とする必要がない。 In this embodiment, when each of the multiple splines 24a to 24f is fan-shaped, only adjacent splines 24 have a common overlap region 30 where they overlap when viewed in the axial direction of the shaft 20. In other words, non-adjacent splines 24 do not overlap when viewed in the axial direction of the shaft 20 and do not have an overlap region 30. Therefore, it is not necessary for the splines 24 to have a shape that is excessively twisted around the central axis of the shaft 20.

 図3に示すように、先端部材22は、複数のスプライン24のうちの少なくとも2つの隣り合うスプライン24、例えばスプライン24aおよびスプライン24bを、シャフト20の中心軸周りで所定の角度間隔αとなるようにそれぞれ固定している。また、シャフト20は、シャフト20の中心軸周りで角度間隔αの1倍以上3倍以下の角度だけ先端部材22に対して回転した位置で、上記少なくとも2つの隣り合うスプライン24、例えばスプライン24aおよびスプライン24bを、それぞれ固定している。 As shown in FIG. 3, the tip member 22 fixes at least two adjacent splines 24, for example, spline 24a and spline 24b, among the plurality of splines 24, at a predetermined angular interval α around the central axis of the shaft 20. The shaft 20 also fixes the at least two adjacent splines 24, for example, spline 24a and spline 24b, at a position rotated relative to the tip member 22 by an angle between 1 and 3 times the angular interval α around the central axis of the shaft 20.

 図3では、スプライン24aが先端部材22に固定された位置を基準として、スプライン24aがシャフト20に固定された位置における時計回りの角度を、捻り角度βとして示している。スプライン24bも同様に、先端部材22に固定された位置に対して捻り角度βだけ時計回りに回転した位置で、シャフト20に固定されている。このとき、捻り角度βは、角度間隔αの1倍以上3倍以下である。捻り角度βを角度間隔αの1倍以上とすることで、重複領域30を形成させやすくなるため、肺静脈112から左心房114への異常な電気信号の伝達を遮断させやすい。捻り角度βを角度間隔αの3倍以下とすることで、スプライン24がシャフト20の中心軸周りで過剰に捻られた形状とすることを回避できる。 3, the twist angle β is the clockwise angle at the position where the spline 24a is fixed to the shaft 20, based on the position where the spline 24a is fixed to the tip member 22. Similarly, the spline 24b is fixed to the shaft 20 at a position rotated clockwise by the twist angle β from the position where the spline 24b is fixed to the tip member 22. In this case, the twist angle β is 1 to 3 times the angle interval α. By making the twist angle β 1 or more times the angle interval α, it becomes easier to form the overlap region 30, and therefore it becomes easier to block the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114. By making the twist angle β 3 times or less the angle interval α, it becomes possible to avoid the spline 24 being excessively twisted around the central axis of the shaft 20.

 本実施形態では、スプライン24aおよびスプライン24bに限らず、全ての隣り合うスプライン24において、上述の角度間隔αおよび捻り角度βの関係を満たす。この場合、本実施形態では複数のスプライン24a~24fは6本であるため、角度間隔αは約60°であってよい。また、捻り角度βは、約60°以上約180°以下であってよい。 In this embodiment, the above-mentioned relationship between the angular interval α and the twist angle β is satisfied not only for spline 24a and spline 24b but also for all adjacent splines 24. In this case, since there are six splines 24a to 24f in this embodiment, the angular interval α may be approximately 60°. Furthermore, the twist angle β may be approximately 60° or more and approximately 180° or less.

 図3に示すように、複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fが有する複数の電極26のうち、複数の円弧状領域28a~28fに配置される複数の電極26は、仮想円50の円周上で等間隔に配置される。具体的に、複数のスプライン24a~24fは、それぞれ4つの電極26を有し、これらの電極26は各スプライン24の長手方向に沿ってシャフト20の軸方向から見て等間隔に配置される。そして、隣り合うスプライン24同士の互いに最も近接する電極26同士は、シャフト20の軸方向から見て各スプライン24の各電極26間と略同じ間隔に配置される。この場合、複数の電極26が等間隔であるとは、図3に示すようなシャフト20の軸方向から見た平面において、任意の2つの隣り合う電極26の間隔と、全ての隣り合う電極26の間隔の平均値との差が、例えば10%未満であることをいう。複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fのそれぞれは、円弧状領域28以外の領域に配置される1つ以上の電極26を有していてもよい。 As shown in FIG. 3, when each of the splines 24a to 24f is fan-shaped, the electrodes 26 of the splines 24a to 24f that are located in the arc-shaped regions 28a to 28f are arranged at equal intervals on the circumference of the imaginary circle 50. Specifically, each of the splines 24a to 24f has four electrodes 26, which are arranged at equal intervals along the longitudinal direction of each spline 24 as viewed from the axial direction of the shaft 20. The electrodes 26 that are closest to each other on adjacent splines 24 are arranged at approximately the same intervals as the electrodes 26 of each spline 24 as viewed from the axial direction of the shaft 20. In this case, the electrodes 26 being evenly spaced means that the difference between the interval between any two adjacent electrodes 26 and the average interval between all adjacent electrodes 26 on a plane viewed from the axial direction of the shaft 20 as shown in FIG. 3 is less than 10%, for example. When each of the multiple splines 24a-24f is fan-shaped, each of the multiple splines 24a-24f may have one or more electrodes 26 arranged in an area other than the arc-shaped area 28.

 複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fが有する複数の電極26は、シャフト20の軸方向から見て、仮想円50の円周上で等間隔に位置する複数の仮想点にそれぞれ対応する位置に配置されていてもよい。この場合、電極26が仮想点に対応する位置に配置されるとは、電極26の少なくとも一部がシャフト20の軸方向から見て仮想点と重なる位置に配置されることを意味する。 When each of the multiple splines 24a to 24f is fan-shaped, the multiple electrodes 26 of the multiple splines 24a to 24f may be disposed at positions corresponding to multiple imaginary points that are equally spaced around the circumference of an imaginary circle 50, as viewed in the axial direction of the shaft 20. In this case, the electrodes 26 being disposed at positions corresponding to the imaginary points means that at least a portion of the electrodes 26 is disposed at a position that overlaps with the imaginary points as viewed in the axial direction of the shaft 20.

 図2に示すように、複数のスプライン24a~24fのそれぞれが扇形状であるとき、各スプライン24の円弧状領域28は、軸方向における当該スプライン24の中心を含む領域に位置する。各スプライン24の円弧状領域28は、電極アセンブリ16の軸方向全長の90%以内の領域に位置し、好ましくは80%以内の領域に位置する。各スプライン24は、軸方向における中心付近で軸方向に直交する径方向に最も大きくなりやすい。このような領域に円弧状領域28が位置することになるので、円弧状領域28を図1に示した肺静脈112と左心房114との境界部などの管状の体組織の内周に確実に接触させやすい。 As shown in FIG. 2, when each of the multiple splines 24a to 24f is fan-shaped, the arc-shaped region 28 of each spline 24 is located in a region that includes the center of the spline 24 in the axial direction. The arc-shaped region 28 of each spline 24 is located in a region that is within 90% of the total axial length of the electrode assembly 16, and preferably within 80%. Each spline 24 tends to be largest in the radial direction perpendicular to the axial direction near the center in the axial direction. Since the arc-shaped region 28 is located in such a region, it is easy to reliably bring the arc-shaped region 28 into contact with the inner circumference of tubular body tissue, such as the boundary between the pulmonary vein 112 and the left atrium 114 shown in FIG. 1.

 上述の通り、第1実施形態に係る電極カテーテル10は、6つのスプライン24a~24fを備えるとして説明した。ただし、電極カテーテル10が備えるスプライン24の個数は、6つには限定されず、4つ以上であればよい。 As described above, the electrode catheter 10 according to the first embodiment has been described as having six splines 24a to 24f. However, the number of splines 24 provided on the electrode catheter 10 is not limited to six, and may be four or more.

 図4は、電極カテーテル10によって焼灼される肺静脈112と左心房114との境界部116を模式的に示す図である。心房細動の治療の際、電極カテーテル10は、左心房114の内部から、電極カテーテル10の先端側が肺静脈112に向かうようにして、境界部116に進入する。このとき、複数のスプライン24a~24fのそれぞれを扇形状に変形させ、複数のスプライン24a~24fを境界部116の内壁に接触させる。この状態で、複数の電極26を通じて電気パルスが印加されると、境界部116は複数の焼灼箇所130において焼灼される。複数の焼灼箇所130は、図1にも示した焼灼範囲Saに含まれる。 FIG. 4 is a schematic diagram showing the boundary 116 between the pulmonary vein 112 and the left atrium 114, which is cauterized by the electrode catheter 10. When treating atrial fibrillation, the electrode catheter 10 enters the boundary 116 from inside the left atrium 114, with the tip of the electrode catheter 10 facing the pulmonary vein 112. At this time, each of the multiple splines 24a to 24f is deformed into a fan shape, and the multiple splines 24a to 24f are brought into contact with the inner wall of the boundary 116. In this state, when an electrical pulse is applied through the multiple electrodes 26, the boundary 116 is cauterized at multiple cauterization points 130. The multiple cauterization points 130 are included in the cauterization range Sa also shown in FIG. 1.

 複数の焼灼箇所130は、それぞれ複数のスプライン24a~24fが境界部116に接触する箇所に対応する。複数のスプライン24a~24fが境界部116に接触する箇所は、主に複数の円弧状領域28である。すなわち、複数の焼灼箇所130は、複数の円弧状領域28の各形状および配置に対応して形成される。心房細動に伴う肺静脈112から左心房114に向かう異常な電気信号の伝達経路118は、境界部116に形成される心筋スリーブなどに沿って、図4に示すように肺静脈112から左心房114に真っ直ぐ向かう経路となりやすい。そのため、複数の円弧状領域28の各形状および配置に対応して形成される複数の焼灼箇所130によって、異常な電気信号の伝達経路118を遮断することできる。 The ablation points 130 correspond to the locations where the splines 24a-24f contact the boundary 116. The locations where the splines 24a-24f contact the boundary 116 are mainly the arc-shaped regions 28. That is, the ablation points 130 are formed to correspond to the shapes and arrangement of the arc-shaped regions 28. The transmission path 118 of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 associated with atrial fibrillation tends to be a straight path from the pulmonary vein 112 to the left atrium 114 along the myocardial sleeve formed at the boundary 116, as shown in FIG. 4. Therefore, the ablation points 130 formed to correspond to the shapes and arrangement of the arc-shaped regions 28 can block the transmission path 118 of abnormal electrical signals.

 このように、本実施形態の電極カテーテル10を用いれば、複数のスプライン24a~24fが肺静脈112と左心房114との境界部116の内壁に接触した状態で、複数の電極26を通じて電気パルスが印加されることで、心房細動の電気的な伝達経路118を一度に遮断するように焼灼することができる。 In this way, by using the electrode catheter 10 of this embodiment, the multiple splines 24a-24f are in contact with the inner wall of the boundary 116 between the pulmonary vein 112 and the left atrium 114, and an electrical pulse is applied through the multiple electrodes 26, thereby cauterizing the electrical transmission pathway 118 of atrial fibrillation so as to block it all at once.

 図5は、電極カテーテル10の全体構成の一例を模式的に示す側面図である。図5に示すように、電極カテーテル10は、シャフト20の基端側に接続されたハンドル8を備えていてもよい。ハンドル8は、電極カテーテル10の使用時に、医師などの操作者が掴んだり握ったりする部分である。ハンドル8は、シャフト20の基端側に装着されたハンドル本体11と、回転操作部12と、スライド部材13とを有していてもよい。 FIG. 5 is a side view showing a schematic example of the overall configuration of the electrode catheter 10. As shown in FIG. 5, the electrode catheter 10 may include a handle 8 connected to the base end side of the shaft 20. The handle 8 is a part that an operator such as a doctor grasps or holds when using the electrode catheter 10. The handle 8 may include a handle main body 11 attached to the base end side of the shaft 20, a rotation operation unit 12, and a slide member 13.

 ハンドル本体11は、操作者が実際に握る部分に相当する。ハンドル本体11は、どのような形状であっても構わない。ハンドル本体11は、一例として、シャフト20の中心軸に沿って延びる形状である。また、ハンドル本体11は、例えば、ポリカーボネート、ポリアセタール、ABS等といった公知の樹脂から構成される。 The handle body 11 corresponds to the part that the operator actually grips. The handle body 11 may have any shape. As an example, the handle body 11 has a shape that extends along the central axis of the shaft 20. The handle body 11 is made of a known resin, such as polycarbonate, polyacetal, ABS, etc.

 回転操作部12は、シャフト20の先端付近を双方向に曲げるもしくは撓ませる動作の際に、回転操作などの操作をされる部分である。回転操作部12には、ハンドル本体11内において一対のプルワイヤの基端が固定されている。一対のプルワイヤの先端は、ハンドル本体11内からシャフト20内を通り、シャフト20の先端側に固定されている。よって、回転操作部12を操作すると、プルワイヤが基端側へ引っ張られ、プルワイヤの先端が固定されているシャフト20の先端側が曲がるもしくは撓む。 The rotation operation unit 12 is the part that is operated by rotation operation and the like when bending or flexing the vicinity of the tip of the shaft 20 in both directions. The base ends of a pair of pull wires are fixed to the rotation operation unit 12 within the handle body 11. The tips of the pair of pull wires pass from inside the handle body 11 through the shaft 20 and are fixed to the tip side of the shaft 20. Therefore, when the rotation operation unit 12 is operated, the pull wires are pulled toward the base end, and the tip side of the shaft 20 to which the tips of the pull wires are fixed bends or flexes.

 スライド部材13は、複数のスプライン24の形状を、上述した非展開形状もしくは収縮形状と、展開形状もしくは拡張形状との間で変形させる際に、操作者によってスライド操作などの変形操作をされる部分である。スライド部材13は、ハンドル本体11において、シャフト20の中心軸に沿ってスライド可能となっている。 The slide member 13 is a part that is deformed by an operator, such as by sliding, when changing the shape of the multiple splines 24 between the undeployed or contracted shape and the deployed or expanded shape described above. The slide member 13 is slidable along the central axis of the shaft 20 in the handle body 11.

 スライド部材13には、変形用部材14の基端が固定されている。変形用部材14の先端は、ハンドル本体11内からシャフト20内を通り、先端部材22内に固定されている。そして、スライド部材13は、ハンドル本体11において、シャフト20の中心軸に沿った任意の位置に、移動可能となっている。したがって、スライド部材13の位置に応じて、複数のスプライン24の形状を、前述した非展開形状もしくは収縮形状、展開形状もしくは拡張形状、または非展開形状および展開形状の間の任意の中間形状に変形可能となっている。 The base end of the deformation member 14 is fixed to the slide member 13. The tip of the deformation member 14 passes from inside the handle body 11 through the shaft 20 and is fixed in the tip member 22. The slide member 13 can be moved to any position along the central axis of the shaft 20 in the handle body 11. Therefore, depending on the position of the slide member 13, the shape of the multiple splines 24 can be deformed to the previously described non-expanded shape or contracted shape, the expanded shape or expanded shape, or any intermediate shape between the non-expanded shape and the expanded shape.

 変形用部材14は、長尺であれば、どのような形状、構造、材質であっても構わない。一例として、変形用部材14はワイヤである。 The deformation member 14 may be of any shape, structure, or material as long as it is long. As an example, the deformation member 14 is a wire.

[第2実施形態]
 図6および図7を参照して、本開示の第2実施形態を説明する。以降の実施形態において、第1実施形態で説明した構成要素のうち、以下において説明していない構成要素は、第1実施形態と同じ内容が適用されてもよい。図6は、第2実施形態に係る電極カテーテル10Aの先端付近を模式的に示す側面図である。図7は、電極カテーテル10Aをシャフト20の軸方向の先端側から見た図である。
[Second embodiment]
A second embodiment of the present disclosure will be described with reference to Figures 6 and 7. In the following embodiments, among the components described in the first embodiment, the same content as in the first embodiment may be applied to the components not described below. Figure 6 is a side view showing the vicinity of the tip of the electrode catheter 10A according to the second embodiment. Figure 7 is a view of the electrode catheter 10A as seen from the tip side in the axial direction of the shaft 20.

 本実施形態の電極カテーテル10Aは、複数のスプライン24a~24fがそれぞれ有する複数の電極26の配置が、第1実施形態の電極カテーテル10と異なる。すなわち、複数のスプライン24a~24fのそれぞれが扇形状であるとき、少なくとも2つの隣り合うスプライン24、例えばスプライン24aおよびスプライン24bのうち、一方のスプライン24が有する電極26の少なくとも一部と、他方のスプライン24が有する電極26の少なくとも一部とが、シャフト20の軸方向から見て互いに重なり合う。具体的に、図7に示すように、スプライン24aが有する電極261と、スプライン24bが有する電極262とが、シャフト20の軸方向から見て互いに重なり合う。これにより、これらの電極26を用いて焼灼することで、肺静脈112から左心房114への異常な電気信号の伝達をより確実に遮断することができる。 The electrode catheter 10A of this embodiment differs from the electrode catheter 10 of the first embodiment in the arrangement of the electrodes 26 of each of the splines 24a to 24f. That is, when each of the splines 24a to 24f is fan-shaped, at least a portion of the electrode 26 of one of at least two adjacent splines 24, for example, spline 24a and spline 24b, overlaps with at least a portion of the electrode 26 of the other spline 24 when viewed from the axial direction of the shaft 20. Specifically, as shown in FIG. 7, the electrode 261 of the spline 24a and the electrode 262 of the spline 24b overlap with each other when viewed from the axial direction of the shaft 20. As a result, by cauterizing using these electrodes 26, the transmission of abnormal electrical signals from the pulmonary vein 112 to the left atrium 114 can be more reliably blocked.

 本実施形態では、スプライン24aが有する電極26のうち最もスプライン24b側に位置する電極261と、スプライン24bが有する電極26のうち最もスプライン24a側に位置する電極262とが、シャフト20の軸方向から見て互いに重なり合う。このような構成にすることで、互いに重なり合う電極26の数を最低限にしつつ、異常な電気信号の伝達を遮断する効果を発揮することができる。 In this embodiment, the electrode 261 located closest to the spline 24b among the electrodes 26 of the spline 24a and the electrode 262 located closest to the spline 24a among the electrodes 26 of the spline 24b overlap each other when viewed from the axial direction of the shaft 20. This configuration can minimize the number of overlapping electrodes 26 while still achieving the effect of blocking the transmission of abnormal electrical signals.

 本実施形態においては、複数のスプライン24a~24fのそれぞれが扇形状であるとき、複数のスプライン24a~24fが有する複数の電極26が、シャフト20の軸方向から見て仮想円50の円周上で等間隔に配置されていなくてもよい。ただし、隣り合うスプライン24の重なり合う電極26を1つの電極26とみなせば、各電極26をシャフト20の軸方向から見て仮想円50の円周上で等間隔に配置することも可能である。 In this embodiment, when each of the multiple splines 24a to 24f is fan-shaped, the multiple electrodes 26 of the multiple splines 24a to 24f do not have to be equally spaced on the circumference of the virtual circle 50 when viewed in the axial direction of the shaft 20. However, if the overlapping electrodes 26 of adjacent splines 24 are considered to be one electrode 26, it is also possible to arrange the electrodes 26 at equal intervals on the circumference of the virtual circle 50 when viewed in the axial direction of the shaft 20.

 以上、本開示の実施の形態について詳細に説明した。前述した実施の形態は、本開示を実施するにあたっての具体例を示したものにすぎない。実施の形態の内容は、本開示の技術的範囲を限定するものではなく、請求の範囲に規定された本開示の思想を逸脱しない範囲において、構成要素の変更、追加、削除等の多くの設計変更が可能である。設計変更が加えられた新たな実施の形態は、組み合わされる実施の形態および変形それぞれの効果をあわせもつ。前述の実施の形態では、このような設計変更が可能な内容に関して、「本実施形態の」、「本実施形態では」等の表記を付して強調しているが、そのような表記のない内容でも設計変更が許容される。各実施の形態に含まれる構成要素の任意の組み合わせも、本開示の態様として有効である。図面の断面に付したハッチングは、ハッチングを付した対象の材質を限定するものではない。 The above describes the embodiments of the present disclosure in detail. The above-mentioned embodiments merely show specific examples of implementing the present disclosure. The contents of the embodiments do not limit the technical scope of the present disclosure, and many design changes such as changes, additions, and deletions of components are possible within the scope of the idea of the present disclosure defined in the claims. A new embodiment with design changes has the effects of each of the combined embodiments and modifications. In the above-mentioned embodiments, the contents for which such design changes are possible are emphasized by adding notations such as "in this embodiment" and "in this embodiment", but design changes are permitted even in contents without such notations. Any combination of components included in each embodiment is also valid as an aspect of the present disclosure. Hatching on the cross sections of the drawings does not limit the material of the objects to which the hatching is applied.

 実施の形態は、以下に記載する項目によって特定されてもよい。 The embodiment may be specified by the items described below.

[第1項目]
 体内に挿入されるシャフト(20)と、
 シャフト(20)の先端に設けられた電極アセンブリ(16)と、を備え、
 電極アセンブリ(16)は、それぞれ少なくとも1つの電極(26)を有する複数のスプライン(24)と、複数のスプライン(24)の先端側に接続された先端部材(22)と、を備え、
 複数のスプライン(24)のそれぞれは、シャフト(20)の軸方向から見て、共通の仮想円(50)に沿う円弧状領域(28)を有する扇形状に変形可能であり、
 複数のスプライン(24)のそれぞれが扇形状であるとき、複数のスプライン(24)によって形成される複数の円弧状領域(28)は、全体として仮想円(50)の円周の80%以上を占める、
 電極カテーテル(10)。
[First item]
A shaft (20) to be inserted into the body;
an electrode assembly (16) provided at the tip of the shaft (20);
The electrode assembly (16) includes a plurality of splines (24) each having at least one electrode (26) and a tip member (22) connected to a tip side of the plurality of splines (24);
Each of the plurality of splines (24) is deformable into a sector shape having an arc-shaped region (28) along a common imaginary circle (50) when viewed in the axial direction of the shaft (20);
When each of the plurality of splines (24) is fan-shaped, the plurality of arc-shaped regions (28) formed by the plurality of splines (24) occupy 80% or more of the circumference of the imaginary circle (50) as a whole.
An electrode catheter (10).

 第1項目に係る電極カテーテル(10)によれば、複数のスプライン(24)によって形成される複数の円弧状領域(28)が全体として仮想円(50)の円周の80%以上を占める。そのため、複数のスプライン(24)を肺静脈と左心房との境界部などの管状の体組織の内壁の周方向の大部分に亘って同時に接触させることができる。よって、複数のスプライン(24)の位置を変えなくても、一度の焼灼で肺静脈から左心房への異常な電気信号の伝達を遮断することができる。 According to the electrode catheter (10) of the first item, the multiple arc-shaped regions (28) formed by the multiple splines (24) occupy 80% or more of the circumference of the virtual circle (50) as a whole. Therefore, the multiple splines (24) can be simultaneously brought into contact with most of the circumferential direction of the inner wall of tubular body tissue, such as the boundary between the pulmonary vein and the left atrium. Therefore, the transmission of abnormal electrical signals from the pulmonary vein to the left atrium can be blocked with a single cauterization without changing the position of the multiple splines (24).

[第2項目]
 複数のスプライン(24)のそれぞれが扇形状であるとき、複数のスプライン(24)のうちの少なくとも2つの隣り合うスプライン(24)は、軸方向から見て互いに重なり合う重複領域(30)を有する、
 第1項目に記載の電極カテーテル(10)。
[Second item]
When each of the plurality of splines (24) is fan-shaped, at least two adjacent splines (24) of the plurality of splines (24) have overlapping regions (30) that overlap each other when viewed in the axial direction.
Item 1. An electrode catheter (10) as described in item 1.

 第2項目に係る電極カテーテル(10)によれば、少なくとも2つの隣り合うスプライン(24)同士が、軸方向から見て隙間なく配置されるので、肺静脈から左心房への異常な電気信号の伝達をより確実に遮断することができる。 The electrode catheter (10) according to the second item has at least two adjacent splines (24) arranged so that there is no gap between them when viewed in the axial direction, so that the transmission of abnormal electrical signals from the pulmonary vein to the left atrium can be blocked more reliably.

[第3項目]
 複数のスプライン(24)のそれぞれが扇形状であるとき、少なくとも2つの隣り合うスプライン(24)のうち、一方のスプライン(24)が有する電極(26)の少なくとも一部と、他方のスプライン(24)が有する電極(26)の少なくとも一部とが、軸方向から見て互いに重なり合う、
 第2項目に記載の電極カテーテル(10)。
[Third item]
When each of the multiple splines (24) is fan-shaped, at least a portion of an electrode (26) of one spline (24) and at least a portion of an electrode (26) of the other spline (24) among at least two adjacent splines (24) overlap each other when viewed in the axial direction.
Item 2. An electrode catheter (10) as described in item 2.

 第3項目に係る電極カテーテル(10)によれば、少なくとも2つの隣り合うスプライン(24)同士が、軸方向から見て重なり合う少なくとも2つの電極(26)を有するので、これらの電極(26)を用いて焼灼することで、肺静脈から左心房への異常な電気信号の伝達をより確実に遮断することができる。 According to the electrode catheter (10) of the third item, at least two adjacent splines (24) have at least two electrodes (26) that overlap when viewed in the axial direction, so that cauterization using these electrodes (26) can more reliably block the transmission of abnormal electrical signals from the pulmonary vein to the left atrium.

[第4項目]
 複数のスプライン(24)のそれぞれが扇形状であるとき、複数のスプライン(24)のうちの隣り合わないスプライン(24)同士は、重複領域(30)を有さない、
 第2項目または第3項目に記載の電極カテーテル(10)。
[4th item]
When each of the plurality of splines (24) is fan-shaped, non-adjacent splines (24) among the plurality of splines (24) do not have an overlapping region (30);
Item 2. An electrode catheter (10) according to item 2 or 3.

 第4項目に係る電極カテーテル(10)によれば、隣り合わないスプライン(24)同士は重複領域(30)を有さないので、スプライン(24)がシャフト(20)の中心軸周りで過剰に捻られた形状とする必要がなく、取り扱いやすくすることができる。 In the electrode catheter (10) according to the fourth item, non-adjacent splines (24) do not have overlapping regions (30), so there is no need for the splines (24) to be excessively twisted around the central axis of the shaft (20), making it easier to handle.

[第5項目]
 先端部材(22)は、複数のスプライン(24)のうちの少なくとも2つの隣り合うスプライン(24)を、シャフト(20)の中心軸周りで所定の角度間隔となるようにそれぞれ固定し、
 シャフト(20)は、前記中心軸周りで前記角度間隔の1倍以上3倍以下の角度だけ先端部材(22)に対して回転した位置で少なくとも2つの隣り合うスプライン(24)をそれぞれ固定している、
 第1項目から第4項目のいずれかに記載の電極カテーテル(10)。
[Item 5]
The tip member (22) fixes at least two adjacent splines (24) of the plurality of splines (24) so as to be spaced at a predetermined angle around the central axis of the shaft (20);
The shaft (20) has at least two adjacent splines (24) fixed at positions rotated relative to the tip member (22) by an angle between 1 and 3 times the angular interval around the central axis.
5. An electrode catheter (10) according to any one of claims 1 to 4.

 第5項目に係る電極カテーテル(10)によれば、肺静脈から左心房への異常な電気信号の伝達を遮断しつつ、スプライン(24)がシャフト(20)の中心軸周りで過剰に捻られた形状とすることを回避できる。 The electrode catheter (10) according to the fifth item can block the transmission of abnormal electrical signals from the pulmonary vein to the left atrium while avoiding the spline (24) from being excessively twisted around the central axis of the shaft (20).

[第6項目]
 複数のスプライン(24)のそれぞれが扇形状であるとき、複数のスプライン(24)が有する複数の電極(26)のうち、複数の円弧状領域(28)に配置される複数の電極(26)は、仮想円(50)の円周上で等間隔に配置される、
 第1項目から第5項目のいずれかに記載の電極カテーテル(10)。
[Item 6]
When each of the plurality of splines (24) is fan-shaped, among the plurality of electrodes (26) of the plurality of splines (24), the plurality of electrodes (26) arranged in the plurality of arc-shaped regions (28) are arranged at equal intervals on the circumference of the imaginary circle (50).
6. An electrode catheter (10) according to any one of claims 1 to 5.

 第6項目に係る電極カテーテル(10)によれば、仮想円(50)の円周上で等間隔に配置された複数の電極(26)により、肺静脈と左心房との境界部の内周を一度に均等に焼灼することができる。 The electrode catheter (10) according to the sixth aspect of the present invention allows the inner circumference of the boundary between the pulmonary vein and the left atrium to be cauterized uniformly at once using multiple electrodes (26) arranged at equal intervals around the circumference of an imaginary circle (50).

 [第7項目]
 複数のスプライン(24)のそれぞれが扇形状であるとき、各スプライン(24)の円弧状領域(28)は、軸方向における当該スプライン(24)の中心を含み、かつ、電極アセンブリ(16)の軸方向全長の90%以内の領域に位置する、
 第1項目から第6項目のいずれかに記載の電極カテーテル(10)。
[Item 7]
When each of the plurality of splines (24) is fan-shaped, the arcuate region (28) of each spline (24) includes the center of the spline (24) in the axial direction and is located in a region within 90% of the total axial length of the electrode assembly (16);
7. An electrode catheter (10) according to any one of claims 1 to 6.

 第7項目に係る電極カテーテル(10)によれば、電極アセンブリ(16)が軸方向に直交する径方向に最も大きくなりやすい軸方向中心を含む領域に、円弧状領域(28)が位置することになるので、円弧状領域(28)を管状の体組織の内周に確実に接触させやすい。 In the electrode catheter (10) according to the seventh item, the arc-shaped region (28) is located in a region including the axial center where the electrode assembly (16) is most likely to become large in the radial direction perpendicular to the axial direction, making it easier to reliably bring the arc-shaped region (28) into contact with the inner circumference of the tubular body tissue.

 [第8項目]
 体内に挿入されるシャフト(20)と、
 シャフト(20)の先端に設けられた電極アセンブリ(16)と、を備え、
 電極アセンブリ(16)は、それぞれ少なくとも1つの電極(26)を有する複数のスプライン(24)と、複数のスプライン(24)の先端側に接続された先端部材(22)と、を備え、
 複数のスプライン(24)が肺静脈(112)と左心房(114)との境界部(116)の内壁に接触した状態で、複数の電極(26)を通じて電気パルスが印加されることで、心房細動の電気的な伝達経路(118)を一度に遮断するように焼灼可能である、
 電極カテーテル(10)。
[Item 8]
A shaft (20) to be inserted into the body;
an electrode assembly (16) provided at the tip of the shaft (20);
The electrode assembly (16) includes a plurality of splines (24) each having at least one electrode (26) and a tip member (22) connected to a tip side of the plurality of splines (24);
With the multiple splines (24) in contact with the inner wall of the boundary (116) between the pulmonary vein (112) and the left atrium (114), an electrical pulse is applied through the multiple electrodes (26), thereby enabling cauterization so as to simultaneously block the electrical transmission pathway (118) of atrial fibrillation.
An electrode catheter (10).

 本開示は、電極カテーテルに利用することができる。 This disclosure can be used in electrode catheters.

 10 電極カテーテル、 16 電極アセンブリ、 20 シャフト、 22 先端部材、 24 スプライン、 26 電極、 28 円弧状領域、 30 重複領域、 50 仮想円、 112 肺静脈、 114 左心房、 116 境界部、 118 伝達経路。 10 electrode catheter, 16 electrode assembly, 20 shaft, 22 tip member, 24 spline, 26 electrode, 28 arc region, 30 overlap region, 50 virtual circle, 112 pulmonary vein, 114 left atrium, 116 boundary portion, 118 transmission path.

Claims (8)

 体内に挿入されるシャフトと、
 前記シャフトの先端に設けられた電極アセンブリと、を備え、
 前記電極アセンブリは、それぞれ少なくとも1つの電極を有する複数のスプラインと、前記複数のスプラインの先端側に接続された先端部材と、を備え、
 前記複数のスプラインのそれぞれは、前記シャフトの軸方向から見て、共通の仮想円に沿う円弧状領域を有する扇形状に変形可能であり、
 前記複数のスプラインのそれぞれが前記扇形状であるとき、前記複数のスプラインによって形成される複数の円弧状領域は、全体として前記仮想円の円周の80%以上を占める、
 電極カテーテル。
A shaft that is inserted into the body;
an electrode assembly provided at a tip of the shaft;
The electrode assembly includes a plurality of splines each having at least one electrode, and a tip member connected to a tip side of the plurality of splines,
each of the plurality of splines is deformable into a sector shape having an arc-shaped region along a common imaginary circle when viewed in an axial direction of the shaft;
when each of the plurality of splines is in the sector shape, a plurality of arc-shaped regions formed by the plurality of splines occupy 80% or more of a circumference of the virtual circle as a whole;
Electrode catheter.
 前記複数のスプラインのそれぞれが前記扇形状であるとき、前記複数のスプラインのうちの少なくとも2つの隣り合うスプラインは、前記軸方向から見て互いに重なり合う重複領域を有する、
 請求項1に記載の電極カテーテル。
When each of the plurality of splines has the sector shape, at least two adjacent splines among the plurality of splines have overlapping regions that overlap each other when viewed in the axial direction.
10. The electrode catheter of claim 1.
 前記複数のスプラインのそれぞれが前記扇形状であるとき、前記少なくとも2つの隣り合うスプラインのうち、一方のスプラインが有する電極の少なくとも一部と、他方のスプラインが有する電極の少なくとも一部とが、前記軸方向から見て互いに重なり合う、
 請求項2に記載の電極カテーテル。
when each of the plurality of splines has the sector shape, at least a portion of an electrode of one of the at least two adjacent splines and at least a portion of an electrode of the other spline overlap with each other when viewed from the axial direction;
3. The electrode catheter of claim 2.
 前記複数のスプラインのそれぞれが前記扇形状であるとき、前記複数のスプラインのうちの隣り合わないスプライン同士は、前記重複領域を有さない、
 請求項2に記載の電極カテーテル。
when each of the plurality of splines has the sector shape, non-adjacent splines among the plurality of splines do not have the overlapping region.
3. The electrode catheter of claim 2.
 前記先端部材は、前記複数のスプラインのうちの少なくとも2つの隣り合うスプラインを、前記シャフトの中心軸周りで所定の角度間隔となるようにそれぞれ固定し、
 前記シャフトは、前記中心軸周りで前記角度間隔の1倍以上3倍以下の角度だけ前記先端部材に対して回転した位置で前記少なくとも2つの隣り合うスプラインをそれぞれ固定している、
 請求項1に記載の電極カテーテル。
the tip member fixes at least two adjacent splines among the plurality of splines so as to be spaced at a predetermined angle around a central axis of the shaft,
The shaft fixes the at least two adjacent splines at positions rotated relative to the tip member by an angle between 1 and 3 times the angular interval around the central axis.
10. The electrode catheter of claim 1.
 前記複数のスプラインのそれぞれが前記扇形状であるとき、前記複数のスプラインが有する複数の電極のうち、前記複数の円弧状領域に配置される複数の電極は、前記仮想円の円周上で等間隔に配置される、
 請求項1に記載の電極カテーテル。
when each of the plurality of splines is in the sector shape, among the plurality of electrodes of the plurality of splines, the plurality of electrodes arranged in the plurality of arc-shaped regions are arranged at equal intervals on the circumference of the virtual circle.
10. The electrode catheter of claim 1.
 前記複数のスプラインのそれぞれが前記扇形状であるとき、各スプラインの前記円弧状領域は、前記軸方向における当該スプラインの中心を含み、かつ、前記電極アセンブリの軸方向全長の90%以内の領域に位置する、
 請求項1から6のいずれか一項に記載の電極カテーテル。
When each of the plurality of splines is in the sector shape, the arcuate region of each spline includes a center of the spline in the axial direction and is located in a region within 90% of the total axial length of the electrode assembly.
7. An electrode catheter according to any one of claims 1 to 6.
 体内に挿入されるシャフトと、
 前記シャフトの先端に設けられた電極アセンブリと、を備え、
 前記電極アセンブリは、それぞれ少なくとも1つの電極を有する複数のスプラインと、前記複数のスプラインの先端側に接続された先端部材と、を備え、
 前記複数のスプラインが肺静脈と左心房との境界部の内壁に接触した状態で、複数の前記電極を通じて電気パルスが印加されることで、心房細動の電気的な伝達経路を一度に遮断するように焼灼可能である、
 電極カテーテル。
A shaft that is inserted into the body;
an electrode assembly provided at a tip of the shaft;
The electrode assembly includes a plurality of splines each having at least one electrode, and a tip member connected to a tip side of the plurality of splines,
When the plurality of splines are in contact with the inner wall of the boundary between the pulmonary vein and the left atrium, an electric pulse is applied through the plurality of electrodes, thereby enabling cauterization so as to block the electrical transmission pathway of atrial fibrillation at once.
Electrode catheter.
PCT/JP2024/025672 2023-11-29 2024-07-17 Electrode catheter Pending WO2025115280A1 (en)

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JP2023-201812 2023-11-29

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2020517355A (en) * 2017-04-28 2020-06-18 ファラパルス,インコーポレイテッド Systems, devices, and methods for delivering pulsed field ablation energy to endocardial tissue
US20220304745A1 (en) * 2019-06-13 2022-09-29 St. Jude Medical, Cardiology Division, Inc. Electrode basket having high-density circumferential band of electrodes
CN217566285U (en) * 2021-12-31 2022-10-14 深圳市先健呼吸科技有限公司 Ablation device

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2020517355A (en) * 2017-04-28 2020-06-18 ファラパルス,インコーポレイテッド Systems, devices, and methods for delivering pulsed field ablation energy to endocardial tissue
US20220304745A1 (en) * 2019-06-13 2022-09-29 St. Jude Medical, Cardiology Division, Inc. Electrode basket having high-density circumferential band of electrodes
CN217566285U (en) * 2021-12-31 2022-10-14 深圳市先健呼吸科技有限公司 Ablation device

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