CN102686178B - Electrode catheter - Google Patents

Abstract

The electrode catheter of the present invention comprises a catheter main body (10), a control handle (20), catheter tip sections (31, 32, 33, 34), and a plurality of ring electrodes attached to the respective catheter tip sections, wherein the electrode width of 1 ring electrode (41B) attached to the 1 st catheter tip section (31) and the electrode width of 1 ring electrode (42C) attached to the 2 nd catheter tip section (32) are wider than the electrode widths of the other ring electrodes (41C, 42B, 43C, 44B, 44C), and the arrangement positions of the ring electrode (41B) and the ring electrode (42C) having the wider electrode widths at the catheter tip sections to which they are attached are different from each other. With this electrode catheter, it is possible to easily grasp which position of the catheter tip the specific electrode is attached to in the X-ray image.

Description

Lead

technical field

The present invention relates to an electrode catheter having a plurality of catheter tip portions.

Background technique

As a catheter for mapping electrical activity in the heart, there is known a catheter having a plurality of catheter tip portions extending radially from the tip of the catheter body, specifically five catheter tip portions (protrusions 14 ). Catheter (see Patent Document 1 and Patent Document 2).

A tip electrode and a ring-shaped electrode are attached to each tip of the catheter, and the potential of a region inside a circle whose radius is the length of the tip of the catheter can be measured simultaneously with one catheter.

Patent Document 1: Japanese Patent Laid-Open No. 2003-235821

Patent Document 2: Japanese Patent Laid-Open No. 2004-130114

Contents of the invention

The problem to be solved by the invention

The catheter described in the above-mentioned patent documents is not only used for mapping electrical activity, but also used for various diagnostic and therapeutic activities.

For example, after ablation therapy to confirm that the intended cautery was performed reliably. Specifically, two electrodes (tip electrodes or ring-shaped electrodes) attached to different distal end portions of the catheters were placed in symmetrical positions with the ablation line as the axis, and the transmission speed of the potential was measured. Here, when cauterization is performed reliably, the transmission path of the potential between the two electrodes is blocked by the ablation line, and the potential is transmitted in a detour, thereby delaying the transmission speed. On the other hand, when cauterization is not performed reliably, the electric potential is transmitted between the two electrodes at the shortest distance, and thus no delay in the transmission speed occurs.

(1) After the ablation treatment, various diagnosis and treatment actions using a catheter having a plurality of catheter tip portions, such as an operation to confirm whether the cauterization is performed reliably, are usually performed while observing X-ray images.

In addition, the measured potential data is displayed on the monitor of the electrocardiograph for the electrodes (intervals) used, so it is necessary to know which electrode (interval) the potential data (waveform) displayed on the monitor was measured.

Therefore, the operator is required to know at which position of the catheter tip each electrode reflected in the X-ray image is attached (for example, which ring-shaped electrode is attached to the catheter tip from the tip).

However, it is extremely difficult to ascertain at which position of the distal end portion of the catheter a specific electrode is attached on an X-ray image.

Here, when all the electrodes (electrodes attached to all the distal end portions of the catheter) are reflected on the X-ray image, the arrangement at the distal end portion of the catheter can be ascertained about a specific electrode on the X-ray image. position (the electrode that is installed on the distal end of the catheter from the distal end), but since the arrangement of the electrodes at the distal end of the catheter is the same, it is possible to instantly grasp which catheter a specific electrode is installed on the X-ray image Electrodes on the front end are practically impossible.

In addition, when all the electrodes are reflected on the X-ray image, it is sometimes mistaken whether the electrodes on the image and the plurality of catheter distal ends on which these electrodes are installed are viewed from the distal end side of the catheter or from the base of the catheter. seen side by side.

(2) In the case of confirming whether cautery is reliably performed with a catheter having a plurality of catheter distal ends, it is desired to install electrodes at the same position among the plurality of catheter distal ends (hereinafter, the electrode attached to the plurality of catheter distal ends Electrodes at the same location (also referred to as "counter-electrodes" or "counter-electrodes") are placed at equal distances from the ablation line.

However, in the catheter described in the above-mentioned patent documents, it is impossible to indwell the corresponding five electrodes at equal distances from the ablation line.

For example, as shown in FIG. 12 , among the five catheter front end portions 81 , 82 , 83 , 84 , and 85 extending radially from the front end of the catheter main body 80 , the adjacent catheter front end portions 81 and 82 When the two front-end electrodes 91 and 92 (corresponding electrodes) on the top are placed at symmetrical positions with the ablation line AL as the axis, the separation distances between the front-end electrodes 95 and 93 and the ablation line AL are longer than those of the front-end electrodes 91 and 92 The separation distance from the ablation line AL and the remaining tip electrode 94 are located on the ablation line AL. In such a case, the tip electrode 94 cannot be used for potential measurement.

(3) In the catheter described in the above-mentioned patent document, after the electrode to be used for potential measurement is positioned with respect to the ablation line, the distal end portion of the catheter body is bent to move the catheter distal end portion, so that the electrode to be used for potential measurement is moved. Potentiometric electrodes are brought into proximity (contact) with the inner wall of the heart or moved along the ablation line.

For example, by arranging two adjacent catheter tip parts across the ablation line, the front end electrodes (corresponding electrodes) respectively mounted on these catheter tip parts are positioned at symmetrical positions with the ablation line as the axis, and then the The catheter main body is bent so that the above-mentioned distal electrode comes close to (contacts) the inner wall of the heart.

However, in the catheter described in the aforementioned patent document, since the distal end portion of the catheter main body is bent, there is a possibility that the adjusted positional relationship between the distal end portion of the catheter (the electrode to be used for potential measurement) and the ablation line is misaligned. The problem. For example, since the distal end portion of the catheter main body is bent, the state (positional relationship before bending) of the two catheter distal ends straddling the ablation line cannot be maintained, and the distal electrode close to the inner wall of the heart deviates greatly from the ablation line.

(4) In the catheter described in the above-mentioned patent document, when the bending direction of the distal end portion of the catheter main body coincides with the direction in which the distal end portion of the catheter extends, when the distal end portion of the catheter main body is bent, it is attached to the The distal end electrode of the catheter distal end extending in the same direction as the bending direction may press (puncture) the inner wall of the heart and damage the inner wall.

The present invention is made based on the above circumstances.

A first object of the present invention is to provide an electrode catheter in which a plurality of electrodes are respectively attached to a plurality of catheter distal ends, and this electrode catheter can easily grasp at which position of the catheter distal end a specific electrode is attached on an X-ray image. electrode.

A second object of the present invention is to provide an electrode catheter in which electrodes are respectively attached to a plurality of catheter distal ends extending from the distal end of the catheter body, and the electrode catheter can indwell the corresponding electrodes at equal distances from the ablation line.

A third object of the present invention is to provide a state in which the distal end portion of the catheter is adjusted relative to the ablation line (for example, a state in which two distal end portions of the catheter straddle the ablation line) can be maintained even if the distal end portion of the catheter main body is bent. 1. The positional relationship of the electrode relative to the ablation line (for example, the relationship between two corresponding electrodes in a symmetrical position with the ablation line as the axis) of the electrode catheter.

A fourth object of the present invention is to provide an electrode catheter in which the distal electrode attached to the distal end of the catheter does not damage the inner wall of the heart even if the distal end portion of the catheter body is bent.

Solution to the problem

(1) The electrode catheter of the present invention (the first technical solution) is characterized in that the electrode catheter has: a catheter body having at least one inner hole; a control handle connected to the base end of the catheter body; at least 3 a catheter front end, which extend from the front end of the catheter main body at substantially equal angular intervals; a ring electrode, which is mounted on each of the above catheter front ends,

The electrode width of one ring-shaped electrode attached to the front end of the first catheter and the electrode width of one ring-shaped electrode attached to the front end of the second catheter located next to the front end of the first catheter and the electrode widths of the other ring electrodes ( "Electrode widths of other ring electrodes" are the same as each other) different,

The arrangement positions of the two ring-shaped electrodes having different electrode widths from the other ring-shaped electrodes on the distal end portion of the catheter to which the two ring-shaped electrodes are attached are different from each other.

According to the electrode catheter according to the first aspect having such a structure, by finding two ring-shaped electrodes whose electrode width is different from that of other ring-shaped electrodes on the X-ray image, the tip of the catheter on which the two ring-shaped electrodes are attached can be identified The parts are the first catheter distal end and the second catheter distal end, respectively.

In addition, two ring-shaped electrodes having different electrode widths from other ring-shaped electrodes are arranged at different positions on the catheter distal end (the first catheter distal end or the second catheter distal end) on which the two ring-shaped electrodes are attached. , the first catheter tip and the second catheter tip can be easily identified.

If the first catheter tip and the second catheter tip can be identified on the X-ray image, then it can be identified which catheter tip is the other catheter tip on the X-ray image (for example, the number of catheter tip is four In the case of the third catheter tip, the fourth catheter tip).

In addition, the arrangement position of the ring-shaped electrodes attached to the distal end of each catheter (which electrode is attached from the distal end) can be easily grasped on the X-ray image.

As a result, it is possible to easily grasp which arrangement position of the distal end portion of the catheter all the ring-shaped electrodes on the X-ray image are attached to.

(2) In the electrode catheter according to the first aspect configured as described above, it is preferable that the electrode width of the first annular electrode on the distal end of the first catheter from the distal side is the same as the electrode width of the first annular electrode on the distal end of the second catheter from the distal side. The electrode width of the second ring-shaped electrode is wider than that of the other ring-shaped electrodes.

According to the electrode catheter of the first aspect having such a configuration, by finding a ring-shaped electrode with a wider electrode width located first from the front end side on the X-ray image, the catheter tip on which the ring-shaped electrode is attached can be identified The first part is the distal end of the catheter. In addition, by finding a ring-shaped electrode with a wider electrode width positioned second from the tip side, it can be identified that the catheter tip portion on which the ring-shaped electrode is attached is the second catheter tip portion.

(3) The electrode catheter of the first aspect configured as described above preferably has four catheter distal end portions.

Four ring-shaped electrodes (corresponding ring-shaped electrodes) attached to the same position (for example, the first one from the front end side) of the four catheter distal ends are located at vertices of the square, respectively.

Using the electrode catheter of the first technical solution (the electrode catheter having four catheter tip parts) in which the corresponding ring-shaped electrodes are located at the vertices of the square, for example, in the case of confirming whether ablation is reliably performed after ablation therapy, it is possible to easily The corresponding four ring-shaped electrodes were arranged at equal distances from the ablation line.

For example, if two of the corresponding four ring-shaped electrodes are placed at the front end of the adjacent catheter so that the ablation line is positioned at their midpoint, the remaining two ring-shaped electrodes can also be Leave in such a way that the ablation lines are at their midpoint.

(4) In addition, the electrode catheter according to the first technical solution is characterized in that the electrode catheter has: a catheter body having at least one inner hole; a control handle connected to the base end of the catheter body; at least three catheter front end parts extending from the front end of the catheter main body at substantially equal angular intervals; front end electrodes mounted on the front ends of each of the above catheters; ring electrodes at least one mounted on the front ends of each of the catheters,

The electrode width of the distal electrode attached to the distal end of the first catheter is different from that of the other distal electrodes,

The electrode width of one ring-shaped electrode attached to the distal end portion of the second catheter located next to the distal end portion of the first catheter is different from the electrode width of the other ring-shaped electrodes.

According to the electrode catheter according to the first aspect having such a structure, by finding a distal electrode having a different electrode width from other distal electrodes on the X-ray image, it is possible to recognize that the distal end portion of the catheter on which the distal electrode is attached is the first distal end portion of the catheter. .

In addition, by finding a ring-shaped electrode having a different electrode width from other ring-shaped electrodes on the X-ray image, it can be identified that the catheter distal end to which the ring-shaped electrode is attached is the second catheter distal end.

If the first catheter distal end and the second catheter distal end can be identified on the X-ray image, it can be identified which catheter distal end the other catheter distal end on the X-ray image is.

In addition, the arrangement positions of the distal electrode and the ring electrode attached to the distal end of each catheter can be easily grasped on the X-ray image.

As a result, it is possible to easily grasp at which arrangement position of the distal end portion of the catheter all the electrodes (distal electrode and ring electrode) on the X-ray image are attached.

(5) In the electrode catheter of the first aspect configured as described above, it is preferable that the electrode width of the distal electrode attached to the distal end of the first catheter is wider than the electrode width of the other distal electrodes,

The electrode width of one ring-shaped electrode attached to the distal end portion of the second catheter is wider than that of the other ring-shaped electrodes.

According to the electrode catheter according to the first aspect having such a structure, by finding a distal electrode having a wider electrode width than other distal electrodes on the X-ray image, it is possible to identify the catheter distal end portion on which the distal electrode is attached as the first catheter distal portion. . In addition, by finding a ring-shaped electrode having a wider electrode width than other ring-shaped electrodes, it can be recognized that the catheter distal end portion on which the ring-shaped electrode is attached is the second catheter distal end portion.

(6) The electrode catheter of the first aspect configured as described above preferably has four catheter distal end portions.

The four electrodes corresponding to the front ends of the four catheters (for example, the front end electrodes) are respectively located at vertices of the square.

Using the electrode catheter of the first technical solution (the electrode catheter having four catheter tip portions) in which the corresponding electrodes are located at the vertices of the square, for example, in the case of confirming whether ablation is reliably performed after ablation therapy, the corresponding The corresponding four electrodes are arranged at equal distances from the ablation line.

For example, if two of the four front-end electrodes attached to the adjacent catheter tip are placed so that the ablation line is located at their midpoint, the remaining two front-end electrodes can also be placed at their intermediate points with the ablation line. in the way of the middle point.

(7) In the electrode catheter according to the first aspect, it is preferable to include a (Bidirectional Control) deflection mechanism (oscillating head) capable of bending (flexing) the front end portion of the catheter body in two directions around the axis of the catheter body. mechanism).

There are many linear tissues called tendons on the inner wall of the heart, especially around the valves. In order to prevent the distal end of the catheter from being entangled in the tendons, it is preferable that the catheter body inserted into the heart cavity does not rotate around the axis as much as possible.

Therefore, according to the electrode catheter of the first technical aspect having the above-mentioned deflection mechanism, for example, when the distal end portion of the catheter body is deflected by 180°, it is not necessary to rotate the catheter body around the axis. This is advantageous compared to electrode catheters that have a mechanism that can only bend the catheter body in one direction, since the catheter body needs to be rotated around the axis.

(8) The electrode catheter of the present invention (the second technical solution) is characterized in that the electrode catheter has:

a catheter body having at least 1 inner bore;

a control handle connected to the base end of the catheter body;

4 catheter front ends, which extend from the front end of the catheter body at equal angular intervals along the circumference of the catheter body axis;

an electrode mounted on the front end of each of the aforementioned catheters;

The deflection mechanism bends the front end portion of the catheter main body in a direction that bisects an angle formed by two adjacent catheter front end portions.

In the electrode catheter according to the second aspect having such a structure, the four corresponding electrodes (for example, the distal electrodes) attached to the four distal end portions of the catheter are respectively located at the vertices of the square.

Using the electrode catheter of the second technical aspect (electrode catheter having four catheter tip portions) in which four corresponding electrodes are located at the vertices of a square, the four corresponding electrodes can be placed at equal distances from the ablation line.

For example, by leaving two of the four front-end electrodes as corresponding electrodes, which are attached to the adjacent catheter front-end portion, at symmetrical positions with the ablation line as the axis, the remaining two front-end electrodes can also be placed on the ablation line. Symmetrical position with the ablation line as the axis. As a result, the 4 leading electrodes can be easily placed at equal distances from the ablation line.

The deflection mechanism of the electrode catheter constituting the second aspect bends the distal end portion of the catheter main body in a direction that bisects an angle formed by two adjacent catheter distal end portions.

That is, the direction in which the front end portion of the catheter main body bends (the plane including the locus of the curved front end portion) and the direction in which the bisector of the angle formed by two adjacent catheter front end portions (including the two) is moved by the deflection mechanism. The plane of the locus of the bisector) coincides.

With this deflection mechanism, it is possible to maintain the state that the adjacent catheter tip straddles the ablation line (the corresponding electrodes installed at each catheter tip are in a symmetrical position with the ablation line as the axis), and make the electrode to be used for potential measurement and the heart The inner walls approach (touch) or move along the ablation line.

(9) In the electrode catheter according to the second aspect, it is preferable that the deflection mechanism bends the front end portion of the catheter body in two directions around the axis of the catheter body (Bidirectional Control).

There are many tissues called tendons on the inner wall of the heart, especially around the valves. In order to prevent the catheter tip and the like from being entangled with the tendons, it is preferable that the catheter body inserted into the heart chamber not rotate about the axis as much as possible.

Then, with the electrode catheter of the second technical solution having the above-mentioned deflection mechanism, for example, when deflecting the catheter distal end portion by 180°, it is not necessary to rotate the catheter main body around the axis, so (in the above case, it is necessary to make the catheter The main body rotates around the axis), which is advantageous in that the leading end portion of the catheter is less likely to be entangled with the tendon, compared with an electrode catheter having a mechanism that can only bend the catheter main body in one direction.

(10) In the electrode catheter according to the second aspect, it is preferable that a distal electrode and at least one, particularly 2 to 3 ring-shaped electrodes are attached to each of the distal end portions of the catheter.

(11) In addition, it is preferable that the electrode width of the ring-shaped electrode that is the first from the distal side on the distal end of the first catheter is the same as the electrode width of the annular electrode that is the first from the distal side on the distal end of the second catheter located next to the distal end of the first catheter. The electrode width of the two annular electrodes is wider than that of the other annular electrodes.

According to the electrode catheter of the second aspect having such a structure, by finding a ring-shaped electrode with a wider electrode width located first from the front end side on the X-ray image, the catheter on which the ring-shaped electrode is mounted can be identified. The distal end is the first catheter distal end. In addition, by finding a ring-shaped electrode with a wider electrode width positioned second from the tip side, it can be identified that the catheter tip portion on which the ring-shaped electrode is attached is the second catheter tip portion. Moreover, if the first catheter tip and the second catheter tip can be identified, then it can be recognized that the catheter tip located next to the second catheter tip is the third catheter tip, and it can be recognized that the catheter tip located next to the third catheter tip is The catheter distal end on the side is the fourth catheter distal end. In addition, the arrangement position of the ring-shaped electrodes attached to the distal end of each catheter (which electrode is attached to the distal end) can be easily grasped on the X-ray image. Thereby, it is possible to easily grasp at which position of the distal end portion of the catheter all the ring-shaped electrodes on the X-ray image are attached.

(12) In addition, it is preferable that the electrode width of the distal electrode attached to the distal end of the first catheter is wider than that of the other distal electrodes, and that the electrode width of one annular electrode attached to the distal end of the second catheter is wider than that of the other annular electrodes. The electrode width of the electrode is wide.

According to the electrode catheter according to the second aspect having such a structure, by finding a distal electrode having a wider electrode width than other distal electrodes on the X-ray image, it is possible to recognize that the distal end portion of the catheter to which the distal electrode is attached is the first distal end portion of the catheter. . In addition, by finding a ring-shaped electrode having a wider electrode width than other ring-shaped electrodes, it can be recognized that the catheter distal end portion on which the ring-shaped electrode is attached is the second catheter distal end portion. Moreover, if the first catheter tip and the second catheter tip can be identified, then it can be recognized that the catheter tip located next to the second catheter tip is the third catheter tip, and it can be recognized that the catheter tip located next to the third catheter tip is The catheter distal end on the side is the fourth catheter distal end. In addition, the arrangement positions of the distal electrode and the ring electrode attached to the distal end of each catheter can be easily grasped on the X-ray image. Thereby, it is possible to easily grasp at which arrangement position of which catheter distal end part all the electrodes (distal electrode and ring-shaped electrode) on the X-ray image are attached.

Invention effect

According to the electrode catheter according to the first aspect, it is possible to easily grasp at which position of the distal end portion of the catheter the electrode specified on the X-ray image is attached.

According to the electrode catheter according to the second technical solution, it is possible to indwell the four corresponding electrodes respectively attached to the front ends of the four catheters at positions equidistant from the ablation line.

In addition, even if the distal end portion of the catheter main body is bent, the arrangement state of the catheter distal end with respect to the ablation line (for example, a state where two catheter distal ends straddle the ablation line), which was adjusted before bending, and the position of the electrode with respect to the ablation line can be maintained. The positional relationship (for example, the two corresponding electrodes are in a symmetrical position with the ablation line as the axis). Therefore, the arrangement of the distal end of the catheter with respect to the ablation line and the positional relationship of the electrodes with respect to the ablation line are maintained, and the electrodes attached to the distal end of each catheter are brought into proximity (contact) with the inner wall of the heart or moved along the ablation line.

In addition, when the distal end portion of the catheter main body is bent, the distal electrode attached to the distal end portion of the catheter does not damage the inner wall of the heart.

Description of drawings

FIG. 1 is a schematic front view of an electrode catheter according to an embodiment of the present invention.

FIG. 2 is a side view of the electrode catheter shown in FIG. 1 (the view taken along the line I-I in FIG. 1 ).

FIG. 3 is a cross-sectional view (II-II cross-sectional view in FIG. 2 ) of the tip portion of the electrode catheter shown in FIG. 1 .

FIG. 4 is a sectional view (III-III sectional view in FIG. 2 ) at the tip portion of the electrode catheter shown in FIG. 1 .

FIG. 5 is a cross-sectional view (IV-IV cross-sectional view of FIG. 1 ) at the tip portion of the electrode catheter shown in FIG. 1 .

Fig. 6 is a schematic diagram showing a state of use of the electrode catheter shown in Fig. 1 .

FIG. 7 is a plan view and a side view showing the state of use of the electrode catheter shown in FIG. 1 (the state in which the distal end portion of the catheter main body is not bent).

8 is a plan view and a side view showing the state of use of the electrode catheter shown in FIG. 1 (the state in which the distal end portion of the catheter body is bent).

Fig. 9 is a side view of an electrode catheter according to another embodiment of the present invention.

Fig. 10 is a side view showing a modified example of the electrode catheter of the present invention.

Fig. 11 is a schematic side view showing a state of use of an electrode catheter of a comparative example.

Fig. 12 is a schematic plan view showing a conventional electrode catheter in use.

Detailed ways

<First Embodiment>

The electrode catheter 1 of this embodiment is used, for example, for the diagnosis or treatment of cardiac arrhythmia.

The electrode catheter 1 has a catheter main body 10, a control handle 20, and four catheter distal ends (a first catheter distal end 31, a second catheter distal end 32, a third catheter distal end 33, and a fourth catheter distal end 34), which are attached to each The distal end electrodes 41a, 42a, 43a, 44a at the distal end of the catheter, and the eight ring-shaped electrodes 41B·41c, 42b·42C, 43b·43c, 44b·44c respectively attached to each distal end of the catheter, make the catheter main body 10 The tip portion is bent in a direction that bisects the angle formed by the two catheter tip portions (catheter tip portion 32 and catheter tip portion 33/catheter tip portion 34 and catheter tip portion 31) (direction of arrow A/direction of arrow B) Bias mechanism (shaking head mechanism).

The catheter body 10 is composed of a pipe member 11 and a distal end member 12 .

In addition, in FIG. 1 , the length of the catheter body 10 is shown to be short, but actually the length of the catheter body 10 is several to several tens of times longer than the length of the control handle 20 in the Z-axis direction.

The pipe member 11 constituting the catheter body 10 has at least one inner hole (lumen). In the lumen of the tube member 11, there are lead wires (not shown) connected to the front end electrode and the ring electrode, and the pulling wires (shown in Fig. Marks 51, 52 indicate).

The pipe member 11 may also be made of materials having the same characteristics in the axial direction, but it is preferably integrally formed using materials having different rigidities (hardness) in the axial direction. Specifically, it is preferable that the constituent material on the proximal end side has relatively high rigidity, and the constituent material on the distal end side have relatively low rigidity.

The pipe member 11 is made of, for example, a synthetic resin such as polyolefin, polyamide, polyether polyamide, polyurethane, nylon, or PEBAX (polyether block amide). In addition, the proximal end side of the pipe member 11 may be a braided pipe made of these synthetic resins braided with stainless steel wires.

The outer diameter of the pipe member 11 is preferably 1.0 to 3.0 mm, more preferably 1.6 to 2.7 mm.

The length of the pipe member 11 is preferably 600 to 1500 mm, more preferably 900 to 1200 mm.

As shown in FIG. 3 , the front end member 12 constituting the catheter main body 10 is integrally formed with a cylindrical portion 121 inserted into the lumen of the pipe member 11 and has four catheter front end portions ( 31 , 32 , 33 , 34 ). Each base end portion of each is inserted into the holding portion 122 of the four fine holes.

The front end member 12 can be made of the same material as the pipe member 11, for example, PEBAX.

The outer diameter of the front end member 12 (holding portion 122 ) is preferably the same as that of the pipe member 11 .

The length of the front end member 12 (holding portion 122 ) is preferably 2 to 60 mm, more preferably 5 to 10 mm.

The control handle 20 is connected to the proximal end of the catheter main body 10 (tube member 11 ). In FIG. 1 , reference numeral 21 is a grip portion, and reference numeral 22 is a rotating plate constituting a deflection mechanism that bends the distal end portion of the catheter main body.

The electrode catheter 1 of this embodiment has four catheter distal portions (a first catheter distal portion 31 , a second catheter distal portion 32 , a third catheter distal portion 33 , and a fourth catheter distal portion 34 ).

As shown in FIG. 2 , the four catheter front ends are spaced at substantially equal angles from the front end of the catheter body 10 (the front end member 12 ) along the circumference of the axis of the catheter body 10 (approximately 90° when viewed from the side as shown in the figure). ) extends radially.

The four catheter distal end portions are respectively bent outward in the radial direction of the shaft of the catheter body 10 and extend in the distal direction.

The outer diameter of the catheter tip (the portion extending from the tip member 12 ) is preferably 0.3 to 1.4 mm, more preferably 0.5 to 1.0 mm.

The outer diameter of the distal end portion of the catheter is preferably 0.15 to 0.4 times the outer diameter of the pipe member 11 .

The length of the catheter tip (the portion extending from the tip member 12 ) is preferably 5 to 50 mm, more preferably 10 to 30 mm.

As shown in FIGS. 3 and 5 , the catheter distal ends 31 , 32 , 33 , 34 are composed of elongated plate-shaped core members 311 , 321 , 331 , 341 and cladding tubes 312 , 322 , 332 , 342 .

As shown in FIG. 3 , the core member 311 constituting the first catheter tip portion 31 extends along the inner hole of the covering tube 312 , and the tip portion thereof is fixed in a state of being embedded in the tip electrode 41 a.

In addition, the core member 331 constituting the third catheter tip portion 33 extends along the inner hole of the cladding tube 332, and the tip portion thereof is fixed in a state of being embedded in the tip electrode 43a.

In addition, the internal structures of the second catheter distal portion 32 and the fourth catheter distal portion 34 are also the same as those of the first catheter distal portion 31 and the third catheter distal portion 33 .

The core member memorizes the shape of the distal end of the catheter and is deformed by applying a force (for example, deformed into a straight line), but returns to the memorized shape (expanded shape as shown in Figs. 1 to 4 ) when the force is removed.

Examples of the constituent material of the core member include Ni—Ti alloys. The ratio of Ni and Ti in the Ni—Ti alloy is preferably 54:46 to 57:43. Nitinol is mentioned as a preferable Ni-Ti alloy.

Examples of the constituent material of the covering tube include bioresistant resin materials such as polyurethane and PEBAX.

The base end parts of the four catheter front end parts 31, 32, 33, 34 are respectively inserted into the fine holes formed on the front end member 12 (holding part 122), and the covering tubes 312, 322, 332, 342 and The holding portion 122 is thermally welded, whereby the catheter distal end portions 31 , 32 , 33 , and 34 are respectively fixed to the catheter main body 10 (the distal end member 12 ).

Front-end electrodes 41a, 42a, 43a, 44a and two The ring electrodes 41B·41c, 42b·42C, 43b·43c, 44b·44c.

Lead wires (not shown) connected to the distal end electrode and the ring electrode respectively pass through the inner hole of the catheter distal end portion (coating tube) and the inner cavity of the catheter main body 10 in an insulated state.

The tip electrode and the ring electrode are made of a metal having good electrical conductivity, such as aluminum, copper, stainless steel, gold, platinum, iridium, or alloys thereof. The outer diameters of the tip electrode and the ring electrode are not particularly limited, but are preferably the same as the outer diameter of the catheter tip.

As shown in FIG. 2 , among the eight annular electrodes 41B·41c, 42b·42C, 43b·43c, 44b·44c constituting the electrode catheter 1, the annular electrode 41B attached to the first catheter distal end portion 31 and the annular electrode 41B attached to the The electrode width (length in the tube axis direction) of the annular electrode 42C of the second catheter distal end portion 32 is longer than that of other annular electrodes, specifically 1.5 to 2.0 times.

Here, the electrode widths of the ring-shaped electrodes other than the ring-shaped electrode 41B and the ring-shaped electrode 42C are the same as each other, preferably 0.5 to 4.0 mm, and more preferably 0.6 to 1.2 mm.

With the electrode catheter 1 having such a configuration, by finding the ring-shaped electrode 41B having a wider electrode width among the ring-shaped electrodes 41B, 42b, 43b, and 44b located first from the distal end side on the X-ray image, it is possible to The catheter distal end to which the ring-shaped electrode 41B is attached is identified as the first catheter distal end 31 .

And, if the first catheter distal end portion 31 can be recognized on the X-ray image, it can be recognized that the distal end electrode and the ring electrode attached to the first catheter distal end portion 31 are the distal electrode 41a and the ring electrodes 41B·41c, respectively. .

In addition, by finding the ring electrode 42C having a wider electrode width among the ring electrodes 41c, 42C, 43c, and 44c located second from the distal end side on the X-ray image, it can be recognized that the ring electrode is installed. The catheter tip portion of 42C is the second catheter tip portion 32 .

And, if the second catheter distal end portion 32 can be recognized on the X-ray image, it can be recognized that the distal end electrode and the ring electrode attached to the second catheter distal end portion 32 are the distal electrode 42a and the ring electrodes 42b·42c, respectively. .

In addition, if the first catheter distal end 31 and the second catheter distal end 32 can be recognized on the X-ray image, it can be recognized that the tube is located next to the second catheter distal end 32 (on the side opposite to the first catheter distal end 31 ). The leading end portion of the catheter is the third leading end portion 33 of the catheter.

And, if the third catheter distal end portion 33 can be recognized on the X-ray image, the distal electrode and the ring electrode attached to the third catheter distal end portion 33 can be recognized as the distal electrode 43a and the ring electrodes 43b·43c, respectively. .

In addition, if the first catheter distal end portion 31, the second catheter distal end portion 32, and the third catheter distal end portion 33 can be identified on the X-ray image, then it can be recognized that the tube located next to the third catheter distal end portion 33 (located at the third catheter distal end portion 33 and the first catheter distal end portion 31) is the fourth catheter distal end portion 34.

And, if the fourth catheter distal end portion 34 can be recognized on the X-ray image, the distal electrode and the ring electrode attached to the fourth catheter distal end portion 34 can be recognized as the distal electrode 44a and the ring electrodes 44b·44c, respectively. .

As a result, it is possible to easily grasp to which catheter distal end portion all the distal electrodes 41a, 42a, 43a, and 44a on the X-ray image are attached.

In addition, it is also possible to easily grasp at which arrangement position of the distal end portion of the catheter all the annular electrodes 41B, 41c, 42b, 42C, 43b, 43c, 44b, 44c are attached on the X-ray image.

The electrode catheter 1 of this embodiment is characterized in that two ring electrodes (ring electrode 41B and ring electrode 42C) having wider electrode widths than other ring electrodes are attached to adjacent catheter distal ends (the first catheter distal end portion 31 and the second catheter tip portion 32) are at different positions from each other.

When there is only one ring-shaped electrode with a wide electrode width, for example, only the ring-shaped electrode 41B has a wide electrode width, the second catheter distal end portion 32 and the fourth catheter cannot be recognized immediately on the X-ray image. For example, the front end part 34 may mistake the front electrode 42a reflected on the X image as the front electrode 44a.

In such a case, for example, when the distal electrode 43a attached to the third catheter distal end portion 33 and the distal electrode 42a attached to the second catheter distal end portion 32 are placed across the ablation line, the distal electrode 42a on the X-ray image may be mistaken for The tip electrode 44a is misdiagnosed as "unexpected ablation" based on the potential data between the tip electrode 43a and the tip electrode 44a displayed on the monitor and not crossing the ablation line.

In contrast, in the electrode catheter 1 of this embodiment, in addition to the wide electrode width of the ring electrode 41B, the electrode width of the ring electrode 42C attached to the second catheter distal end portion 32 is also wide. The second catheter distal portion 32 and the fourth catheter distal portion 34 are recognized immediately, and the distal electrode 42a reflected on the X-ray image cannot be mistaken for the distal electrode 44a, so that misdiagnosis as described above can be reliably avoided.

In addition, when two ring-shaped electrodes having a wider electrode width than other ring electrodes are attached to the same position on the distal end of the adjacent catheter, the electrode with a wider electrode width cannot be recognized on the X-ray image. The two catheter distal ends of the ring electrode are respectively the first catheter distal end and the second catheter distal end.

In such a case, it cannot be immediately recognized whether the four catheter distal end portions on the X-ray image are viewed from the distal end side of the catheter or from the proximal end side of the catheter.

On the other hand, in the electrode catheter 1 of this embodiment, due to the arrangement position of the ring-shaped electrode 41B attached to the distal end portion 31 of the first catheter (the first ring electrode from the distal end side) and the location of the ring-shaped electrode attached to the second catheter The attachment positions of the ring electrodes 42C (the ring electrodes are second from the front end side) of the distal end 32 are different from each other, so that the first catheter distal end 31 and the second catheter distal end 32 can be reliably identified. Accordingly, it is possible to immediately recognize whether the four catheter distal end portions on the X-ray image are viewed from the distal end side of the catheter or from the proximal end side of the catheter.

The electrode catheter 1 of this embodiment has a deflection mechanism (oscillating mechanism) that deflects the distal end portion of the catheter body 10 in two directions around the axis of the catheter body 10 .

This deflection mechanism is a mechanism that bends the distal end portion of the catheter main body 10 in a direction that bisects an angle formed by two adjacent catheter distal end portions.

That is, the direction in which the tip portion of the catheter body 10 is bent by the deflection mechanism (the plane including the trajectory of the curved tip portion) and the bisection of the angle formed by the two catheter tip portions as the tip portion of the catheter body 10 bends The direction in which the line moves (the plane containing the trajectory of the bisector) is the same.

Utilizing such a deflection mechanism, the front end portion of the catheter main body 10 can be oriented in a direction that bisects the angle formed by the catheter front end portion 32 and the catheter front end portion 33 (direction indicated by arrow A in FIGS. 1 and 2 ) and The direction of bisecting the angle formed by the catheter distal end portion 34 and the catheter distal end portion 31 (the direction indicated by the arrow B in FIGS. 1 and 2 ) is bent.

Then, by bending the distal end portion of the catheter body 10 in the direction indicated by the arrow A or the arrow B, the four catheter distal ends 31 , 32 , 33 , 34 move integrally in the directions indicated by the arrow A or the arrow B.

The biasing mechanism is not particularly limited, and examples include two leaf springs (not shown) housed in the distal end portion of the pipe member 11 and two penetrating through the lumen of the pipe member 11 on the front and back sides of the leaf spring. Pulling wires (indicated by reference numerals 51 and 52 in FIG. 4 ) and the mechanism of the rotating plate 22 connected to the respective proximal ends of the two pulling wires.

Here, the distal ends of the two pull wires may be fixed to the inner wall of the pipe member 11 at opposing positions across the leaf spring, or may be fixed to the front and back surfaces of the flat plate portion at the distal end of the leaf spring.

On the other hand, the proximal ends of the pull wires 51, 52 are connected to positions separated from each other on the rotating plate 22 of the control handle 20, and the rotating plate 22 can be freely centered on a rotating axis perpendicular to the Z axis shown in FIG. rotate.

The operator grasps the grip portion 21 of the control handle 20 with one hand, and operates the rotary plate 22 (rotates in a predetermined direction) with fingers of the other hand. As a result, the tension of the pulling wires 51 and 52 changes, and the distal end portion of the catheter body 10 bends in the direction indicated by arrow A or arrow B in FIGS. 1 and 2 .

That is, when the rotating plate 22 is rotated, for example, in the direction A1 shown in FIG. 1 , the pulling wire 52 is stretched, and the pulling wire 51 is loosened. As a result, the distal portion of the catheter main body 10 bends in a direction that bisects the angle formed by the catheter distal end portion 32 and the catheter distal end portion 33 (arrow A direction), whereby the four catheter distal end portions move integrally in the arrow A direction. And biased.

Similarly, when the rotating plate 22 is rotated, for example, in the B1 direction shown in FIG. 1 , the pulling wire 51 is stretched, and the pulling wire 52 is loosened. As a result, the distal portion of the catheter main body 10 bends in a direction that bisects the angle formed by the catheter distal end portion 34 and the catheter distal end portion 31 (arrow B direction), whereby the four catheter distal end portions move integrally in the arrow B direction. And biased.

Furthermore, if the control handle 20 is rotated about the Z-axis shown in FIG. 1 , the orientation of the control handle 20 in the A direction or the B direction can be freely set in the state inserted into the cardiac cavity.

An example of how to use the electrode catheter 1 according to this embodiment is shown. First, the electrode catheter 1 is moved in a state where the electrode catheter 1 is inserted into a cylindrical sheath (a state where the four catheter distal ends are deformed into a straight line). Go to the vicinity of the target site in the cardiac cavity, push out the four catheter tip parts from the sheath near the target site, and restore the catheter tip part to the memory shape (the expanded shape shown in Figures 1 to 4).

Next, as shown in (1) of FIG. 6 , the distal end portion of the catheter body 10 (the distal end portion of the tube member 11 ) is bent so that the ablation line AL is positioned between the distal end electrode 42 a attached to the second catheter distal end portion 32 and the distal end portion of the catheter body 10 . The distal electrode 42 a and the distal electrode 43 a are placed so as to be at the middle point of the distal electrode 43 a attached to the third catheter distal portion 33 .

In this way, by indwelling the two annular electrodes attached to the adjacent catheter distal end, the ablation line AL can also be positioned on the remaining two annular electrodes, that is, the distal end electrode 41a attached to the first catheter distal end 31 and the front end electrode 41a attached to the first catheter distal end 31. The distal electrode 41a and the distal electrode 44a of the fourth catheter distal end portion 34 are placed so as to be at the middle point of the distal electrode 44a. As a result, the four distal electrodes 41a, 42a, 43a, and 44a can be arranged at equal distances from the ablation line AL.

After such arrangement, the ablation line AL can be evaluated by giving electrical stimulation (pacing) from any one of the distal electrodes, and measuring the potential at the other distal electrodes, and comparing the transmission speed (time to detect potential).

Alternatively, other electrode catheters may be arranged around the catheter main body 10, electrical stimulation (constant speed) may be given from the other electrode catheters, potential measurement may be performed at each distal electrode, and the transmission speeds may be compared.

By arranging the four front-end electrodes at equal distances from the ablation line AL, if the desired ablation is performed along the ablation line AL, the potentials between the front-end electrode 42a and the front-end electrode 43a and between the front-end electrode 41a and the front-end electrode 44a The transmission speed (the transmission speed of the potential between the electrodes crossing the ablation line AL) is faster than the transmission speed of the potential between the front end electrode 42a and the front electrode 41a and between the front end electrode 43a and the front electrode 44a (the transmission speed between the electrodes not crossing the ablation line AL). The transmission speed of the potential) is slow.

Furthermore, if uniform ablation is performed along the ablation line AL, the transmission speed of the potential between the distal electrode 42a and the distal electrode 43a is equal to the transmission speed of the potential between the distal electrode 41a and the distal electrode 44a.

In addition, the ablation line AL shown in (1) of FIG. 6 is not displayed on the X-ray image and is usually grasped by the operator.

As described above, with the electrode catheter 1 of this embodiment in which the number of catheter tip portions is four, corresponding four electrodes (for example, tip electrodes) can be easily arranged at equal distances from the ablation line AL.

According to the electrode catheter 1 of this embodiment, it is possible to immediately recognize whether the electrode on the X-ray image and the catheter distal end on which the electrode is mounted are viewed from the distal end side of the catheter or from the proximal end side of the catheter.

On the X-ray image of the state shown in (1) in FIG. 6 , by finding the ring-shaped electrode 41B with a wider electrode width located first from the front end side, it is possible to identify the position where the ring-shaped electrode 41B is attached. The catheter distal end portion on the lower left side in the drawing is the first catheter distal end portion 31 .

In addition, by finding the ring-shaped electrode 42C that is second from the tip side and has a wider electrode width, it can be recognized that the catheter tip portion on the upper left side of the drawing to which the ring-shaped electrode 42C is attached is the second catheter tip. Section 32.

Moreover, in (1) of FIG. 6 , since the first catheter tip portion 31, the second catheter tip portion 32, the third catheter tip portion 33, and the fourth catheter tip portion 34 are arranged “clockwise”, it is possible to immediately This X-ray image was recognized by looking at the distal end portion of the catheter from the proximal end side of the catheter.

On the other hand, in the X-ray image of the state shown in (2) of FIG. 6, it is obvious at a glance that, as in (1) of FIG. The individual annular electrode 41B having a wider electrode width can be identified as the first catheter distal end portion 31 at the lower right side of the drawing to which the annular electrode 41B is attached.

In addition, by finding the ring-shaped electrode 42C that is second from the tip side and has a wider electrode width, it can be recognized that the catheter tip portion on the upper right side of the drawing to which the ring-shaped electrode 42C is attached is the second catheter tip. Section 32.

Moreover, in (2) of FIG. 6 , since the first catheter tip portion 31 , the second catheter tip portion 32 , the third catheter tip portion 33 , and the fourth catheter tip portion 34 are arranged “counterclockwise”, it is possible to immediately This X-ray image is recognized by looking at the distal end portion of the catheter from the distal end side of the catheter.

A method of arranging the four distal electrodes 41a, 42a, 43a, and 44a at equal distances from the ablation line AL in one example of the method of using the electrode catheter 1 according to this embodiment will be described more specifically below.

First, insert the electrode catheter 1 into the cylindrical sheath, and move the electrode catheter 1 to the target site in the cardiac cavity (for example, the site where the ablation line is formed) while the four catheter tip parts are deformed into a straight line (closed state). ) near the target site, push the four catheter tip parts out of the sheath near the target site, and restore the catheter tip part to the memory shape (the deployed shape as shown in Fig. 1 to Fig. 4).

Next, the catheter main body 10 is arranged along the ablation line (in parallel) while observing the X-ray image, and the catheter main body 10 is rotated around the axis, and the angle formed by two adjacent catheter distal ends on the X-ray image becomes the largest position stop.

(1) and (2) of FIG. 7 are plan views and side views showing the state at this time, and are states that can be grasped on X-ray images. In the plan view shown in ( 1 ) of FIG. 7 , the ablation line AL extends along a direction that bisects the angle formed by the catheter distal end portion 32 and the catheter distal end portion 33 (the bisector line).

That is, in the plan view shown in (1) of FIG. 7 , the catheter distal end portion 32 and the catheter distal end portion 33 are axisymmetric with the ablation line AL as the axis (these catheter distal end portions straddle the ablation line), and the distal end electrode 42 a and the distal end portion The electrodes 43a are positioned symmetrically with respect to the ablation line AL as the axis.

In addition, as shown in (2) of FIG. 7 , the catheter tip 31 and the catheter tip 34 are in a state of straddling the ablation line AL, and the tip electrode 41 a and the tip electrode 44 a are located at symmetrical positions with the ablation line AL as the axis.

Next, the distal end portion of the catheter body 10 is bent along the ablation line AL (toward the inner wall side of the heart) by the deflection mechanism. Thereby, the catheter tip 32 ( 31 ) and the catheter tip 33 ( 34 ) straddle the ablation line AL, and the distal electrodes respectively attached to these catheter tip portions can be brought into contact with the inner wall of the heart.

For example, the rotating plate 22 is rotated in the direction of arrow B1 shown in FIG. Bending 90° in the direction of arrow B.

As a result, the four catheter tip portions 31, 32, 33, and 34 move integrally in the arrow B direction, as shown in (1) and (2) of FIG. 41a, 42a, 43a, 44a are in contact with the inner wall of the heart.

According to the electrode catheter 1 of this embodiment, the bending direction of the distal end portion of the catheter main body 10 (moving direction of the catheter distal portion), that is, the direction of arrow A and the direction of arrow B, coincides with the direction formed by the ablation line. The front end portion of the catheter main body 10 is bent by 90° so that the state where the catheter front end 32 ( 31 ) and the catheter front end 33 ( 34 ) straddle the ablation line AL can be maintained [the front end electrode 42 a ( 41 a ) and the front end electrode 43 a ( 44 a ) are in the The ablation line AL is the positional relationship of the symmetrical position of the axis] and the four catheter front ends 31, 32, 33, 34 are moved integrally, so that the four front end electrodes 41a, 42a, 43a, 44a respectively mounted on these catheter front ends Contact with the inner wall of the heart or move along the ablation line.

In addition, the ablation line AL shown in FIG. 7 and FIG. 8 is usually not displayed on the X-ray image, and is usually grasped by the operator.

As shown in (1) of FIG. 8 , after the distal end portion of the catheter body 10 is bent, the four distal electrodes 41 a , 42 a , 43 a , and 44 a are arranged at equal distances from the ablation line AL.

The ablation line AL can be evaluated by giving electrical stimulation (fixed speed) from any one of the distal electrodes arranged in this way, and measuring the potential at the other distal electrode, and comparing the transmission speed (time to detect potential).

Alternatively, other electrode catheters may be arranged around the catheter main body 10, electrical stimulation (constant speed) may be given from the other electrode catheters, potential measurement may be performed at each distal electrode, and the transmission speeds may be compared.

By arranging the four front-end electrodes at equal distances from the ablation line AL, if the desired ablation can be performed along the ablation line AL, the potential between the front-end electrode 42a and the front-end electrode 43a and between the front-end electrode 41a and the front-end electrode 44a The transmission speed of the electric potential between the front-end electrode 42a and the front-end electrode 41a and between the front-end electrode 43a and the front-end electrode 44a (the transmission speed of the potential between the electrodes crossing the ablation line AL) is higher than that of the electric potential between the front-end electrode 42a and the front-end electrode 41a (the transmission speed of the electric potential between the front-end electrode 43a and the front-end electrode 44a (the transmission speed of the electric potential between the electrodes not crossing the ablation line AL) The transmission speed of the potential between them) is slow.

Furthermore, if uniform ablation is performed along the ablation line AL, the transmission speed of the potential between the distal electrode 42a and the distal electrode 43a is equal to the transmission speed of the potential between the distal electrode 41a and the distal electrode 44a.

As shown in FIG. 11 , instead of the deflection mechanism constituting the electrode catheter of the present invention (the second technical solution), the front end portion of the catheter main body 610 is used to extend the direction of the catheter front end 633 and the catheter front end 631 (arrow a and arrow a). In the case of a deflection mechanism that bends in the direction shown in b), even if the catheter tip portion 632 ( 631 ) and the catheter tip portion 633 ( 634 ) are arranged so that the axis of the ablation line AL is Axisymmetric (the state in which these catheter distal ends straddle the ablation line), bending the distal end portion of the catheter body 610 in, for example, the direction b, as shown in (2) of FIG. In a state where the catheter tip portion 633 ( 634 ) straddles the ablation line (positional relationship before bending), the tip electrodes 641 a , 642 a , 643 a , and 644 a that are close to the inner wall of the heart deviate greatly from the ablation line AL.

In addition, when the distal end portion of the catheter main body 610 is bent along the ablation line AL by the deflection mechanism described above, the catheter distal end portions 633 and 631 move along the ablation line AL, and the distal end electrodes 643a and 641a attached to these catheter distal end portions move along the ablation line AL. AL, therefore, these front electrodes cannot be used for potentiometric measurements.

In addition, in the above description, the tip electrodes 41 a , 42 a , 43 a , and 44 a have been described as corresponding electrodes as examples, and the corresponding ring-shaped electrodes (eight ring-shaped electrodes shown in FIG. 2 ) are also the same.

That is, according to the electrode catheter 1 of this embodiment, it is possible to maintain the positional relationship between the ring electrode 42b ( 41B) and the ring electrode 43b ( 44b ) at symmetrical positions with the ablation line AL as the axis, and make these ring electrodes 41B, 42b , 43b, 44b approach (contact) the inner wall of the heart or move along the ablation line.

Furthermore, after bending the distal end portion of the catheter main body 10, the four ring-shaped electrodes 41B, 42b, 43b, and 44b as corresponding electrodes can be arranged at equal distances from the ablation line AL.

In addition, according to the electrode catheter 1 of this embodiment, it is possible to maintain the positional relationship between the ring electrode 42C ( 41c ) and the ring electrode 43c ( 44c ) at symmetrical positions with the ablation line AL as the axis, and make these ring electrodes 41c and 42C , 43c, 44c approach (contact) the inner wall of the heart or move along the ablation line.

Furthermore, after bending the distal end portion of the catheter main body 10, the four ring-shaped electrodes 41c, 42C, 43c, and 44c as corresponding electrodes can be arranged at equal distances from the ablation line AL.

And, according to the electrode catheter 1 of this embodiment, the bending direction in which the deflection mechanism bends the distal end portion of the catheter body 10 is the direction that bisects the angle formed by the two catheter distal end portions. Therefore, the distal end portion of the catheter body 10 is The force during bending is not concentrated on one of the catheter distal ends, and since the distal electrode attached to the catheter distal end presses the inner wall of the heart with extremely small force, the inner wall will not be damaged.

<Second Embodiment>

The electrode catheter 2 shown in FIG. 9 has four catheter tip portions (36, 37, 38) radially extending from the tip of the catheter body 10 (tip member 12) at equiangular (approximately 90° in side view) intervals. , 39), the front-end electrodes (46A, 47a, 48a, 49a) installed on the front ends of these catheters respectively, and the eight ring-shaped electrodes (46b·46c, 47B·47c, 48b· 48c, 49b 49c).

As shown in FIG. 9 , among the four distal electrodes ( 46A, 47 a , 48 a , 49 a ) constituting the electrode catheter 2 , the electrode width of the distal electrode 46A attached to the first catheter distal portion 36 is longer than that of the other distal electrodes. , specifically 1.5 times.

In addition, among the eight annular electrodes (46b·46c, 47B·47c, 48b·48c, 49b·49c) constituting the electrode catheter 2, the electrode width of the annular electrode 47B attached to the second catheter distal end portion 37 is wider than that of the other electrodes. The electrode width of the ring electrode is longer, specifically, 1.5 to 2.0 times.

With the electrode catheter 2 configured in this way, by finding the distal electrode 46A having a wider electrode width on the X-ray image, the catheter distal end on which the distal electrode 46A is attached can be recognized as the first catheter distal portion 36 .

Furthermore, if the first catheter distal end portion 36 can be recognized on the X-ray image, the ring electrodes attached to the first catheter distal end portion 36 can be recognized as the ring electrode 46b and the ring electrode 46c, respectively.

In addition, by finding the ring-shaped electrode 47B having a wide electrode width on the X-ray image, it can be recognized that the catheter tip portion on which the ring-shaped electrode 47B is attached is the second catheter tip portion 37 .

And, if the second catheter distal end portion 37 can be recognized on the X-ray image, the distal electrode and the ring electrode attached to the second catheter distal end portion 37 can be recognized as the distal electrode 47a and the ring electrodes 47B·47c, respectively. .

In addition, if the first catheter distal portion 36 and the second catheter distal portion 37 can be recognized on the X-ray image, it can be recognized that the tube located next to the second catheter distal portion 37 (the side opposite to the first catheter distal portion 36 ) The leading end portion of the conduit is the third leading end portion 38 of the conduit.

And, if the third catheter distal end portion 38 can be recognized on the X-ray image, the distal electrode and the ring electrode attached to the third catheter distal end portion 38 can be recognized as the distal electrode 48a and the ring electrodes 48b·48c, respectively. .

In addition, if the first catheter distal end portion 36, the second catheter distal end portion 37, and the third catheter distal end portion 38 can be identified on the X-ray image, then it can be recognized that the tube located next to the third catheter distal end portion 38 (located at the third catheter distal end portion 38 and the first catheter distal end portion 36) is the fourth catheter distal end portion 39.

And, if the fourth catheter distal end portion 39 can be recognized on the X-ray image, the distal electrode and the ring electrode attached to the fourth catheter distal end portion 39 can be recognized as the distal electrode 49a and the ring electrodes 49b·49c, respectively. .

As a result, it is possible to easily grasp to which catheter distal portion all the distal electrodes ( 46A, 47a , 48a , 49a ) on the X-ray image are attached.

In addition, it is possible to easily grasp at which arrangement position of the distal end portion of the catheter all the ring electrodes ( 46b·46c, 47B·47c, 48b·48c, 49b·49c) are attached on the X-ray image.

As mentioned above, although embodiment of this invention was described, this invention is not limited to this, Various changes are possible as shown below.

For example, in the present invention (first claim), the number of ring-shaped electrodes attached to the tip of each catheter is not limited to two, but may be three or more. In addition, as shown in the second embodiment, when the electrode width of the distal electrode attached to the distal end of the first catheter is wider than that of the other distal electrodes, the number of ring-shaped electrodes attached to the distal end of each catheter may be for 1 pc.

In addition, in the present invention (first aspect), the number of catheter distal end portions extending from the distal end of the catheter body is not limited to four, but may be three or five or more.

Here, the electrode catheter shown in (1) of FIG. 10 has three catheter distal end portions radially extending from the distal end of the catheter main body 10 (tip member 12 ) at equiangular (approximately 120° in side view) intervals. (131, 132, 133), front-end electrodes (141a, 142a, 143a) mounted on the front-end parts of these catheters, and six ring-shaped electrodes (141B·141c, 142b·142C, 142b·142C, 143b·143c), the ring-shaped electrode 141B installed on the first catheter tip 131 and the ring-shaped electrode 142C installed on the second catheter tip 132 are wider electrode widths than other ring-shaped electrodes of the present invention (first technical solution ) lead wire.

In addition, the electrode catheter shown in (2) of FIG. 10 has five catheter distal end portions ( 231, 232, 233, 234, 235), front-end electrodes (241a, 242a, 243a, 244a, 245a) respectively installed on the front-end parts of these catheters, and 10 ring-shaped electrodes (241B 241c, 242b, 242C, 243b, 243c, 244b, 244c, 245b, 245c), the ring-shaped electrode 241B mounted on the first catheter tip 231 and the ring-shaped electrode 242C mounted on the second catheter tip 232 are different than the other The electrode catheter of the present invention (first claim) in which the electrode width of the ring electrode is wide.

Also in the electrode catheter shown in (1) to (2) of FIG. 10 , it is possible to easily grasp at which catheter distal portion all the electrodes (distal electrode and ring-shaped electrode) on the X-ray image are attached.

In addition, in the present invention (second aspect), the number of ring-shaped electrodes attached to the distal end of each catheter is not limited to two, but may be three or more. In addition, the electrode widths of all the annular electrodes may be the same.

The electrode catheter of the present invention can be used not only for confirmation of ablation therapy but also for various diagnoses and treatments. For example, it can simultaneously measure the potential of the area within a circle whose radius is the length of the front end of the catheter, so it can be preferably used for mapping catheters.

Symbol Description

1 electrode catheter, 10 catheter body, 11 tube member, 12 tip member, 121 cylindrical part, 122 holding part, 20 control handle, 21 grip part, 22 rotating plate, 31 first catheter tip, 32 second catheter tip Part, 33 3rd catheter tip, 34 4th catheter tip, 311, 321, 331, 341 core member, 312, 322, 332, 342 cladding tube, 41a tip electrode, 41B·41c ring electrode, 42a tip Electrode, 42b·42C ring electrode, 43a front end electrode, 43b·43c ring electrode, 44a front end electrode, 44b·44c ring electrode.

Claims (13)

1. an electrode catheter, is characterized in that, this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles interval from the front end of above-mentioned catheter main body; Ring electrode, it is provided with multiple in each above-mentioned catheter proximal end portion;

The electrode width of 1 ring electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other ring electrodes with the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end radical limit,

The allocation position of electrode width above-mentioned 2 ring electrodes different from other ring electrodes in the catheter proximal end portion that these 2 ring electrodes are installed differs from one another.

2. electrode catheter according to claim 1, is characterized in that,

The electrode width of ring electrode of the 2nd from front electrode width and the 2nd catheter proximal end portion of ring electrode of the 1st from front in the 1st catheter proximal end portion is wider than the electrode width of other ring electrodes.

3. electrode catheter according to claim 2, is characterized in that,

This electrode catheter has 4 catheter proximal end portions.

4. according to the electrode catheter described in any one in claim 1～3, it is characterized in that,

This electrode catheter has the fore-end that can make above-mentioned catheter main body deflection mechanism to both direction bending centered by the axis of this catheter main body.

5. an electrode catheter, is characterized in that, this electrode catheter has: catheter main body, and it has at least 1 endoporus; Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body; At least 3 catheter proximal end portions, they extend with actual equal angles interval from the front end of above-mentioned catheter main body; Front termination electrode, it is installed on each above-mentioned catheter proximal end portion; Ring electrode, it at least installs 1 in each above-mentioned catheter proximal end portion;

The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other front termination electrodes,

The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end radical limit is different with the electrode width of other ring electrodes.

6. electrode catheter according to claim 5, is characterized in that,

The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front termination electrodes,

The electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion is wider than the electrode width of other ring electrodes.

7. electrode catheter according to claim 6, is characterized in that,

This electrode catheter has 4 catheter proximal end portions.

8. according to the electrode catheter described in any one in claim 5～7, it is characterized in that,

This electrode catheter has the fore-end that can make above-mentioned catheter main body deflection mechanism to both direction bending centered by the axis of this catheter main body.

9. an electrode catheter, is characterized in that, this electrode catheter has:

Catheter main body, it has at least 1 endoporus;

Joystick, it is connected with the cardinal extremity of above-mentioned catheter main body;

4 catheter proximal end portions, they circumferentially extend with equal angles interval from the axis of this catheter main body of front end edge of above-mentioned catheter main body;

Deflection mechanism, it makes the fore-end of above-mentioned catheter main body to the binary direction bending in angle that 2 adjacent catheter proximal end portions are become;

Ring electrode, it is provided with multiple in each above-mentioned catheter proximal end portion;

The electrode width of 1 ring electrode that is installed on the 1st catheter proximal end portion is different with the electrode width of other ring electrodes with the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end radical limit,

The allocation position of electrode width above-mentioned 2 ring electrodes different from other ring electrodes in the catheter proximal end portion that these 2 ring electrodes are installed differs from one another.

10. electrode catheter according to claim 9, is characterized in that,

The fore-end that above-mentioned deflection mechanism makes above-mentioned catheter main body centered by the axis of this catheter main body to both direction bending.

11. according to the electrode catheter described in claim 9 or 10, it is characterized in that,

Termination electrode before each above-mentioned catheter proximal end portion is provided with.

12. according to the electrode catheter described in claim 9 or 10, it is characterized in that, in the 1st catheter proximal end portion from front the 1st ring electrode electrode width and to be positioned at the electrode width of ring electrode of the 2nd from front the 2nd catheter proximal end portion on the 1st catheter proximal end radical limit wider than the electrode width of other ring electrodes.

13. electrode catheters according to claim 11, is characterized in that,

The electrode width of front termination electrode that is installed on the 1st catheter proximal end portion is wider than the electrode width of other front termination electrodes, and the electrode width of 1 ring electrode that is installed on the 2nd catheter proximal end portion that is positioned at the 1st catheter proximal end radical limit is wider than the electrode width of other ring electrodes.