JP2736531B2 - Pacing catheter - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Prior Art] When an atrioventricular block of the heart occurs, or when a right leg block occurs due to a high degree of arrhythmia, myocardial infarction, or the like, the patient cannot be temporarily treated as an emergency treatment. Extracorporeal pacing is applied. As a treatment method, for example,
A peripheral vein, such as a right femoral vein or a right subclavian vein, is punctured through an incision in the skin by an introducer. A temporary pacing catheter is inserted through this introducer and its tip is placed in the right ventricular apex. Connect the positive and negative lead wires of the outer end of the catheter to the terminal of the temporary pacemaker, turn on the switch and start it, start pacing, adjust the heart rate and output to the desired values, and adjust the skin insertion part of the catheter. It is to be sutured and fixed.

Conventionally used temporary pacing catheters are used for insertion and indwelling at a target site, for example, by including a heavy metal compound and a contrast agent in the catheter main body, performing the operation under fluoroscopy, or communicating with the distal hole. A pressure measurement device is connected to the catheter proximal end side of the lumen, and the catheter is inserted and placed while measuring the catheter tip pressure. In addition, there are already temporary pacing catheters designed to allow the balloon to be inserted into the tip in each of the above examples and to float within the heart and blood vessels.

However, in the above temporary pacing catheter, the tip electrode is made of a hard metal such as stainless steel or platinum, and also in a temporary pacing catheter with a balloon, the tip electrode protrudes from the balloon when the balloon is expanded. I have. In this way, conventional pacing
When a catheter is percutaneously inserted into a blood vessel and is to be placed at a target site, the tip electrode often damages the heart and blood vessels, and there is a risk of perforation if the catheter is forcibly inserted.

[Problems to be Solved by the Invention] In view of the drawbacks of the conventional temporary pacing catheter, the inventors have developed a tip structure and a tip structure for preventing the risk of damaging the heart and blood vessels by the catheter tip electrode when the catheter is inserted. While maintaining this structure, it is possible to perform safe, quick and accurate placement at the target site, for example, the apical part of the right ventricle, and to efficiently transmit the stimulation current from the pacemaker connected to the catheter tip. The present inventors have made various studies and found means capable of solving the above-mentioned problems, and have completed the present invention.

[Means for Solving the Problems] Thus, according to the present invention, a balloon is attached to the distal end portion of the catheter, and the balloon retains a shape covering the catheter distal end electrode when inflated. A temporary pacing catheter having an annular tip electrode in communication is provided.

The present invention will be described with reference to the drawings. FIG. 1 is an enlarged longitudinal sectional view of the distal end of the first structural example, which basically comprises a catheter section (1), a balloon (3) and a distal electrode (2). The vicinity electrode (4) may be provided, and a side hole (6) for injecting a chemical solution may be opened on the side surface of the distal end portion. The position is 10 ~ from the tip electrode (2).
A position of 15 cm is preferred.

The catheter section (1) is preferably made of an antithrombotic material, preferably silicone, polyurethane or the like. The balloon (3) is made of an elastic material, and preferably has excellent pressure sensitivity, mechanical properties and antithrombotic properties, and is made of silicone rubber, polyurethane, natural rubber or the like. Further, in order to maintain a shape covering the tip electrode when the balloon (3) is expanded, it is preferable that the balloon tip (3a) be folded and attached to the catheter section (1), while the tip (3b) Is not particularly limited. The balloon (3) attached to the catheter section (1) in this way expands by insufflation from the balloon lumen (7) to form an expanded shape (3 ') enclosing the tip electrode (2). .

The electrodes (2) and (4) are made of a metal conductor, usually stainless steel or platinum, and are connected to the outside of the catheter by lead wires passing through the electrode lumens (8) and (9). The electrode (4) in the vicinity of the tip preferably has a distance of 1.0 to 2.0 cm from the tip electrode, and the tip electrode (2) is covered with the balloon-expanded shape (3 '). Is designed to be short enough. The contact portion (2a) between the tip electrode (2) and the balloon (3) is appropriately rounded so that the balloon is not damaged when the balloon is expanded.

FIG. 2 is an enlarged longitudinal sectional view of the tip portion of the second structural example, which has the following advantages as compared with the structural example of FIG. That is, the annular tip electrode (10) at the tip has the same function as the tip electrode (2) in that the stimulation current from the external pacemaker can be efficiently transmitted to the target site. By being able to measure
Can be inserted exactly at the target site. This is because the annular tip electrode (10) covers the catheter tip and the measurement lumen (11) for measuring the catheter tip pressure is open as the catheter tip hole (12). This is achieved by connecting to a pressure measurement device on the proximal end side of the catheter in fluid communication with the catheter, and inserting and placing the catheter while measuring the distal pressure of the catheter. More specifically, measuring the catheter tip pressure has the advantage that the catheter operator can easily grasp the position of the catheter tip in the blood vessel and the heart without necessarily using a fluoroscope.

Further, a side hole (6) for injecting a chemical solution may be opened in the side surface of the tip portion, and its position is 10 to 15 cm from the tip electrode (2).
Is preferred. In the above embodiment, the pacing catheter having the bipolar electrode is shown, but the pacing catheter may have a monopolar electrode or two or more electrodes.

[Operation] According to the present invention, the risk of damaging the heart and blood vessels that may occur at the time of catheter insertion can be prevented by mounting a balloon having a shape that covers the tip electrode at the time of dilatation, and is safe and quick. In the heart and blood vessels.

Further, by attaching a tip electrode having an annular structure, the tip pressure can be measured while maintaining the balloon shape, so that the tip pressure can be accurately placed at the target site. In addition, since the distal electrode is in contact with a target site inside the heart, a stimulation current from a pacemaker connected to the proximal end of the catheter can be efficiently transmitted to the target site.

[Effects of the Invention] According to the pacing catheter of the present invention, the tip of the catheter can be quickly and safely and securely inserted and placed, and the stimulation current can be efficiently transmitted to the target site and the drug solution can be injected. Very useful as.

[Brief description of the drawings]

1 and 2 are enlarged longitudinal sectional views of the distal end of each catheter of the present invention. (1) ... catheter part, (2) ... tip electrode, (3)
... balloon, (3a) ... balloon at the time of expansion, (4) electrode near the tip, (6) ... side hole, (7) ... lumen for balloon, (10) ... annular tip electrode, (11) )… Measurement lumen.

 ──────────────────────────────────────────────────の Continuation of front page (72) Inventor Masaru Miyahara 3-7-11-802 Nishiwaseda, Shinjuku-ku, Tokyo

Claims (2)

(57) [Claims] 1. A pacing device comprising a catheter provided with an electrode at a distal end thereof, wherein a balloon is mounted near the distal end of the catheter, and the balloon is provided so as to cover the distal electrode when inflated. ·catheter. 2. The pacing catheter according to claim 1, wherein the tip electrode is annular, and has a lumen through which fluid is connected to the tip.