CN103908334A - Multi-electrode ablation catheter - Google Patents
Multi-electrode ablation catheter Download PDFInfo
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- CN103908334A CN103908334A CN201210594339.XA CN201210594339A CN103908334A CN 103908334 A CN103908334 A CN 103908334A CN 201210594339 A CN201210594339 A CN 201210594339A CN 103908334 A CN103908334 A CN 103908334A
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Abstract
The invention relates to a multi-electrode ablation catheter which comprises a catheter, electrodes distributed on the catheter, a wire connected onto the electrodes to transmit signals and radio frequency energy and a handle used for adjusting the shape of the catheter. The electrodes comprise basket-shaped electrodes and head electrodes arranged at the farthest end of the catheter. The catheter comprises a basket-shaped section with the basket-shaped electrodes, a flexible transition section and a main body section coupled to the handle, wherein the basket-shaped section is formed by a center catheter and a plurality of branch catheters evenly distributed around the center catheter and connected with the center catheter at two ends. The basket-shaped electrodes are formed by electrodes distributed on the branch catheters, and contracting, base state and stretching of the branch catheters relative to the center catheter are achieved by controlling the handle. The catheter can be contracted to conveniently enter the renal artery vessel to be transferred to the position nearby a target spot of a complex structure, the catheter can extend after the catheter reaches the place to cling to the vessel wall completely, protrusions are not formed in the middle, the problem that the vessel is irritated to be narrow due to the fact that a certain position is ablated too much is solved, and blood flow of the renal artery is not affected.
Description
Technical field
The present invention relates to technical field of medical instruments.More specifically, the invention provides a kind of multi-electrode ablation catheter.
Background technology
Intractable hypertension claims again refractory hypertension, refers to and adopts life style improvement and more than 3 kinds or 3 kinds antihypertensive drugs (comprising a kind of diuretic) to treat the hypertension that still can not effectively control.Experimental data proves that hypertension is higher relevant with patient's kidney sympathetic excitability, and blocking-up kidney sympathetic nerve not only can make blood pressure drops, and the chronic organ specificity disease of sympathetic nerve excessive activation is exerted an influence; Blocking-up kidney sympathetic nerve can also improve left ventricular hypertrophy and insulin resistant.
Congestive heart failure (CHF) is a kind of disease, and described disease occurs in the time that the blood flow that is damaged and arrives organ when heart reduces.If blood flow fully reduces, renal function is changed, and it causes fluid retention, not normal hormone secretion and the vasoconstriction of increase.These results increase the workload of heart and further reduce the ability of heart pump blood through kidney and blood circulation.
In animal model, determine that heart failure condition can cause abnormal high kidney sympathetic nerve to activate.The orthosympathetic such high level activity of kidney causes the hydration sodium of removing from health to reduce, and renin secretion increases.The renin secretion increasing causes to the vasoconstriction of kidney blood supply, and then causes that renal blood flow reduces.For example, reduce the orthosympathetic activity of kidney by denervation, can reverse these processes.
Blood circulation develops into the process of hypertension state from normal condition, and sympathetic nerve participates in its process, is all accompanied by orthosympathetic excessive activation in most of hyperpietics.Moreover, the excessive activation of sympathetic nervous system is the risk factor of the multiple cardiovascular event such as myocardial infarction, arrhythmia.Therefore sympathetic nerve suppression therapy becomes the hypertensive important directions for the treatment of for many years, treats heart failure and intractable hypertension receives much concern by intervening mode.
Up-to-date animal and clinical experiment digital proof, adopt percutaneous catheter technology that kidney sympathetic nerve is carried out to radio-frequency (RF) ablation can reduce significantly enduringly intractable hypertension, within 6 months, follows up a case by regular visits to the systolic pressure of blood pressure and diastolic pressure on average decline respectively 22mmHg and 12mmHg.And, the method utilizes radio-frequency (RF) energy to carry out impedance type heating to the sympathetic nerve at renal artery position via conduit intervention means, can weaken its activity and even make it to lose conduction function, the method not only can effectively be treated intractable hypertension, and has the advantage such as Wicresoft, few intercurrent disease.Industry is considered as breakthrough this method, and thinks that it is that treatment intractable hypertension is opened up Liao Xin main road.But this emerging technology also lacks professional operating theater instruments, particularly special radio frequency ablation catheter.
For conduit that kidney sympathetic nerve is carried out to radio-frequency (RF) ablation in vivo with time need to spend many time and find to recline and melt target spot, raising is melted efficiency and reduced operating time is the common target of doctor and patient, therefore, in the urgent need to realizing the conduit melting of the many target spots of labyrinth.
Publication number is that the Chinese patent application of CN102274074A has been introduced a kind of multi-electrode opening type radio frequency ablation catheter, and the one end at its electrode place is connected with catheter main body, and the other end is that multi-electrode is open.The open bad guarantee of safety entering in renal artery blood vessel of multi-electrode, and, its way moving in renal artery of bad control.
Publication number is that the international patent application of WO2011/060339A1 has been introduced a kind of four electrode ablation conduits, its one-time positioning can realize melting of four target spots, but cannot realize and melting accurately for the renal artery vessel position of renal artery blood vessel mouth and labyrinth.
Application number be 200610150659.0 and publication number be CN1947810A Chinese patent application has been introduced a kind of net-cage electrode catheter, melt for orifices of pulmonary veins, this conduit can not be used for orthosympathetic the melting of kidney at renal artery position, thereby is very easy to cause renal artery stenosis because the electrode of conduit is too fine and close.In addition, the projection in the middle of the electrode section of conduit is excessive, excessive to the damage of renal artery blood vessel.
Publication number be WO2007/003058 International Patent Application Publication a kind of ablation catheter that struts four electrodes with sacculus, four electrodes of this ablation catheter are in same plane, while melting in renal artery, easily cause narrow, in addition, the sacculus strutting can block renal artery blood flow, and kidney is had a certain impact.
The multi-electrode ablation catheter of prior art exploitation as above cannot adapt to the target spot of labyrinth and in the time melting, be easy to cause arterial vascular narrow.Therefore, a kind of multi-electrode ablation catheter need to be provided, it can shrink with smooth and easy and enters easily renal artery blood vessel and be delivered near the target spot of its labyrinth, can be in rear expansion in place to fit completely with renal artery blood vessel wall, thereby can not form at middle part projection avoids the local location of renal artery blood vessel to cause too much stimulation, multiple electrodes are posted by renal artery blood vessel wall dispersedly, can not melt too much and stimulate angiostenosis certain position, also can not have influence on arteriorenal blood flow.
Summary of the invention
The invention provides a kind of multi-electrode ablation catheter, comprise conduit, be distributed in supravasal electrode, be connected to the wire of electrode with transmission of signal and radio-frequency (RF) energy, and for regulating the hands handle of shape of described conduit, described electrode comprises basket electrode and is arranged on the head end electrode of the distal-most end of described conduit, described conduit comprises and is provided with basket section of basket electrode, flexible changeover portion and the main paragraph that is coupled to handle, it is characterized in that: described basket section is uniformly distributed and multiple brasnch conducts of converging with it at two ends place form by centre pipe with around described centre pipe, described basket electrode is made up of each electrode being distributed on each brasnch conduct, realize the contraction of described brasnch conduct with respect to described centre pipe by joystick, ground state and stretching, extension.Thus, can realize the switching of multi-electrode ablation catheter between contraction, ground state and extended configuration by joystick, the demand adapting to such as sending, under the different condition such as expansion and packed and transported.
Preferably, via the tension degree that is connected to the bracing wire on handle by described centre pipe, changeover portion and main paragraph, realize described contraction, ground state and stretching, extension.This mode is simple compared to the mode more convenient operation strutting with sacculus of prior art, the lower more compact structure of required installation cost.
Preferably, on each brasnch conduct, be distributed with one or more electrodes.
The quantity of described brasnch conduct can be selected from any in 2-6.Preferably, the quantity of described brasnch conduct is 2,4 or 6.
Each electrode in basket electrode can have different distribution modes.Preferably, the electrode 105 on each brasnch conduct 103 is relative set, makes each respective electrode 105 on each brasnch conduct 103 form an electrode group.In each electrode group, most typical two kinds of modes of each electrode are paired distribution mode and Spiral distribution mode.
Described paired distribution mode is: each electrode in each electrode group distributes in pairs, each to arrangement of electrodes identical axial positions on the axisymmetric corresponding a pair of brasnch conduct about centre pipe, the line of its line and adjacent pair of electrodes forms by 360 degree the angle divided by the quantity gained of brasnch conduct, and vertically at a distance of identical distance.If adopt paired distribution mode, the electrode in each electrode group add up to even number.
Described Spiral distribution mode is: each electrode in each electrode group forms taking longitudinally as spiral-shaped as radius of the axial distance taking brasnch conduct and centre pipe, and in spiral-shaped, the anglec of rotation of the part between adjacent electrode equals the quantity of 360 degree divided by brasnch conduct.
Preferably, described multi-electrode ablation catheter comprises the seal wire of at least part of guidewire lumen and the described guidewire lumen of process that run through conduit.Coordinate renal artery sheath expediently the guiding of multi-electrode ablation catheter to be entered to renal artery blood vessel and to be delivered near the target position of labyrinth in renal artery blood vessel via described seal wire, can greatly improve the safety of conduit approach.Described seal wire and guidewire lumen have different set-up modes, such as, but be not limited to following several.
Preferably, described guidewire lumen is arranged in centre pipe and runs through the far-end of described multi-electrode ablation catheter, and thus, seal wire passes from the nearside of conduit through described guidewire lumen from described far-end.Or, described guidewire lumen starts from the opening of middle part one side that is arranged on centre pipe and runs through part and the described far-end of centre pipe in described opening distally, thus, seal wire enters the guidewire lumen centre pipe from the far-end of conduit, passes from the described opening part of centre pipe.
The another kind of set-up mode of described seal wire and guidewire lumen is: described guidewire lumen runs through the far-end of described multi-electrode ablation catheter and extends in the space between described brasnch conduct and centre pipe, thus, seal wire can arrive in described space through described guidewire lumen from described far-end, and passes from the gap between brasnch conduct.Or described guidewire lumen runs through described far-end and described space and enters in changeover portion and end in the opening on the sidewall of changeover portion, thus, seal wire can pass through the opening of described guidewire lumen from the sidewall of described changeover portion from described far-end.
Multi-electrode ablation catheter provided by the present invention can reduce the in place of renal artery radiofrequency ablation and recline the time, can shrink with smooth and easy and enter easily renal artery blood vessel and be delivered to (" in place ") near the target spot of its labyrinth, can expand with fit completely with renal artery blood vessel wall (" reclining "), the multiple spot that after this can be evenly distributed melts, reduce patient and operate conduit in place and recline number of times and the time of renal artery blood vessel, can reduce to a great extent patient's operation easier, shorten operating time, reduce patient's misery, thereby and avoid the too much stimulation of arterial vascular part to avoid causing angiostenosis and affect blood flow.
Brief description of the drawings
In order more clearly to describe technical scheme of the present invention, briefly introduce below in conjunction with accompanying drawing.Obviously, these accompanying drawings are only some detailed description of the invention that the application records.The specific embodiment of the present invention includes but not limited to following these accompanying drawings.
Fig. 1 shows according to the schematic diagram of multi-electrode ablation catheter of comprising of prior art basket electrode and basket catheter.
Fig. 2 a and Fig. 2 b show respectively according to the perspective view of a kind of embodiment of multi-electrode ablation catheter of the present invention and front view;
Fig. 3 illustrates according to the diagram of the handle 3 of a kind of embodiment of multi-electrode ablation catheter of the present invention;
Fig. 4 a and Fig. 4 b illustrate respectively according to perspective view and the front view of the distribution of the structure of basket section 21 of a kind of embodiment of multi-electrode ablation catheter of the present invention and upper basket electrode thereof, wherein, the electrode in each electrode group of basket electrode adopts paired distribution mode;
Fig. 5 a illustrates that a kind of embodiment of the multi-electrode ablation catheter shown in Fig. 4 a and Fig. 4 b enters the diagram of renal artery blood vessel under contraction state;
Fig. 5 b illustrates recline under the extended configuration diagram of renal artery blood vessel wall of a kind of embodiment of the multi-electrode ablation catheter shown in Fig. 5 a;
Fig. 5 c illustrates diagram in Fig. 5 b cutaway view along II-II line gained;
Fig. 6 a illustrates the diagram that enters renal artery blood vessel according to the another kind of embodiment of multi-electrode ablation catheter of the present invention under contraction state, and wherein, the electrode in each electrode group of basket electrode also adopts paired distribution mode;
Fig. 6 b illustrates recline under the extended configuration diagram of renal artery blood vessel wall of the another kind of embodiment of the multi-electrode ablation catheter shown in Fig. 6 a;
Fig. 6 c illustrates diagram in Fig. 6 b cutaway view along I-I line gained;
Fig. 7 a-7d illustrates that respectively wherein, the electrode in each electrode group all adopts Spiral distribution mode according to the front view of the distribution of the structure of basket section 21 of four of another embodiment of multi-electrode ablation catheter of the present invention examples and upper basket electrode thereof;
Fig. 8 a-8d illustrates respectively according to the perspective view of the guidewire lumen 108 of four of another embodiment of multi-electrode ablation catheter of the present invention examples.
Detailed description of the invention
In order further to understand the present invention, below in conjunction with embodiment, preferred version of the present invention is described.These descriptions just illustrate the features and advantages of the present invention, but not limit the scope of the invention.Reader below the several terms that hereinafter adopt made an explanation, so that can determine its implication exactly.Hereinafter, that end that in multi-electrode ablation catheter, intention is delivered to target position is called " far-end ", and one end is in contrast called " near-end ", and that side that approaches " far-end " is called " distally ", and a side is in contrast called " nearside ".The parts of pure conduit in term " conduit " expression " multi-electrode ablation catheter ", form and contrast with the parts of the non-conduit such as electrode, wire, bracing wire and handle.Statement " middle part " not represents proper core, but is illustrated in the major part between two ends, forms and contrasts with two ends.Statement " the spiral-shaped anglec of rotation " represents the central angle forming between this spiral-shaped Origin And Destination spiral-shaped on along its axis projection to radial section.Hereinafter occur " each ... " statement, so that " electrode on each brasnch conduct is relative set, make each respective electrode on each brasnch conduct form an electrode group " be example, implication is: each electrode on each brasnch conduct has corresponding relation, make the corresponding each electrode on each brasnch conduct form a corresponding electrode group, for example, on each brasnch conduct, be respectively equipped with n electrode, on each brasnch conduct the 1st, the 2nd, on n electrode and other brasnch conducts the 1st, the 2nd, n electrode forms respectively the 1st group, the 2nd group, n group.
Fig. 1 shows according to the schematic diagram of multi-electrode ablation catheter of comprising of prior art basket electrode and basket catheter, conventionally in fact, described multi-electrode ablation catheter comprises conduit 2, be distributed in supravasal electrode (not shown), be connected to electrode with the wire (not shown) of transmission of signal and radio-frequency (RF) energy with for regulating the handle 3 of shape of described conduit, described electrode comprises basket electrode and is arranged on the head end electrode of the distal-most end of described conduit, described conduit 2 comprises and is provided with basket section 21 of basket electrode, flexible changeover portion 22 and the main paragraph 23 that is coupled to handle 3.Normally, bracing wire is delivered to through conduit 2 in handle 3 to regulate the bending of conduit 2, and described wire and temperature monitoring line be delivered in handle 3 via conduit 2, to be connected to output temperature signal and received pulse radio-frequency (RF) energy on the socket on handle 3.Although Fig. 1 shows the blank of basket electrode and basket catheter in multi-electrode ablation catheter, it cannot be applicable to melting of renal artery position.Taking if the Chinese patent application disclosed net-cage electrode catheter of application number in background technology as 200610150659.0 is as example, be very easy to cause renal artery stenosis thereby its distribution of electrodes is too fine and close; In addition, the projection in the middle of the electrode section of conduit is excessive, excessive to the damage of renal artery blood vessel.In prior art also may there is other problem in other the multi-electrode ablation catheter that comprises basket electrode and basket catheter, for example, basket catheter cannot shrink as required, causes conduit successfully to be entered to renal artery blood vessel and being delivered near the target spot of its labyrinth; Or, the extension degree of uncontrollable basket catheter, stretch recline when inadequate cannot be in place and ablation energy send deficiency, stretch and injure vascular tissue when too much and cause ablation of excess or localization stimulates.
Be conceived to this, inventor has manufactured a kind of multi-electrode ablation catheter, and it can overcome these defects of prior art.
Fig. 2 a and Fig. 2 b show respectively according to the perspective view of a kind of embodiment of multi-electrode ablation catheter of the present invention and front view.As shown in Figure 2 a and 2 b, comprise centre pipe 104 for basket section 21 and around the equally distributed multiple brasnch conducts 103 of centre pipe, brasnch conduct 103 and centre pipe 104 converge and be connected to the changeover portion 22 of described conduit at its two ends place.The electrode of multi-electrode ablation catheter comprises basket electrode and is arranged on the head end electrode 101 of the distal-most end of conduit, and basket electrode is made up of each electrode 105 being distributed on each brasnch conduct 103, electrode can be realized transmission of signal and radio-frequency (RF) energy by corresponding connected wire with it.The wire that should be connected with each electrode pair in basket electrode meets at changeover portion 22 places after by brasnch conduct 103, is connected after handle 3 through the main paragraph 23 of conduit 2 with relevant device.Preferably, comprise insulating segment 102 at the far-end of conduit 2, this insulating segment 102 can be strengthened brasnch conduct 103 and the connective stability of centre pipe 104 at far-end, jointly forms basket section 21 of conduit 2 with both, and this insulating segment 102 can connect as one with head end electrode 101.Insulating segment 102 is preferably at brasnch conduct 103 and centre pipe 104 in the time that the connective stability of far-end is inadequate, but can omit in the time that this connective stability is enough.
Can realize contraction, ground state and the stretching, extension of brasnch conduct 103 with respect to described centre pipe 104 by joystick 3.In the time not using conduit 2, brasnch conduct 103, that is to say in ground state with respect to described centre pipe 104, and multi-electrode ablation catheter, in stress not, is convenient to storage and transport.Under contraction state, the diameter of basket section 21 of conduit reduces, be conducive to multi-electrode ablation catheter intravasation or enter corresponding with it sheath pipe etc., for the orthosympathetic ablation applications of kidney, be conducive in multi-electrode ablation catheter income renal artery sheath and successfully coordinate and be delivered near the target spot of labyrinth in renal artery with it, increasing operation safety.Under extended configuration, the diameter of basket section 21 increases, each electrode 105 being beneficial on brasnch conduct 103 clings in renal artery blood vessel wall, can control by handle 3 extension degree of basket section 21, ensure that each electrode 105 on basket section 21 can cling to target position effectively, thereby reduce catheter delivery near target position and time of reclining, and can keep conduit can effectively moderately strut in renal artery blood vessel, thereby ensuring the power that enough reclines so that in kidney sympathetic nerve is carried out to sufficient radio-frequency (RF) ablation, avoid renal artery blood vessel due to pulse radiation frequency melt excessively or localization stimulate and contingent spasm is even narrow.
In above-mentioned multi-electrode ablation catheter, each electrode 105 can be by preparation of metals such as gold, platinum, rustless steel, copper, platinumiridio, silver, and diameter is 0.3-3.0mm, and length is 0.3-4.0mm.Preferably, the diameter of brasnch conduct 103 is 0.3-2.0mm, and length is 5.0-50.0mm.Wherein, the backing material of brasnch conduct 103 can be realized by silk, sheet, thin sheet material or the tubing with given shape, as stainless steel silk, NITI silk, copper, polyurethane, polyimides, polyetheramides, polyamide etc., the diameter of this backing material is 0.1-2.0mm, length is 5.0-50.0mm.In addition, changeover portion 22 should have good compliance, can ensure that conduit can successfully enter renal artery blood vessel through renal artery ostium, preferably adopt the tubing of being prepared by materials such as polyurethane, polyimides, polyetheramides, polyamide to manufacture, the tubing of can the zone of preference metal knitted silk of this tubing, also can select non-metal knitted silk, preferably, the diameter of tubing is 1.0-3.0mm, and length is 10.0-20.0mm.The main paragraph 23 of conduit 2 is the functional area of conduit 2 and the important join domain of operating area, this main paragraph 23 preferably adopts the tubing of being prepared by materials such as polyurethane, polyimides, polyetheramides, polyamide to manufacture, the tubing of can the zone of preference metal knitted silk of this tubing, also can select non-metal knitted silk, preferably, the diameter of tubing is 1.0-3.0mm, and length is 500.0-1500.0mm.
Can adopt number of mechanisms to realize joystick 3 makes to switch between contraction, ground state and the extended configuration with respect to described centre pipe 104 at brasnch conduct 103.For example can utilize bracing wire to realize, this bracing wire is connected on handle 3 after centre pipe 104, changeover portion 22 and main paragraph 23, utilizes the tension degree of bracing wire to realize the switching between contraction, ground state and extended configuration.
As shown in Figure 2 a, the brasnch conduct 103 of basket section 21 is evenly distributed on around centre pipe 104, and brasnch conduct 103 is " arc ".Preferably, under ground state, contracted state and deployed condition, the middle part of brasnch conduct 103 is all parallel with centre pipe 104, keep thus electrode 105 can abut in equably the target position place in renal artery blood vessel in the time launching for basket section 21, in the time shrinking for basket section 21, make brasnch conduct 103 centre pipe 104 that reclines more closely, be convenient in basket section 21 income renal artery sheath.
Fig. 3 illustrates according to the diagram of the handle 3 of a kind of embodiment of multi-electrode ablation catheter of the present invention.Referring to Fig. 3, a kind of handle of multi-electrode ablation catheter comprises handle head end 301, push away turn round 302, handle main body 303 and handle tail end 304.Wherein, handle head end 301 is connected with the main paragraph 23 of conduit 2, and by the bracing wire in conduit, the signal of telecommunication/pulsed radio-frequency power transfer line, temperature monitoring line is delivered in handle 3, the signal of telecommunication/pulsed radio-frequency power transfer line and temperature monitoring line are connected on the socket (not indicating in figure) on handle tail end 304, then by the buttock line supporting with multi-electrode ablation catheter, described multi-electrode ablation catheter and corresponding radiofrequency generator are coupled together, the temperature signal thus multi-electrode ablation catheter being obtained passes to radiofrequency generator, radiofrequency generator is delivered to target position by wire via each electrode 105 in head end electrode 101 and basket electrode by pulsed radio-frequency power and removes kidney sympathetic nerve to melt, thereby realize the object reducing blood pressure.
Particularly, can implement the ablation to the target position in renal artery blood vessel by joystick 3 in accordance with the following steps: push away and turn round 302 and make basket section 21 of conduit 2 in contracted state by the near-end to multi-electrode ablation catheter, conduit, via sheath or the retrograde target spot position entering in renal artery of guiding catheter intravascular of femoral artery puncture point, then withdraws sheath or guiding catheter and makes conduit remain near the target position (" in place ") in renal artery blood vessel; Push away and turn round 302 by the far-end to multi-electrode ablation catheter, be adjusted into deployed condition by basket section 21 of the conduit after in place 2, confirm that by intravascular contrast media each electrode paste in basket electrode leans on target position, this confirmation process can be that expansion-radiography is interactively, namely continue according to the result of radiography, the expansion degree of current basket section 21 to be finely tuned, until finally confirm that each electrode paste in basket electrode leans on target position; Then the energy of radiofrequency generator is delivered to target position by buttock line and conduit, realizes first group of denervation and melt.If also need second group of denervation carrying out the second target position place to melt, push away and turn round 302 and make basket section 21 again in contracted state to near-end, conduit is regained in sheath or guiding catheter, and then conduit is withdrawn together with sheath to described the second target position, to melt similar step to first group of denervation, carry out second group of denervation and melt.Under normal circumstances, multi-electrode ablation catheter carries out 1 group or 2 groups and melts the denervation that can complete a side renal artery blood vessel and melt.
Although being distributed with the quantity of an electrode 105 and brasnch conduct 103 on each brasnch conduct 103 shown in Fig. 2 a and 2b is 4, this is as just example.Can on each brasnch conduct, be distributed with as required one or more electrodes.The quantity of described brasnch conduct can be selected from any in 2-6.Preferably, the quantity of described brasnch conduct 103 is 2,4 or 6.
Each electrode in basket electrode on basket section 21 can have different distribution modes.Preferably, the electrode 105 on each brasnch conduct 103 is relative set, makes each respective electrode 105 on each brasnch conduct 103 form an electrode group.For example, the in the situation that 2 electrodes 105 being set respectively on each brasnch conduct 103, on each brasnch conduct 103, form an electrode group along the electrode 105 in left side, the electrode 105 on right side forms another electrode group.In each electrode group the distribution mode of electrode 105 most typical be paired distribution mode and Spiral distribution mode.
Described paired distribution mode is: each electrode 105 in each electrode group distributes in pairs, each electrode 105 is arranged in about identical axial positions on the axisymmetric corresponding a pair of brasnch conduct 103 of centre pipe, the line of its line and adjacent pair of electrodes 103 forms by 360 degree the angle divided by the quantity gained of brasnch conduct 103, and vertically at a distance of identical distance.If adopt paired distribution mode, the electrode in each electrode group add up to even number, be preferably 2,4 or 6, more preferably 4 or 6.
Fig. 4 a and Fig. 4 b illustrate respectively according to perspective view and the front view of the distribution of the structure of basket section 21 of a kind of embodiment of multi-electrode ablation catheter of the present invention and upper basket electrode thereof.As shown in Figs. 4a and 4b, basket catheter 4 comprises 6 brasnch conducts 403 and a centre pipe 404, brasnch conduct 403 is evenly distributed on around centre pipe 404, an electrode 405 is set respectively on each brasnch conduct 403, that is to say, the electrode 405 in basket electrode only forms a group.As shown in Figure 4 b, electrode 405 is to distribute in pairs, and each electrode 405 is distributed on a corresponding radial section, particularly, be arranged in about identical axial positions on the axisymmetric corresponding a pair of brasnch conduct 403 of centre pipe, the line of its line and adjacent pair of electrodes 403 forms the angle of 60 °, and vertically at a distance of identical distance.Under ground state, contracted state and deployed condition, the middle part of each brasnch conduct 403 is all parallel with centre pipe 404, is convenient to basket section 21 and can successfully enters in renal artery sheath under contraction state together with the basket electrode on it closely reclines renal artery target spot under deployed condition.
Fig. 5 a illustrates that a kind of embodiment of the multi-electrode ablation catheter shown in Fig. 4 a and Fig. 4 b enters the diagram of renal artery blood vessel under contraction state.As shown in Figure 5 a, control the handle 3 of multi-electrode ablation catheter, with by basket section 21 contraction, then under the guiding of renal artery sheath, the multi-electrode ablation catheter under this contraction state is transported near the target position in renal artery blood vessel.As shown in Figure 5 b, after this multi-electrode ablation catheter is in place, launch it basket section 21, make each electrode 405 in basket electrode cling to kidney sympathetic nerve point (Renal sympathetic nerve Point the is called for short RP) target position in renal artery blood vessel.As shown in Figure 5 c, under extended configuration, each electrode 405a-405f is not on same radial section, but, each electrode 405a-405f vertically uniform projection is justifying on 406, head end electrode 401 is projected in the center of circle of circle 406 vertically, centre pipe 404 runs through the described center of circle, wherein, pair of electrodes 405a and 405b are on a radial section, another pair of electrodes 405c and 405d on another radial section, again pair of electrodes 405e and 405f on another radial section, these three radial sections identical distance in interval vertically each other.
Fig. 6 a illustrates the diagram that enters renal artery blood vessel according to the another kind of embodiment of multi-electrode ablation catheter of the present invention under contraction state, and the difference of the multi-electrode ablation catheter shown in this embodiment and Fig. 4 a and Fig. 4 b is only, the quantity of brasnch conduct 403 is 4.Thus, two in electrode 405 are distributed in respectively on corresponding a pair of centrosymmetric brasnch conduct 403 and are positioned on the same radial section of its nearside, 405, two other electrode be distributed in respectively corresponding another on centrosymmetric brasnch conduct 403 and be positioned on the same radial section in its distally, wherein, the line of two of described distally and nearside electrodes 405 is orthogonal.
Referring to Fig. 6 a, basket section 21 by handle control multi-electrode ablation catheter in contraction state, then pass through renal artery sheath (not indicating in figure) by near described basket section 21 of multi-electrode ablation catheter kidney sympathetic nerve point (Renal sympathetic nerve Point the is called for short RP) target spot being transported in renal artery blood vessel.Referring to Fig. 6 b, joystick, by basket section 21 expansion, clings in renal artery blood vessel wall each electrode 105a, 105b, 105c and 105d distribution in basket electrode, and makes head end electrode 101 also cling to corresponding target position place.As shown in the radial cross-section in Fig. 6 c, under the deployed condition of basket section 21, uniform projection is on circle 106 vertically for electrode 105a-105d, and electrode 101 is projected in circle 106 in the heart vertically, and centre pipe 104 runs through the center of circle.Pulsed radio-frequency power is delivered to electrode 105a-105d upper, realizes the removal kidney sympathetic nerve treatment to target position, to reduce patient's hypertension.
Described Spiral distribution mode is: each electrode in each electrode group forms taking longitudinally as spiral-shaped as radius of the axial distance taking brasnch conduct and centre pipe, and in spiral-shaped, the anglec of rotation of the part between adjacent electrode equals the angle of 360 degree divided by the quantity gained of brasnch conduct.
Fig. 7 a-7d illustrates that respectively wherein, the electrode in each electrode group all adopts Spiral distribution mode according to the front view of the distribution of the structure of basket section 21 of four of another embodiment of multi-electrode ablation catheter of the present invention examples and upper basket electrode thereof.
As shown in the first example in Fig. 7 a, 4 brasnch conducts 103 are uniformly distributed around centre pipe 104, on each brasnch conduct 103, be provided with a corresponding electrode 105, and each electrode 105 is sequentially taking longitudinally as axial spiral-shaped taking the distance of brasnch conduct 103 and centre pipe 104 as radius, and in spiral-shaped, the anglec of rotation of the part between adjacent electrode 105 equals 90 degree.
Fig. 7 b shows the second example according to another embodiment of multi-electrode ablation catheter of the present invention, being different from the first example part is only, on each brasnch conduct 103, be provided with corresponding 2 electrodes 105, be called nearside electrode 105 and distal electrodes 105, each nearside electrode 105 on each brasnch conduct 103 is sequentially taking longitudinally as axial spiral-shaped taking the distance of brasnch conduct 103 and centre pipe 104 as radius, and in spiral-shaped, the anglec of rotation of the part between adjacent nearside electrode 105 equals 90 degree; Each distal electrodes 105 on each brasnch conduct 103 is sequentially taking longitudinally as axial spiral-shaped taking the distance of brasnch conduct 103 and centre pipe 104 as radius, and the anglec of rotation of the part in spiral-shaped between adjacent distal electrodes 105 equals 90 degree, wherein, the spiral-shaped hand of spiral that nearside electrode and distal electrodes form is respectively identical.
Fig. 7 c shows the 3rd example according to another embodiment of multi-electrode ablation catheter of the present invention, being different from the second example part is only, the spiral-shaped hand of spiral that nearside electrode and distal electrodes form is respectively contrary, and one is clockwise, and another is counterclockwise.
Fig. 7 d shows the 4th example according to another embodiment of multi-electrode ablation catheter of the present invention, wherein, 6 brasnch conducts 103 are uniformly distributed around centre pipe 104, on each brasnch conduct 103, be provided with a corresponding electrode 105, and each electrode 105 is sequentially taking longitudinally as axial spiral-shaped taking the distance of brasnch conduct 103 and centre pipe 104 as radius, and in spiral-shaped, the anglec of rotation of the part between adjacent electrode 105 equals 60 degree.
Preferably, described multi-electrode ablation catheter comprises the seal wire 108 of at least part of guidewire lumen 107 and the described guidewire lumen 107 of process that run through conduit 2.Coordinate renal artery sheath expediently the guiding of multi-electrode ablation catheter to be entered to renal artery blood vessel and to be delivered near the target position of labyrinth in renal artery blood vessel via described seal wire 108, can greatly improve the safety of conduit approach.Described seal wire 108 and guidewire lumen 107 have different set-up modes, four examples that illustrate respectively such as, but be not limited to Fig. 8 a-8d.
Referring to Fig. 8 a, the centre pipe 104 of multi-electrode radio frequency ablation catheter contains guidewire lumen 107, and guidewire lumen 107 runs through the far-end of conduit 2, and thus, seal wire 108 can pass from the nearside of conduit 2 through described guidewire lumen 107 from described far-end.Multi-electrode radio frequency ablation catheter can enter renal artery vascular delivery near the target position of labyrinth through seal wire 108 and the guiding of renal artery sheath, increases the safety that conduit uses.
Or, as shown in Figure 8 b, one side at centre pipe 104 middle parts of multi-electrode ablation catheter is provided with opening, and opening arranges guidewire lumen 107 between the far-end of electrode ablation conduit at the most, makes described guidewire lumen 107 run through part and the described far-end of centre pipe 104 in described opening distally.Thus, seal wire 108 enters the guidewire lumen 107 centre pipe 104 from described far-end, passes from the described opening part of centre pipe 104.
Guidewire lumen also can not utilized the inner space of centre pipe 104.As shown in Figure 8 c, guidewire lumen 107 runs through the far-end of described multi-electrode ablation catheter and extends in the space between described brasnch conduct 103 and centre pipe 104, thus, seal wire 108 can arrive in described space through described guidewire lumen 107 from described far-end, and passes from the gap between brasnch conduct 103.Arrange insulating segment 102 at the immediately nearside of head end electrode 101, the distal part of described guidewire lumen 107 is through electrode 101 and insulating segment 102.Described multi-electrode ablation catheter can enter expediently renal artery blood vessel and be delivered near the target position of labyrinth under the guiding of seal wire 108 and renal artery sheath.
Can also 107 proximads of guidewire lumen as shown in Figure 8 c be extended more morely.For example, as shown in Fig. 8 d, described guidewire lumen 107 can run through in the changeover portion 22 that described far-end and described space enter conduit 2 and end in the opening on the sidewall of changeover portion 22, thus, seal wire 108 can pass through the opening of described guidewire lumen 107 from the sidewall of described changeover portion 22 from described far-end.Arrange insulating segment 102 at the immediately nearside of head end electrode 101, the distal part of described guidewire lumen 107 is through electrode 101 and insulating segment 102.Preferably, the distance of basket section 21 of this extended distance is 20mm ~ 1200mm.Thus, multi-electrode ablation catheter can enter renal artery blood vessel and then be delivered near the target position of labyrinth under the guiding of seal wire 108 and renal artery sheath.
Although be illustrated as an example of the target position that is applied to labyrinth in renal artery example above, the target position that those skilled in the art can apply the present invention to labyrinth in other blood vessel or tissue as required also can realize transmit in place rapidly, melt suitably and avoid the effect of local stenosis.
The explanation of above embodiment is just for helping to understand core concept of the present invention.It should be pointed out that for the ordinary skill in the art, under the premise without departing from the principles of the invention, can also carry out some improvement and modification to the present invention, but these improvement and modification also fall in the scope of the claims in the present invention request protection.
Claims (11)
1. a multi-electrode ablation catheter, comprise conduit, be distributed in supravasal electrode, be connected to electrode with the wire of transmission of signal and radio-frequency (RF) energy with for regulating the hands handle of shape of described conduit, described electrode comprises basket electrode and is arranged on the head end electrode of the distal-most end of described conduit, described conduit comprises and is provided with basket section of basket electrode, flexible changeover portion and the main paragraph that is coupled to handle, it is characterized in that: described basket section is uniformly distributed and multiple brasnch conducts of converging with it at two ends place form by centre pipe with around described centre pipe, described basket electrode is made up of each electrode being distributed on each brasnch conduct, realize the contraction of described brasnch conduct with respect to described centre pipe by joystick, ground state and stretching, extension.
2. multi-electrode ablation catheter according to claim 1, is characterized in that: via the tension degree that is connected to the bracing wire on handle by described centre pipe, changeover portion and main paragraph, realize described contraction, ground state and stretching, extension.
3. multi-electrode ablation catheter according to claim 1, is characterized in that: on each brasnch conduct, be distributed with one or more electrodes.
4. according to the multi-electrode ablation catheter described in claim 1 or 3, it is characterized in that: the quantity of described brasnch conduct is selected from any in 2-6.
5. multi-electrode ablation catheter according to claim 4, is characterized in that: the quantity of described brasnch conduct is 2,4 or 6.
6. multi-electrode ablation catheter according to claim 4, is characterized in that, the electrode on each brasnch conduct is relative set, makes each respective electrode on each brasnch conduct form an electrode group.
7. multi-electrode ablation catheter according to claim 6, it is characterized in that: the quantity of described brasnch conduct is 2,4 or 6, each electrode in each electrode group distributes in pairs, each to arrangement of electrodes identical axial positions on the axisymmetric corresponding a pair of brasnch conduct about centre pipe, the line of its line and adjacent pair of electrodes forms by 360 degree the angle divided by the quantity gained of brasnch conduct, and vertically at a distance of identical distance.
8. multi-electrode ablation catheter according to claim 6, it is characterized in that: each electrode in each electrode group forms taking longitudinally as spiral-shaped as radius of the axial distance taking brasnch conduct and centre pipe, and in spiral-shaped, the anglec of rotation of the part between adjacent electrode equals the angle of 360 degree divided by the quantity gained of brasnch conduct.
9. multi-electrode ablation catheter according to claim 1, is characterized in that: comprise and run through at least part of guidewire lumen of conduit and the seal wire through described guidewire lumen.
10. multi-electrode ablation catheter according to claim 9, is characterized in that: described guidewire lumen is arranged in centre pipe and runs through the far-end of described multi-electrode ablation catheter; Or described guidewire lumen starts from the opening of middle part one side that is arranged on centre pipe and runs through part and the described far-end of centre pipe in described opening distally.
11. multi-electrode ablation catheters according to claim 9, is characterized in that: described guidewire lumen runs through the far-end of described multi-electrode ablation catheter and extends in the space between described brasnch conduct and centre pipe; Or described guidewire lumen runs through described far-end and described space and enters in changeover portion and end in the opening on the sidewall of changeover portion.
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| CN201210594339.XA CN103908334A (en) | 2012-12-31 | 2012-12-31 | Multi-electrode ablation catheter |
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| CN201210594339.XA CN103908334A (en) | 2012-12-31 | 2012-12-31 | Multi-electrode ablation catheter |
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Application publication date: 20140709 |