Content of the invention
It is an object of the invention to provide a kind of magnetic orientation cool brine frequency ablation electrode catheter, technical problem to be solved isFacilitate doctor quickly to identify the structure at body operation position, improve the security of operation.
The present invention employs the following technical solutions: a kind of magnetic orientation cool brine frequency ablation electrode catheter, proximally to far-endBeing linked in sequence has joystick device, conduit pipe shaft, electrode end pipe and termination electrode, connects between described conduit pipe shaft and electrode end pipeIt is connected to double-hole tube, diplopore pipe orifice is the first tube chamber, and in the first tube chamber, eccentric setting has the second tube chamber, in the near-end of electrode end pipeIn tube wall, outside the second lumen distal, it is fixed with bracing wire steel wire, bracing wire steel wire distal end is connected to termination electrode, and near-end is through second pipeChamber and conduit pipe shaft are connected on joystick device；It is provided with electromagnetic sensor and pressure sensor in described electrode end pipe；It is provided with temperature sensor in described termination electrode.
It is connected with the riveting pipe coaxial with the second tube chamber, bracing wire steel wire passes through riveting in the near-end tube wall of the electrode end pipe of the present inventionPipe, and be connected with riveting pipe.
The inner chamber of electrode end pipe tubulose of the present invention is connected with the first tube chamber and the second tube chamber, embedding on the outer wall of electrode end pipeEnter to have circular ring electrode.
The termination electrode profile of the present invention be cylinder, the direction that parallels to the axis have salt solution tube chamber, temperature sensor tube chamber andBracing wire tube chamber, hole centered on salt solution tube chamber, temperature sensor tube chamber and bracing wire tube chamber are blind hole, and opening is proximally facing, Brine PipeThe proximal face of termination electrode is extended in chamber, forms tubular configured joint；The distal end of described termination electrode is hemispherical or circular arc,Radially radial cold brine perfusion hole is had on the root of hemispherical or circular arc, the section of vertical end electrode axis,Cold brine perfusion hole is intersected in circle centre position, connects with salt solution tube chamber.
The electromagnetic sensor of the present invention is connected with wire, is connected to joystick device through the first tube chamber, conduit pipe shaftOn connector；Described pressure sensor is connected with wire, is connected to the connection of joystick device through the first tube chamber, conduit pipe shaftOn device；It is nested with described salt solution tube chamber and is connected with salt solution microtubular, be connected to control through electrode end pipe, the first tube chamber, conduit pipe shaftOn the Brine Pipe of handle apparatus processed；Described ring electrode is connected with electrode cable, through electrode end pipe, the first tube chamber, conduit pipe shaft evenIt is connected on the connector of joystick device；Described temperature sensor is connected with wire, through electrode end pipe, the first tube chamber, conduitPipe shaft is connected on the connector of joystick device.
One section of external diameter of the proximal end of the termination electrode of the present invention is less than the external diameter of termination electrode, forms the boss towards near-end,The part of boss near-end puts in the hole in the far-end of electrode end pipe, forms the attachment structure of termination electrode and electrode end pipe.
It is equipped with insulating sleeve outside the temperature sensor end of the present invention.
The present invention is equipped with bracing wire outer tube from described riveting pipe near-end to entering joystick device, described bracing wire steel wire.
The bracing wire outer pipe surface of the present invention is wound with stainless steel helical spring, and helical spring surface is equipped with spring overcoatPipe.
The joystick device of the present invention is provided with handle casing, handle casing along its axis be from far-end to near-end aperture byThe stair-stepping ladder hole of three-level that step expands, on the hole wall in the middle part of handle casing, in the middle of ladder hole, one section has admittedlyFixed column hole；In described handle casing, in one section of the far-end of ladder hole, it is provided with push rod, the far-end of push rod stretches out outside handleOutside shell, the outer rim of push rod radially convexes to form discoid handle；It is coaxially arranged with one section of the centre of described ladder holeThe handle inner core that profile is in the form of a column, the axis along handle inner core has inner core through hole, the radial direction of handle inner core have withThe fixation with steel wire post holes of inner core through hole connection；Fixation with steel wire post forms interference fit even through fixing post hole and fixation with steel wire post holesConnect, its diametric(al) of the lower end edge of fixation with steel wire post has steel wire locating dowel through hole.
Compared with prior art, the second tube chamber eccentric setting adjusts the bending of double-hole tube to the present invention, and termination electrode can be made to produceRaw a certain degree of bending, termination electrode is provided with cold brine perfusion hole, places the temperature sensor tube chamber of temperature sensor, can makeTemperature survey is more accurate, the electromagnetic sensor of setting and pressure sensor in electrode end pipe, realizes the electrode end pipe to conduitPositioning and the degree that reclines measurement, simultaneously be additionally provided with place bracing wire steel wire bracing wire tube chamber, be used for preventing termination electrode and electrodeEnd pipe departs from, and serves protective effect, the part using the boss near-end of termination electrode puts in the hole in the far-end of electrode end pipe, plusStrong bonding strength between termination electrode and electrode end pipe, makes operation safer, can be formed and more be defined within the shorter timeTrue 3-D stereoscopic image, decreases the use of contrast preparation, when reducing the x light exposure that traditional cardiac electrophysiology mapping producesBetween, reduce the difficulty of doctor's identification, facilitate doctor to operate, reduce operating time, more safe and reliable.
Specific embodiment
With reference to the accompanying drawings and examples the present invention is described in further detail.
As shown in figure 1, the magnetic orientation cool brine frequency ablation electrode catheter of the present invention, proximally arrange to far-end order and connectIt is connected to joystick device 6, conduit pipe shaft 5, double-hole tube 4, electrode end pipe 2 and termination electrode 1.
As shown in Fig. 2 conduit pipe shaft 5 is tubulose, there is elasticity, the far-end of conduit pipe shaft 5 can the direction determining toRadial direction bends.
Electrode end pipe 2 is shaped as tubulose, and for the inner chamber of electrode end pipe 2 in pipe, inner chamber is used for arranging electromagnetic sensor 14 HePressure sensor 35, wears for salt solution microtubular 21, electrode cable 22, the wire 23 of temperature sensor 27 and bracing wire steel wire 15Cross.The outer wall of pipe is to embed on the outer wall of electrode end pipe 2 to be provided with least one in circular ring electrode 3.
Double-hole tube 4 is shaped as tubulose, is axially arranged with two separate and disconnected through holes: the first tube chamber 19 He along itSecond tube chamber 20, wherein, double-hole tube 4 endoporus is the first tube chamber 19, and the second tube chamber 20 is eccentrically set in the first tube chamber 19, electrodeThe inner chamber of end pipe 2 is connected with the first tube chamber 19 and the second tube chamber 20.First tube chamber 19 be used for electromagnetic sensor 14 wire 141,The wire 351 of pressure sensor 35, the wire 23 of salt solution microtubular 21, electrode cable 22 and temperature sensor 27 pass through, and secondTube chamber 20 passes through for bracing wire steel wire 15.
As shown in figure 4, termination electrode 1 profile is cylinder, the direction that parallels to the axis in it has three separated from each other pores,Be respectively salt solution tube chamber 12, setting temperature sensor 27 temperature sensor tube chamber 11 be fixedly connected bracing wire steel wire 15 distal endThe bracing wire tube chamber 13 in portion.Hole centered on salt solution tube chamber 12, temperature sensor tube chamber 11 and bracing wire tube chamber 13 are blind hole, opening directionNear-end, is symmetrically arranged at centre bore both sides.Salt solution tube chamber 12 extends the proximal face of termination electrode 1, forms tubular configured joint,Connect salt solution microtubular 21 for being nested with.
As shown in figure 3, the distal end of termination electrode 1 be hemispherical or circular arc, hemispherical or circular arc root, hang downAt least 6 radially radial cold brine perfusion holes 10, radial cool brine are had on the section of straight end electrode 1 axisFill orifice 10 is intersected in circle centre position, and connects with salt solution tube chamber 12.
The near-end of joystick device 6 is provided with connector 9 and Brine Pipe 8.Brine Pipe 8 is arranged in joystick device 6,The near-end of Brine Pipe 8 is connected with salt solution pipe joint, and far-end is connected with salt solution microtubular 21.Salt solution microtubular 21 is through double-hole tube 4The salt solution tube chamber 12 of the first tube chamber 19, the inner chamber of electrode end pipe 2 and termination electrode 1 is connected.
As shown in figure 5, one section of external diameter of proximal end of termination electrode 1 is less than the external diameter of termination electrode 1, formed convex towards near-endPlatform, the part of boss near-end puts in the hole in the far-end of electrode end pipe 2, forms the attachment structure of termination electrode 1 and electrode end pipe 2,It is adhesively fixed using hot melt or glue.Salt solution microtubular 21 is nested with the tubular configured joint being connected to termination electrode 1.The temperature of termination electrode 1Degree sensor tube chamber 11 and bracing wire tube chamber 13 are respectively arranged with temperature sensor 27 and the termination of bracing wire steel wire 15.
In the present embodiment, temperature sensor 27 adopts thermoelectricity occasionally thermistor (temperature) sensor, outside temperature sensor 27 endIt is equipped with insulating sleeve 26, for increasing itself insulating properties and termination electrode 1 between, temperature sensor 27 is arranged on termination electrode 1In temperature sensor tube chamber 11, for measuring the temperature of termination electrode 1, recline the temperature being ablated to tissue measurement in ablation, moreRecord actual temperature well.
Electrode cable 22 near-end is welded on connector 9, electrode cable 22 through handle apparatus 6, conduit pipe shaft 5, diploporeFirst tube chamber 19 of pipe 4 and electrode end pipe 2, far-end passes through the tube wall of electrode end pipe 2 to be welded on the inwall of ring electrode 3.
The distal tip of bracing wire steel wire 15 arranges and is weldingly fixed in bracing wire tube chamber 13.Bracing wire steel wire 15 is as safetyLine, it is to avoid potential risks.Because the connection between termination electrode 1 and electrode end pipe 2 is to carry out even by hot melt or glue are bondingConnect, for preventing improper use, glue aging or the incomplete factor of hot melt leads to termination electrode 1 to come off from electrode end pipe 2, will drawLine steel wire 15 is connected with termination electrode 1, even if unexpected, bracing wire steel wire in the connection in operation between termination electrode 1 and electrode end pipe 215 are also possible to prevent termination electrode 1 comes off from electrode end pipe 2.
As shown in fig. 6, electrode end pipe 2 is connected for end face with the attachment structure of double-hole tube 4, by the method for hot melt by electrodeEnd pipe 2 is welded together with double-hole tube 4.
First tube chamber 19 of double-hole tube 4 is used for wire 141 through electromagnetic sensor 14, the wire of pressure sensor 35351st, the wire 23 of salt solution microtubular 21, electrode cable 22 and temperature sensor 27.Second tube chamber 20 of double-hole tube 4 is used for arrangingIt is equipped with the bracing wire steel wire 15 of bracing wire outer tube 18.
The inner chamber of electrode end pipe 2 is used for arranging electromagnetic sensor 14, pressure sensor 35, through salt solution microtubular 21, electricityPolar conductor 22, the wire 23 of temperature sensor 27 and bracing wire steel wire 15.
It is provided with the riveting pipe 17 of tubulose in the near-end of electrode end pipe 2, riveting pipe 17 is weldingly fixed on the near-end end of electrode end pipe 2Portion tube wall side, coaxial with the second tube chamber 20, it is close to double-hole tube 4 far-end, outside riveting pipe 17, be equipped with riveting pipe-in-pipe 16, in riveting pipe 17Footpath is slightly larger than the internal diameter of the second tube chamber 20.Bracing wire steel wire 15 passes through riveting pipe 17, is welded to connect with riveting pipe 17, that is, bracing wire steel wire 15 is wornCross and be fixedly connected with riveting pipe 17 at riveting pipe 17.Riveting pipe 17 act as increase cross-sectional area, make riveting pipe 17 be arranged on electrode tipThe near-end of pipe 2, must not enter in the first tube chamber 19 of double-hole tube 4, when the push rod 29 of driving handle device 6, bracing wire steel wire 15Stress point at riveting pipe 17 rather than bracing wire steel wire 15 and termination electrode 1 junction.Fill from riveting pipe 17 near-end to joystickPut in 6, bracing wire steel wire 15 is equipped with bracing wire outer tube 18.
The wire 141 of electromagnetic sensor 14, the wire 351 of pressure sensor 35, electrode cable 22 and temperature sensor 27Wire 23 near-end through in electrode end pipe 2, the first tube chamber 19 of double-hole tube 4, conduit pipe shaft 5 and joystick device 6 with evenConnect device 9 to connect.
As shown in fig. 7, in electrode end pipe 2, electromagnetic sensor 14, bracing wire steel wire 15, the electrode cable of connection ring electrode 322 and salt solution microtubular 21 be in 90 ° distribution setting.The wire 23 of temperature sensor 27 and pressure sensor 35 are arranged on electromagnetism and passThe both sides of sensor 14.
As shown in figure 8, in conduit pipe shaft 5, the wire 141 of electromagnetic sensor 14, bracing wire steel wire 15, connection ring electrode 3Electrode cable 22 and salt solution microtubular 21 be in 90 ° distribution setting.The wire 23 of temperature sensor 27 and set pressure sensor 35Wire 351 put the both sides of the wire 141 in electromagnetic sensor 14.
Bracing wire steel wire 15 surface outside riveting pipe 17 near-end is equipped with bracing wire outer tube 18 it is therefore an objective to preventing other wires and drawingLine steel wire 15 produce interfere, the distal tip of bracing wire steel wire 15 through the second tube chamber 20 of double-hole tube 4 and the inner chamber of electrode end pipe 2,In the bracing wire tube chamber 13 of insertion termination electrode 1, it is welded to connect with bracing wire tube chamber 13.
Bracing wire outer tube 18 surface wrap has stainless steel helical spring 24, or bracing wire outer tube 18 and bracing wire steel wire 15 insert stainlessAround plug around making in the plug hole pumping plug after helical spring, helical spring 24 surface is equipped with spring overcoat pipe to steel wire25.The purpose of setting helical spring 24 and spring overcoat pipe 25 is to ensure that double-hole tube 4 bending drives catheter tube body 5 to bendAfterwards, using the original state of spring return conduit pipe shaft 5, improve the screen resilience of conduit pipe shaft 5.Helical spring 24 and spring overcoat pipe25 length are from double-hole tube 4 far-end to conduit pipe shaft 5 near-end, are connected by glue bonding.
As shown in figure 9, joystick device 6 is provided with handle casing 31, handle casing 31 be shaped as cylindrical shape, cylinderExternal diameter little intermediate outer in profile two ends is big, in intermediate shape.Cylinder is interior to be progressively to expand from far-end to near-end aperture along its axisThe stair-stepping ladder hole of three-level 313.One section of the distal end of handle casing 31 is external thread structure.In the middle part of handle casing 31Hole wall on, be located at ladder hole 313 one section of far-end have spacing screw 311.On the hole wall at handle casing 31 middle part, it is located atIn the middle of ladder hole 313, one section has fixing post hole 312.
The distal threads of handle casing 31 are connected with handle cover 30, and the far-end end face of handle cover 30 has with through hole 313 togetherThe handle cap bore 34 of axle.
In handle casing 31, in one section of the far-end of ladder hole 313, it is provided with push rod 29, the far-end of push rod 29 stretches outOutside the handle cap bore 34 of handle cover 30.Radially convex to form discoid handle in outer, push rod 29 the outer rim of handle cap bore 34291.Handle 291 far-end side is far-end bar portion 292, and the far-end latter end external diameter of far-end bar portion 292 is less than the outer of far-end bar portion 292Footpath, forms its axis vertical, one week step in the face of far-end.One section of next-door neighbour's step near-end is external thread structure.Handle 291 nearEnd side is proximal stem portion 293, has seal groove within one week in the outer rim of the near proximal ends of proximal stem portion 293, for setting sealingCircle.The middle part of proximal stem portion 293, elongated slot 295 is had along axis on push rod 29, the stop screw screwing in spacing screw 31132 bottoms put in elongated slot, for limiting the relative position of push rod 29 and handle casing 31.It is from remote along its axis in push rod 29Hold the three-level progressively reducing to near-end aperture stair-stepping push rod through hole 294, push rod through hole 294 is coaxial with ladder hole 313.
The proximal end of conduit pipe shaft 5 puts in the maximum in the hole of far-end, the step of far-end bar portion 292 in push rod through hole 294Proximal threads are connected with locking nut 28, for A/C pipe shaft 5.
As shown in Figure 10, it is coaxially arranged with the handle inner core 33 that profile is in the form of a column, edge in one section of the centre of ladder hole 313The axis of handle inner core 33 has inner core through hole 331, has in the radial direction of handle inner core 33 and connects with inner core through hole 331Fixation with steel wire post holes 332, relative with fixation with steel wire post holes 332 180 °, the axis along handle inner core 33 has the whole handle of insertionThe groove 333 of inner core 33, the proximal end of handle inner core 33 has driver flutes.
Fixation with steel wire post 7 forms interference fit through fixing post hole 312 and fixation with steel wire post holes 332 and is connected.In fixation with steel wireIts diametric(al) of the lower end edge of post 7 has a steel wire locating dowel through hole 71, fixation with steel wire post 7 screw in after fixation with steel wire post holes 312 withInner core through hole 331 connects.The proximal tips of bracing wire steel wire 15 pass through push rod through hole 294, inner core through hole 331 distal portions, steel wireAfter locating dowel through hole 71 and inner core through hole 331 proximal part, rotatable wire fixed column 7, make steel wire locating dowel through hole 71 and inner coreThrough hole 331 misplaces, and bracing wire steel wire 15 is fixed on handle inner core 33.
The wire 141 of electromagnetic sensor 14, the wire 351 of pressure sensor 35, electrode cable 22 and temperature sensor 27The push rod through hole 294 through push rod 29 for the wire 23, the groove 333 of handle inner core 33, be connected with connector 9.Salt solution microtubular 21 warpThe push rod through hole 294 of push rod 29, the groove 333 of handle inner core 33, are connected with Brine Pipe 8.
Promote the handle 291 on push rod 29, the degree of crook of adjustable double-hole tube 4, concretely comprise the following steps: bracing wire steel wire 15 is wornCross the second tube chamber 20 of double-hole tube 4, due to axis runout conduit pipe shaft 5 axis of the second tube chamber 20, the bracing wire at far-end riveting pipeSteel wire 15 is fixedly connected with riveting pipe 17, and near-end is fixedly connected with handle inner core 33, and length in double-hole tube 4 for the bracing wire steel wire 15 is trueFixed, when promoting push rod 29 to far-end, because double-hole tube 4 can bend, therefore the thrust of push rod 29 can be compeled by bracing wire steel wire 15Make double-hole tube 4 to eccentric the second tube chamber 20 curving, by controlling the offset of the second tube chamber 20 of double-hole tube 4, permissibleRealize the degree of crook of double-hole tube 4.
As shown in figure 11, the tube wall in conduit pipe shaft 5 has been embedded in stainless steel cloth 35.Conduit pipe shaft 5 is as magnetic orientationThe structural member of cool brine frequency ablation electrode catheter, connects handle apparatus 6 and double-hole tube 4, is simultaneously used for electromagnetic sensor 14Wire 141, the wire 351 of pressure sensor 35, salt solution microtubular 21, electrode cable 22, wire 23 and of temperature sensor 27Bracing wire steel wire 15 passes through.
In the present embodiment, termination electrode 1 external diameter is 1.6-4mm, preferably 2-3mm, and the aperture in cold brine perfusion hole 10 is0.4-0.8mm, termination electrode 1 adopts platinumiridio or gold.
The internal diameter of electrode end pipe 2 is 1.4-1.8mm, and external diameter is 1.6-4mm, preferably 2-3mm, the length of electrode end pipe 2For 10-30mm, electrode end pipe 2 is using nylon elastomer pebax, polyurethane, block polyamide or nylon material.
The external diameter of ring electrode 3 is 1.35-1.85mm, and internal diameter is 1.3-1.8mm, and width is 1-2mm, and ring electrode 3 is provided with 3Individual, the spacing between termination electrode 1 and 3 ring electrodes 3 can arbitrarily be arranged, preferably 2-5-2mm, 3-3-3mm or 4-4-4mm, relativelyIt is well 2-5-2mm, ring electrode 3 adopts platinumiridio or gold.
The external diameter of double-hole tube 4 is 1.6-4mm, preferably 2-3mm, and length is 30-50mm, and the first tube chamber 19 of double-hole tube 4 is straightFootpath is that 0.75-0.85mm, a diameter of 0.6-0.7mm of the second tube chamber 20 of double-hole tube 4, second tube chamber 20 is eccentric with double-hole tube 4Away from for 0.5-1.1mm, double-hole tube 4 adopts pebax, polyurethane, block polyamide or nylon material.
The external diameter of conduit pipe shaft 5 is 1.6-4mm, preferably 2-3mm, and internal diameter is 1-2mm, and the length of conduit pipe shaft 5 is1100-1300mm, is embedded in the stainless steel cloth of a diameter of 1-3mm, (opening density), conduit in the tube wall of conduit pipe shaft 5Pipe shaft 5 adopts polyurethane, leading portion polyamide or nylon material.
A diameter of 0.2-0.5mm of bracing wire steel wire 10, length is 1200-1500mm, using stainless steel or Nitinol.
Electrode cable 22 adopts the copper cash of a diameter of 0.1-0.2mm.
The using method of the present invention: by the magnetic orientation cool brine frequency ablation electrode catheter of the present invention from superior vena cava orVena cave pushes in the heart chambers of the heart, by the joystick device 6 of near-end, promotes the handle 291 of push rod 29 to far-end, makes doubleHole pipe 4 bends, and when the eccentric setting of the second tube chamber 20 is by riveting pipe 17 stress, drives double-hole tube 4 to the one of the second tube chamber 20 biasLateral bend, so that termination electrode 1 and ring electrode 3 are reclined with chambers of the heart inwall, obtains each point position information, feeds back to three-dimensional mapping systemConstruction in a systematic way mould.Termination electrode 1 can also carry out radio-frequency ablation procedure, and the chambers of the heart inwall that reclined, it is possible to carry out RF ablation, is being heldIt is provided with temperature sensor 27 and cold brine perfusion hole 10 so that radio-frequency ablation procedure is more safe and reliable in electrode 1.
Second tube chamber 20 of double-hole tube 4 is eccentrically set in the first tube chamber 19 present invention, when promoting push rod 19, permissibleMake double-hole tube 4 produce bending, termination electrode 1 can move in the chambers of the heart, facilitate doctor to operate, reduce operating time.
The present invention is provided with bracing wire steel wire 15, and bracing wire steel wire 15 far-end is fixedly connected in bracing wire tube chamber 13, is used for preventingTermination electrode 1 is departed from electrode end pipe 2, serves protective effect, reduces the risk in surgical procedure.
Be provided with termination electrode 1 place temperature sensor 27 temperature sensor tube chamber 11 so that temperature sensor 27 morePlus closing to reality ablation areas, without interruption, the temperature recording is more accurate for the information that temperature sensor 27 measurement obtains.
The electromagnetic sensor 14 of setting in electrode end pipe 2, realizes the positioning to electrode end pipe 2, using the Computerized three-dimensional heartDirty Electrophysiological mapping directly can carry out the three-dimensional imaging of the chambers of the heart to patient, clinically considerably increase operation validity andOperability.
In electrode end pipe 2, the pressure sensor 35 of setting, realizes the measurement of pressure between end electrodes 1 and wall of the heart,Pressure sensor 35 arranges and abuts in the inwall of electrode end pipe 2, when termination electrode 1 distal end touches wall of the heart,Electrode end pipe 2 can be subject to the power transmission transmitted from termination electrode 1 to bend from distal end to near-end, and pressure sensor 35 can be by measurementCalculate, calculate exposure level and the stress of termination electrode 1 distal end and wall of the heart, such that it is able to judge termination electrode 1 and the heartThe degree that reclines between dirty inwall, clinically considerably increases validity and the operability of operation.
Termination electrode 1 can also carry out radio-frequency ablation procedure, and in termination electrode 1, the temperature sensor 27 of setting and cool brine fillOrifice 10, so that radio-frequency ablation procedure is more safe and reliable, adjusts termination electrode 1 using double-hole tube 4 and bends, so that doctor is not according toSame clinical needs are selected.
The part of the boss near-end of termination electrode 1 puts in the hole in the far-end of electrode end pipe 2, forms termination electrode 1 and electrode tipThe attachment structure of pipe 2, increases the contact area between termination electrode 1 and electrode end pipe 2, strengthens between termination electrode 1 and electrode end pipe 2Bonding strength, make operation safer.