Summary of the invention
The purpose of the present invention is to provide a kind of no conducting wire pacemaker, with solve existing no conducting wire pacemaker only oneThe problem of pace-making perception point.
In order to solve the above technical problems, the present invention provides a kind of no conducting wire pacemakers comprising:
Pacemaker ontology, to pace or perceive the first object；
Extension component, one end are electrically connected with the pacemaker ontology；And
Head-end segment is electrically connected with the other end of the extension component；
Wherein, the pacemaker ontology is also to be paced or be perceived the second object by the head-end segment.
Optionally, the head-end segment includes fixing piece, and the fixing piece is described the extension component to be fixed toSecond object.
Optionally, the fixing piece is in hook-shaped, and the free end of the fixing piece is equipped with needle portion, and the needle portion is to be inserted intoState the first predetermined position of the second object.
Optionally, the needle portion is equipped with non-slip groove.
Optionally, the non-slip groove includes at least one cricoid groove, and the groove is circumferentially disposed at the needle portion.
Optionally, the head-end segment further includes shank, and the shank is clamped with for external conveyer.
Optionally, the shank has positive stop lug boss, and the positive stop lug boss is to limit the conveyer.
Optionally, the extension component is flexibility.
Optionally, the extension component includes several conductive filaments and the insulating sleeve that is coated on outside the conductive filament.
Optionally, the pacemaker ontology includes fixing seat, and the fixing seat is pre- to second with first objectPositioning, which is set, mutually to be fixed, and the fixing seat is electric conductor, is electrically connected with the internal circuit of the pacemaker ontology.
Optionally, the fixing seat includes the fixed pin extended spirally, and the fixed pin is to be inserted into first objectThe second predetermined position.
Optionally, the fixing seat includes more than two fixed pins, more than two fixed pin spirals in the same directionExtend.
Optionally, the length that the fixed pin extends spirally is less than a circle.
Optionally, the helix angle of the fixed pin is 5~20 °.
Optionally, the pacemaker ontology further includes adapter, and the adapter is to connect the pacemaker ontologyInternal circuit and the extension component；Sealing connects between the adapter and the extension component and the pacemaker ontologyIt connects.
In conclusion no conducting wire pacemaker provided by the invention includes pacemaker ontology, extension component and head-end segment.InstitutePacemaker ontology is stated to pace or perceive the first object；One end of the extension component is electrically connected with the pacemaker ontology；The head-end segment is electrically connected with the other end of the extension component；Wherein, the pacemaker ontology is also to pass through the headThe second object of end pieces pace-making or perception.Configured in this way, pacemaker ontology perceives point as first pace-making, and head-end segment passes throughExtension component is electrically connected with pacemaker ontology, that is, is formed second pace-making and perceived point.First pace-making perception point such as may be provided atVentricle, second pace-making perception point such as may be provided at atrium, compare existing no conducting wire pacemaker, can be respectively to atrium and ventricleThe problems such as being paced or perceived, being can be reduced or even avoid chamber asynchronous, indication range are wider.In addition, extension componentSetting is also suitable for just to lead to replace pacemaker in developmental children because cardiac growth becomes larger, reducing patient'sPain and financial burden.
Specific embodiment
To keep the purpose of the present invention, advantages and features clearer, below in conjunction with the drawings and specific embodiments to the present inventionIt is described in further detail.It should be noted that attached drawing is all made of very simplified form and is not drawn on scale, only to sideJust, the purpose of the embodiment of the present invention is lucidly aided in illustrating.In addition, the structure that attached drawing is shown is often one of practical structuresPoint.Particularly, the emphasis that each attached drawing needs to show is different, uses different ratios sometimes.
As used in this specification and in the appended claims, singular "a", "an" and "the" packetPlural reference is included, in addition in addition non-content explicitly points out.As used in the specification and the appended claims, term"or" be usually carried out with including the meaning of "and/or" using, in addition in addition non-content explicitly points out.
Core of the invention thought is to provide a kind of no conducting wire pacemaker comprising pacemaker ontology, extension component withHead-end segment.The pacemaker ontology is to pace or perceive the first object；One end of the extension component and the pacemakerOntology electrical connection；The head-end segment is electrically connected with the other end of the extension component；Wherein, the pacemaker ontology also toThe second object is paced or perceived by the head-end segment.Configured in this way, pacemaker ontology perceives point, head as first pace-makingEnd pieces are electrically connected by extension component with pacemaker ontology, that is, are formed second pace-making and perceived point.First pace-making perceives pointIt such as may be provided at ventricle, second pace-making perception point such as may be provided at atrium, compare existing no conducting wire pacemaker, can be right respectivelyThe problems such as atrium is paced or perceived with ventricle, be can be reduced or even is avoided chamber asynchronous, indication range is wider.In addition,The setting of extension component is also suitable for just to lead to replace pacemaker because cardiac growth becomes larger in developmental children,Reduce the pain and financial burden of patient.
It is described below with reference to attached drawing.
Fig. 1 is please referred to Fig. 6, wherein Fig. 1 is the schematic diagram without conducting wire pacemaker that one embodiment of the invention provides, Fig. 2It is the schematic diagram for the extension component that one embodiment of the invention provides, Fig. 3 is showing for the head-end segment that one embodiment of the invention providesIt is intended to, Fig. 4 is the schematic diagram for the adapter that one embodiment of the invention provides, and Fig. 5 is the fixing seat that one embodiment of the invention providesSchematic diagram, Fig. 6 be one embodiment of the invention provide without conducting wire pacemaker use when schematic diagram.
As shown in Figure 1, one embodiment of the invention provides a kind of no conducting wire pacemaker comprising: pacemaker ontology 1 extendsComponent 2 and head-end segment 3.For the pacemaker ontology 1 to pace or perceive the first object, which such as can be ventricle；One end of the extension component 2 is electrically connected with the pacemaker ontology 1；The head-end segment 3 is another with the extension component 2End electrical connection；Wherein, the pacemaker ontology 1 by the head-end segment 3 also to pace or perceive the second object, this secondObject such as can be atrium.Referring to FIG. 6, its for no conducting wire pacemaker provided in this embodiment for being set to when heartPreferable example, wherein pacemaker ontology 1 is mainly set to right ventricle, and extension component 2 is after the extraction of pacemaker ontology 1, viaTricuspid valve is worn to atrium dextrum, and head-end segment 3 is mainly set to superior vena cava and atrium dextrum transition region.Configured in this way, pacemaker sheetBody 1 perceives point as first pace-making, mainly to pace or perceive ventricle；Head-end segment 3 passes through extension component 2 and pacemakerOntology 1 is electrically connected, and head-end segment is fixed on the second object and forms second pace-making perception point, mainly to pace or perceive the heartRoom.Compared to existing no conducting wire pacemaker, can atrium be paced or be perceived with ventricle respectively, can be reduced or even avoid chamberThe problems such as asynchronous, indication range are wider.In addition, the setting of extension component, is also suitable for just in developmental children, it will notLead to replace pacemaker because cardiac growth becomes larger, reduces the pain and financial burden of patient.
Referring to FIG. 2, and combine Fig. 6, further, the head-end segment 3 include fixing piece, the fixing piece to willThe extension component 2 is fixed to second object.It is preferred that the fixing piece, in hook-shaped, the free end of the fixing piece is equipped withNeedle portion 31, first predetermined position of the needle portion 31 to be inserted into second object.Needle portion 31 has a tip, the tip energyIt is enough pierced into the first predetermined position (tissue of such as heart), head-end segment 3 is fixed on to the first predetermined position of heart.ThisIn, the second object refers mainly to atrium dextrum region, and the first predetermined position of the second object can be such as superior vena cava 43 and atrium dextrum 42Transition region, for another example can for superior vena cava 43 at sinoatrial node.Needle portion 31 is configured as being easy the second object of insertion, when needle portion31 when being inserted in the region, has preferable pace-making and perceived effect, and be not easy to puncture the tissue of heart.Preferably, the needlePortion 31 is equipped with non-slip groove 311, and non-slip groove 311 such as may include at least one cricoid groove, and the groove is circumferentially disposed at instituteState needle portion 31.If the non-slip groove includes more than two grooves, more than two groove arranged for interval.Non-slip groove 311Setting can prevent head-end segment 3 from deviating from from the first predetermined position.Preferably, stay hook is curved form, with preferably solidDue to the first predetermined position.It should be understood that in the present embodiment, the bending angle of stay hook is not limited to as shown in the figure, head-end segment 3It is also not necessarily limited to only include a stay hook, several stay hooks can be set as needed in those skilled in the art.Stay hook is preferredIt is made of corrosion resistant metal material, also can be used as electrode simultaneously for fixing, to realize auricular pacemaking or senseKnow.
With continued reference to FIG. 2, the head-end segment 3 further includes shank 32, the shank 32 is with for external conveyerClamping.Preferably, the shank 32 has positive stop lug boss 321, and the positive stop lug boss 321 is to limit the conveyer.Shank32 such as can be a cylindrical body, the disc for the periphery that positive stop lug boss 321 such as can be raised in shank 32 for one, shank 32 and limit convexPlatform 321 can be coaxial arrangement.Configured in this way, external conveyer is when pushing and pulling head-end segment 3, the limit through positive stop lug boss 321Without loosening.Compared to existing no conducting wire pacemaker, no conducting wire pacemaker provided in this embodiment is easier when removing, i.e.,Make easily remove after being implanted into the several years.
Referring to FIG. 3, the extension component 2 is flexibility, it is preferred that extension component 2 can be conductive, the extension component 2Including several conductive filaments 21 and the insulating sleeve 22 being coated on outside the conductive filament 21.In practice, extension component 2 be it is soft andLoose conducting wire, with certain extensibility, in developmental children, will not just causing because cardiac growth becomes largerPacemaker is replaced, the pain and financial burden of patient are reduced.Conductive filament 21 is preferably twisted by strands of metal wire, is so setIt sets, even if the overall performance for thering is one metal wire fracture to nor affect on conductive filament 21.In general, being traditionally used for implantation patient's bodyInterior bipolar electrode conducting wire is thicker, and general diameter is 2 millimeters, and in order to achieve the purpose that ventricular pacemaking, traditional bipolar electrodeConducting wire needs to penetrate through tricuspid valve, has a certain impact to tricuspid valve closure, some patients result even in tricuspid valve closure notEntirely, myocardial blood flows back into atrium.And in the present embodiment, since extension component 2 is without pass through blood vessel, twisted wire can be usedStructure and relatively hard thinner insulating sleeve 22.For example, conductive filament 21 can be in the state of spring like coiled coil, to mentionHigh flexibility.The relatively traditional bipolar electrode conducting wire of the outer diameter of extension component 2 is thinner, if the outer diameter of extension component 2 can be 0.8mm, byThis, extension component 2 is arranged across tricuspid valve, can be without influence on the closure of tricuspid valve.In addition, relative to traditional implantable electrode21 tensile strength of conductive filament of conducting wire, the present embodiment is higher, flexible stronger, therefore reliability is also higher.Preferably, the conductionSilk 21 is made of MP35N alloy material, and MP35N alloy material is a kind of nickel cobalt chrome molybdenum of no magnetic, has unique superelevationTensile strength, good ductility and toughness and extraordinary corrosion resistant material.
The setting of insulating sleeve 22 then keeps apart conductive filament 21 with heart tissue, and conductive filament 21 is avoided to connect with heart tissueTouching is known to avoid accidentally pace-making or false sense is generated to heart other than predetermined position.1 electricity of one end and pacemaker ontology of conductive filament 21Connection, the other end can then be realized with needle portion 31 by the shank 32 of head-end segment 3 and be electrically connected.
Referring to FIG. 4, the pacemaker ontology 1 further includes adapter 11, the adapter 11 is to connect the pace-makingThe internal circuit 12 of device ontology 1 and the extension component 2；The adapter 11 and the extension component 2 and the pacemaker sheetIt is tightly connected between body 1.In an exemplary embodiment, adapter 11 such as can be a feedthrough, and the feedthrough includes theOne shell 111, feed-through insulators 112 and feedthrough conductor 113, the feedthrough conductor 113 are worn by the feed-through insulators 112In the first shell 111；One end of the feedthrough conductor 113 and the internal circuit 12 of the pacemaker ontology 1 are electrically connectedIt connects, the other end is electrically connected with the extension component 2.Preferably, one end of the feedthrough conductor 113 and the pacemaker ontology 1Internal circuit 12 weld, the other end and the extension component 2 weld, and mainly weld with the conductive filament 21 of extension component 2.SwitchingThe effect of part 11 is the internal circuit 12 and extension component 2 of connection pacemaker ontology 1, and pacemaker ontology 1 is passed through extensionComponent 2 is electrically connected with the realization of head-end segment 3.It is connected to it since head-end segment 3 is mainly used for pace-making or perception to atriumElectric conductor should be avoided to be in contact with ventricle, is known to avoid accidentally pace-making or false sense.Therefore, feedthrough conductor 113 is exhausted by feedthroughEdge body 112 is connect with first shell 111.In practice, feedthrough conductor 113 may include one or more wire, feedthrough insulationBody 112 is a cylinder with through hole, and wire is arranged in the through hole of feed-through insulators 112, and then feed-through insulators112 are arranged in the first shell 111 of tubular.In this way, feedthrough conductor 113 is electrically insulated with first shell 111.Further, extendIt is connected and sealed between component 2 and the pacemaker ontology 1 by adapter 11, can guarantee feedthrough conductor 113 and heart groupIt knits and does not generate contact, to effectively avoid the electric signal transmitted between extension component 2 and the pacemaker ontology 1 and heart groupKnit contact；Furthermore it is connected and sealed between extension component 2 and the pacemaker ontology 1 by adapter 11 and is also avoided that body fluidThe inside of no conducting wire pacemaker is not entered.
Further, the pacemaker ontology 1 further includes second shell 13, the second shell 13 and the first shell111 connections, to be installed with internal circuit 12.Second shell 13 is preferably corrosion resistant metal shell, can be used as electrode, to realizeVentricular pacemaking or perception.Second shell 13 such as can be cylinder, and one end is installed with fixing seat 14, and the other end is realized by adapter 11Sealing, to protect the internal circuit 12 being located in inside second shell 13.Specifically, internal circuit 12 can be set, there are two electrodes to connectContact perceives the electrode of point to connect two different pace-makings respectively.Wherein, first electrode connection points and feedthrough conductor113 welding, internal circuit 12 pass sequentially through feedthrough conductor 113, the conductive filament 21 of extension component 2, shank 32 and needle portion 31, realThe pace-making in existing atrium or perception.Second electrode connection points is electrically connected pace-making or perception, it can be achieved that ventricle with second shell 13.Optionally, first shell 111 can also be that corrosion resistant metal shell, first shell 111 and second shell 13 pass through connection realization etc.Current potential, i.e. first shell 111 are also electrically connected with second electrode connection points realization, first shell 111 and second shell 13As a part for the electrode for realizing ventricular pacemaking or perception, to expand the contact area of electrode and heart tissue.
Referring to FIG. 5, and combine Fig. 6, the pacemaker ontology 1 include fixing seat 14, the fixing seat 14 to instituteThe second predetermined position for stating the first object is mutually fixed.Preferably, the fixing seat 14 includes the fixed pin 141 extended spirally, instituteState second predetermined position of the fixed pin 141 to be inserted into first object.Here, the second predetermined position of the first object, such asIt can be the apical region of heart 44 of right ventricle 41.When the rotation of 14 relative heart tissue of fixing seat, fixed pin 141 can screw in cardiac muscular tissue simultaneouslyIt is fixed, that is, it may make pacemaker ontology 1 to be fixed in cardiac muscular tissue, be fixed conveniently.It is furthermore preferred that fixing seat 14 include two withOn fixed pin 141, more than two fixed pins 141 extend spirally in the same direction.In an exemplary embodiment, GuReservation 14 be set to pacemaker ontology 1 far from be equipped with extension component 2 one end, fixing seat 14 include two fixed pins 141, twoFixed pin 141 is centrosymmetric distribution about the axis of pacemaker ontology 1, fixation when being used to be inserted into cardiac muscular tissue, canIt leans on.It is preferred that the length that fixed pin 141 extends spirally is less than a circle, helix angle (the i.e. extension of fixed pin 141 of fixed pin 141The angle in direction and the end face of pacemaker ontology 1) it is 5~20 °, configured in this way, when fixed pin 141 is in the thickness of insertion cardiac muscular tissueIt spends in lesser situation, self-lock ability is good, good fixing effect, and does not allow to easily cause myocardial perforation.In addition, due to fixed pin 141Helix angle it is limited, fixed pin 141 be inserted into cardiac muscular tissue thickness it is smaller, need take out without conducting wire pacemaker when, only needReversed (i.e. with the contrary direction of fixed pin 141 extended spirally) rotation pacemaker ontology 1 can be taken off no conducting wireThe process of pacemaker, taking-up is more convenient.Preferably, fixing seat 14 is electric conductor, can be made of corrosion resistant metal material.GuReservation 14 is electrically connected with the internal circuit 12 of pacemaker ontology 1, is such as electrically connected with second electrode connection points of internal circuit 12,So set, fixing seat 14 and second shell 13 realize equipotential, fixing seat 14 can it is for fixing simultaneously, also can be used asA part of electrode realizes ventricular pacemaking or perception.
Preferably, the pacemaker ontology 1 further includes clamping part 15, and the clamping part 15 is pressed from both sides with for external conveyerIt holds.Since the fixation of fixing seat 14 needs the entire pacemaker ontology 1 of turn, so can be in the second shell 13 of pacemaker ontology 1Upper setting clamping part 15.Clamping part 15 such as can be outer-hexagonal shape, and shape applies torsion convenient for conveyer.Preferably, the clamping part 15 is made of nonmetallic materials, is insulator.Clamping part 15 may be provided at adapter 11 and extension component 2One end of connection.Since the welding of feedthrough conductor 113 and conductive filament 21 can expose the wire or conductive filament of a part of conduction,The clamping part 15 of insulation is also used as the wire that protective exposes this part or conductive filament package, avoids this part sudden and violentThe wire or conductive filament of exposing are contacted with blood or heart tissue, internal from extension component 2 to pacemaker ontology 1 to realizeThe complete insulation system of circuit 12.Certainly in some other embodiment, the protective that can also separately set insulation is sudden and violent by this partThe wire or conductive filament of exposing wrap up, and the setting position of clamping part 15 can be unlimited at this time, such as clamping part 15 at this timeThe shape of outer-hexagonal can be formed by the periphery of second shell 13 to realize.The present embodiment is unlimited to this.
The no adoptable working method of conducting wire pacemaker provided in this embodiment is for example:
1. auricular pacemaking -- ventricular sense: excitement under normal Atrioventricular Conduction approach through passing after patient's auricular pacemaking, by ventriclePerception and inhibition ventricular pace pulse granting, are similar to AAI mode；
2. auricular pacemaking -- ventricular pacemaking: patient's intrinsic atrial rate is slower than lower bound frequency, and there are AVB (AV BLOCK, roomsRoom block, A are the abbreviations in (atrium) Atria, and V is the abbreviation of Ventricular (ventricle)), then atrium first paces, then passes throughPreset atrio-ventricular delay paces ventricle, is in atrial-ventricular sequential pacing, is similar to AAI+VVI mode or DVI mode；
3. atrial sense -- ventricular sense: patient's intrinsic atrial rate is faster than lower bound frequency, and Atrioventricular Conduction is normal,P-R interphase is shorter than preset atrio-ventricular delay, then atrial ventricle's pace-making is suppressed；
4. atrial sense -- ventricular pacemaking: patient's intrinsic atrial rate is faster than lower bound frequency, but has AVB, then perceives the P of itselfAfter wave, ventricle is paced by preset atrio-ventricular delay, is equivalent to VAT mode or VDD mode.
The working method of no conducting wire pacemaker provided in this embodiment is similar to DDD pacemaker, and DDD pacemaker is idealTwo-chamber Physiological Pacing device, be suitable for permanent or intermittent AVB (atrioventricular block), sick sinus syndrome or withThe patient of AVB, it is more demanding to heart rate response and haemodynamics or once have the patient of pacemaker syndrome even more ideal.It needs to manageSolution, above-mentioned several working method are only schematical example and non-limiting, and those skilled in the art can also be according to different troubleThe setting others working method of person and different situations to no conducting wire pacemaker.
In conclusion no conducting wire pacemaker provided by the invention includes pacemaker ontology, extension component and head-end segment.InstitutePacemaker ontology is stated to pace or perceive the first object；One end of the extension component is electrically connected with the pacemaker ontology；The head-end segment is electrically connected with the other end of the extension component；Wherein, the pacemaker ontology is also to pass through the headThe second object of end pieces pace-making or perception.Configured in this way, pacemaker ontology perceives point as first pace-making, and head-end segment passes throughExtension component is electrically connected with pacemaker ontology, that is, is formed second pace-making and perceived point.First pace-making perception point such as may be provided atVentricle, second pace-making perception point such as may be provided at atrium, compare existing no conducting wire pacemaker, can be respectively to atrium and ventricleThe problems such as being paced or perceived, being can be reduced or even avoid chamber asynchronous, indication range are wider.In addition, extension componentSetting is also suitable for just to lead to replace pacemaker in developmental children because cardiac growth becomes larger, reducing patient'sPain and financial burden.
It should be noted that above-mentioned several embodiments are only to exemplary description of the invention rather than to limit of the inventionFixed, without departing from the inventive concept of the premise, various modifications and improvements can be made by those skilled in the art,Belong to the protection scope of claims.