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WO2018179339A1 - Système de cathéter de défibrillation - Google Patents

Système de cathéter de défibrillation Download PDF

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Publication number
WO2018179339A1
WO2018179339A1 PCT/JP2017/013609 JP2017013609W WO2018179339A1 WO 2018179339 A1 WO2018179339 A1 WO 2018179339A1 JP 2017013609 W JP2017013609 W JP 2017013609W WO 2018179339 A1 WO2018179339 A1 WO 2018179339A1
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WO
WIPO (PCT)
Prior art keywords
defibrillation
power supply
signal
input
supply device
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2017/013609
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English (en)
Japanese (ja)
Inventor
小島　康弘
伊藤　康平
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Japan Lifeline Co Ltd
Original Assignee
Japan Lifeline Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Japan Lifeline Co Ltd filed Critical Japan Lifeline Co Ltd
Priority to KR1020197027891A priority Critical patent/KR102045714B1/ko
Priority to CN201780084967.4A priority patent/CN110234393B/zh
Publication of WO2018179339A1 publication Critical patent/WO2018179339A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
    • A61N1/056—Transvascular endocardial electrode systems
    • A61N1/0563—Transvascular endocardial electrode systems specially adapted for defibrillation or cardioversion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/296—Bioelectric electrodes therefor specially adapted for particular uses for electromyography [EMG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/389—Electromyography [EMG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6867—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive specially adapted to be attached or implanted in a specific body part
    • A61B5/6869—Heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays
    • A61B5/7445—Display arrangements, e.g. multiple display units
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/746—Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
    • A61N1/36507—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by gradient or slope of the heart potential
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3925—Monitoring; Protecting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators
    • A61N1/3975—Power supply

Definitions

  • the present invention relates to a defibrillation catheter that includes a defibrillation catheter that is inserted into a heart chamber and performs defibrillation, and a power supply device that supplies power to the defibrillation catheter during defibrillation.
  • a defibrillation catheter that includes a defibrillation catheter that is inserted into a heart chamber and performs defibrillation, and a power supply device that supplies power to the defibrillation catheter during defibrillation.
  • a defibrillation catheter system has been developed as one of medical devices for removing atrial fibrillation generated during cardiac catheterization (performing electrical defibrillation) (see, for example, Patent Document 1). .
  • the defibrillation catheter system includes a defibrillation catheter that is inserted into a heart chamber and performs defibrillation, and a power supply device that supplies power to the defibrillation catheter during defibrillation.
  • electrical stimulation for example, electrical energy consisting of DC voltage
  • Defibrillation treatment has been realized.
  • a defibrillation catheter system includes a defibrillation catheter that is inserted into a heart chamber to perform defibrillation, and power supply for defibrillation to the defibrillation catheter. And a power supply device for performing the above.
  • the power supply device is measured by a power supply unit that supplies power during defibrillation, a first input terminal for inputting a first electrocardiographic signal output from an electrocardiograph, and a biometric mechanism. And a second input terminal to which the second electrocardiographic signal is directly input without going through the electrocardiograph.
  • the first electrocardiogram measurement mode in which the second electrocardiogram signal is obtained from the second input terminal, and the first electrocardiogram signal is obtained from the first input terminal.
  • the second cardiac potential measurement mode and the defibrillation mode in which the defibrillation is performed can be switched, and the first or second cardiac potential signal can be selectively input. It has become.
  • the second electrocardiographic signal measured by the biometric mechanism is supplied to the power supply device that supplies power to the defibrillation catheter during defibrillation. Is input directly without going through an electrocardiograph, a second input terminal is provided. In this way, since the second electrocardiographic signal is directly input to the power supply device without going through the electrocardiograph, it is less affected by the device configuration of the electrocardiograph, for example. It becomes easy to cope with environmental conditions when using.
  • the first electrocardiogram measurement mode, the second electrocardiogram measurement mode, and the defibrillation mode can be switched, and the first or second electrocardiogram is switched.
  • a signal can be selectively input. For this reason, for example, one of the above-described plural types of modes can be used selectively according to the application, situation, etc., and one of the above-described two types of electrocardiographic signals is alternatively used. Be available.
  • an arithmetic processing unit for adjusting the gain of the peak value in the input first or second electrocardiographic signal is further provided in the power supply device. Also good. In this case, the peak values of these first or second electrocardiographic signals can be arbitrarily adjusted so as to be easily used in the power supply device.
  • a display unit that displays a cardiac potential waveform based on the first or second cardiac potential signal after the gain adjustment is performed may be further provided in the power supply device.
  • the first or second electrocardiogram signal after gain adjustment is made easy to see. Further improvement is achieved.
  • the myoelectric potential signal measured by the biometric mechanism can be directly input to the second input terminal without using an electrocardiograph. It may be.
  • the myoelectric potential signal obtained in the biometric mechanism can be used in the power supply apparatus.
  • the convenience can be further improved.
  • Examples of such a myoelectric potential signal include a signal indicating a compound muscle action potential (CMAP) obtained at a site near the diaphragm of the patient (CMAP: Compound Motor Action Potentials).
  • the second input terminal may be capable of selectively inputting the second cardiac potential signal or the myoelectric potential signal.
  • one of these two types of biological signals can be alternatively used depending on, for example, the application and situation. Therefore, the convenience can be further improved.
  • the power supply unit may stop supplying power for defibrillation during a period in which a myoelectric potential signal is input to the second input terminal.
  • power supply for defibrillation is erroneously executed (due to an erroneous operation or the like). It is prevented that it is done. As a result, the convenience can be further improved.
  • a display unit that displays a myoelectric potential waveform based on the input myoelectric potential signal may be further provided in the power supply device.
  • the myoelectric potential signal measured by the biomeasuring mechanism can be monitored at any time on the display unit in the power supply device. Therefore, the convenience can be further improved.
  • the power supply device may issue a warning to the outside.
  • the power supply device may issue a warning to the outside.
  • an excessive attenuation state of the myoelectric potential signal can be immediately grasped, it is possible to take a quick response. As a result, the convenience can be further improved.
  • the first electrocardiographic signal when the first electrocardiographic signal is measured using, for example, the biometric mechanism, the following may be performed. That is, the first electrocardiographic signal obtained in this biometric mechanism may be input to the first input terminal via the electrocardiograph. In this case, the first electrocardiographic signal obtained in the biometric mechanism can be used in the electrocardiograph and the power supply device. Therefore, the convenience can be further improved.
  • biometric mechanism for example, a method using at least two (plural) electrode pads, or another electrode catheter (inserted into a patient's heart chamber) different from the defibrillation catheter. Is mentioned.
  • the second input terminal to which the second electrocardiographic signal measured in the biometric mechanism is directly input without passing through the electrocardiograph Since the power supply device is provided, it is possible to easily cope with environmental conditions when the defibrillation catheter system is used.
  • the first electrocardiogram measurement mode, the second electrocardiogram measurement mode, and the defibrillation mode can be switched, and the first or second electrocardiogram signal is selectively input. Since it was made possible, for example, one of a plurality of modes or one of two types of electrocardiogram signals can be used alternatively depending on the application or situation. Therefore, convenience can be improved.
  • FIG. 5 is a block diagram schematically illustrating an example of an operation state at the time of measuring an electrocardiogram shown in FIG. 4.
  • FIG. 5 is a block diagram schematically illustrating an example of an operation state at the time of resistance measurement illustrated in FIG. 4.
  • FIG. 5 is a block diagram schematically illustrating an example of an operation state when performing defibrillation illustrated in FIG. 4.
  • FIG. 8 is a schematic diagram illustrating an example of an electrocardiographic waveform measured when performing defibrillation illustrated in FIG. 7. It is a block diagram showing typically the composition and example of an operation state of the defibrillation catheter system concerning a comparative example.
  • FIG. 2 is a block diagram schematically illustrating an example of an operation state when measuring a myoelectric potential in the defibrillation catheter system illustrated in FIG. 1. It is a schematic diagram showing the example of arrangement
  • FIG. 6 is a block diagram schematically showing another example of the operating state when measuring the cardiac potential in the defibrillation catheter system shown in FIG. 1.
  • FIG. 14 is a block diagram schematically illustrating an example of an operation state when performing defibrillation in the case illustrated in FIG. 13.
  • Embodiment Configuration Defibrillation catheter, power supply device, electrocardiograph, electrocardiogram display device, biometric mechanism
  • Action action and effect (basic action, details of defibrillation, comparative example, myoelectric potential measurement, etc.) 2. Modified example
  • FIG. 1 is a block diagram schematically showing an example of the overall configuration of a defibrillation catheter system (defibrillation catheter system 3) according to an embodiment of the present invention.
  • the defibrillation catheter system 3 is a system that is used, for example, when removing atrial fibrillation (electrical defibrillation) that has occurred in a patient (patient 9 in this example) during cardiac catheterization.
  • the defibrillation catheter system 3 includes a defibrillation catheter 1 and a power supply device 2 as shown in FIG.
  • the electrocardiograph 4 the electrocardiogram display device 5 (waveform display device), and the biological measurement mechanism 6 are used. are also used appropriately.
  • the defibrillation catheter 1 is an electrode catheter that is inserted into the body (inside the heart chamber) of a patient 9 through blood vessels to perform electrical defibrillation.
  • FIG. 2 schematically shows a schematic configuration example of the defibrillation catheter 1.
  • the defibrillation catheter 1 has a shaft 11 (catheter shaft) as a catheter body and a handle 12 attached to the proximal end of the shaft 11.
  • the shaft 11 has a flexible insulating tubular structure (tubular member, tube member), and has a shape extending along its own axial direction (Z-axis direction).
  • the shaft 11 has a so-called multi-lumen structure in which a plurality of lumens (pores, through-holes) are formed so as to extend along the axial direction of the shaft 11.
  • various thin wires conductive wires, operation wires, etc.
  • the outer diameter of the shaft 11 is, for example, about 1.2 mm to 3.3 mm.
  • a plurality of electrodes are provided in the tip region P ⁇ b> 1 of the shaft 11.
  • one tip electrode 110 and a plurality of ring-shaped electrodes 111, 112, 113 are respectively predetermined in this order from the tip side to the base end side of the shaft 11.
  • Each of the ring-shaped electrodes 111, 112, 113 is fixedly disposed on the outer peripheral surface of the shaft 11, while the tip electrode 110 is fixedly disposed at the forefront of the shaft 11.
  • FIG. 1 a plurality of electrodes
  • an electrode group 111 ⁇ / b> G is configured by a plurality of ring-shaped electrodes 111 arranged at intervals.
  • an electrode group 112G is constituted by a plurality of ring-shaped electrodes 112 arranged at intervals
  • an electrode group 113G is constituted by a plurality of ring-shaped electrodes 113 arranged at intervals.
  • the “electrode group” here refers to a plurality of electrodes that constitute the same pole (having the same polarity) or are mounted at a narrow interval (for example, 5 mm or less) with the same purpose. The same applies to the following.
  • the distance between the electrode group 111G (the base-side ring electrode 111) and the electrode group 112G (the front-side ring electrode 112) is preferably about 40 to 100 mm, for example. If shown, it is 66 mm.
  • the ring-shaped electrodes 111, 112, and 113 are electrically connected to the handle 12 through a plurality of conductive wires (lead wires) inserted into the lumen of the shaft 11, as will be described in detail later.
  • the lead wire is not connected to the tip electrode 110 in this example.
  • a conductive wire may be connected to the tip electrode 110 as well.
  • Each of the tip electrode 110 and the ring-shaped electrodes 111, 112, 113 is electrically conductive, such as aluminum (Al), copper (Cu), stainless steel (SUS), gold (Au), platinum (Pt), etc. It is comprised with the metal material with favorable property, or various resin materials.
  • the tip electrode 110 and the ring electrodes 111, 112, 113 are each made of platinum or an alloy thereof. It is preferable.
  • the above-mentioned electrode group 111G is composed of a plurality of ring-shaped electrodes 111 that constitute the same pole (-pole or + pole).
  • the number of ring-shaped electrodes 111 constituting the electrode group 111G varies depending on the electrode width and arrangement interval, but is 4 to 13, for example, and preferably 8 to 10.
  • the width (length in the axial direction) of the ring-shaped electrode 111 is preferably about 2 to 5 mm, for example, and 4 mm is a preferable example.
  • the mounting interval of the ring electrodes 111 (the distance between adjacent electrodes) is preferably about 1 to 5 mm, for example, and 2 mm is a preferable example.
  • the electrode group 111G is positioned, for example, in a coronary vein.
  • the electrode group 112G is composed of a plurality of ring-shaped electrodes 112 that constitute an opposite pole (+ pole or ⁇ pole) to the electrode group 111G described above.
  • the number of ring-shaped electrodes 112 constituting this electrode group 112G varies depending on the width and arrangement interval of the electrodes, but is 4 to 13, for example, and preferably 8 to 10.
  • the width (length in the axial direction) of the ring-shaped electrode 112 is preferably about 2 to 5 mm, for example, and 4 mm is a preferable example.
  • the mounting interval of the ring-shaped electrodes 112 (the distance between adjacent electrodes) is preferably about 1 to 5 mm, for example, and 2 mm is a preferable example.
  • the electrode group 113G includes four ring electrodes 113.
  • the width (length in the axial direction) of the ring-shaped electrode 113 is preferably about 0.5 to 2.0 mm, for example, and is 1.2 mm as a suitable example.
  • the mounting interval of the ring-shaped electrodes 113 is preferably about 1.0 to 10.0 mm, for example, and 5 mm is a preferable example.
  • the electrode group 113G is located, for example, in the superior vena cava where an abnormal potential is likely to occur.
  • FIG. 3 schematically shows a cross-sectional configuration example (XY cross-sectional configuration example) of the shaft 11 along the line II-II in FIG.
  • the shaft 11 has a multi-lumen structure having an outer portion 70 (shell portion), a strand 71, an inner portion 72 (core portion), and a resin layer 73.
  • the shaft 11 is formed with four lumens L1 to L4 separated from each other.
  • the outer part 70 is a tubular member located on the outermost periphery of the shaft 11 as shown in FIG.
  • the outer portion 70 is made of, for example, a high hardness nylon elastomer.
  • nylon elastomer constituting the outer portion 70 for example, those having different hardness along the axial direction (Z-axis direction) are used.
  • the shaft 11 is configured so that its hardness gradually increases from the distal end side toward the proximal end side.
  • the strands 71 are disposed between the outer portion 70 and the inner portion 72, and form a braided blade. Further, the braided blade is formed only in a partial region of the shaft 11 along the axial direction, for example.
  • a strand 71 is made of stainless steel, for example, and is a stainless strand.
  • the inner part 72 is a core member located on the inner peripheral side of the outer part 70 and the wire 71 as shown in FIG.
  • the inner portion 72 is made of, for example, a low hardness nylon elastomer.
  • the four lumens L1 to L4 described above are formed in the inner portion 72, respectively.
  • the resin layer 73 is a layer that partitions the four lumens L1 to L4, and is made of, for example, a fluororesin.
  • fluororesin include materials having high insulating properties such as perfluoroalkyl vinyl ether copolymer (PFA) and polytetrafluoroethylene (PTFE).
  • the lumen L1 (first lumen) is arranged on the positive direction side of the X axis in the shaft 11 as shown in FIG.
  • a lead wire group 81G including a plurality of lead wires 81 is inserted through the lumen L1.
  • Each of the conductive wires 81 is individually electrically connected to the plurality of ring electrodes 111 in the electrode group 111G described above.
  • the conducting wire 81 electrically connected to the ring electrode 111 in this way constitutes a signal line for an electrocardiographic signal Sc0a described later (see FIG. 2).
  • the lumen L2 (second lumen) is arranged on the negative side of the X axis in the shaft 11 as shown in FIG.
  • a lead wire group 82G including a plurality of lead wires 82 is inserted through the lumen L2.
  • Each of these conducting wires 82 is individually electrically connected to the plurality of ring electrodes 112 in the electrode group 112G described above.
  • the conducting wire 82 electrically connected to the ring electrode 112 in this way also constitutes a signal line for an electrocardiographic signal Sc0a described later (see FIG. 2).
  • the lumen L3 (third lumen) is arranged on the negative side of the Y axis in the shaft 11 as shown in FIG.
  • a lead wire group 83G including a plurality of lead wires 83 is inserted through the lumen L3.
  • Each of the conductive wires 83 is individually electrically connected to the plurality of ring electrodes 113 in the electrode group 113G described above.
  • the conducting wire 83 electrically connected to the ring electrode 113 in this way constitutes a signal line for an electrocardiographic signal Sc0b described later (see FIG. 2).
  • the lumen L4 (fourth lumen) is arranged on the positive side of the Y axis in the shaft 11 as shown in FIG.
  • one operating wire 80 is inserted through the lumen L4. That is, the operation wire 80 is arranged in an eccentric state with respect to the central axis of the shaft 11.
  • the operation wire 80 is a member for performing a deflection movement operation (swing operation), which is an operation for deflecting (curving) the vicinity of the tip of the shaft 11.
  • the tip portion of the operation wire 80 is fixed to the tip electrode 110 by solder, for example. Note that a large-diameter portion (a retaining portion) for retaining may be formed at the tip of the operation wire 80.
  • the proximal end portion of the operation wire 80 is connected to the inside of the handle 12 (rotary plate 122) described later.
  • each of the above-described conductive wires 81, 82, and 83 is formed of a resin-coated wire in which the outer peripheral surface of the metal conductive wire is coated with a resin such as polyimide, for example.
  • the operation wire 80 is made of, for example, stainless steel or a Ni (nickel) -Ti (titanium) superelastic alloy.
  • the operation wire 80 is not necessarily made of metal, and may be made of, for example, a high-strength non-conductive wire.
  • the handle 12 is attached to the proximal end of the shaft 11, and has a handle body 121 (gripping part) and a rotating plate 122.
  • the handle body 121 is a portion that is gripped (gripped) by an operator (doctor) when the defibrillation catheter 1 is used. Inside the handle main body 121, the above-described various thin wires (the conductive wires 81, 82, 83, the operation wire 80, etc.) extend from the inside of the shaft 11 while being electrically insulated from each other.
  • the rotating plate 122 is a member for performing a deflection movement operation, which is an operation for deflecting the vicinity of the tip of the shaft 11. Specifically, for example, an operation of rotating the rotating plate 122 along the rotation direction d1 indicated by the dashed arrow in FIG. 2 is possible. By such a rotation operation, the operation wire 80 described above is pulled toward the base end side, whereby an operation for deflecting the vicinity of the distal end of the shaft 11 (deflection movement operation) is possible.
  • the power supply device 2 is a device that supplies power to the defibrillation catheter 1 during defibrillation. Specifically, as shown in FIGS. 1 to 3, the power supply device 2 applies a DC voltage Vdc applied at the time of defibrillation to electrode groups 111G and 112G (on the shaft 11 of the defibrillation catheter 1).
  • the ring-shaped electrodes 111 and 112) are supplied via conductor groups 81G and 82G (conductors 81 and 82).
  • the power supply device 2 includes an input unit 21, a power supply unit 22, a switching unit 23, an arithmetic processing unit 24 (control unit), a display unit 25, and an audio output unit 26.
  • the power supply device 2 also has three (three types) input terminals Tin1, Tin2, Tin3 and two (two types) output terminals Tout1, Tout2, as shown in FIG. Further, in this power supply device 2, although details will be described later, a cardiac potential measurement mode in which cardiac potential measurement is performed (a “cardiac potential measurement mode A (see FIG. 5)” described later) or a “cardiac potential measurement mode B (see FIG. 13). ) ”) And“ defibrillation mode (see FIGS. 7 and 14) ”in which defibrillation is performed can be switched.
  • the power supply device 2 can be switched between these plural types (for example, three types) of modes.
  • the “cardiac potential measurement mode A” corresponds to a specific example of the “first cardiac potential measurement mode” in the present invention
  • the “cardiac potential measurement mode B” in the present invention This corresponds to a specific example of “second electrocardiographic measurement mode”.
  • the above-mentioned “defibrillation mode” (“defibrillation mode A (see FIG. 7)” or “defibrillation mode B (see FIG. 14)” described later) is the “defibrillation mode” in the present invention. This corresponds to a specific example.
  • the input unit 21 is a part for inputting various set values and an input signal Sin (operation input signal) for instructing a predetermined operation, and is configured using, for example, a predetermined dial, switch, touch panel, or the like.
  • These set values and instructions (input signal Sin) are input by an operator (for example, an engineer) of the power supply device 2.
  • an operator for example, an engineer
  • some setting values or the like may not be input by the operator but may be set in the power supply device 2 in advance at the time of shipping the product. The details of the above-described switch will be described later.
  • the above-described plural types of modes (“cardiac potential measurement mode A”, “cardiac potential measurement mode B”, “defibrillation mode (defibrillation mode A) Or a mode changeover switch for switching between defibrillation modes B) ”), an applied energy setting switch for setting electric energy (DC voltage Vdc) applied at the time of defibrillation, and charging the power supply unit 22 A charge switch for the purpose, an energy application switch (discharge switch) for performing defibrillation by applying electric energy, and the like.
  • the input signal Sin input at the input unit 21 is supplied to the arithmetic processing unit 24 as shown in FIG.
  • the power supply unit 22 is a part that outputs the DC voltage Vdc described above toward the electrode groups 111G and 112G (ring-shaped electrodes 111 and 112) in the defibrillation catheter 1. Such a power supply operation in the power supply unit 22 is controlled by the arithmetic processing unit 24 based on an input signal Sin from the input unit 21, for example.
  • the power supply unit 22 is configured using a predetermined power supply circuit (for example, a switching regulator) and a capacitor (capacitance element) for charging electric energy.
  • the switching unit 23 is a part that performs an operation (switching operation) of switching a supply path of the DC voltage Vdc, a resistance value R, and electrocardiogram signals Sc0a and Sc1, which will be described later.
  • Such a switching operation in the switching unit 23 is controlled by the arithmetic processing unit 24 based on an input signal Sin from the input unit 21, for example. The details of the switching operation in the switching unit 23 will be described later.
  • the arithmetic processing unit 24 is a part that controls the entire power supply device 2 and performs predetermined arithmetic processing, and includes, for example, a microcomputer. Specifically, the arithmetic processing unit 24 controls operations of the power supply unit 22, the switching unit 23, the display unit 25, and the audio output unit 26 based on the input signal Sin from the input unit 21. . Details of the operation example in the arithmetic processing unit 24 will be described later.
  • the arithmetic processing unit 24 includes an output circuit 241 and a gain adjusting unit 242 as shown in FIG.
  • the output circuit 241 transfers the DC voltage Vdc output from the power supply unit 22 to the electrode groups 111G and 112G (ring-shaped electrodes 111 and 112) of the defibrillation catheter 1 via the switching unit 23 and an output terminal Tout1 described later. It is a circuit for outputting. Specifically, although details will be described later, the output circuit 241 is configured so that the electrode groups 111G and 112G have different polarities (when one electrode group is a negative electrode, the other electrode group is a positive electrode). In addition, a DC voltage Vdc is output.
  • the gain adjusting unit 242 is a part that performs gain adjustment (amplification processing, etc.) of the crest value in various input signals (cardiac potential signals Sc1, Sc2, and myoelectric potential signal Sm to be described later). Note that various signals after gain adjustment (cardiac potential signals Sc1 ′, Sc2 ′, myoelectric potential signal Sm ′, etc. after gain adjustment) are supplied to the display unit 25 as shown in FIG. It has become so.
  • the display unit 25 is a part (monitor) that displays various information based on various signals supplied from the arithmetic processing unit 24 and outputs the information to the outside.
  • the display unit 25 has a function of displaying a cardiac potential waveform based on the above-described gain-adjusted cardiac potential signals Sc1 'and Sc2', for example, as shown in FIG.
  • the display unit 25 also has a function of displaying a myoelectric potential waveform based on the input myoelectric potential signal (for example, the myoelectric potential signal Sm ′ after gain adjustment described above).
  • the display target information is not limited to these signal information, and other information may also be displayed.
  • Such a display unit 25 is configured using a display of various types (for example, a liquid crystal display, a CRT (Cathode Ray Tube) display, an organic EL (Electro Luminescence) display, or the like).
  • the audio output unit 26 is a part that outputs various sounds to the outside based on the audio signal Ss supplied from the arithmetic processing unit 24. Note that such an audio output unit 26 is configured using, for example, a speaker.
  • the input terminal Tin1 is a terminal for inputting an electrocardiogram signal Sc1 output from an electrocardiograph 4 described later.
  • the cardiac potential signal Sc1 is a biological signal obtained by measurement in a later-described biological measurement mechanism 6 (a plurality of electrode pads 61 described later) and supplied to the electrocardiograph 4.
  • the electrocardiographic signal Sc1 (for example, an analog signal) input to the input terminal Tin1 in this way is supplied to the arithmetic processing unit 24.
  • the input terminal Tin1 corresponds to a specific example of “first input terminal” in the present invention
  • the cardiac potential signal Sc1 corresponds to a specific example of “first cardiac potential signal” in the present invention. is doing.
  • the input terminal Tin2 is a terminal for inputting a biological signal (cardiac potential signal Sc2 or myoelectric potential signal Sm) measured by the biological measurement mechanism 6 described later.
  • a biological signal cardiac potential signal Sc2 or myoelectric potential signal Sm
  • both of the electrocardiogram signal Sc2 and the myoelectric potential signal Sm do not pass through other devices such as the electrocardiograph 4.
  • the power is directly input to the input terminal Tin2 of the power supply device 2.
  • the electrocardiographic signal Sc2 or the myoelectric potential signal Sm (either one) is selectively input to the input terminal Tin2.
  • the cardiac potential signal Sc2 or myoelectric potential signal Sm input to the input terminal Tin2 in this way is supplied to the arithmetic processing unit 24, respectively.
  • either one of the electrocardiogram signal Sc2 via the input terminal Tin2 and the electrocardiogram signal Sc1 via the input terminal Tin1 is selectively selected. It is designed to be entered.
  • the input terminal Tin2 corresponds to a specific example of “second input terminal” in the present invention
  • the cardiac potential signal Sc2 is a specific example of “second cardiac potential signal” in the present invention. It corresponds to.
  • the input terminal Tin3 is a terminal for inputting the electrocardiographic signals Sc0a and Sc0b and the resistance value R measured in the defibrillation catheter 1 as shown in FIG.
  • the cardiac potential signal Sc0a is a cardiac potential signal measured in the above-described electrode groups 111G and 112G (ring-shaped electrodes 111 and 112) and transmitted via the above-described conducting wires 81 and 82 (FIGS. 2 and 2). 3).
  • the cardiac potential signal Sc0b is a cardiac potential signal measured in the above-described electrode group 113G (ring-shaped electrode 113) and transmitted through the above-described conducting wire 83 (see FIGS. 2 and 3).
  • the resistance value R is a resistance value between the electrode groups 111G and 112G.
  • the cardiac potential signal Sc0a is passed through the switching unit 23 and the output terminal Tout2 described later in this order as shown in FIG. It is supplied to the electric meter 4.
  • the electrocardiogram signal Sc0b is supplied to the electrocardiograph 4 only through an output terminal Tout2, which will be described later, without going through the switching unit 23.
  • the resistance value R is supplied to the arithmetic processing unit 24 via the switching unit 23 as shown in FIG.
  • the output terminal Tout1 receives the DC voltage Vdc output from the output circuit 241 and supplied via the switching unit 23 as the electrode groups 111G and 112G ( This is a terminal for outputting to the ring-shaped electrodes 111, 112).
  • the output terminal Tout2 passes through the cardiac potential signal Sc0b supplied from the defibrillation catheter 1 via the input terminal Tin3, the input terminal Tin3 and the switching unit 23 in this order.
  • This is a terminal for outputting the electrocardiographic signal Sc0a supplied from the defibrillation catheter 1 to the electrocardiograph 4.
  • the electrocardiograph 4 is a device having a function of recording information such as an electrocardiogram signal (in this example, electrocardiogram signals Sc0a, Sc0b, Sc1). Specifically, in this example, as shown in FIG. 1, the electrocardiograph 4 includes an electrocardiogram signal Sc0a, Sc0b output from the output terminal Tout2 of the power supply device 2 and a biomeasuring mechanism 6 (described later). A cardiac potential signal Sc1 output from a plurality of electrode pads 61) to be described later is input and recorded. In this example, the electrocardiograph 4 also has a function of outputting an inputted and recorded cardiac potential signal to the outside. Specifically, although details will be described later, in this example, as shown in FIG.
  • the electrocardiograph 4 outputs the above-described electrocardiogram signal Sc1 to the input terminal Tin1 of the power supply device 2. ing.
  • the electrocardiograph 4 outputs the above-described electrocardiogram signals Sc1, Sc0a, Sc0b to the electrocardiogram display device 5 described later.
  • the electrocardiogram display device 5 is a device that displays an electrocardiogram waveform (electrocardiogram) and the like based on the electrocardiogram signals Sc1, Sc0a, Sc0b output from the electrocardiograph 4 described above.
  • the electrocardiograph 4 and the electrocardiogram display device 5 may be collectively referred to as a polygraph, a biological information monitor, a cardiac catheter inspection device, or an EP recording system. In this way, the electrocardiographic waveform and the like displayed on the electrocardiogram display device 5 are monitored at any time by, for example, an operator (physician) of the defibrillation catheter 1.
  • the biological measurement mechanism 6 is used in a state of being attached (attached) to the body surface of the patient 9 during defibrillation treatment or the like, and the above-described biological signals (cardiac potential signals Sc1, Sc2 and myoelectric potential signals).
  • This is a device for measuring Sm) from the patient 9.
  • the biometric mechanism 6 is configured by using a plurality (for example, six or eight) of electrode pads (electrode pads 61 and 62).
  • the living body measurement mechanism 6 includes two electrode pads 62 and a plurality of (for example, four or six) electrode pads 61 that are other electrode pads.
  • the above-described electrocardiogram signal Sc1 is measured by using a general measurement method as shown in FIG. .
  • the electrocardiographic signal Sc1 obtained from the electrode pad 61 in this way is supplied to the electrocardiograph 4.
  • the electrocardiogram waveform of the electrocardiogram signal Sc1 obtained by the above-described general measurement technique corresponds to what is called “12-lead electrocardiogram”. .
  • the electrocardiographic signal Sc2 or the myoelectric potential signal Sm obtained from the electrode pad 62 in this way is the above-mentioned of the power supply device 2 without passing through other devices such as the electrocardiograph 4 as shown in FIG. It is supplied to the arithmetic processing unit 24 in the power supply device 2 only through the input terminal Tin2.
  • the operation wire 80 moves to the proximal end side in the shaft 11. Be pulled.
  • the vicinity of the tip end region P1 of the shaft 11 is curved, for example, along the direction d2 indicated by the arrow in FIG.
  • defibrillation is performed from the power supply device 2 (power supply unit 22) to the electrode groups 111G and 112G (ring-shaped electrodes 111 and 112) of the defibrillation catheter 1.
  • a DC voltage Vdc is supplied as electrical energy.
  • the output circuit 241 in the power supply device 2 is set so that the electrode groups 111G and 112G have different polarities (when one electrode group is a negative electrode, the other electrode group is a positive electrode). Outputs a DC voltage Vdc.
  • the DC voltage Vdc in which the electrode groups 111G and 112G have different polarities is directly applied to the heart of the patient 9 from the distal end region P1 of the defibrillation catheter 1 inserted into the patient 9 body. By being applied as electric energy, an electrical defibrillation process is performed.
  • an AED Automatic External Defibrillator: automatic external defibrillator
  • a fibrillator there are the following advantages compared with a fibrillator). That is, first, electrical energy is directly applied to the heart that has caused fibrillation by the electrode groups 111G and 112G of the defibrillation catheter 1 disposed in the heart chamber, thereby defibrillation treatment. Necessary and sufficient electrical stimulation (electric shock) can be reliably supplied only to the heart.
  • the biometric mechanism 6 (electrode pads 61 and 62) attached to the body surface of the patient 9 or a defibrillation catheter inserted into the body of the patient 9.
  • the cardiac potential is measured using one electrode (ring-shaped electrodes 111, 112, 113) or the like (see FIG. 1).
  • the cardiac potential of the patient 9 may be measured using another electrode catheter (inserted into the heart chamber of the patient 9) different from the defibrillation catheter 1.
  • the electrocardiogram signals Sc1 and Sc2 are supplied into the power supply apparatus 2 via the input terminals Tin1, Tin2 and the like of the power supply apparatus 2 (see FIG. 1). .
  • electrocardiographic signals Sc1, Sc0a, Sc0b are supplied to the electrocardiogram display device 5 (see FIG. 1).
  • an electrocardiographic waveform based on these electrocardiographic signals is displayed on the display unit 25 and the electrocardiogram display device 5 in the power supply device 2, so that the operator (engineer or the like) of the power supply device 2 and the defibrillation catheter 1 It is appropriately monitored by an operator (doctor).
  • FIG. 4 is a flowchart showing an example of the defibrillation process in the defibrillation catheter system 3 of the present embodiment.
  • FIGS. 5 to 7 are schematic block diagrams showing examples of various operation states to be described later in the defibrillation process.
  • the electrocardiogram measurement mode set in the electrocardiogram measurement process (steps S13 and S23) described later is selected. That is, one of “cardiac potential measurement mode A” (see FIG. 5) and “cardiac potential measurement mode B” (see FIG. 13) described later is input to the input unit 21 by the operator (engineer or the like) of the power supply device 2. (For example, an input operation to the mode switch) is performed (step S11). In other words, the selection of the input terminal (one of the input terminals Tin1, Tin2) during the measurement process of the cardiac potential and the selection of the cardiac potential signal (one of the cardiac potential signals Sc1, Sc2). Selection).
  • the electrocardiographic signal Sc1 input from the input terminal Tin1 and the electrocardiographic signal Sc2 input from the input terminal Tin2 The electrocardiographic signal switching process (switching operation) is performed so that one of them is selectively supplied to the arithmetic processing unit 24.
  • one of such electrocardiographic signal switching operations (the electrocardiographic signal Sc 1 input from the input terminal Tin 1 and the electrocardiographic signal Sc 2 input from the input terminal Tin 2 is selected.
  • a switching unit that performs an operation to be supplied to the arithmetic processing unit 24) may be provided separately. In this case, the switching operation in the switching unit is controlled by the arithmetic processing unit 24 based on the input signal Sin supplied from the input unit 21, for example.
  • each electrode ring-shaped electrodes 111, 112, 113 of the defibrillation catheter 1 in the body of the patient 9 is subsequently determined by using an X-ray image or the like. Confirmed (step S12).
  • a measurement process of the cardiac potential of the patient 9 is performed (step S13). That is, in this example, the defibrillation catheter system 3 is set to the “cardiac potential measurement mode A”, whereby the cardiac potential measurement process is performed as follows. Moreover, the gain setting at the time of gain adjustment in the gain adjusting unit 242 is performed according to an operation on the input unit 21 by an operator (engineer or the like) of the power supply apparatus 2 (step S14).
  • the cardiac potential signal Sc2 measured by the biological measurement mechanism 6 (electrode pad 62) attached to the body surface of the patient 9 is an electrocardiograph. 4 is directly input to the input terminal Tin2 of the power supply device 2 without going through 4 or the like, and is supplied to the arithmetic processing unit 24 in the power supply device 2.
  • the cardiac potential signal Sc2 is gain-adjusted by the gain adjusting unit 242 in the arithmetic processing unit 24, and a cardiac potential waveform based on the cardiac potential signal Sc2 'after gain adjustment is displayed on the display unit 25.
  • the electrocardiogram signal Sc1 measured by the biological measurement mechanism 6 (electrode pad 61) is output to the electrocardiogram display device 5 via the electrocardiograph 4.
  • the electrocardiogram waveform based on the electrocardiogram signal Sc1 is displayed on the electrocardiogram display device 5.
  • the cardiac potential signal Sc0a measured by the electrode groups 111G and 112G (ring-shaped electrodes 111 and 112) of the defibrillation catheter 1 is input to the input terminal Tin3 of the power supply device 2. Then, the signal is supplied to the electrocardiograph 4 through the switching unit 23 and the output terminal Tout2 in this order.
  • the cardiac potential signal Sc0b measured by the electrode group 113G (ring-shaped electrode 113) of the defibrillation catheter 1 passes through the input terminal Tin3 and the output terminal Tout2 of the power supply device 2 in this order (through the switching unit 23). (Without going through), it is supplied to the electrocardiograph 4.
  • the electrocardiogram signals Sc0a and Sc0b thus supplied to the electrocardiograph 4 are respectively output to the electrocardiogram display device 5, and the electrocardiogram waveforms based on these electrocardiogram signals Sc0a and Sc0b are displayed on the electrocardiogram display device 5. Is displayed.
  • the input signal Sin is supplied to the arithmetic processing unit 24 by an operation on the input unit 21 (for example, an input operation to the mode changeover switch) by an operator (engineer or the like) of the power supply device 2, so that the deduplication is performed.
  • the “defibrillation mode” for executing the movement is set (step S15).
  • a measurement process of the resistance value R between the electrode groups 111G and 112G in the defibrillation catheter 1 is performed (step S16). That is, when the defibrillation catheter system 3 is set to the “resistance measurement mode”, the resistance value R is measured as follows.
  • the resistance value R measured by the electrode groups 111 ⁇ / b> G and 112 ⁇ / b> G (ring-shaped electrodes 111 and 112) of the defibrillation catheter 1 is the input terminal of the power supply device 2.
  • the data is supplied to the arithmetic processing unit 24 via the Tin 3 and the switching unit 23 in this order. Information on the resistance value R thus obtained is displayed on the display unit 25.
  • the electrocardiogram signal Sc2 measured by the biological measurement mechanism 6 (electrode pad 62) is continuously input to the input terminal of the power supply device 2 without passing through the electrocardiograph 4 or the like. Directly input to Tin 2 and supplied to the arithmetic processing unit 24.
  • the cardiac potential signal Sc2 is gain-adjusted by the gain adjustment unit 242 in the arithmetic processing unit 24, and the cardiac potential waveform based on the cardiac potential signal Sc2 ′ after gain adjustment is continuously displayed on the display unit 25.
  • the electrocardiogram signal Sc1 measured by the biological measurement mechanism 6 (electrode pad 61) is also continuously output to the electrocardiogram display device 5 via the electrocardiograph 4.
  • the electrocardiographic waveform based on the electrocardiographic signal Sc1 is subsequently displayed on the electrocardiogram display device 5.
  • the electrocardiographic signal Sc0b measured by the electrode group 113G (ring-shaped electrode 113) of the defibrillation catheter 1 also continues to the input terminal Tin3 of the power supply device 2 and The output is supplied to the electrocardiograph 4 via the output terminal Tout2 in this order (without passing through the switching unit 23).
  • the electrocardiogram signal Sc0b is output from the electrocardiograph 4 to the electrocardiogram display device 5, and the electrocardiogram waveform based on the electrocardiogram signal Sc0b is displayed on the electrocardiogram display device 5.
  • the arithmetic processing unit 24 in the power supply device 2 determines whether or not the resistance value R obtained in this way is within a predetermined range defined by predetermined threshold values Rth1 and Rth2 (Rth2> R > Whether or not Rth1 is satisfied is determined (step S17).
  • the electrode groups 111G and 112G of the defibrillation catheter 1 are determined. This means that it is not reliably brought into contact with a predetermined part (for example, a coronary vein tube wall or a right atrial inner wall) in the body of the patient 9.
  • the process returns to step S12 described above, and the position of each electrode (ring-shaped electrodes 111, 112, 113) is confirmed again using an X-ray image or the like.
  • the subsequent defibrillation is executed only when the electrode groups 111G and 112G of the defibrillation catheter 1 are reliably brought into contact with a predetermined site in the body of the patient 9. Therefore, it is possible to perform an effective defibrillation treatment.
  • step S17 when it is determined that the resistance value R is within a predetermined range (Rth2> R> Rth1 is satisfied) (step S17: Y), as described above, the electrode group 111G, This means that 112G is reliably in contact with a predetermined part in the body of the patient 9. Therefore, in this case, the input signal Sin is then supplied to the arithmetic processing unit 24 by an operation (for example, an input operation to the applied energy setting switch) to the input unit 21 by an operator (engineer or the like) of the power supply device 2. As a result, the applied energy at the time of defibrillation is set (step S18). Specifically, the applied energy is set in increments of 1 J, for example, within a range from 1 J (joule) to 30 J.
  • an input signal Sin is supplied to the arithmetic processing unit 24 by an operation (for example, an input operation to the charging switch) on the input unit 21 by an operator (engineer or the like) of the power supply device 2, whereby the power supply unit 22.
  • the inner capacitor is charged with energy (electric charge) for defibrillation (step S19).
  • step S20 execution of defibrillation is started (step S20). Specifically, an input signal Sin is supplied to the arithmetic processing unit 24 by an operation (for example, an input operation to the energy application switch) to the input unit 21 by an operator (engineer or the like) of the power supply device 2.
  • the “defibrillation mode” described below is executed.
  • the “defibrillation mode (defibrillation mode A)” described in FIG. 7 below is a defibrillation mode performed when the above-described “cardiac potential measurement mode A” is set (selected). It corresponds to.
  • defibrillation mode A for example, as shown in FIG. 7, a DC voltage Vdc as electric energy is applied between the electrode groups 111G and 112G in the defibrillation catheter 1. Thus, defibrillation in the body of the patient 9 is performed.
  • the DC voltage Vdc output from the power supply unit 22 in the power supply device 2 causes the output circuit 241, the switching unit 23, and the output terminal Tout1 in the arithmetic processing unit 24 to be in this order. Via, it is applied between the electrode groups 111G and 112G in the defibrillation catheter 1. At this time, as described above, the electrode groups 111G and 112G have different polarities (when one electrode group is a negative electrode, the other electrode group is a positive electrode). A DC voltage Vdc is output from the output circuit 241.
  • the electrocardiogram signal Sc2 measured by the biological measurement mechanism 6 (electrode pad 62) is continuously input to the input terminal of the power supply device 2 without passing through the electrocardiograph 4 or the like. Directly input to Tin 2 and supplied to the arithmetic processing unit 24.
  • the cardiac potential signal Sc2 is gain-adjusted by the gain adjustment unit 242 in the arithmetic processing unit 24, and the cardiac potential waveform based on the cardiac potential signal Sc2 ′ after gain adjustment is continuously displayed on the display unit 25.
  • the electrocardiogram signal Sc1 measured by the biological measurement mechanism 6 (electrode pad 61) is also continuously output to the electrocardiogram display device 5 via the electrocardiograph 4.
  • the electrocardiographic waveform based on the electrocardiographic signal Sc1 is subsequently displayed on the electrocardiogram display device 5.
  • the electrocardiographic signal Sc0b measured by the electrode group 113G (ring-shaped electrode 113) of the defibrillation catheter 1 also continues to be applied to the input terminal Tin3 of the power supply device 2 and The output is supplied to the electrocardiograph 4 via the output terminal Tout2 in this order (without passing through the switching unit 23).
  • the electrocardiogram signal Sc0b is output from the electrocardiograph 4 to the electrocardiogram display device 5, and the electrocardiogram waveform based on the electrocardiogram signal Sc0b is displayed on the electrocardiogram display device 5.
  • the arithmetic processing unit 24 controls the operation of the power supply unit 22 so that the DC voltage Vdc is applied in synchronization with the cardiac potential signal Sc2 supplied through the above-described path. Specifically, the arithmetic processing unit 24 first detects one R wave (maximum peak) in the electrocardiogram waveform of the sequentially inputted electrocardiogram signal Sc2, and obtains the peak height. Then, the arithmetic processing unit 24 starts the predetermined time (for example, the R wave) from the time when the potential difference reaches the height (trigger level) of 80% with respect to the obtained peak height (when the next R wave rises).
  • the predetermined time for example, the R wave
  • the electrode group 111G is negative (negative electrode).
  • the DC voltage Vdc is applied so that the electrode group 112G becomes a positive electrode (positive electrode). Then, by supplying such electric energy, the measurement potential rises (see the broken arrow at the timing t1 in FIG. 8).
  • the DC voltage Vdc whose polarity is inverted is applied so that the electrode group 111G becomes a positive pole and the electrode group 112G becomes a negative pole. Then, by supplying such electric energy, the measurement potential rises in the opposite direction (see the broken arrow at the timing t3 in FIG. 8).
  • timing t4 the arithmetic processing unit 24 stops the output of the DC voltage Vdc from the power supply unit 22, thereby executing defibrillation in the body of the patient 9. Is stopped (step S21).
  • an application record at the time of defibrillation (for example, recording of a cardiac potential waveform as shown in FIG. 8) is temporarily (for example, 5 seconds) displayed on the display unit 25 of the power supply device 2 (step 5). S22).
  • step S13 the above-described “cardiac potential measurement mode A” (step S13, see FIG. 5) is set again.
  • the electrocardiographic waveform based on the electrocardiographic signal Sc2 ′ after gain adjustment is displayed again on the display unit 25 of the power supply device 2, and the electrocardiographic waveforms based on the electrocardiographic signals Sc1, Sc0a, Sc0b are displayed on the electrocardiogram. It is displayed again on the device 5. That is, the electrocardiographic waveform after the above defibrillation is executed is displayed (step S23).
  • step S24 the electrocardiographic waveform after such defibrillation is observed to determine whether or not it is normal. If it is determined that the condition is not normal (atrial fibrillation has not subsided) (step S24: N), the process returns to step S15 described above and proceeds to defibrillation again. On the other hand, if it is determined to be normal (step S24: Y), the series of defibrillation processes shown in FIG. 4 ends.
  • FIG. 9 is a block diagram schematically illustrating a configuration and an operation state example of a defibrillation catheter system (defibrillation catheter system 103) according to a comparative example.
  • the defibrillation catheter system 103 of this comparative example includes a defibrillation catheter 1 and a power supply device 102 as shown in FIG. That is, this defibrillation catheter system 103 is provided with a power supply device 102 according to a comparative example instead of the power supply device 2 according to the embodiment in the defibrillation catheter system 3 of the present embodiment shown in FIG. It corresponds to the thing. Further, in the case of defibrillation using the defibrillation catheter system 103, the electrocardiograph 4, the electrocardiogram display device 5, and the biometric mechanism 106 are similar to the defibrillation catheter system 3 of the present embodiment. Are also used appropriately. However, unlike the biometric mechanism 6 of the embodiment, the biometric mechanism 106 according to this comparative example is configured using only one type of electrode pad (a plurality of electrode pads 61). ) Electrode pads 62 are not provided.
  • the power supply apparatus 102 of the comparative example is not provided (omitted) with the input terminal Tin ⁇ b> 2 in the power supply apparatus 2 of the present embodiment, and is compared with the arithmetic processing unit 24.
  • This corresponds to the one provided with the arithmetic processing unit 204 according to the example.
  • the arithmetic processing unit 204 of this comparative example corresponds to the arithmetic processing unit 24 of the embodiment in which the gain adjusting unit 242 is not provided.
  • the cardiac potential signal Sc ⁇ b> 1 is calculated in the power supply apparatus 102 through the following path.
  • the unit 204 is supplied.
  • the electrocardiogram signal Sc1 measured by the living body measurement mechanism 6 is supplied to the electrocardiogram display device 5 via the electrocardiograph 4, and the electrocardiograph 4 and the power supply device 102.
  • the electrocardiogram display device 5 displays a cardiac potential waveform based on the cardiac potential signal Sc1
  • the display unit 25 of the power supply apparatus 102 displays the cardiac potential waveform based on the cardiac potential signal Sc1.
  • the cardiac potential signal Sc0a measured by the electrode groups 111G and 112G (ring electrodes 111 and 112) of the defibrillation catheter 1 is supplied to the input terminal Tin3, the switching unit 23, and the output terminal Tout2 of the power supply device 102 in this order. Via, it is supplied to the electrocardiograph 4.
  • the cardiac potential signal Sc0b measured by the electrode group 113G (ring-shaped electrode 113) of the defibrillation catheter 1 passes through the input terminal Tin3 and the output terminal Tout2 of the power supply apparatus 102 in this order (through the switching unit 23). (Without going through), it is supplied to the electrocardiograph 4.
  • the electrocardiogram signals Sc0a and Sc0b thus supplied to the electrocardiograph 4 are respectively output to the electrocardiogram display device 5, and the electrocardiogram waveforms based on these electrocardiogram signals Sc0a and Sc0b are displayed on the electrocardiogram. Displayed on the device 5.
  • the electrocardiogram signal Sc1 obtained by measurement is supplied to the display unit 25 and the electrocardiogram display device 5 via the electrocardiograph 4, so that the electrocardiogram waveform. Is displayed. For this reason, it is easily affected by the device configuration of the electrocardiograph 4, for example, in a case where the electrocardiograph 4 does not have an electrocardiogram signal output function (no electrocardiogram signal output terminal is provided). Therefore, waveform information (cardiac potential signal Sc1) necessary for defibrillation cannot be supplied to the power supply apparatus 102.
  • the defibrillation catheter system 3 of the present embodiment is as follows, unlike the defibrillation catheter system 103 of the comparative example. That is, as shown in FIG. 1 and the like, the electrocardiographic signal Sc2 measured by the biometric mechanism 6 (electrode pad 62) is input to the power supply device 2 without passing through other devices such as the electrocardiograph 4. Direct input is made to the terminal Tin2. In other words, unlike the power supply device 102 in the defibrillation catheter system 103, the power supply device 2 in the defibrillation catheter system 3 directly inputs such a cardiac potential signal Sc2 (without passing through the electrocardiograph 4 or the like). An input terminal Tin2 is provided for this purpose.
  • the electrocardiograph 4 compared to the comparative example, for example, it is less affected by the device configuration of the electrocardiograph 4 and can easily cope with environmental conditions when the defibrillation catheter system 3 is used.
  • the electrocardiograph 4 does not have an electrocardiographic signal output function (no electrocardiographic signal output terminal is provided), for example, FIG.
  • waveform information (cardiac potential signal Sc2) necessary for defibrillation can be supplied to the power supply device 2 via the input terminal Tin2.
  • gain adjustment in the electrocardiograph 4 and gain adjustment in the power supply device 2 can be performed separately. Therefore, the peak value can be individually set between these gain adjustments.
  • gain adjustment is performed in the electrocardiograph 4 so that an electrocardiographic waveform having a peak value as large as possible is displayed as described above.
  • the display unit 25 of the power supply device 2 an arbitrary gain adjustment by the gain adjustment unit 242 is performed so that it can be easily used in the power supply device 2 (as described above, it is easy to adjust the timing of defibrillation execution).
  • the electrocardiographic waveform is monitored on the display unit 25, the electrocardiographic signal Sc2 'or the like after gain adjustment is made so that it is easy to see and the convenience is further improved.
  • the electrocardiographic signal Sc2 is input to the power supply device 2 without passing through the electrocardiograph 4, the following can also be said. That is, unlike the comparative example described above, the occurrence of a time lag due to the filtering process (gain adjustment) in the electrocardiograph 4 until the electrocardiogram signal Sc2 is displayed on the display unit 25 is avoided. Is done.
  • the above-described “cardiac potential measurement mode A (see FIG. 5)”, “cardiac potential measurement mode B (see FIG. 13)” described later), A plurality of types of modes such as “motion mode (see FIGS. 7 and 14)” can be switched.
  • the cardiac potential signal Sc2 see FIGS. 5 to 7 and the like
  • the cardiac potential signal Sc1 via the input terminal Tin1. Any one of these is selectively input.
  • the switching process between the plurality of types of modes and the selection process of one of the input terminal Tin1 (cardiac potential signal Sc1) and the input terminal Tin2 (cardiac potential signal Sc2) are respectively For example, it is performed via the input unit 21 according to an operation by an operator (engineer or the like) of the power supply device 2.
  • a mode or electrocardiographic signal selection process in this embodiment, for example, one of the above-described multiple types of modes can be used alternatively depending on the application, situation, etc.
  • one of the two types of electrocardiogram signals Sc1 and Sc2 can be used alternatively. Therefore, the convenience can be further improved.
  • the cardiac potential signal Sc0b measured in the electrode group 113G can be used.
  • the electrode groups 111G and 112G are used for processes other than the measurement process of the cardiac potential (for example, the measurement process of the resistance value R shown in FIG. 6 and the application process of the DC voltage Vdc shown in FIG. 7).
  • an electrocardiogram signal (cardiac potential signal Sc0b) can be acquired from the defibrillation catheter 1. That is, even in such a case, defibrillation treatment can be performed while displaying and monitoring the electrocardiogram signal Sc0b on the electrocardiogram display device 5, so that the convenience can be further improved.
  • the defibrillation catheter system 3 of the present embodiment is also provided with a myoelectric potential measurement function (myoelectric potential signal acquisition function) as described below, for example.
  • a myoelectric potential measurement function myoelectric potential signal acquisition function
  • Examples of such a myoelectric potential signal include a signal indicating a composite muscle action potential (CMAP) obtained in a region near the diaphragm of the patient 9.
  • CMAP composite muscle action potential
  • FIG. 10 is a block diagram schematically showing an example of the operation state when measuring the myoelectric potential in the defibrillation catheter system 3 as described above.
  • the myoelectric potential signal Sm measured by the living body measurement mechanism 6 is an electrocardiograph as with the above-described electrocardiographic signal Sc2. It is directly input to the input terminal Tin2 of the power supply device 2 without passing through other devices such as 4.
  • the power supply device 2 of the present embodiment has an input terminal Tin2 for directly inputting such a myoelectric potential signal Sm (not via the electrocardiograph 4 or the like) in addition to the electrocardiographic signal Sc2. Is provided.
  • the myoelectric potential signal Sm input to the power supply device 2 in this way is supplied to the arithmetic processing unit 24.
  • the gain adjustment unit 242 in the arithmetic processing unit 24 performs gain adjustment of the peak value, so that the myoelectric potential waveform based on the myoelectric potential signal Sm ′ after such gain adjustment is displayed on the display unit 25. It is displayed.
  • FIG. 11 is a schematic diagram showing an arrangement example of the electrode pads at the time of such myoelectric potential measurement (an example in the case of the above-described myoelectric potential signal Sm indicating CMAP).
  • two electrode pads 62 (referred to as electrode pads 62 a and 62 b) in the biometric mechanism 6 are respectively attached to portions near the diaphragm in the patient 9 (see the region Ad in FIG. 11). ing. Then, a myoelectric potential signal Sm indicating CMAP is obtained at these electrode pads 62a and 62b.
  • a mounting position of the electrode pad 62a for example, as shown in FIG.
  • a mounting position of the electrode pad 62b for example, as shown in FIG. 11 a position near the lower right rib can be mentioned.
  • a function for measuring myoelectric potential is provided in addition to the function for measuring cardiac potential (the input terminal Tin2 of the power supply device 2 receives the myoelectric potential signal Sm in addition to the cardiac potential signal Sc2. (Acquisition function is provided). That is, in addition to the cardiac potential signal Sc2 obtained in the biometric mechanism 6 (electrode pad 62), the myoelectric potential signal Sm obtained in the biometric mechanism 6 (electrode pad 62) can also be used in the power supply device 2. It becomes like this. As a result, the convenience can be further improved.
  • ablation treatment for atrial fibrillation including treatment using cryoballoon ablation
  • phrenic nerve palsy is included as a serious one.
  • the nerve that moves the diaphragm, which is one of the respiratory muscles is the phrenic nerve
  • the right phrenic nerve descends from the cervical spinal cord and is located just beside the superior vena cava.
  • Ablation treatment for atrial fibrillation may injure the phrenic nerve, and in many cases is temporary and recovers, but in rare cases, phrenic nerve palsy may persist. In most cases, the symptoms are asymptomatic, but a dyspnea may appear.
  • a signal indicating the above-mentioned CMAP may be observed.
  • a signal indicating CMAP can be easily obtained using the biometric mechanism 6 (electrode pad 62) used in the defibrillation treatment and the input terminal Tin2 of the power supply device 2. It becomes feasible.
  • the myoelectric potential signal Sm obtained in this way is supplied to the arithmetic processing unit 24 in the power supply device 2, and the myoelectric potential waveform is displayed on the display unit 25. It has come to be.
  • the gain adjustment unit 242 in the arithmetic processing unit 24 performs gain adjustment of the peak value of the myoelectric potential signal Sm, and the myoelectric potential signal Sm after such gain adjustment.
  • a myoelectric potential waveform based on ' is displayed on the display unit 25.
  • one of the electrocardiogram signal Sc2 (see FIGS. 5 to 7 and the like) and the myoelectric signal Sm (see FIG. 10) is selectively applied to the input terminal Tin2 of the power supply device 2.
  • the selection process of one of the cardiac potential signal Sc2 and the myoelectric potential signal Sm is performed via the input unit 21 in accordance with an operation by an operator (engineer or the like) of the power supply device 2, for example. Done.
  • the cardiac potential signal Sc2 or the myoelectric potential signal Sm input to the input terminal Tin2 in this way is supplied to the arithmetic processing unit 24, respectively.
  • one of these two types of biological signals (cardiac potential signal Sc2 and myoelectric potential signal Sm) is selected according to the application or situation. Available. Therefore, the convenience can be further improved.
  • the defibrillation is stopped (cannot be performed). Specifically, the arithmetic processing unit 24 in the power supply device 2 stops power supply (output of the DC voltage Vdc) for defibrillation from the power supply unit 22 during such myoelectric potential measurement period. As described above, operation control is performed. In this way, during the myoelectric potential measurement period, the output of the DC voltage Vdc from the power supply unit 22 is stopped, and the following occurs.
  • FIG. 12 is a schematic diagram showing an example of the myoelectric waveform obtained by the myoelectric potential measurement of the present embodiment. Specifically, an example of a myoelectric potential waveform based on the myoelectric potential signal Sm (or the myoelectric potential signal Sm ′ after gain adjustment) obtained by the measurement is displayed on the display unit 25 in the power supply device 2. .
  • the maximum value Smax shown in FIG. 12 indicates the maximum value of the crest value in this myoelectric waveform.
  • the maximum value Smax and the minimum threshold value Smin are shown only on the positive (+) side of the vertical axis for convenience of illustration.
  • a warning operation to the outside is performed.
  • the arithmetic processing unit 24 in the power supply device 2 issues a warning to the outside when it is determined that the crest value in the input myoelectric potential signal Sm is equal to or less than a threshold value (minimum threshold value Smin). It has become.
  • a warning operation include an operation of performing a predetermined warning display on the display unit 25 and outputting a predetermined warning sound using the audio output unit 26.
  • an excessive attenuation state of the myoelectric potential signal Sm can be immediately grasped, and an operator (such as an engineer) can take a quick response. Is possible. As a result, the convenience can be further improved.
  • the electrocardiographic signal Sc2 measured by the biometric mechanism 6 and the like are supplied to the power supply device 2 that supplies power to the defibrillation catheter 1 at the time of defibrillation. 4 is provided with an input terminal Tin ⁇ b> 2 that is directly input without going through 4. In this way, since the electrocardiogram signal Sc2 is directly input to the power supply device 2 without going through the electrocardiograph 4, the defibrillation catheter system is less affected by the device configuration of the electrocardiograph 4, for example. It becomes easy to cope with the environmental conditions when using 3.
  • the above-described plural types of modes (“cardiac potential measurement mode A”, “cardiac potential measurement mode B”, “defibrillation mode”) can be switched, and the cardiac potential signal Sc 1.
  • the electrocardiogram signal Sc2 can be selectively input, the following is obtained. That is, for example, one of the above-described plural types of modes or one of the above-described two types of electrocardiogram signals can be alternatively used according to the application or situation. Therefore, in this embodiment, convenience can be improved.
  • a myoelectric potential measuring function is provided in addition to the cardiac potential measuring function (the function of acquiring the myoelectric potential signal Sm in addition to the cardiac potential signal Sc2 at the input terminal Tin2 of the power supply device 2).
  • the following effects can also be obtained. That is, in addition to the electrocardiogram signal Sc2 obtained in the biometric mechanism 6, the myoelectric signal Sm obtained in the biometric mechanism 6 can be used in the power supply device 2. As a result, it is possible to further improve convenience.
  • cardiac potential measurement process B defibrillation processing
  • defibrillation mode B defibrillation processing
  • FIG. 13 a cardiac potential measurement process as shown in FIG. 13 can be used. That is, in addition to the above-described electrocardiogram measurement process in “cardiac potential measurement mode A”, the electrocardiogram measurement process in “cardiac potential measurement mode B” shown in FIG. 13 can be used. This corresponds to the case where “cardiac potential measurement mode B” is selected instead of “cardiac potential measurement mode A” in step S11 of FIG.
  • the electrocardiogram signal Sc1 measured by the biological measurement mechanism 6 is expressed as follows.
  • the signal is input to the power supply device 2 through a route. That is, the electrocardiogram signal Sc1 obtained in this way is input to the input terminal Tin1 of the power supply device 2 via the electrocardiograph 4.
  • the cardiac potential signal Sc1 input to the power supply device 2 is subjected to the gain adjustment described above to become a cardiac potential signal Sc1 ', and a cardiac potential waveform based on this cardiac potential signal Sc1' is displayed on the display unit 25.
  • An electrocardiographic waveform based on the electrocardiographic signal Sc1 input to the electrocardiograph 4 is displayed on the electrocardiogram display device 5. Further, at this time, regarding the electrocardiogram signal Sc0a measured by the electrode groups 111G and 112G in the defibrillation catheter 1, the power supply device 2 (input terminal Tin3, switching unit 23, output terminal Tout2) and the electrocardiograph 4 These may be displayed on the electrocardiogram display device 5 in this order. Similarly, the electrocardiographic signal Sc0b measured by the electrode group 113G in the defibrillation catheter 1 also passes through the power supply device 2 (input terminal Tin3, output terminal Tout2) and the electrocardiograph 4 in this order. It may be displayed on the electrocardiogram display device 5.
  • the electrocardiogram signal Sc1 obtained in the living body measurement mechanism 6 (electrode pad 61) is used in the electrocardiograph 4 and the power supply device 2. Will be able to. Therefore, it is possible to further improve convenience.
  • FIG. 14 shows an example of an operation state in the “defibrillation mode (defibrillation mode B)” performed when such “cardiac potential measurement mode B” is set (selected). It is schematically represented by a block diagram.
  • the “defibrillation mode B” basically, the “defibrillation mode” described above is basically used except that the input terminal Tin1 (cardiac potential signal Sc1) is used instead of the input terminal Tin2 (cardiac potential signal Sc2).
  • the defibrillation process is performed in the same manner as in “Mode A” (see FIG. 7).
  • the DC voltage Vdc output from the power supply unit 22 in the power supply device 2 is connected to the output circuit 241, the switching unit 23, and the output terminal Tout1 in the arithmetic processing unit 24.
  • the electrodes are applied between the electrode groups 111G and 112G in the defibrillation catheter 1 in order.
  • the DC voltage Vdc is output from the output circuit 241 in the power supply device 2 so that these electrode groups 111G and 112G have different polarities.
  • the electrocardiograph Sc1 measured by the biomeasuring mechanism 6 continues from the above “cardiac potential measurement mode B”. 4 is input to the input terminal Tin 1 of the power supply device 2 through the power supply device 2 and supplied to the arithmetic processing unit 24.
  • the cardiac potential signal Sc1 is gain-adjusted by the gain adjustment unit 242 in the arithmetic processing unit 24, and the cardiac potential waveform based on the cardiac potential signal Sc1 'after gain adjustment is displayed on the display unit 25.
  • An electrocardiographic waveform based on the electrocardiographic signal Sc1 input to the electrocardiograph 4 is displayed on the electrocardiogram display device 5.
  • the electrocardiographic signal Sc0b measured by the electrode group 113G (ring electrode 113) of the defibrillation catheter 1 is input to the input terminal Tin3 and the output terminal Tout2 of the power supply device 2.
  • the electrocardiogram signal Sc0b is output from the electrocardiograph 4 to the electrocardiogram display device 5, and the electrocardiogram waveform based on the electrocardiogram signal Sc0b is displayed on the electrocardiogram display device 5.
  • the arithmetic processing unit 24 controls the operation of the power source unit 22 so that the DC voltage Vdc is applied in synchronization with the cardiac potential signal Sc1 supplied through the above-described path. In this way, the defibrillation process by the “defibrillation mode B” is performed.
  • the defibrillation process is performed in the same manner as in the case of the defibrillation catheter system 103 (see FIG. 9) according to the comparative example described above. become. That is, in the case of the “defibrillation mode B” (and the “cardiac potential measurement mode B” described above), the “defibrillation mode A (see FIG. 7)” described above (and the “cardiac potential measurement mode A ( Unlike FIG. 5)))), even if the electrode pad 62 is affixed to the patient 9, it is not used for the defibrillation process or the cardiac potential measurement process.
  • these “Defibrillation mode B” and “cardiac potential measurement mode B” can be suitably used, and the convenience is further improved.
  • each member described in the above embodiment is not limited, and other materials may be used.
  • the structure of the defibrillation catheter 1 was mentioned concretely and demonstrated, it is not necessary to necessarily provide all the members, and you may further provide other members.
  • a leaf spring that can be deformed in the bending direction may be provided inside the shaft 11 as a swinging member.
  • the configuration of the electrodes in the shaft 11 is not limited to that described in the above embodiment.
  • each member in the defibrillation catheter 1 is not limited to that described in the above embodiment, and other shapes, arrangements, materials, numbers, etc. May be.
  • the values, ranges, magnitude relationships, and the like of various parameters described in the above embodiments are not limited to those described in the above embodiments, and may be other values, ranges, magnitude relationships, and the like. .
  • the defibrillation catheter of the type in which the shape of the shaft 11 near the tip region P1 changes in one direction according to the operation with the handle 12 has been described as an example. Not limited. That is, the present invention can also be applied to, for example, a defibrillation catheter in which the shape of the shaft 11 near the distal end region P1 changes in both directions according to the operation with the handle 12. A plurality of operation wires are used. The present invention can also be applied to a defibrillation catheter of the type in which the shape near the distal end region P1 of the shaft 11 is fixed. In this case, the operation wire, the rotary plate 122, etc. Is no longer necessary. That is, the handle is composed of only the handle main body 121.
  • the biometric mechanism 6 demonstrated and demonstrated the example in the case where it was comprised using the several electrode pad (electrode pad 61, 62), it is not restricted to this example. That is, for example, another electrode catheter (inserted into the heart chamber of the patient 9) different from the defibrillation catheter 1 may be used as the biometric mechanism.
  • the block configuration of the power supply device 2 has been specifically described, but it is not always necessary to include all the blocks described in the above embodiment, and further includes other blocks. It may be.
  • the defibrillation catheter system 3 as a whole may further include other devices in addition to the devices described in the above embodiment. Specifically, for example, in some cases, the electrocardiograph 4 and the biological measurement mechanism 6 (electrode pads 61 and 62) may be included in the defibrillation catheter system.
  • the series of processing described in the above embodiment may be performed by hardware (circuit) or software (program).
  • the software is composed of a group of programs for causing each function to be executed by a computer.
  • Each program may be used by being incorporated in advance in the computer, for example, or may be used by being installed in the computer from a network or a recording medium.

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Abstract

La présente invention concerne un système de cathéter de défibrillation qui est capable d'une commodité améliorée. Le système de cathéter de défibrillation 3 comprend un cathéter de défibrillation 1 qui est inséré dans une chambre cardiaque et effectue une défibrillation et un dispositif d'alimentation électrique 2 qui fournit de l'électricité au cathéter de défibrillation 1 au moment de la défibrillation. Le dispositif d'alimentation électrique 2 comprend : une unité d'alimentation électrique 22 qui fournit de l'électricité au moment de la défibrillation; une première borne d'entrée (borne d'entrée Tin1) pour l'entrée d'un premier signal de potentiel cardiaque (signal de potentiel cardiaque Sc1) délivré en sortie par un électrocardiographe 4; et une deuxième borne d'entrée (borne d'entrée Tin2) dans laquelle un deuxième signal de potentiel cardiaque (signal de potentiel cardiaque Sc2) mesuré par un mécanisme biométrique 6 est directement entré sans traverser l'électrocardiographe 4. Le dispositif d'alimentation électrique 2 peut être commuté entre un premier mode de mesure de potentiel cardiaque (mode de mesure de potentiel cardiaque A) dans lequel un deuxième signal de potentiel cardiaque est acquis depuis la deuxième borne d'entrée, un deuxième mode de mesure de potentiel cardiaque (mode de mesure de potentiel cardiaque B) dans lequel le premier signal de potentiel cardiaque est acquis depuis la première borne d'entrée, et un mode de défibrillation pour effectuer une défibrillation. En outre, dans le dispositif d'alimentation électrique 2, le premier ou le deuxième signal de potentiel cardiaque peut être sélectivement entré.
PCT/JP2017/013609 2017-03-31 2017-03-31 Système de cathéter de défibrillation Ceased WO2018179339A1 (fr)

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