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1.发明授权RF ablation apparatus and method having electrode/tissue contact assessment scheme and electrocardiogram filtering 有权RF消融装置和方法，其具有电极/组织接触评估方案和心电图滤波公开(公告)号：US06391024B1
公开(公告)日：2002-05-21
申请号：US09335200
申请日：1999-06-17
申请人： Weimin Sun , Thomas M. Castellano , Russ E. Anderson , Wade A. Bowe , John A. Simpson , Marshall L. Sherman , Kathryn E. Lockwood
发明人： Weimin Sun , Thomas M. Castellano , Russ E. Anderson , Wade A. Bowe , John A. Simpson , Marshall L. Sherman , Kathryn E. Lockwood
IPC分类号： A61B1804
CPC分类号： A61B18/1206 , A61B18/1492 , A61B2018/0066 , A61B2090/065
摘要： A method of assessing the adequacy of contact between an ablation electrode and biological tissue within a biological organ having biological fluid therein includes the steps of positioning the ablation electrode proximal the biological tissue; positioning a reference electrode a distance from the ablation electrode; measuring the impedance between the ablation electrode and the reference electrode at a first frequency and measuring the impedance between the ablation electrode and the reference electrode at a second frequency. The percentage difference between the first-frequency impedance and the second-frequency impedance provides an indication of the state of electrode/tissue contact. In general, a percentage difference of at least approximately 10% serves as an indication of substantially complete electrode/tissue contact. A percentage difference in the approximate range between 5% and 10% serves as an indication of partial electrode/tissue contact. A percentage difference less than approximately 5% serves as an indication of no electrode/tissue contact. Ratiometric measurements may also be used to assess the state of electrode/tissue contact.
摘要翻译： 一种评估消融电极与生物体内具有生物流体的生物组织之间接触的充分性的方法包括以下步骤：将消融电极定位在生物组织附近; 将参考电极定位到距离消融电极的距离; 以第一频率测量消融电极和参考电极之间的阻抗，并以第二频率测量消融电极和参考电极之间的阻抗。 第一频率阻抗和第二频率阻抗之间的百分比差异提供了电极/组织接触状态的指示。 通常，至少约10％的百分比差异用作基本上完整的电极/组织接触的指示。 在5％和10％之间的近似范围内的百分比差异用作部分电极/组织接触的指示。 小于约5％的百分比差异表示没有电极/组织接触。 比例测量也可用于评估电极/组织接触的状态。
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公开(公告)号：US06312425B1
公开(公告)日：2001-11-06
申请号：US09515382
申请日：2000-02-29
IPC分类号： A61B1804
CPC分类号： A61N1/06 , A61B18/1492 , A61B2017/00097 , A61B2017/00101 , A61B2018/00797 , A61B2018/00821
摘要： A tip electrode for an ablation catheter mounted at the distal tip of an elongated catheter body member has a distal-end region and a proximal-end region. A tip thermal sensor is located at or near the apex of the distal-end region and one or more side thermal sensors are located near the surface of the proximal-end region. The electrode is preferably an assembly formed from a hollow dome-shaped shell with a core disposed within the shell. The side thermal sensor wires are electrically connected inside the shell and the core has a longitudinal channel for the side thermal sensor wires welded to the shell. The shell also preferably has a pocket in the apex of the shell, and the end thermal sensor wires pass through the core to the apex of the shell. Spaces between the shell and the core can be filled with epoxy resin. Alternatively, the electrode is formed of a solid metal having a plurality of bores for positioning thermal sensors at the tip and near the surface of the electrode.
摘要翻译： 安装在细长导管本体构件的远端的消融导管的尖端电极具有远端区域和近端区域。 尖端热传感器位于远端区域的顶点处或附近，并且一个或多个侧面热传感器位于近端区域的表面附近。 电极优选是由具有设置在壳体内的芯的中空圆顶形壳体形成的组件。 侧面热传感器线电连接在壳体内部，并且芯部具有用于焊接到壳体的侧部热传感器线的纵向通道。 外壳还优选地在壳的顶点具有凹穴，并且端部热传感器线穿过芯到壳的顶点。 外壳和芯之间的空间可以填充环氧树脂。 或者，电极由具有多个孔的固体金属形成，用于在电极的顶端和附近定位热传感器。
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公开(公告)号：US06616657B2
公开(公告)日：2003-09-09
申请号：US09948334
申请日：2001-09-06
IPC分类号： A61B1818
CPC分类号： A61N1/06 , A61B18/1492 , A61B2017/00097 , A61B2017/00101 , A61B2018/00797 , A61B2018/00821
摘要： A tip electrode for an ablation catheter mounted at the distal tip of an elongated catheter body member has a distal-end region and a proximal-end region. A tip thermal sensor is located at or near the apex of the distal-end region and one or more side thermal sensors are located near the surface of the proximal-end region. The electrode is preferably an assembly formed from a hollow dome-shaped shell with a core disposed within the shell. The side thermal sensor wires are electrically connected inside the shell and the core has a longitudinal channel for the side thermal sensor wires welded to the shell. The shell also preferably has a pocket in the apex of the shell, and the end thermal sensor wires pass through the core to the apex of the shell. Spaces between the shell and the core can be filled with epoxy resin. Alternatively, the electrode is formed of a solid metal having a plurality of bores for positioning thermal sensors at the tip and near the surface of the electrode.
摘要翻译： 安装在细长导管本体构件的远端的消融导管的尖端电极具有远端区域和近端区域。 尖端热传感器位于远端区域的顶点处或附近，并且一个或多个侧面热传感器位于近端区域的表面附近。 电极优选是由具有设置在壳体内的芯的中空圆顶形壳体形成的组件。 侧面热传感器线电连接在壳体内部，并且芯部具有用于焊接到壳体的侧部热传感器线的纵向通道。 外壳还优选地在壳的顶点具有凹穴，并且端部热传感器线穿过芯到壳的顶点。 外壳和芯之间的空间可以填充环氧树脂。 或者，电极由具有多个孔的固体金属形成，用于在电极的顶端和附近定位热传感器。
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4.发明授权System and method for assessing electrode-tissue contact and lesion quality during RF ablation by measurement of conduction time 有权通过测量传导时间来评估RF消融期间电极组织接触和病变质量的系统和方法公开(公告)号：US06761716B2
公开(公告)日：2004-07-13
申请号：US09955551
申请日：2001-09-18
IPC分类号： A61B1812
CPC分类号： A61B18/1206 , A61B18/12 , A61B2018/00642 , A61B2018/0066
摘要： The efficacy of a lesion produced between a pair of ablation electrodes is assessed by analyzing the time it takes for a pulse of energy to travel from one electrode to the other. During a first time period, a first pulse of energy is applied to a first electrode. The time it takes for the pulse to conduct through the tissue to a second electrode is determined. During a time period subsequent to the first time, a subsequent pulse of energy is applied to the first electrode and the time it takes for the subsequent pulse to conduct through the tissue to the second electrode is determined. Changes in the conduction times are monitored by calculating the difference between consecutive conduction times and comparing the difference to a preset value. If the difference is below the preset value the lesion is considered adequate.
摘要翻译： 通过分析能量脉冲从一个电极传播到另一个电极所花费的时间来评估在一对消融电极之间产生的损伤的功效。 在第一时间段期间，向第一电极施加第一能量脉冲。 确定脉冲通过组织传导到第二电极所花费的时间。 在第一次之后的时间段期间，确定随后的能量脉冲到第一电极并且随后的脉冲通过组织传导到第二电极所花费的时间。 通过计算连续传导时间之间的差异并将差值与预设值进行比较来监测传导时间的变化。 如果差异低于预设值，则认为病变足够。
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5.发明授权公开(公告)号：US06869414B2
公开(公告)日：2005-03-22
申请号：US10105087
申请日：2002-03-22
CPC分类号： A61M25/0147 , A61M25/0041 , A61M25/0138 , A61M25/0152 , A61M2025/0161 , A61M2025/0163
摘要： A catheter employs a pre-formed distal end and a proximal deflection mechanism for steering the catheter. A shaped member extends from a shaped region of the catheter sheath to at least a portion of an anchor region. A steering ribbon extends from a proximal region of the sheath and passes within at least a portion of the anchor region. A distal end of the steering ribbon is joined with a proximal portion of the shaped member. At least one steering tendon is disposed within the sheath and has a first end attached at the anchor region and a second end located at the proximal region of the sheath. Movement of the steering tendon in a proximal direction causes the deflection region to deflect relative to the longitudinal axis of the catheter while the shape of shaped region of the sheath is substantially maintained.
摘要翻译： 导管采用预先形成的远端和用于转导导管的近端偏转机构。 成形构件从导管护套的成形区域延伸到锚定区域的至少一部分。 转向带从护套的近侧区域延伸并且在锚定区域的至少一部分内通过。 转向带的远端与成形构件的近端部分连接。 至少一个转向筋设置在护套内并且具有附接在锚定区域处的第一端和位于护套的近侧区域处的第二端。 转向腱在近端方向的移动导致偏转区域相对于导管的纵向轴线偏转，同时护套的成形区域的形状基本上保持。
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公开(公告)号：US5681280A
公开(公告)日：1997-10-28
申请号：US434003
申请日：1995-05-02
IPC分类号： A61B18/14 , A61M25/01 , A61M25/092
CPC分类号： A61M25/0147 , A61B18/1492 , A61M25/0136 , A61B2018/00214 , A61B2018/00916 , A61M2025/015
摘要： A steerable catheter comprising a resilient deflectable body member having an expandable electrode array at the distal end thereof, and a manipulation handle attached to the proximal end of the body member, the handle including an array deployment device. A mandrel is movable through the shaft of the catheter by control movements at the handle to deploy the array or collapse the array as selected. A displacement compensation system is operatively connected to the mandrel such that when the array is expanded, the compensation system biases the mandrel so keep the array expanded, even during instances of deflection of the distal end. Similarly, the displacement compensation system biases the mandrel to keep the array collapsed when that configuration is selected, even during instances of straightening of the catheter. The displacement compensation system also compensates for overturning the control device in the handle to protect the array and deployment systems.
摘要翻译： 一种可导向的导管，其包括在其远端处具有可扩张电极阵列的弹性可偏转主体构件和附接到主体构件的近端的操纵手柄，所述手柄包括阵列展开装置。 心轴可以通过导管的轴移动，通过手柄处的控制运动来部署阵列或者按选择折叠阵列。 位移补偿系统可操作地连接到心轴，使得当阵列膨胀时，补偿系统偏压心轴，使得即使在远端的偏转的实例期间也使阵列扩张。 类似地，即使在导尿管矫正的情况下，位移补偿系统也会偏心心轴以保持阵列在选择该构型时收缩。 位移补偿系统还补偿了手柄中的控制装置的翻转，以保护阵列和展开系统。
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7.发明授权公开(公告)号：US07419477B2
公开(公告)日：2008-09-02
申请号：US10855544
申请日：2004-05-27
CPC分类号： A61M25/0147 , A61M25/0041 , A61M25/0138 , A61M25/0152 , A61M2025/0161 , A61M2025/0163
摘要： Methods of using a catheter involve providing a sheath comprising a proximal region, a deflection region, a distal-end region including a shapeable region, an anchor region defined between the deflection region and the shapeable region, and a longitudinal axis. The method also involves imparting a pre-established shape to the shapeable region. The method further involves applying axial force in a proximal direction at the anchor region so as to cause the deflection region to deflect relative to the longitudinal axis while the pre-established shape imparted to the shapeable region of the sheath is substantially maintained.
摘要翻译： 使用导管的方法包括提供包括近端区域，偏转区域，包括可形成区域的远端区域，限定在偏转区域和可成形区域之间的锚定区域以及纵向轴线的护套。 该方法还涉及将可建立的形状赋予可塑区域。 该方法还包括在锚定区域处沿近端方向施加轴向力，以使得偏转区域相对于纵向轴线偏转，同时基本上保持赋予护套的可塑区域的预先确定的形状。
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公开(公告)号：US06605086B2
公开(公告)日：2003-08-12
申请号：US09848114
申请日：2001-05-02
IPC分类号： A61B1818
CPC分类号： A61M25/0144 , A61M25/0147 , A61M2025/015
摘要： A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, and a torque transfer system at the distal portion to enhance torque transfer from the handle to the distal tip. The steering mechanism includes two steering tendons. The steering tendons are attached to the distal-end region of the catheter. The steering tendons may be located approximately angularly aligned, thus causing the deflection profiles to be unidirectional. Alternatively, the steering tendons may be located angularly separated from each other, thus causing the deflection profiles to be bidirectional. In other aspects, the torque transfer system includes a flat ribbon within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter.
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公开(公告)号：US06585718B2
公开(公告)日：2003-07-01
申请号：US09848087
申请日：2001-05-02
IPC分类号： A61B100
CPC分类号： A61M25/0138 , A61B18/1492 , A61B2017/003 , A61B2018/00577 , A61M25/0141 , A61M25/0144 , A61M25/0147 , A61M2025/015
摘要： A catheter includes a steering mechanism for manipulating the distal end of the catheter to obtain a plurality of deflection profiles, a torque transfer system to enhance torque transfer from the handle to the distal tip, and a support system to reduce undesirable deformation of the distal-end region during steering. The torque transfer system includes a flat ribbon within the relatively flexible distal-end region to enhance torque transfer through the distal-end region of the catheter. The support system includes a compression cage and longitudinal struts that are located within the distal-end region of the catheter. The support system can support axial loads and deflect laterally in the direction of the steering, thereby reducing the amount of stretching and compression of the catheter sheath within the deflecting region.
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公开(公告)号：US06270496B1
公开(公告)日：2001-08-07
申请号：US09516280
申请日：2000-03-01
IPC分类号： A61B1818
CPC分类号： B82Y15/00 , A61B2017/00053 , A61B2017/00057 , A61B2017/00243 , A61B2017/00867 , A61M25/0041 , A61M25/0147 , A61M25/0152 , A61M2025/0161 , A61N1/056
摘要： A catheter has a stylet formed of a shape-retentive and resilient material having a preformed curved shape at its distal end resulting in the catheter sheath having the preformed curved shape. The catheter sheath has a plurality of electrodes at its distal end for contacting selected biological tissue for imparting ablation energy thereto. The catheter sheath also has an axially mounted tendon for causing deflection of the distal end. The stylet material permits straightening the catheter sheath during insertion into the patient and advancing the electrodes to the target tissue. Upon removal of the straightening forces, such as by entry into a chamber of the heart, the stylet material resumes its preformed curved distal shape thereby forcing the catheter distal end with the electrodes into the same preformed curved shape. The operator may place the curved distal end into contact with the target tissue and axially move the tendon as desired to gain greater control over the bend in the distal end of the catheter sheath to adjust the radius of curvature of the distal end to obtain greater contact of the electrodes with the heart tissue. Preferably, the stylet is formed of nitinol.
摘要翻译： 导管具有由形状保持性和弹性材料形成的探针，其在其远端处具有预成型的弯曲形状，导致导管护套具有预成型的弯曲形状。 导管鞘在其远端具有多个电极，用于接触选定的生物组织以向其施加消融能量。 导管护套还具有轴向安装的腱，用于引起远端的偏转。 探针材料允许在插入患者期间矫正导管鞘，并将电极推进到靶组织。 在去除矫直力时，例如通过进入心脏室，探针材料恢复其预先形成的弯曲远端形状，从而迫使导管远端与电极形成相同的预成形弯曲形状。 操作者可以将弯曲的远端放置成与目标组织接触，并根据需要轴向移动肌腱以获得对导管套管远端的弯曲部的更大控制，以调节远端的曲率半径以获得更大的接触 的电极与心脏组织。 探针最好由镍钛诺形成。
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