JP5641591B1 - Catheter system - Google Patents

Abstract

A catheter system capable of obtaining a good examination waveform is provided. A catheter system 6 includes an ablation catheter 1 having an electrode and a temperature sensor (thermocouple 113) in the vicinity of a distal end P1, a power supply device 3 for supplying power to the ablation catheter 1 at the time of ablation, and the above-mentioned A waveform display device (electrocardiogram display device 2) for displaying a test waveform signal Sw measured using electrodes, and a temperature measurement signal St output from the temperature sensor are relayed and supplied to the power supply device 3, and the electrodes A relay 5 that relays the inspection waveform signal Sw output from the signal and supplies the waveform display device to the waveform display device, and a path cut-off switch 52 provided on the output path of the temperature measurement signal St and configured to cut off the output path. And. [Selection] Figure 1

Description

  The present invention relates to a catheter system including an ablation catheter, a power supply device, and a waveform display device used for examination and treatment of arrhythmia, for example.

  An electrode catheter is inserted into a body (for example, the inside of a heart) through a blood vessel, and is used for arrhythmia examination or treatment. In such electrode catheters, in general, the shape near the tip (distal end) of the catheter tube inserted into the body is attached to the proximal end (proximal end, rear end, hand side) placed outside the body. Depending on the operation of the part, it changes (deflects, curves, bends) in one direction or both directions. In addition to the type in which the shape near the tip is arbitrarily changed according to the operation in this way, there is a type in which the shape near the tip is fixed.

  Among such electrode catheters, mainly for therapeutic use (so-called ablation catheter), power for ablation (cauterization) is supplied from a power supply device (high frequency generator). A catheter system including an ablation catheter and a power supply device is disclosed in Patent Document 1, for example.

Japanese Patent Laid-Open No. 5-42121

  In such a catheter system, a test waveform (electrocardiogram waveform or the like) is measured using an electrode of an ablation catheter and displayed on a waveform display device (so-called polygraph). Further, a temperature measurement signal is obtained by a temperature measurement mechanism (for example, a temperature sensor made of a thermocouple or the like) provided near the distal end of the ablation catheter, and is used for temperature control by a control unit in the power supply apparatus. Such inspection waveform signals, temperature measurement signals, and the like are supplied from the ablation catheter to the waveform display device or the power supply device via the relay.

  By the way, a noise signal from a circuit may be superimposed on these inspection waveform signals and temperature measurement signals in the repeater. In particular, when a noise signal is superimposed on the inspection waveform signal, it may be difficult to obtain (display) a good inspection waveform in the waveform display device. Therefore, it is desired to propose a method that can reduce or avoid the possibility of such a noise signal being superimposed and obtain a good inspection waveform.

  The present invention has been made in view of such problems, and an object of the present invention is to provide a catheter system capable of obtaining a good test waveform.

  The first catheter system of the present invention includes an ablation catheter having an electrode and a temperature sensor in the vicinity of the tip, a power supply device for supplying power to the ablation catheter during ablation, and an inspection waveform measured using the electrode. A waveform display device that displays a signal, and a relay that relays the temperature measurement signal output from the temperature sensor to the power supply device, and relays the inspection waveform signal output from the electrode to the waveform display device. And a path cutoff switch provided on the temperature measurement signal output path and configured to be able to block the output path.

  In the first catheter system of the present invention, a path cutoff switch capable of blocking the output path is provided on the output path of the temperature measurement signal output from the temperature sensor in the ablation catheter. Thereby, a noise signal from a circuit (for example, an amplifier or the like) connected to the temperature measurement signal output path can be cut off on the temperature measurement signal output path. That is, the noise signal generation source is disconnected. As a result, for example, in the repeater, the possibility that the noise signal is superimposed on the inspection waveform signal via the output path of the temperature measurement signal is reduced or avoided.

  In the first catheter system of the present invention, it is preferable to provide the above-described path cutoff switch in the repeater. When configured in this manner, the output path of the temperature measurement signal can be interrupted in the repeater, so that the noise signal is less likely to be superimposed on the inspection waveform signal. In this case, it is more preferable that an amplifier for amplifying the temperature measurement signal is provided in the repeater, and a path cut-off switch is disposed on the output path on the ablation catheter side than the amplifier. When configured in this manner, the output path can be blocked relatively on the near side (ablation catheter side) in the repeater. Therefore, the antenna action in this output path is reduced, and the generation of noise signals is suppressed.

  In the first catheter system of the present invention, it is preferable that an on state or an off state of the route blocking switch can be set according to an operation of the operator. When configured in this manner, for example, the output path can be blocked at a timing desired by the operator in accordance with the state of examination or treatment using an ablation catheter. Therefore, the convenience at the time of such a test | inspection and treatment improves.

  In the first catheter system of the present invention, the power supply device may output a control signal for automatically setting the path cutoff switch to an on state or an off state in conjunction with its own operation state. . In such a configuration, since the on / off state of the path cut-off switch is automatically controlled in conjunction with the operating state of the power supply device, the operator does not need to operate each time, and convenience is improved. In this case, the power supply device outputs a control signal so that the path cutoff switch is set to the on state when the power supply is being executed, and when the power supply is stopped, the path cutoff switch is It is preferable to output the control signal so as to be set to the off state. In such a configuration, when power supply is executed (temperature ablation) that requires temperature measurement by the temperature sensor, the path cut-off switch is set to the on state, and temperature measurement is ensured (the temperature measurement signal is Output to the power supply). On the other hand, when power supply is not necessarily required (for example during inspection), the path cut-off switch is set to the off state and temperature measurement is stopped, and noise signal superposition is reduced. Alternatively, it is possible to perform a highly accurate inspection using the avoided inspection waveform.

  The second catheter system of the present invention includes an ablation catheter having an electrode and a temperature sensor in the vicinity of the distal end, a power supply device that supplies power to the ablation catheter at the time of ablation, and a test waveform measured using the electrode. A waveform display device that displays a signal, and a relay that relays the temperature measurement signal output from the temperature sensor to the power supply device, and relays the inspection waveform signal output from the electrode to the waveform display device. It is equipped with. This repeater has an amplifier that amplifies the temperature measurement signal and a power shut-off mechanism that shuts off the power of the amplifier.

  In the second catheter system of the present invention, the power supply of the amplifier that amplifies the temperature measurement signal output from the temperature sensor in the ablation catheter can be cut off by the power cut-off mechanism. As a result, generation of a noise signal from the amplifier can be prevented. As a result, for example, in the repeater, the possibility that the noise signal is superimposed on the inspection waveform signal via the output path of the temperature measurement signal is reduced or avoided.

  In the second catheter system of the present invention, it is preferable that the power shut-off mechanism shuts off the power of the amplifier based on an operation signal input in accordance with an operation of the operator. When configured in this way, for example, the amplifier can be powered off at a timing desired by the operator in accordance with, for example, the state of examination or treatment using an ablation catheter. Therefore, the convenience at the time of such a test | inspection and treatment improves.

  In the second catheter system of the present invention, the power supply device may output a control signal for automatically controlling the operation of the power shut-off mechanism in conjunction with its operation state. When configured in this manner, the power-off operation of the amplifier is automatically controlled in conjunction with the operating state of the power supply device, so that the operator does not need to operate each time and convenience is improved. In this case, the power supply device outputs a control signal so that the power supply of the amplifier is held when the power supply is executed, and the power supply of the amplifier is shut off when the power supply is stopped. Thus, it is preferable to output a control signal. When configured in this way, the power supply of the amplifier is held (maintained) and temperature measurement is ensured when power supply is executed, which requires temperature measurement by the temperature sensor. On the other hand, when power supply is stopped, such temperature measurement is not necessarily required, a good inspection waveform is used in which noise signal superposition is reduced or avoided while the power supply to the amplifier is shut off and temperature measurement is stopped High-precision inspection can be performed.

  According to the first catheter system of the present invention, the path cut-off switch that can cut off the output path is provided on the output path of the temperature measurement signal output from the temperature sensor in the ablation catheter. The possibility of being superimposed on the inspection waveform signal can be reduced or avoided. Therefore, a good inspection waveform can be obtained.

  According to the second catheter system of the present invention, since the power source of the amplifier that amplifies the temperature measurement signal output from the temperature sensor in the ablation catheter can be shut off by the power shut-off mechanism, the noise signal is converted into the test waveform signal. The possibility of being superimposed can be reduced or avoided. Therefore, a good inspection waveform can be obtained.

It is a block diagram showing typically the example of whole composition of the catheter system concerning a 1st embodiment of the present invention. It is a schematic diagram showing the detailed structural example of the ablation catheter shown in FIG. It is a perspective view which represents typically the example of an external appearance structure of the repeater shown in FIG. It is a schematic diagram showing the detailed structural example of the repeater shown in FIG. It is a block diagram which represents typically the whole structure of the catheter system which concerns on the comparative example 1. 6 is a timing waveform diagram illustrating an example of a test waveform signal according to Comparative Example 1. FIG. 10 is a timing waveform diagram illustrating an example of a test waveform signal according to Comparative Example 2. FIG. It is a schematic diagram for demonstrating the effect | action of the path | route cutoff switch shown in FIG. It is another schematic diagram for demonstrating the effect | action of the path | route cutoff switch shown in FIG. It is a timing waveform diagram showing an example of a test waveform signal according to the first embodiment. It is a block diagram showing typically the example of whole composition of the catheter system concerning a 2nd embodiment. It is a schematic diagram showing the detailed structural example of the repeater shown in FIG. It is a flowchart showing the operation example of the catheter system shown in FIG. It is a schematic diagram for demonstrating the effect | action of the path | route cutoff switch shown in FIG. FIG. 12 is another schematic diagram for explaining the operation of the path cutoff switch illustrated in FIG. 11. It is a block diagram showing typically the example of whole composition of the catheter system concerning a 3rd embodiment. It is a block diagram for demonstrating the effect | action of the power-supply-cutoff mechanism shown in FIG. It is a block diagram showing typically the example of whole composition of the catheter system concerning a 4th embodiment. It is a flowchart showing the operation example of the catheter system shown in FIG. It is a block diagram for demonstrating an effect | action of the power-supply-cutoff mechanism shown in FIG.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The description will be given in the following order.
1. 1st Embodiment (example in which the state of a path | route cutoff switch is set according to an operator's operation)
2. Second embodiment (an example in which a path cutoff switch is automatically controlled in conjunction with the operation of a power supply device)
3. Third embodiment (an example in which the power supply of the amplifier is cut off according to the operation of the operator)
4). Fourth embodiment (an example of automatically controlling power-off of an amplifier in conjunction with the operation of a power supply device)
5. Modified example

<First Embodiment>
[Constitution]
FIG. 1 is a block diagram schematically showing an example of the entire configuration of a catheter system (catheter system 6) according to a first embodiment of the present invention. This catheter system 6 is a system used in the examination and treatment of arrhythmia and the like in a patient (patient 9 in this example), and includes an ablation catheter 1, an electrocardiogram display device 2 (waveform display device), a power supply device 3, and a counter electrode plate. 4 and a repeater 5 are provided.

(Ablation catheter 1)
The ablation catheter 1 is an electrode catheter that is inserted into the body of a patient 9 through a blood vessel and performs ablation and examination of an arrhythmia and the like.

  FIG. 2 schematically shows a schematic configuration example of the ablation catheter 1. The ablation catheter 1 has a shaft 11 (catheter shaft) as a catheter body and an operation unit 12 attached to the proximal end of the shaft 11.

  The shaft 11 is made of a flexible tubular structure (tubular member) and has a shape extending along its own axial direction (Z-axis direction). Further, the shaft 11 has a so-called single lumen structure in which one lumen (pore, through-hole) is formed so as to extend along its own axial direction, or a plurality of (for example, four) lumens are formed. So-called multi-lumen structure. In the shaft 11, both a region having a single lumen structure and a region having a multi-lumen structure may be provided. Various kinds of thin wires (not shown) (conductive wires, operation wires, etc.) are inserted through such lumens while being electrically insulated from each other.

  Near the tip P1 of the shaft 11, a mechanism (temperature measurement mechanism) for measuring the temperature in the vicinity of the tip P1 (around the affected area) is provided. Specifically, a temperature sensor that functions as such a temperature measurement mechanism is disposed in the lumen inside the shaft 11 (for example, as a specific example of such a temperature sensor, a thermocouple 113 described later has a lumen. ). Note that the temperature information in the vicinity of the tip P1 measured in this way is supplied as a temperature measurement signal St from the ablation catheter 1 to the power supply device 3 via the relay 5 as shown in FIG. It is like that.

  Such a shaft 11 is comprised by synthetic resins, such as polyolefin, polyamide, polyether polyamide, a polyurethane, for example. The axial length of the shaft 11 is about 500 to 1200 mm (for example, 1170 mm), and the outer diameter (outer diameter of the XY cross section) of the shaft 11 is about 0.6 to 3 mm (for example, 2). 0.0 mm).

  A plurality of electrodes are provided in the vicinity of the tip P1 of the shaft 11 as shown in the enlarged view in the vicinity of the tip P1 in FIG. Specifically, the ring-shaped electrodes 111 a, 111 b, 111 c and the tip electrode 112 are arranged at a predetermined interval in this order toward the most distal side of the shaft 11 in the vicinity of the tip P 1. The ring electrodes 111 a, 111 b, and 111 c are each fixedly disposed on the outer peripheral surface of the shaft 11, while the tip electrode 112 is fixedly disposed at the forefront of the shaft 11. These electrodes are electrically connected to the operation unit 12 through a plurality of conductive wires (not shown) inserted through the lumen of the shaft 11 described above. These conducting wires constitute a signal line for an inspection waveform signal Sw described later.

  Such ring-shaped electrodes 111a, 111b, 111c and the tip electrode 112 are electrically conductive, such as aluminum (Al), copper (Cu), stainless steel (SUS), gold (Au), platinum (Pt), respectively. It is comprised with the metal material with favorable property. In addition, in order to make the contrast property with respect to X-rays favorable at the time of use of the ablation catheter 1, it is preferable to be comprised with platinum or its alloy. Further, the outer diameters of the ring-shaped electrodes 111a, 111b, 111c and the tip electrode 112 are not particularly limited, but are preferably approximately the same as the outer diameter of the shaft 11 described above.

  The operation unit 12 is attached to the proximal end of the shaft 11 and includes a handle 121 (gripping unit) and a rotating plate 122.

  The handle 121 is a portion that is gripped (gripped) by an operator (doctor) when the ablation catheter 1 is used. Inside the handle 121, the various thin wires described above extend from the inside of the shaft 11.

  The rotating plate 122 is a member for performing a deflection movement operation (swing operation) that is an operation for deflecting the vicinity of the tip of the shaft 11. Specifically, here, as shown by the arrow in FIG. 2, an operation of rotating the rotating plate 122 along the rotation direction d1 is possible.

(Electrocardiogram display device 2)
The electrocardiogram display device 2 uses the above-described electrodes (ring-shaped electrodes 111a, 111b, 111c and the tip electrode 112) in the vicinity of the distal end P1 of the ablation catheter 1 and the examination waveform signal Sw (in this example, an electrocardiogram waveform, etc.) Is a device for displaying. That is, it is a monitor that displays such an inspection waveform signal Sw and outputs it to the outside, and is a so-called polygraph. The test waveform signal Sw is supplied from the ablation catheter 1 to the electrocardiogram display device 2 via the relay 5 as shown in FIG.

(Power supply 3)
The power supply device 3 is a device (high frequency generator) that supplies power (for example, output power Pout composed of radio frequency (RF)) at the time of ablation to the ablation catheter 1 and the counter electrode plate 4. The output power Pout is supplied from the power supply device 3 to the ablation catheter 1 and the counter electrode plate 4 via the relay 5 as shown in FIG. As illustrated in FIG. 1, the power supply device 3 includes an input unit 31, a power supply unit 32, a voltage measurement unit 33, a current measurement unit 34, a control unit 35, and a display unit 36.

  The input unit 31 is a part for inputting various setting values and an instruction signal for instructing a predetermined operation. Examples of various set values include set power Ps (= maximum power in output power Pout), threshold power, target temperature Tt, various standby times, and the like. These set values are input by an operator (for example, an engineer) of the power supply device 3. However, for example, the threshold power may not be input by the operator but may be set in advance in the power supply device 3 at the time of shipment of the product. Further, the set value and the instruction signal input by the input unit 31 are supplied to the control unit 35, respectively. Such an input unit 31 is configured using, for example, a predetermined dial, button, touch panel, or the like.

  The power supply unit 32 is a part that supplies the output power Pout described above to the ablation catheter 1 and the counter electrode plate 4 in accordance with a control signal CTLp described later. Such a power supply part 32 is comprised using the predetermined power supply circuit (for example, switching regulator etc.). When the output power Pout is high frequency power, the frequency is, for example, about 450 kHz to 550 kHz (for example, 500 kHz).

  The voltage measurement unit 33 is a part that measures (detects) the voltage in the output power Pout output from the power supply unit 32 as needed, and is configured using a predetermined voltage detection circuit. The voltage (measured voltage Vm) measured by the voltage measuring unit 33 in this way is output to the control unit 35.

  The current measurement unit 34 is a part that measures the current in the output power Pout output from the power supply unit 32 as needed, and is configured using a predetermined current detection circuit. The current (measured current Im) measured by the current measuring unit 34 in this way is output to the control unit 35.

  The control unit 35 is a part that controls the entire power supply device 3 and performs predetermined arithmetic processing, and is configured using, for example, a microcomputer. Specifically, the control unit 35 first has a function of calculating an actually measured power Pm (corresponding to the power value of the output power Pout) described below. Further, the control unit 35 has a function (power supply control function) for controlling the supply operation of the output power Pout in the power supply unit 32 by using the control signal CTLp.

First, the calculation function of the actually measured power Pm is as follows. That is, the control unit 35 calculates the measured power Pm as needed based on the measured voltage Vm output from the voltage measuring unit 33 and the measured current Im output from the current measuring unit 34. Specifically, the control unit 35 calculates the actually measured power Pm using the following arithmetic expression (1). The actual measurement power Pm calculated by the control unit 35 in this way is output to the display unit 36, for example.
Pm = (Vm × Im) (1)

  Next, the power supply control function described above is as follows. That is, the control unit 35 generates the control signal CTLp based on the above-described temperature measurement signal St (temperature information in the vicinity of the tip P1), and outputs the control signal CTLp to the power supply unit 32, thereby generating the output power Pout. Adjust the size (fine adjustment). Specifically, the temperature in the vicinity of the tip P1 of the shaft 11 indicated by the temperature measurement signal St (strictly speaking, a temperature measurement signal St ′ after signal amplification described later) is kept substantially constant (preferably constant). In other words, the magnitude of the output power Pout is adjusted so that this temperature is substantially equal (desirably equal) to a preset target temperature Tt.

  Specifically, the control unit 35 performs control so that the value of the output power Pout increases when the temperature near the tip P1 is equal to or lower than the target temperature Tt. On the other hand, when the temperature near the tip P1 exceeds the target temperature Tt, control is performed so that the value of the output power Pout decreases. In this manner, the actual output power Pout is supplied after appropriate power adjustment is made based on the input set power Ps.

  The display unit 36 is a part (monitor) that displays various types of information and outputs the information to the outside. Examples of the display target information include the above-described various set values (set power Ps and the like) input from the input unit 31, the actually measured power Pm supplied from the control unit 35, and the ablation catheter 1 via the relay 5 Temperature information (temperature measurement signal St ′) supplied in this manner. However, the information to be displayed is not limited to these information, and other information may be displayed instead of or in addition to other information. Such a display part 36 is comprised using the display (For example, a liquid crystal display, a CRT (Cathode Ray Tube) display, an organic EL (Electro Luminescence) display etc.) by various systems.

(Counter electrode 4)
For example, as shown in FIG. 1, the counter electrode plate 4 is used while being attached to the body surface of the patient 9 during ablation. Although details will be described later, high-frequency current is applied between the counter electrode 4 and the electrode of the ablation catheter 1 inserted into the body of the patient 9 during ablation.

(Repeater 5)
As shown in FIG. 1, the repeater 5 is a device that relays various signals and power among the ablation catheter 1, the electrocardiogram display device 2, the power supply device 3 and the counter electrode plate 4. Specifically, the relay device 5 relays the temperature measurement signal St output from the ablation catheter 1 and supplies it to the power supply device 3 as a temperature measurement signal St ′ described later. Further, the test waveform signal Sw output from the ablation catheter 1 is relayed and supplied to the electrocardiogram display device 2. The output power Pout output from the power supply device 3 is relayed and supplied to the ablation catheter 1 and the counter electrode plate 4 respectively.

  FIG. 3 schematically shows an external configuration example of the repeater 5 in a perspective view. FIG. 4 schematically shows a detailed configuration example of the repeater 5 together with a part of the ablation catheter 1.

  As shown in FIG. 3, in this example, three terminals 50 a, 50 b, and 50 c are arranged side by side on one side surface of the casing 50 in the repeater 5. Further, on the other side surface of the housing 50, one terminal 50d and a path cut-off switch 52 described later are arranged. A wiring 60a for outputting output power Pout and the like to the counter electrode plate 4 is connected to the terminal 50a. The terminal 50b is connected to a wiring 60b for outputting the output power Pout and the like to the ablation catheter 1 and inputting the temperature measurement signal St and the test waveform signal Sw from the ablation catheter 1. A wiring 60c for outputting the test waveform signal Sw and the like to the electrocardiogram display device 2 is connected to the terminal 50c. The terminal 50d is connected to a wiring 60d for outputting the temperature measurement signal St 'and the like to the power supply device 3 and inputting the output power Pout and the like from the power supply device 3.

  As shown in FIGS. 1 and 4, an amplifier 51 and a path cut-off switch 52 are provided in the repeater 5 (housing 50).

  The amplifier 51 is an amplifier that amplifies the temperature measurement signal St and outputs it as a temperature measurement signal St ′. In addition to the amplifier 51, another circuit (electric circuit such as a filter circuit) may be provided in the repeater 5.

  As shown in FIG. 4, the path cutoff switch 52 is disposed on the path between the thermocouple 113, which is a specific example of the temperature sensor described above, and the amplifier 51 (on the output path of the temperature measurement signal St). Yes. That is, in this example, the path cutoff switch 52 is arranged on the output path on the ablation catheter 1 side (near side) from the amplifier 51. In addition, the code | symbol Pj shown in FIG. 4 represents the junction of the thermocouple 113. FIG. The path cutoff switch 52 is configured to be able to shut off the output path of the temperature measurement signal St (switchable between terminals on the output path to a connected state or a non-connected state), as indicated by a dashed arrow in FIG. In this example, it has a mechanical switch structure. Further, in the present embodiment, as indicated by an arrow P2 in FIGS. 1 and 4, the path cutoff switch 52 is in an on state (the connected state, the conductive state) or an off state (the non-connected state, the cut off state). ) Can be set (switched) according to the operation of an operator (engineer or the like) of the repeater 5.

[Action / Effect]
(A. Basic operation)
In this catheter system 6, the shaft 11 of the ablation catheter 1 is inserted into the body of the patient 9 through the blood vessel when examining or treating arrhythmia or the like. At this time, according to the operation of the operation unit 12 by the operator, the shape near the tip P1 of the shaft 11 inserted into the body is deflected. Specifically, when the rotating plate 122 is rotated by the operator's finger along, for example, the rotation direction d1 indicated by the arrow in FIG. 2, an operation wire (not shown) in the shaft 11 moves to the proximal end side. Be pulled. As a result, the vicinity of the tip of the shaft 11 is curved along the direction d2 indicated by the arrow in FIG.

  Here, for example, when used for examination of arrhythmia and the like, the cardiac potential is measured using the electrodes (ring-shaped electrodes 111a, 111b, 111c and the tip electrode 112) of the ablation catheter 1 inserted into the body. Information on the electrocardiogram (examination waveform signal Sw) is supplied from the ablation catheter 1 to the electrocardiogram display device 2 via the relay 5. Then, this inspection waveform signal Sw (electrocardiogram waveform) is displayed on the electrocardiogram display device 2, and an inspection regarding the presence and degree of arrhythmia or the like at the inspection site is performed.

  In the treatment of arrhythmia and the like, power (output power Pout) at the time of ablation is supplied to the ablation catheter 1 and the counter electrode 4 from the power supply device 3 (power supply unit 32). As a result, high-frequency energization is performed between the counter electrode plate 4 mounted on the body surface of the patient 9 and the electrode of the ablation catheter 1 inserted into the body of the patient 9. By such high-frequency energization, a site to be treated (treatment part) in the patient 9 is selectively ablated, and percutaneous therapy such as arrhythmia is performed.

(B. Action of the path cutoff switch 52)
Next, the operation of the route cut-off switch 52 of the present embodiment will be described in detail while comparing with comparative examples (Comparative Examples 1 and 2).

(Comparative Example 1)
FIG. 5 is a block diagram schematically showing the overall configuration of the catheter system (catheter system 106) according to Comparative Example 1. The catheter system 106 of Comparative Example 1 corresponds to the catheter system 6 of the present embodiment in which the relay device 105 is provided instead of the relay device 5.

  In the repeater 105, unlike the repeater 5, the path cutoff switch 52 is not provided on the output path of the temperature measurement signal St. For this reason, in the comparative example 1, in the repeater 105, the noise signal Sn (electromagnetic wave or the like) generated in the circuit (the amplifier 51 or the like) may be superimposed on the inspection waveform signal Sw. Specifically, first, since the wiring of the temperature measurement signal St (for example, the thermocouple 113 described above) is connected to the circuit in the repeater 105, the noise signal Sn from this circuit is inevitably generated by the temperature measurement signal. Superposed on St. In addition, a wiring for the inspection waveform signal Sw is arranged in the vicinity of the wiring for the temperature measurement signal St. That is, for example, in the wiring 60b described above, these wirings for the temperature measurement signal St and the inspection waveform signal Sw are arranged in parallel. Therefore, in the repeater 105, the noise signal Sn is also superimposed on the inspection waveform signal Sw via the temperature measurement signal St (see the broken line arrow in FIG. 5).

  Specifically, for example, a high-frequency noise signal Sn is superimposed on the original test waveform (electrocardiogram waveform) in the comparative example 1, like the test waveform signal Sw101 shown in FIG. When the noise signal Sn is superimposed on the test waveform in this way, it is difficult to obtain (display) a good test waveform in the electrocardiogram display device 2, and the test accuracy may be lowered.

  The reason why the wiring of the inspection waveform signal Sw has to be arranged in the vicinity of the wiring of the temperature measurement signal St is, for example, for the following reason. That is, since the diameter of the shaft 11 in the ablation catheter 1 is as small as possible, there is a physical and electrical connection between the wiring of the temperature measurement signal St (the thermocouple 113 and the like) and the wiring of the inspection waveform signal Sw. This is because it is difficult to isolate (to prevent noise).

(Comparative Example 2)
Here, in order to remove the noise signal Sn superimposed in this way, for example, there is a method (referred to as Comparative Example 2) in which a filter (for example, LPF (Low Pass Filter)) is provided on the path of the inspection waveform signal Sw. Conceivable.

  However, in the inspection waveform after passing through the filter, for example, as in the inspection waveform signal Sw102 shown in FIG. 7, the rising and falling slopes of the waveform are gentle (see the dashed arrows in FIG. 7; the peak value) Decreases and the waveform becomes dull), and the inspection waveform becomes difficult to see. For this reason, the doctor's request to observe the raw test waveform (faithful to the original test waveform) cannot be met. In addition, for example, as indicated by reference numeral P102 in FIG. 7, there is a possibility that the weak signal existing in the original inspection waveform may be lost by the filtering process. For these reasons, even if the method of Comparative Example 2 is applied, the inspection accuracy may eventually decrease.

(This embodiment)
On the other hand, in the catheter system 6 of the present embodiment, as shown in FIGS. 1, 3, and 4, the output of the temperature measurement signal St output from the temperature sensor (thermocouple 113 or the like) in the ablation catheter 1 is output. A path cut-off switch 52 that can cut off the output path St is provided on the path.

  Specifically, as shown in FIG. 8A, for example, when the path cut-off switch 52 is set to the on state, the output path of the temperature measurement signal St is in a conductive state, and the temperature measurement signal St is supplied to the amplifier 51. Is done. That is, the temperature measurement is performed, and the temperature measurement signal St ′ after signal amplification is supplied to the control unit 35 in the power supply device 3.

  On the other hand, for example, as shown in FIG. 8B, when the path cutoff switch 52 is set to the OFF state, the output path of the temperature measurement signal St is cut off, and the temperature measurement signal St is not supplied to the amplifier 51. That is, the temperature measurement is stopped, and the temperature measurement signal St ′ after signal amplification is not supplied to the control unit 35 in the power supply device 3.

  By providing such a path cutoff switch 52, a noise signal Sn from a circuit (amplifier 51 or the like) connected to the output path of the temperature measurement signal St is cut off on the output path of the temperature measurement signal St. It becomes possible. That is, the generation source (the circuit) of the noise signal Sn can be disconnected from the output path of the temperature measurement signal St.

  As a result, the noise signal Sn is inspected in the repeater 5 via the output path of the temperature measurement signal St in the present embodiment, for example, as in the inspection waveform signal Sw shown in FIG. The risk of being superimposed on the waveform signal Sw is reduced or avoided. Further, unlike the comparative example 2, there is no possibility that the inspection waveform becomes dull and difficult to see, or the weak signal disappears.

  As described above, in the present embodiment, since the path cut-off switch 52 capable of blocking the output path is provided on the output path of the temperature measurement signal St output from the temperature sensor in the ablation catheter 1, the noise signal The risk of Sn being superimposed on the inspection waveform signal Sw can be reduced or avoided. Therefore, a good inspection waveform can be obtained, and the inspection accuracy can be improved.

  In addition, since the path cut-off switch 52 is provided in the repeater 5, the output path of the temperature measurement signal St can be cut off in the repeater 5. Thereby, the generation source of the noise signal Sn is limited to the path from the ablation catheter 1 to the relay 5. Therefore, the noise signal Sn can be made more difficult to be superimposed on the inspection waveform signal Sw.

  Further, the repeater 5 is provided with an amplifier 51 for amplifying the temperature measurement signal St, and the path cut-off switch 52 is arranged on the output path closer to the ablation catheter 1 than the amplifier 51. The output path can be cut off relatively on the front side. Therefore, it is possible to reduce the antenna action in the output path of the temperature measurement signal St and suppress the generation of a noise signal.

  In addition, since the on / off state of the path cut-off switch 52 can be set according to the operation of the operator of the repeater 5, for example, the timing desired by the operator according to the state of examination or treatment, etc. Thus, the output path of the temperature measurement signal St can be cut off. Therefore, it is possible to improve convenience during such examinations and treatments.

  Hereinafter, other embodiments (second to fourth embodiments) of the present invention will be described. In addition, the same code | symbol is attached | subjected to the same component as 1st Embodiment etc., and description is abbreviate | omitted suitably.

<Second Embodiment>
[Constitution]
FIG. 10 is a block diagram schematically showing an example of the entire configuration of the catheter system (catheter system 6A) according to the second embodiment. The catheter system 6A of the present embodiment corresponds to the catheter system 6 of the first embodiment provided with a relay 5A instead of the relay 5, and the other configurations are basically the same. It has become.

  FIG. 11 schematically shows a detailed configuration example of the relay 5A together with a part of the ablation catheter 1.

  As shown in FIGS. 10 and 11, the repeater 5 </ b> A has a configuration in which, in the repeater 5, the control signal CTL <b> 1 supplied from the control unit 35 in the power supply device 3 is input to the path cutoff switch 52. It has become. That is, in the repeater 5, the state of the path cutoff switch 52 is set (manual setting) according to the operation of the operator, whereas in the repeater 5A, according to the control signal CTL1 supplied from the control unit 35, The state of the path cutoff switch 52 is automatically controlled.

  Specifically, as will be described in detail below, the control unit 35 according to the present embodiment automatically turns on this path cutoff switch 52 in conjunction with the operating state of the power supply device 3 (whether or not the ablation is performed). A control signal CTL1 for setting the state or the off state is output (see the broken line arrow in FIG. 11).

[Action / Effect]
FIG. 12 is a flowchart showing an operation example of the catheter system 6A. In this catheter system 6A, first, when the operator of the power supply device 3 inputs the set power Ps and the target temperature Tt at the time of ablation from the input unit 31, these values are supplied to the control unit 35. Thus, the value is set (step S101).

  Next, the control unit 35 determines whether or not the operator sets (instructs) the start of ablation (high frequency output) from the input unit 31 (step S102). That is, it is determined whether an instruction signal for starting high-frequency output (supply of output power Pout) is input to the control unit 35 via the input unit 31.

(At the time of ablation)
Here, when the start of the high frequency output is instructed (step S102: Y), the control unit 35 outputs the control signal CTL1 so that the path cutoff switch 52 is set to the on state (step S103).

  Thereby, for example, as shown in FIG. 13A, the path cutoff switch 52 is turned on (step S104). Accordingly, the output path of the temperature measurement signal St becomes conductive, and this temperature measurement signal St is supplied to the amplifier 51. That is, the temperature measurement is secured and the execution state is established, and the temperature measurement signal St ′ after signal amplification is supplied to the control unit 35 in the power supply device 3. In this way, when the supply of the output power Pout that requires temperature measurement is stopped (at the time of ablation), the path cutoff switch 52 is set to the on state to ensure temperature measurement.

  Subsequently, the display unit 36 starts temperature display based on the temperature measurement signal St ′ thus supplied to the control unit 35 (step S105). Then, in accordance with the start instruction of the high-frequency output input in step S102, supply of the output power Pout from the power supply unit 32 to the ablation catheter 1 and the counter electrode plate 4 is started (step S106). Thereby, the ablation of the treatment portion is started based on the principle described above.

  Next, the control unit 35 determines whether or not the operator has instructed to stop the high-frequency output (ablation) from the input unit 31 (step S107). That is, it is determined whether or not an instruction signal for stopping the supply of the output power Pout is input to the control unit 35 via the input unit 31. Here, when the stop of the high-frequency output is not instructed (step S107: N), the control unit 35 controls the operation of the power supply unit 32 so as to supply the output power Pout until the stop instruction is given. To do. In step 107, after a predetermined time (or a set time input from the input unit 31 by the operator) has elapsed, the control unit 35 may automatically determine the ablation stop (so-called timer drive). ).

  On the other hand, when the stop of the high frequency output is instructed (step S107: Y), the control unit 35 controls the operation of the power supply unit 32 so that the supply of the output power Pout is stopped, thereby stopping the high frequency output. (Step S108). That is, the ablation of the treatment portion is stopped. Thereafter, the process proceeds to step S109 described below.

(When not ablation)
Here, when the start of the high frequency output is not instructed in step S102 (step S102: N), or when the above step S108 is passed, the control unit 35 performs the following operation. That is, the control unit 35 outputs the control signal CTL1 so that the path cutoff switch 52 is set to the off state (step S109).

  Thereby, for example, as illustrated in FIG. 13B, the path cutoff switch 52 is turned off (step S <b> 110). Accordingly, the output path of the temperature measurement signal St is cut off, and the temperature measurement signal St is not supplied to the amplifier 51. That is, the temperature measurement is stopped, and the temperature measurement signal St ′ after signal amplification is not supplied to the control unit 35 in the power supply device 3. As a result, the display unit 36 does not display (or stops) the temperature display based on the temperature measurement signal St ′ supplied to the control unit 35 (step S111). After that, the process proceeds to step S102 again.

  In this way, when the supply of the output power Pout is not necessarily required for temperature measurement (for example, during a period other than ablation, such as during inspection), the following occurs. That is, while the path cut-off switch 52 is set to the OFF state and the temperature measurement is stopped, the superposition of the noise signal Sn on the inspection waveform signal Sw is reduced or avoided in the same manner as in the first embodiment. A highly accurate inspection using the inspection waveform can be performed.

  As described above, in the present embodiment, the control unit 35 outputs the control signal CTL1 for automatically setting the path cutoff switch 52 to the on state or the off state in conjunction with the operation state of the power supply device 3. Therefore, in addition to the effects similar to those of the first embodiment, the following effects can be obtained. That is, since the on / off state of the path cut-off switch 52 can be automatically controlled in conjunction with the operating state of the power supply device 3, unlike the first embodiment, the operator of the repeater 5 operates each time. There is no need, and convenience can be improved.

  Also, the path cutoff switch 52 is set to the on state when the output power Pout is being supplied, and the path cutoff switch 52 is set to the off state when the supply of the output power Pout is stopped. As described above, it is possible to ensure an appropriate system operation according to the operation state of the power supply device 3.

<Third Embodiment>
[Constitution]
FIG. 14 is a block diagram schematically showing an example of the entire configuration of a catheter system (catheter system 7) according to the third embodiment. The catheter system 7 of the present embodiment corresponds to the catheter system 6 of the first embodiment provided with a relay 5B instead of the relay 5, and the other configurations are basically the same. It has become.

  The repeater 5B corresponds to the repeater 5 in which a power cut-off mechanism 53 is provided instead of the path cut-off switch 52. The power shut-off mechanism 53 has a mechanism capable of shutting off the power of the amplifier 51. For example, a switch that can cut off the power (power supply line) supplied to the amplifier 51 (a power cut-off switch for amplifier) ). The amplifier power cut-off switch has, for example, a mechanical switch structure.

  In this embodiment, as indicated by an arrow P3 in FIG. 14, the operation state of the power shut-off mechanism 53 (the power-off state of the amplifier 51) or the stopped state (the power-holding state of the amplifier 51). However, it can be set (switched) in accordance with an operation signal input in accordance with the operation of the operator of the repeater 5B. In other words, the power shut-off mechanism 53 performs the power shut-off operation of the amplifier 51 based on such an operation signal.

[Action / Effect]
By providing such a power shut-off mechanism 53, the power of the amplifier 51 can be shut off as shown in FIG. 15, for example, in the present embodiment. That is, generation of the noise signal Sn from the amplifier 51 can be prevented. As a result, the risk that the noise signal Sn is superimposed on the inspection waveform signal Sw via the output path of the temperature measurement signal St in the repeater 5B is reduced or avoided.

  As described above, in this embodiment, since the power supply of the amplifier 51 that amplifies the temperature measurement signal St can be shut off by the power shut-off mechanism 53, the possibility that the noise signal Sn is superimposed on the inspection waveform signal Sw is reduced. Or it can be avoided. Therefore, a good inspection waveform can be obtained also in this embodiment, and the inspection accuracy can be improved.

  Further, since the power shut-off mechanism 53 shuts off the power of the amplifier 51 based on the operation signal input in accordance with the operation of the operator of the repeater 5B, for example, depending on the state of examination or treatment, the operator The power supply to the amplifier 51 can be shut off at the desired timing. Therefore, it is possible to improve convenience during such examinations and treatments.

<Fourth embodiment>
[Constitution]
FIG. 16 is a block diagram schematically showing an example of the entire configuration of a catheter system (catheter system 7A) according to the fourth embodiment. The catheter system 7A according to the present embodiment corresponds to the catheter system 7 according to the third embodiment in which a relay 5C is provided instead of the relay 5B, and the other configurations are basically the same. It has become.

  The repeater 5 </ b> C has a configuration in which the control signal CTL <b> 2 supplied from the control unit 35 in the power supply device 3 is input to the power cut-off mechanism 53 in the repeater 5 </ b> B. That is, in the repeater 5B, the operation of the power shut-off mechanism 53 is controlled (manual control) based on the operation signal input according to the operation of the operator. On the other hand, in the repeater 5C, the operation of the power shut-off mechanism 53 is automatically controlled according to the control signal CTL2 supplied from the control unit 35.

  Specifically, as will be described in detail below, the control unit 35 of the present embodiment controls the control signal for automatically controlling the operation of the power shut-off mechanism 53 in conjunction with the operating state of the power supply device 3. CTL2 is output.

[Action / Effect]
FIG. 17 is a flowchart illustrating an operation example of the catheter system 7A. The operation example shown in FIG. 17 includes steps S203, S204, S209, and S210 described below in place of steps S103, S104, S109, and S110 in the operation example of the catheter system 6A shown in FIG. It corresponds to what is to be executed, and the other steps are the same. Therefore, hereinafter, steps S203, S204, S209, and S210 will be mainly described.

(At the time of ablation)
In this catheter system 7A, when the start of high-frequency output is instructed in step S102 (step S102: Y), the control unit 35 performs the following operation. That is, the control unit 35 outputs the control signal CTL2 so that the power of the amplifier 51 is maintained (so that the power cut-off operation by the power cut-off mechanism 53 is not performed) (step S203).

  Thereby, the power supply of the amplifier 51 is held (step S204). That is, the temperature measurement is secured and the execution state is established, and the temperature measurement signal St ′ after signal amplification is supplied to the control unit 35 in the power supply device 3. Thus, when the supply of the output power Pout that requires temperature measurement is stopped (at the time of ablation), the power supply of the amplifier 51 is held (maintained) to ensure temperature measurement.

(When not ablation)
On the other hand, when the start of the high frequency output is not instructed in step S102 (step S102: N), or when the above-described step S108 is performed, the control unit 35 performs the following operation. That is, the control unit 35 outputs the control signal CTL2 so that the power of the amplifier 51 is cut off (so that the power cut-off operation by the power cut-off mechanism 53 is executed) (step S209).

  As a result, for example, as shown in FIG. 18, the power of the amplifier 51 is shut off (step S210). That is, the temperature measurement is stopped, and the temperature measurement signal St ′ after signal amplification is not supplied to the control unit 35 in the power supply device 3.

  In this way, when the supply of the output power Pout is not necessarily required for temperature measurement (for example, during a period other than ablation, such as during inspection), the following occurs. That is, a good test waveform in which the superposition of the noise signal Sn on the test waveform signal Sw is reduced or avoided is performed in the same manner as in the third embodiment while the temperature of the amplifier 51 is shut off and the temperature measurement is stopped. It is possible to carry out high-precision inspections using it.

  As described above, in the present embodiment, the control unit 35 outputs the control signal CTL2 for automatically controlling the operation of the power shut-off mechanism 53 in conjunction with the operation state of the power supply device 3. Basically, in addition to the same effects as those of the third embodiment, the following effects can be obtained. That is, since the power shutoff operation of the amplifier 51 can be automatically controlled in conjunction with the operation state of the power supply device 3, unlike the third embodiment, the operator of the repeater 5C does not need to operate each time. Convenience can be improved.

  Since the power supply of the amplifier 51 is held when the supply of the output power Pout is being executed, and the power supply of the amplifier 51 is shut off when the supply of the output power Pout is stopped, as described above, Appropriate system operation according to the operating state of the power supply device 3 can be ensured.

<Modification>
Although the present invention has been described with reference to some embodiments, the present invention is not limited to these embodiments, and various modifications can be made.

  For example, the material of each member described in the above embodiment is not limited, and other materials may be used. Moreover, in the said embodiment, although the structure of the ablation catheter 1 was mentioned concretely and demonstrated, it is not necessary to necessarily provide all the members, and you may further provide other members. Specifically, for example, a leaf spring that can be deformed in the bending direction may be provided inside the shaft 11 as a swinging member. Further, the configuration of the electrodes in the shaft 11 (arrangement, shape, number, etc. of the ring-shaped electrode and the tip electrode) is not limited to that described in the above embodiment. Further, the temperature measurement mechanism (temperature sensor) disposed near the distal end P1 of the ablation catheter 1 is not limited to the thermocouple 113 described in the above embodiment, and other temperature sensors such as a thermistor may be used. Also good.

  In the above-described embodiment, the ablation catheter of the type in which the shape near the tip P1 of the shaft 11 changes in one direction according to the operation of the operation unit 12 has been described as an example. That is, the present invention can be applied to, for example, an ablation catheter of a type in which the shape of the shaft 11 near the tip P1 changes in both directions according to the operation of the operation unit 12, and in this case, the operation wire Will be used. The present invention can also be applied to an ablation catheter of a type in which the shape near the tip P1 of the shaft 11 is fixed. In this case, the operation wire, the rotating plate 122, and the like are unnecessary. Become. That is, the operation unit is configured only by the handle 121.

  Furthermore, in the above-described embodiment, the case where the amplifier 51 and the path cutoff switch 52 or the power cutoff mechanism 53 are all provided in the repeater has been described. You may make it provide the path | route interruption | blocking switch 52 and the power interruption mechanism 53 in places other than a repeater. That is, for example, the amplifier 51 and the path cutoff switch 52 or the power cutoff mechanism 53 may be provided in the power supply device 3. In that case as well, it is preferable to arrange the path cutoff switch 52 on the output path closer to the ablation catheter 1 than the amplifier 51, as in the above embodiment. In some cases, both the path cutoff switch 52 and the power cutoff mechanism 53 may be provided as the entire catheter system.

  In addition, in the above-described embodiment, the block configuration of the power supply device 3 has been specifically described, but it is not necessary to include all the blocks described in the above-described embodiment, and further include other blocks. It may be. Further, the catheter system as a whole may further include other devices in addition to the devices described in the above embodiments. Specifically, for example, a catheter system including an irrigation mechanism that allows a liquid such as physiological saline to flow when the affected area is ablated may be used. In this case, a liquid supply unit that supplies irrigation liquid to the ablation catheter is provided in a dedicated device (liquid supply device) or a power supply device (control device). In addition, the liquid supply line connecting the liquid supply unit (liquid supply device or control device) and the ablation catheter may be routed through the repeater described in the above embodiment.

  DESCRIPTION OF SYMBOLS 1 ... Ablation catheter, 11 ... Shaft, 111a, 111b, 111c ... Ring electrode, 112 ... Tip electrode, 113 ... Thermocouple, 12 ... Operation part, 121 ... Handle, 122 ... Rotary plate, 2 ... Electrocardiogram display device, 3 DESCRIPTION OF SYMBOLS ... Power supply device 31 ... Input part 32 ... Power supply part 33 ... Voltage measurement part 34 ... Current measurement part 35 ... Control part 36 ... Display part 4 ... Counter electrode plate 5, 5A, 5B, 5C ... Relay 50 ... housing, 50a, 50b, 50c, 50d ... terminal, 51 ... amplifier, 52 ... path cutoff switch, 53 ... power cutoff mechanism, 6, 6A, 7, 7A ... catheter system, 60a, 60b, 60c, 60d ... Wiring, 9 ... Patient, CTL1, CTL2, CTLp ... Control signal, Pout ... Output power, Vm ... Measured voltage, Im ... Measured current, Sw ... Test waveform signal, St, St '... Temperature measurement Nos., Pj ... junction.

Claims (10)

An ablation catheter having an electrode and a temperature sensor near the tip;
A power supply device for supplying power during ablation to the ablation catheter;
A waveform display device for displaying an inspection waveform signal measured using the electrode;
A relay that relays the temperature measurement signal output from the temperature sensor and supplies it to the power supply device, and relays the inspection waveform signal output from the electrode to supply to the waveform display device;
A catheter system comprising: a path cut-off switch provided on the output path of the temperature measurement signal and configured to cut off the output path. The catheter system according to claim 1, wherein the path cutoff switch is provided in the repeater. The repeater has an amplifier that amplifies the temperature measurement signal,
The catheter system according to claim 2, wherein the path cutoff switch is arranged on the output path closer to the ablation catheter than the amplifier. The catheter system according to any one of claims 1 to 3, wherein an on state or an off state of the path blocking switch is configured to be set according to an operation by an operator. The said power supply device outputs the control signal for setting the said path | route interruption | blocking switch to an ON state or an OFF state automatically in response to an own operation state. Catheter system. The power supply device
When executing the power supply, the control signal is output so that the path cutoff switch is set to an on state,
The catheter system according to claim 5, wherein when the power supply is stopped, the control signal is output so that the path cutoff switch is set to an off state. An ablation catheter having an electrode and a temperature sensor near the tip;
A power supply device for supplying power during ablation to the ablation catheter;
A waveform display device for displaying an inspection waveform signal measured using the electrode;
A relay for relaying a temperature measurement signal output from the temperature sensor and supplying the signal to the power supply device, and a relay for relaying the inspection waveform signal output from the electrode and supplying the waveform display device;
The repeater is
An amplifier for amplifying the temperature measurement signal;
A catheter system having a power shut-off mechanism for shutting off the power of the amplifier. The catheter system according to claim 7, wherein the power shut-off mechanism shuts off the power of the amplifier based on an operation signal input in accordance with an operation of an operator. The catheter system according to claim 7, wherein the power supply device outputs a control signal for automatically controlling the operation of the power shut-off mechanism in conjunction with its operation state. The power supply device
When performing the power supply, while outputting the control signal so that the power supply of the amplifier is held,
The catheter system according to claim 9, wherein when the power supply is stopped, the control signal is output so that the power supply of the amplifier is cut off.

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