Electrode catheter for mapping and operating on cardiac cavities

• US 5,482,037 A
• Filed: 01/13/1994
• Issued: 01/09/1996
• Est. Priority Date: 01/18/1993
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: X-Trode Sri
• Inventors: Borghi, Enzo
• Primary Examiner(s): Sykes, Angela D.
• Assistant Examiner(s): HUANG, STEPHEN D
• Application Number:
  US08/180,683
• Time in Patent Office: 726 Days
• Field of Search: 128/642, 128/657, 128/658, 128/696, 128/700, 128/635, 128/634, 606/124, 606/32, 606/47, 606/33, 606/41, 607/122, 607/125
• US Class Current: 600/381
• CPC Class Codes: A61B 1/0056 the insertion parts being asymmetric, e.g. for unilateral bending mechanisms
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/00208 actively driven, e.g. by a motor
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/6855 with a distal curved tip
• CPC Class Codes: A61B 5/6856 with a distal loop

Abstract

An electrode catheter for intravenous insertion into a cavity of the heart comprises a tubular sheath accommodating a first spiral wound wire of conductive biocompatible material, which affords an insulated operative portion exposed from the sheath and capped distally by a domed ring, and a mapping electrode of conductive biocompatible material for sensing the electrical activity in the cardiac muscle, which is carried coaxially by the first spiral wound wire and capable of movement along the operative portion transmitted by means of a second spiral wound wire extending coaxially through the first and connected to an external control handset. The operative portion of the first wire is arched by means of a tension wire designed to establish a restraint between the domed ring and the distal end of the sheath, of which the length can be increased or reduced to alter the loop of the arched profile as expedient for the shape of the cavity explored.

Claims

1. An intravenous electrode catheter for mapping and operating on cardiac cavities, the catheter comprising:

an elongate tubular outer sheath of biocompatible material, the sheath having a distal end and a proximal end;

a first elongate spiral wound wire of biocompatible and electrically conductive material, received within the tubular sheath and including a distal electrically insulated operative portion extending from the distal end of said sheath;

a first ring disposed at a fixed position on the distal end of the sheath;

a second ring disposed on the distal operative portion of the first elongate spiral wound wire;

a second signal wound wire, disposed coaxially with the first spiral wound wire;

an external operatively associated operator mechanism;

a third ring formed of an electrically conductive and biocompatible material for measuring electrical cardiac activity, the third ring being associated coaxially with the first spiral wound wire and adapted for translatory movement along the operative portion of the first spiral wound wire by means of the second spiral wound wire having at least one end attached to the third ring and remaining end that is not connected to the third ring connected to the external operatively associated operator mechanism for inducing and controlling said translatory movement of the third ring; and

altering means for altering a configuration of the operative portion of the first spiral wound wire, said means including a flexible tension element interconnecting the second ring and the distal end of the sheath, the flexible tension element being axially movable in relation to the first wire so as to control the length of the interconnection therebetween according to a cardiac cavity morphology, in such manner that the operative portion can be brought into continuous wiping contact with an interior surface of the cavity by rotating the first spiral wound wire through 360°

.

2. The electrode catheter according to claim 1, further comprising a cylindrical retaining element, a domed cap, and a third spiral wirer wherein the altering means includes a flexible tension wire anchored at one end by the cylindrical retaining element lodged within a cylindrical cavity formed in the second ring, the wire passing through a hole in the domed cap forming an integral part of the second ring, the tension wire then being directed along the sheath substantially parallel with the first spiral wound wire and accommodated within the third spiral wound wire, and the tension wire being connected on the remaining end to the external operatively associated operator mechanism.

3. The electrode catheter according to claim 2, further comprising an operator unit connected to the proximal end of the sheath for controlling movement of the first spiral wound wire, of the tension wire and of the second spiral wound wire from outside the body of a cardiac patient.

4. The electrode catheter according to claim 1, wherein

the first spiral wound wire is attached to the tubular sheath and,

the sheath, the first spiral wound wire, the second ring and the tension element are connected as a composite assembly to the external operatively associated operator mechanism in a manner as to allow their collective rotation together as a composite assembly.

5. The electrode catheter according to claim 1, further comprising an electrode movable along the operative portion of the first spiral wound wire, wherein the second spiral wound wire is accommodated slidably and coaxially within the first spiral wound wire, encased in a second sheath and connected to a worm thread rigidly associated with an internal surface of the third ring, the worm thread engaging the first spiral wound wire, such that relative angular movement between the first spiral wound wire and the second spiral wound wire produces translatory movement of an electrode along the operative portion of the first spiral wound wire.

6. The electrode catheter according to claim 5, wherein the second spiral wound wire terminates distally in an ogival head of spherical profile seated coaxially in the distal end of the second wire, the head facilitating sliding movement of the second wire internally of the first spiral wound wire when the relative angular movement between the first spiral wound wire and the second spiral wound wire occurs.

7. The electrode catheter according to claim 1, further comprising a fourth ring crimped over the first spiral wound wire, wherein the operative portion of the first spiral wound wire is fitted over a cylindrical shank defined by the second ring, the shank being secured to the first spiral wound wire by means of the fourth ring crimped over the first spiral wound wire.

8. The electrode catheter according to claim 1, wherein the third ring is substantially cylindrical and includes flat external surfaces.

9. The electrode catheter according to claim 1, wherein the third ring is substantially cylindrical and includes spherical external surfaces.

10. The electrode catheter according to claim 1, wherein the second ring is electrically active to function as a distal electrode.

11. The electrode catheter according to claim 1, wherein the first ring is electrically active to function as a proximal electrode.

12. An electrode catheter comprising:

an elongate body member having a proximal non-active portion and a distal operative portion;

a proximal electrode on a distal end of said non-active portion of the elongate body member;

a distal electrode on a distal end of said operative portion of the elongate body member; and

,

a medial electrode axially slidable along the elongate body member in said operative portion between said distal electrode and said proximal electrode.

13. The electrode catheter according to claim 12 further comprising a translating member for effecting axial slidable motion of said medial electrode in said operative portion between said distal electrode and said proximal electrode.

14. The electrode catheter according to claim 13 further comprising an external motion control device, wherein said translating member includes a first elongate member passing through said non-active portion of the elongate body member and connecting the medial electrode to the operatively associated external motion control device.

15. The electrode catheter according to claim 14 wherein:

the first elongate member is a flexibly resilient helical member; and

,

the medial electrode threadedly engages the flexibly resilient helical member.

16. The electrode catheter according to claim 15 further comprising a second elongate member connecting said medial electrode to said operatively associated external motion control device for preventing axial rotation of the medial electrode while the first elongate member is axially rotated.

17. The electrode catheter according to claim 16 further wherein said second elongate member is an electrically conductive for electrically connecting the medial electrode to an operatively associated external electric device.

18. The electrode catheter according to claim 17 wherein said first elongate member is electrically conductive for connecting said distal electrode to said operatively associated external electric device.

19. The electrode catheter according to claim 12 further comprising a translating member for effecting axial rotation of said medial electrode in said operative portion.

20. The electrode catheter according to claim 19 further comprising an external motion control device, wherein said translating member includes a first elongate member passing through said non-active portion of the elongate body member and connecting said medial electrode with the operatively associated external motion control device.

21. The electrode catheter according to claim 20 wherein said first elongate member is an electrically conductive member for electrically connecting the medial electrode to an operatively associated external electrode device.

22. The electrode catheter according to claim 12 further comprising a translating member for effecting i) axial slidable motion of said medial electrode in said operative portion between said distal electrode and said proximal electrode, and ii) axial rotation of said medial electrode in said operative portion.

23. The electrode catheter according to claim 22 further comprising an external motion control device., and wherein said translating member includes:

a first flexibly resilient helical member threadedly engaged with said medial electrode and passing through said nonactive portion of the elongate body member for connecting the medial electrode to the operatively associated external motion control device; and

,

a second member connecting said medial electrode to said operatively associated external motion control device for preventing axial rotation of the medial electrode while the first elongate member is axially rotated.

24. The electrode catheter according to claim 23 wherein said first ember is an electrically conductive member for electrically connecting the distal electrode with an operatively associated external electric device;

and,

said second member is an electrically conductive member for electrically connecting the medial electrode to said operatively associated external electric device.

25. The electrode catheter according to claim 12 further comprising an altering member for altering an axial configuration of the distal operative portion of said elongate body member.

26. The electrode catheter according to claim 25 further comprising an external motion control device, and wherein said altering member is a flexible tether connecting a distal tip of said distal electrode to the operatively associated external motion control device, the Eelher extending through said non-active portion of the elongate body member and exiting said distal end of said non-active portion to pass outside said operative portion.

27. An electrode catheter comprising:

an elongate body member having a longitudinal axis and defining a proximal non-active portion and a distal operative portion; and

,

a first electrode having an internal helical surface for engaging the elongate body member, said first electrode being axially slidable along the elongate body member in said operative portion.

28. The electrode catheter according to claim 27 further comprising an external motion control device, and a translating member for effecting axial slidable motion of said first electrode in response to the operatively associated external motion control device.

29. The electrode catheter according to claim 27 further comprising an external motion control device, a medial electrode, and a translating member for effecting axial rotation of said medial electrode in response to the operatively associated external motion control device.

30. The electrode catheter according to claim 27 further comprising an external motion control device, a medial electrode, and a translating member for effecting i) axial slidable motion of said medial electrode, and ii) axial rotation of said medial electrode, in response to the operatively associated external motion control device.

31. The electrode catheter according to claim 27 further comprising an altering member for altering an axial configuration of the distal operative portion of said elongate body member.