Accessory pathway detecting/cauterizing apparatus

• US 5,741,214 A
• Filed: 12/19/1994
• Issued: 04/21/1998
• Est. Priority Date: 12/20/1993
• Status: Expired due to Fees

• Current Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Original Assignee: Terumo Kabushiki Kaisha (Terumo Corporation)
• Inventors: Ouchi, Teruhiko, Katayama, Kunimasa
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US08/358,319
• Time in Patent Office: 1,219 Days
• Field of Search: 128/642, 128/734, 128/696, 606/41, 606/49, 607/122, 607/99, 607/2, 600/374, 600/381, 600/509, 600/547
• US Class Current: 600/374
• 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 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/00178 Electrical connectors
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2562/043 in a linear array
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/308 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/6855 with a distal curved tip
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence

Abstract

An accessory pathway detecting apparatus measures action potentials from first and second electrode leads, and outputs the obtained action potentials, as potential maps, to a CRT or a printer such that the action potentials can be displayed in the form of a list. An ablation catheter is inserted and located at a preexcitation portion obtained from the display, and the impedance between each of the electrodes of the first and second electrode leads and the electrode of the ablation catheter is measured by an impedance measuring circuit. A point where the lowest impedance is measured is regarded as an accessory pathway portion. The ablation catheter is fixed at this point.

Claims

1. An accessory pathway detecting apparatus for detecting an accessory pathway in an object to be tested, comprising:

a first electrode member having a plurality of electrodes located along a longitudinal extent of the first electrode member, said first electrode member having a wire shape capable of being inserted in a coronary sinus to acquire action potentials at a plurality of locations along the coronary sinus;

a second electrode member having a plurality of electrodes located along a longitudinal extent of said second electrode member, said second electrode member having a wire-like shape capable of being inserted in a coronary artery to acquire action potentials at a plurality of locations along the coronary artery;

measuring means for simultaneously measuring the action potentials at the plurality of locations by using said first and second electrode members; and

output means for visually outputting measurement results obtained by said measuring means.

2. The apparatus according to claim 1, wherein said output means outputs data displayed on a display on the basis of the measurement results.

3. The apparatus according to claim 1, wherein said output means outputs data printed on a recording medium by a printing unit on the basis of the measurement results.

4. The apparatus according to claim 1, wherein said output means stores data based on the measurement results in a data storage media.

5. The apparatus according to claim 1, wherein the plurality of electrodes of each of said first and second electrode members are insulated from each other and arranged at predetermined intervals on a distal end portion of each of said first and second electrode members.

6. The apparatus according to claim 1, wherein said first electrode member is in a shape of a catheter.

7. The apparatus according to claim 1, wherein said second electrode member is in a shape of a guide wire.

8. The apparatus according to claim 1, wherein said second electrode member is in a shape of a guide wire and has physical characteristics equivalent to those of a PTCA guide wire in terms of at least wire diameter and elastic force.

9. The apparatus according to claim 1, wherein said first electrode member has a diameter small enough to allow said member to be inserted in a coronary sinus, and said second electrode member has a diameter small enough to allow said member to be inserted in a coronary artery.

10. The apparatus according to claim 1, further comprising pacing means for giving an electrical stimulus to the object.

11. The apparatus according to claim 10, wherein said pacing means is adapted to be inserted in a predetermined portion in the object to give the object a stimulus pulse for an electrophysiological test.

12. The apparatus according to claim 10, wherein the measurement results obtained by said measuring means indicate a conduction time taken to conduct an electrical stimulus given by said pacing means to each electrode of said first and second electrode members.

13. An accessory pathway detecting apparatus for detecting an accessory pathway in an object to be tested, comprising:

a first electrode member having a plurality of electrodes insulated from each other and having a shape capable of being inserted in the object;

action potential measuring means for simultaneously measuring action potentials at a plurality of locations by using the plurality of electrodes of said first electrode member;

a second electrode member having a shape capable of being inserted in the object and having an electrode at a predetermined position; and

measuring means for measuring an impedance between each electrode of said first electrode member and the electrode of said second electrode member.

14. The apparatus according to claim 13, wherein said first electrode member is in a shape of a wire, and the plurality of electrodes on said first electrode member are arranged at predetermined intervals on a distal end portion of said first electrode member.

15. The apparatus according to claim 13, wherein said measuring means comprises:

selecting means for selecting at least one of the plurality of electrodes of said first electrode member,

applying means for applying a predetermined voltage between the selected electrode and the electrode of said second electrode member, and

detecting means for detecting a current generated on the basis of the applied voltage,

wherein an impedance is acquired on the basis of the predetermined voltage and the current detected by said detecting means.

16. The apparatus according to claim 15, further comprising notification means for performing notification on the basis of an impedance value obtained by said measuring means.

17. The apparatus according to claim 16, wherein said notification means notifies an impedance measured by said measuring means by means of a sound.

18. The apparatus according to claim 13, wherein said second electrode member is constituted by an ablation catheter.

19. An accessory pathway cauterizing apparatus for detecting and cauterizing an accessory pathway in an object to be tested, comprising:

a first electrode having a shape capable of being inserted in a first portion of the object and having a plurality of electrodes insulated from each other;

a second electrode having a shape capable of being inserted in a second portion of the object and having a plurality of electrodes insulated from each other;

action potential measuring means for simultaneously measuring action potentials at a plurality of locations by using the plurality of electrodes of said first and second electrode members;

an ablation catheter having an electrode arranged at a predetermined position; and

measuring means for measuring an impedance between each electrode of said first and second electrode members and the electrode of said ablation catheter.

20. The apparatus according to claim 19, wherein each of said first and second electrode members is in a shape of a wire, and the plurality of electrodes insulated from each other and used to acquire a plurality of action potentials are arranged at predetermined intervals at a distal end portion of each of said electrode members.

21. The apparatus according to claim 20, wherein said first electrode member is in a shape of a catheter.

22. The apparatus according to claim 20, wherein said second electrode member is in a shape of a guide wire.

23. The apparatus according to claim 20, wherein said second electrode member is in a shape of a guide wire and has physical characteristics equivalent to those of a PTCA guide wire in terms of at least wire diameter and elastic force.

24. The apparatus according to claim 20, wherein said first electrode member has a diameter small enough to allow said member to be inserted in a coronary sinus, and said second electrode member has a diameter small enough to allow said member to be inserted in a coronary artery.

25. The apparatus according to claim 19, wherein the electrode of said ablation catheter is arranged on a distal end portion of said ablation catheter.

26. The apparatus according to claim 19, wherein said measuring means comprises

selecting means for selecting at least one of the plurality of electrodes of said first electrode member,

applying means for applying a predetermined voltage between the selected electrode and the electrode of said ablation catheter, and

detecting means for detecting a current generated on the basis of the applied voltage,

wherein an impedance is acquired on the basis of the predetermined voltage and the current detected by said detecting means.

27. The apparatus according to claim 26, further comprising notification means for performing notification on the basis of an impedance value obtained by said measuring means.

28. The apparatus according to claim 27, wherein said notification means notifies an impedance measured by said measuring means by means of a sound.

29. An accessory pathway detecting apparatus for detecting an accessory pathway in a heart to be tested, comprising:

a first electrode member having a plurality of electrodes located along a longitudinal extent of said first electrode member and insulated from each other, said first electrode member being in a shape of a wire and being capable of being inserted in a coronary sinus of the heart;

a second electrode member having a plurality of electrodes located along a longitudinal extent of the second electrode member and insulated from each other, said second electrode member being in the shape of a wire and being capable of being inserted in a coronary artery of the heart;

a third electrode member having a shape capable of being inserted in the heart and having an electrode at a predetermined position;

first measuring means for simultaneously measuring action potentials at a plurality of locations by using said first and second electrode members;

output means for visually outputting results obtained by said first measuring means; and

second measuring means for measuring an impedance between each of the electrodes of said first and second electrode members and the electrode of said third electrode member.

30. An accessory pathway detecting apparatus for detecting and cauterizing an accessory pathway in an object to be tested, comprising:

a first electrode member having a plurality of electrodes located along a longitudinal extent of the first electrode member and insulated from each other, said first electrode member being in a shape of a wire and being capable of being inserted in a coronary sinus of the heart;

a second electrode member having a plurality of electrodes located along a longitudinal extent of the second electrode member and insulated from each other, said second electrode member being in a shape of a wire and being capable of being inserted in a coronary artery of the heart;

an ablation catheter having a shape capable of being inserted in the heart and having an electrode at a predetermined position;

first measuring means for simultaneously measuring action potentials at pluralities of locations by using said first and second electrode members;

output means for visually outputting results obtained by said first measuring means such that the results are displayed in the form of a list; and

second measuring means for measuring an impedance between each of the electrodes of said first and second electrode members and the electrode of said ablation catheter.

31. The apparatus according to claim 30, wherein said ablation catheter has an electrode for generating an electrical stimulus, and

the measurement results obtained by said first measuring means indicate a conduction time taken to conduct an electrical stimulus generated by said ablation catheter to a position of each electrode of said first and second electrode members.

32. The method of detecting an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in a coronary sinus of a heart, said first electrode member being in a shape of a wire and having a plurality of electrodes located along a longitudinal extent of the first electrode member, said first electrode member being adapted to acquire action potentials at a plurality of locations along the coronary sinus;

inserting a second electrode member in a coronary artery of the heart, said second electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the second electrode member, said second electrode member being adapted to acquire action potentials at a plurality of locations along the coronary artery;

simultaneously measuring the action potentials at the plurality of locations by using said first and second electrode members; and

visually outputting measurement results obtained in said measuring step.

33. The method according to claim 32, further comprising the step of inserting a third electrode member in the heart, said third electrode member having an electrode for giving an electrical stimulus to the object.

34. A method of detecting an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in the object, said first electrode member having a plurality of electrodes insulated from each other;

simultaneously measuring action potentials at a plurality of locations by using the plurality of electrodes of said first electrode member;

inserting a second electrode member in the object;

said second electrode member having an electrode at a predetermined position; and

measuring an impedance between each of the electrodes of said first electrode member and the electrode of said second electrode member.

35. A method of detecting and cauterizing an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in a first portion of the object, said first electrode member having a plurality of electrodes insulated from each other;

inserting a second electrode member in a second portion of the object, said second electrode member having a plurality of electrodes insulated from each other;

simultaneously measuring action potentials at a plurality of locations by using the plurality of electrodes of said first and second electrode members;

inserting an ablation catheter having an electrode arranged at a predetermined position into the object and measuring an impedance between each of the electrodes of said first and second electrode members and the electrode of said ablation catheter; and

specifying an accessory pathway portion on the basis of measurement results of the impedances, and cauterizing the accessory pathway portion by using said ablation catheter.

36. The method according to claim 35, wherein the first portion is a coronary sinus, and the second portion is a coronary artery.

37. A method of detecting an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in a coronary sinus of a heart, said first electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the first electrode member and insulated from each other;

inserting a second electrode member in a coronary artery of the heart, said second electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the second electrode member and insulated from each other;

simultaneously measuring action potentials at a plurality of locations of the coronary sinus and coronary artery by using said first and second electrode members;

visually outputting measurement results obtained in said measuring step so that an accessory pathway portion can be recognized by the output;

inserting a third electrode member having an electrode into the heart to a position near the recognized accessory pathway portion; and

specifying the accessory pathway portion by measuring an impedance between an electrode, of the electrodes of said first and second electrode members, located near the recognized accessory pathway portion and the electrode of said third electrode member.

38. A method of detecting and cauterizing an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in a coronary sinus of a heart, said first electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the first electrode member and insulated from each other;

inserting a second electrode member in a coronary artery of the heart, said second electrode member having a wire shape and plurality of electrodes located along a longitudinal extent of the second electrode member and insulated from each other;

simultaneously measuring action potentials at a plurality of locations along the coronary sinus and coronary artery by using said first and second electrode members;

visually outputting measurement results so that an accessory pathway portion in the heart can be recognized on the basis of the output;

inserting and locating an ablation catheter at the accessory pathway portion, said ablation catheter having an electrode at a predetermined position;

measuring an impedance between each of the electrodes of said first and second electrode members and the electrode of said ablation catheter, thereby detecting the accessory pathway portion accurately and fixing said ablation catheter; and

cauterizing the accessory pathway portion by using said ablation catheter.

39. A method of detecting and cauterizing an accessory pathway in an object to be tested, comprising the steps of:

inserting a first electrode member in a coronary sinus of a heart, said first electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the first electrode member and insulated from each other;

inserting a second electrode member in a coronary artery of the heart, said second electrode member having a wire shape and a plurality of electrodes located along a longitudinal extent of the second electrode member and insulated from each other;

inserting an ablation catheter in the heart, said ablation catheter having an electrode for generating a stimulus pulse and performing impedance measurement;

measuring a conduction time of a stimulus pulse generated by said catheter by simultaneously measuring action potentials at a plurality of locations along the coronary artery and the coronary sinus by using said first and second electrode members;

visually outputting measurement results so that an accessory pathway portion of the heart can be recognized on the basis of the output;

moving said ablation catheter to the accessory pathway portion of the heart;

measuring an impedance between each of the electrodes of said first and second electrode members and the electrode of said ablation catheter, thereby detecting the accessory pathway portion accurately and fixing said ablation catheter; and

cauterizing the accessory pathway portion by using said ablation catheter.