Myocardial deep origin ventricular stage precontraction epicardial excitation ablation device and method

Abstract

The invention provides a myocardial deep origin ventricular stage preconstriction epicardium excitation ablation device and method.The device comprises an adjustable bending sheath tube assembly, a mapping ablation assembly and an ablation needle assembly, the near end of the adjustable bending sheath tube assembly is used for being operated by a user, and the far end of the adjustable bending sheath tube assembly is used for stretching into coronary veins; the mapping and ablation assembly is arranged on the adjustable bending sheath tube assembly in a penetrating mode, the mapping and ablation assembly can move in the axial direction of the adjustable bending sheath tube assembly and penetrate out of the far end of the adjustable bending sheath tube assembly, and the mapping and ablation assembly is used for conducting mapping and thermal ablation on coronary veins; the ablation needle assembly is installed at the far end of the mapping ablation assembly in a telescopic mode and used for conducting chemical ablation on coronary veins. According to the device, an adjustable bending sheath tube assembly, a mapping ablation assembly and an ablation needle assembly for pushing and injecting anhydrous alcohol are combined, so that after thermal ablation is invalid, the anhydrous alcohol is injected through an ablation needle for chemical ablation. Operation is simple, operation time and risks are reduced, and operation efficiency is improved.

Description

Technical Field

[0001] The present invention relates to the technical field of medical devices, and in particular to a device and method for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium. Background Art

[0002] This section merely provides background information related to the present disclosure and is not necessarily prior art.

[0003] Premature ventricular contraction is one of the main arrhythmia diseases. Radiofrequency ablation is the main treatment method. Through excitation mapping, the origin of abnormal excitation is found and catheter ablation is performed to restore normal heart rhythm. Some premature ventricular contractions originate deep in the heart. Due to the limitations of thermal radiofrequency ablation, the endocardial ablation energy often cannot reach the deep myocardium. Traditional endocardial ablation cannot eliminate the origin of excitation in the deep myocardium and achieve the purpose of treatment.

[0004] Reaching the distal end of the blood vessel through the coronary sinus may be closer to the target of ablation. Because the distal blood vessels are thin, the ablation catheter often cannot enter the target for radiofrequency ablation. In clinical practice, chemical ablation with anhydrous alcohol is believed to be able to infiltrate the deep myocardium to achieve the purpose of treatment. However, because there are many branches of the anterior interventricular vein at the distal end of the coronary vein and the adjacent structures are complex, chemical ablation with anhydrous alcohol often has certain risks. In addition, due to the lack of professional equipment, most of the current coronary intervention guidance catheters should enter the distal end of the coronary vein, and with the assistance of a microcatheter, the guide wire is inserted into the anterior interventricular vein and its branches. The tail end of the guide wire is clamped by an alligator clamp to display electrophysiological signals on the system, and the activation mapping is performed to identify the earliest target blood vessel. Then, the OTW balloon is sent in with the help of the guide wire, and the opening of the target blood vessel is blocked and anhydrous alcohol is given for chemical ablation. The mapping method using the alligator clamp is a monopolar mapping method and cannot be compared at multiple points under a three-dimensional system, so the accuracy of the mapping is poor. It is time-consuming and the replacement and adjustment of different instruments through the guiding catheter is inefficient and there are some risks. Summary of the invention

[0005] The purpose of the present invention is to at least solve the limitations of existing thermal ablation of ventricular premature contractions originating from deep myocardium and the low efficiency and high risk of epicardial ablation. This purpose is achieved through the following technical solutions:

[0006] The first aspect of the present invention provides a device for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium, comprising:

[0007] An adjustable sheath tube assembly, wherein the proximal end of the adjustable sheath tube assembly is used for operation by a user, and the distal end of the adjustable sheath tube assembly is used for extending into a coronary vein;

[0008] A mapping and ablation component is inserted into the adjustable sheath tube component, the mapping and ablation component can move along the axial direction of the adjustable sheath tube component and pass out from the distal end of the adjustable sheath tube component, and the mapping and ablation component is used for mapping and thermal ablation of the coronary veins;

[0009] The ablation needle assembly is installed at the distal end of the mapping and ablation assembly in a telescopic manner and is used for chemical ablation of the coronary vein.

[0010] The first aspect of the present invention proposes an epicardial ablation device for ventricular premature contractions of deep myocardial origin that combines an adjustable curved sheath assembly, a mapping ablation assembly, and an ablation needle assembly for injecting anhydrous alcohol. It can be smoothly delivered to the distal end of a blood vessel, and enter small blood vessels at different distal ends through the mapping ablation assembly to perform excitation mapping to find ablation targets and target blood vessels. After mapping, the mapping ablation assembly seamlessly performs thermal radiofrequency ablation on the target blood vessel. When thermal ablation is ineffective, chemical ablation is performed by injecting anhydrous alcohol through the ablation needle assembly. The epicardial ablation device for ventricular premature contractions of deep myocardial origin conforms to the anatomical structure, is easy to operate, and can enter the distal end of the blood vessel without much operation. The combination of mapping, thermal ablation, and chemical ablation avoids repeated delivery of instruments, reduces operation time and risks, and improves surgical efficiency.

[0011] In some embodiments of the present invention, the deep myocardial origin ventricular premature contraction epicardial excitation ablation device also includes a guide wire, the proximal end of the guide wire is used for user operation, the adjustable bend sheath assembly is slidably connected to the guide wire, and the adjustable bend sheath assembly can move along the guide wire to the distal end of the guide wire.

[0012] In some embodiments of the present invention, the adjustable bending sheath tube assembly comprises:

[0013] Handlebars;

[0014] An adjustable bending sheath tube coaxially connected to the distal end of the handle;

[0015] The first bending adjustment component includes a first bending adjustment wire and a first bending adjustment knob. The first bending adjustment knob is rotatably arranged on the handle portion. The first bending adjustment wire is arranged in the adjustable bending sheath tube and can move axially along the adjustable bending sheath tube. The two ends of the first bending adjustment wire are respectively fixedly connected to the first bending adjustment knob and the distal end of the adjustable bending sheath tube. Along the radial direction of the adjustable bending sheath tube, the first bending adjustment component is used to drive the distal end of the adjustable bending sheath tube to bend in a first direction.

[0016] In some embodiments of the present invention, the adjustable bending sheath tube assembly also includes a second bending adjustment assembly, the second bending adjustment assembly includes a second bending adjustment wire and a second bending adjustment knob, the second bending adjustment knob is rotatably arranged on the handle portion, the second bending adjustment wire is passed through the adjustable bending sheath tube and can move axially along the adjustable bending sheath tube, the two ends of the second bending adjustment wire are respectively fixedly connected to the second bending adjustment knob and the distal end of the adjustable bending sheath tube, and along the radial direction of the adjustable bending sheath tube, the second bending adjustment assembly is used to drive the distal end of the adjustable bending sheath tube to bend in a direction away from the first direction.

[0017] In some embodiments of the present invention, the mapping and ablation assembly comprises:

[0018] handle part;

[0019] a catheter portion, coaxially connected to the distal end of the handle portion;

[0020] A plurality of electrodes are arranged on the outer peripheral surface of the catheter portion, and the electrodes are used for mapping and thermally ablating the coronary veins.

[0021] In some embodiments of the present invention, the mapping and ablation component also includes a third bending adjustment component, which includes a third bending adjustment wire and a third bending adjustment knob, the third bending adjustment knob is rotatably arranged on the handle portion, the third bending adjustment wire is arranged in the catheter portion in a manner that can move axially along the catheter portion, and both ends of the third bending adjustment wire are fixedly connected to the third bending adjustment knob and the distal end of the catheter portion, respectively.

[0022] In some embodiments of the present invention, the ablation needle assembly comprises:

[0023] Ablation needle;

[0024] The ethanol injection channel is sequentially arranged in the adjustable bending sheath assembly and the mapping and ablation assembly. The distal end of the ethanol injection channel is connected to the ablation needle. The proximal end of the ethanol injection channel is arranged on the handle and has an injection port for injecting ethanol.

[0025] In some embodiments of the present invention, the ablation needle assembly further comprises:

[0026] Propulsion wire;

[0027] The advancement adjustment slider is slidably arranged on the handle portion, and the two ends of the advancement wire are respectively connected to the ablation needle and the advancement adjustment slider, and the advancement adjustment slider is used to adjust the length of the ablation needle extending out of the mapping and ablation component.

[0028] In some embodiments of the present invention, the deep myocardial origin ventricular premature contraction epicardial excitation ablation device also includes a balloon and an inflation tube, the balloon is installed at the distal end of the mapping and ablation component, one end of the inflation tube is connected to the balloon, and the other end of the inflation tube is located at the proximal end of the adjustable bend sheath tube component and is used to supply gas to enter, and the part between the two ends of the inflation tube is fixed to the adjustable bend sheath tube component.

[0029] The second aspect of the present invention provides a method for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium, which is implemented by the ablation device for epicardial excitation of ventricular premature contraction originating from deep myocardium provided by the first aspect of the present invention. The method for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium includes the following steps:

[0030] A guide wire is passed through the femoral vein into the right atrium;

[0031] The adjustable curved sheath tube assembly is delivered into the coronary vein under the guidance of the guide wire.

[0032] Adjusting the direction of the adjustable curved sheath assembly and delivering the mapping and ablation assembly into the coronary vein;

[0033] adjusting the position of the mapping and ablation component;

[0034] mapping and thermally ablating the coronary veins by means of the mapping and ablation component;

[0035] re-mapping the coronary veins;

[0036] According to the presence of premature beat signals in the coronary vein, chemical ablation is performed on the coronary vein through the ablation needle assembly.

[0037] The second aspect of the present invention proposes a method for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium, which combines an adjustable curved sheath assembly, a mapping ablation assembly, and an ablation needle assembly for injecting anhydrous alcohol. It can be smoothly delivered to the distal end of a blood vessel, and enter small blood vessels at different distal ends through the mapping ablation assembly to perform excitation mapping to find ablation targets and target blood vessels. After mapping, the mapping ablation assembly seamlessly performs thermal radiofrequency ablation in the target blood vessel. When thermal ablation is ineffective, chemical ablation is performed by injecting anhydrous alcohol through the ablation needle assembly. The device for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium conforms to the anatomical structure, is easy to operate, and can enter the distal end of the blood vessel without much operation. The combination of mapping, thermal ablation, and chemical ablation avoids repeated delivery of instruments, reduces operation time and risks, and improves surgical efficiency. BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Various other advantages and benefits will become apparent to those of ordinary skill in the art by reading the detailed description of the preferred embodiments below. The accompanying drawings are only for the purpose of illustrating the preferred embodiments and are not to be considered as limiting the present invention. Moreover, the same reference numerals are used throughout the accompanying drawings to represent the same components. In the accompanying drawings:

[0039] Figure 1 The schematic diagram of the structure of the device for ablation of ventricular premature contraction epicardial activation originating from deep myocardium according to an embodiment of the present invention is shown schematically;

[0040] Figure 2 The schematic diagram of the structure of the device for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium (ablation needle contraction) according to an embodiment of the present invention is schematically shown;

[0041] Figure 3 The structure diagram of the adjustable bending sheath tube assembly according to the embodiment of the present invention is schematically shown;

[0042] Figure 4 The structure diagram of the mapping and ablation assembly according to the embodiment of the present invention is schematically shown;

[0043] Figure 5 The cross-sectional structure diagram of the adjustable bending sheath tube is schematically shown;

[0044] Figure 6 The schematic diagram shows the adjustable curved sheath assembly entering the coronary sinus through the guide wire;

[0045] Figure 7 The diagram schematically shows a mapping and ablation component entering the deep part of a coronary vein through an adjustable curved sheath component;

[0046] Figure 8 Schematic diagram of chemical ablation of epicardial activation of ventricular premature contraction originating from deep myocardium by ablation device;

[0047] The reference numerals are as follows:

[0048] 100, right atrium; 200, right ventricle; 300, left atrium; 400, left ventricle; 500, coronary sinus; 600, coronary vein;

[0049] 10. Adjustable bending sheath tube assembly; 11. Handle; 12. Adjustable bending sheath tube; 121. First tube cavity; 122. Second tube cavity; 123. Third tube cavity; 13. First bending adjustment wire; 14. First bending adjustment knob; 15. Second bending adjustment wire; 16. Second bending adjustment knob; 17. Push injection hole;

[0050] 20. Mapping and ablation assembly; 21. Handle; 22. Catheter; 23. Electrode; 24. Third bending knob;

[0051] 30. ablation needle assembly; 31. ablation needle; 32. ethanol injection channel;

[0052] 40. Guide wire;

[0053] 50. Balloon. DETAILED DESCRIPTION

[0054] The exemplary embodiments of the present disclosure will be described in more detail below with reference to the accompanying drawings. Although the exemplary embodiments of the present disclosure are shown in the accompanying drawings, it should be understood that the present disclosure can be implemented in various forms and should not be limited by the embodiments described herein. On the contrary, these embodiments are provided in order to enable a more thorough understanding of the present disclosure and to fully convey the scope of the present disclosure to those skilled in the art.

[0055] It should be understood that the terms used herein are only for the purpose of describing specific example embodiments and are not intended to be limiting. Unless the context clearly indicates otherwise, the singular forms "one", "an" and "said" as used herein may also be meant to include plural forms. The terms "include", "comprise", "contain", and "have" are inclusive, and therefore specify the existence of stated features, steps, operations, elements and / or parts, but do not exclude the existence or addition of one or more other features, steps, operations, elements, parts, and / or combinations thereof. The method steps, processes, and operations described herein are not interpreted as necessarily requiring them to be performed in the specific order described or illustrated, unless the execution order is clearly indicated. It should also be understood that additional or alternative steps may be used.

[0056] Although the terms first, second, third, etc. can be used in the text to describe multiple elements, components, regions, layers and / or sections, these elements, components, regions, layers and / or sections should not be limited by these terms. These terms can only be used to distinguish an element, component, region, layer or section from another region, layer or section. Unless the context clearly indicates, terms such as "first", "second" and other numerical terms do not imply order or sequence when used in the text. Therefore, the first element, component, region, layer or section discussed below can be referred to as the second element, component, region, layer or section without departing from the teaching of the example embodiments.

[0057] For ease of description, spatial relative terms may be used herein to describe the relationship of one element or feature relative to another element or feature as shown in the figure, such as "inside", "outside", "inner side", "outer side", "below", "below", "above", "above", etc. Such spatial relative terms are intended to include different orientations of the device in use or operation in addition to the orientation depicted in the figure. For example, if the device in the figure is turned over, then the elements described as "below other elements or features" or "below other elements or features" will subsequently be oriented as "above other elements or features" or "above other elements or features". Therefore, the example term "below..." can include both upper and lower orientations. The device can be oriented otherwise (rotated 90 degrees or in other directions) and the spatial relative descriptors used in the text are interpreted accordingly.

[0058] like Figures 1 to 8 As shown, the first aspect of the present invention proposes a device for ablation of ventricular premature contractions of epicardial excitation originating from deep myocardium, comprising an adjustable sheath assembly 10, a mapping and ablation assembly 20, and an ablation needle assembly 30. The proximal end of the adjustable sheath assembly 10 is used for user operation, and the distal end of the adjustable sheath assembly 10 is used to extend into the coronary vein 600. The mapping and ablation assembly 20 is inserted into the adjustable sheath assembly 10, and the mapping and ablation assembly 20 can move along the axial direction of the adjustable sheath assembly 10 and pass through the distal end of the adjustable sheath assembly 10. The mapping and ablation assembly 20 is used to map and thermally ablate the coronary vein 600. The ablation needle assembly 30 is installed at the distal end of the mapping and ablation assembly 20 in a telescopic manner, and is used to chemically ablate the coronary vein 600.

[0059] It can be understood that a part of the coronary sinus 500 is located between the right atrium 100 and the right ventricle 200, and another part of the coronary sinus 500 is located between the left atrium 300 and the left ventricle 400. The adjustable sheath tube assembly 10 may include at least one adjustable sheath tube 12. The adjustable sheath tube 12 is a hollow tubular structure, and the interior of the adjustable sheath tube 12 can be used for the mapping and ablation assembly 20 and the guide wire 40 to pass through. The interior of the adjustable sheath tube 12 has an adjustment wire, one end of the adjustment wire is fixedly connected to the distal end of the adjustable sheath tube 12, and the other end is located at the proximal end of the adjustable sheath tube 12, and is fixedly connected to an adjustment button movably arranged at the proximal end of the adjustable sheath tube 12. When the user moves the adjustment button, the adjustment wire can be pulled, and the distal end of the adjustable sheath tube 12 is driven to bend, so that it adapts to the direction of the blood vessel and is smoothly delivered to the distal end of the blood vessel without damaging the inner wall of the blood vessel. The mapping and ablation assembly 20 is a catheter-type structure with an electrode 23. The mapping and ablation assembly 20 is inserted into the adjustable bending sheath tube 12. When the adjustable bending sheath tube 12 moves to the distal end of the blood vessel, the mapping and ablation assembly 20 is sent into the blood vessel through the inner cavity of the adjustable bending sheath tube 12, and the distal end of the blood vessel is mapped by the electrode 23 to find out the

[0060] The first aspect of the present invention proposes an epicardial ablation device for ventricular premature contractions of deep myocardial origin, which combines an adjustable curved sheath tube assembly 10, a mapping ablation assembly 20, and an ablation needle assembly 30 for injecting anhydrous alcohol. It can be smoothly delivered to the distal end of a blood vessel, and enter small blood vessels at different distal ends through the mapping ablation assembly 20 to perform excitation mapping to find ablation targets and target blood vessels. After mapping, the mapping ablation assembly 20 seamlessly performs thermal radiofrequency ablation on the target blood vessel. When thermal ablation is ineffective, chemical ablation is performed by injecting anhydrous alcohol through the ablation needle assembly 30. The epicardial ablation device for ventricular premature contractions of deep myocardial origin conforms to the anatomical structure and is easy to operate. It can enter the distal end of the blood vessel without much operation. The combination of mapping, thermal ablation, and chemical ablation avoids repeated delivery of instruments, reduces operation time and risks, and improves surgical efficiency.

[0061] In some embodiments of the present invention, the deep myocardial origin ventricular premature contraction epicardial excitation ablation device also includes a guide wire 40, the proximal end of the guide wire 40 is used for user operation, the adjustable bend sheath assembly 10 is slidably connected to the guide wire 40, and the adjustable bend sheath assembly 10 can move along the guide wire 40 to the distal end of the guide wire 40.

[0062] It can be understood that the function of the guide wire 40 is to be delivered into the coronary vein 600 before the adjustable sheath tube assembly 10. The guide wire 40 is made of a relatively soft metal wire material or a polymer compound material, and the distal end is relatively soft. It can be delivered to the coronary vein 600 via the femoral vein during surgery, and serves as a guide path for the adjustable sheath tube assembly 10, so that after the guide wire 40 is in place, the adjustable sheath tube assembly 10 is slid along the guide wire 40 to the coronary vein 600. The assembly relationship between the guide wire 40 and the adjustable sheath tube 12 can be achieved by the guide wire 40 being built in or the guide wire 40 being passed through, that is, the guide wire 40 can be passed through the adjustable sheath tube 12 to achieve the assembly of the two. The adjustable sheath tube 12 is provided with a sliding cavity for the guide wire 40 to pass through. The guide wire 40 is passed through the sliding cavity, and the adjustable sheath tube 12 can slide along the guide wire 40 to the coronary vein 600. A plurality of fixing parts can also be set axially on the adjustable bending sheath tube 12, and the guide wire 40 is slidably connected to the plurality of fixing parts in sequence to realize the connection between the guide wire 40 and the adjustable bending sheath tube 12. The fixing part can have a C-shaped notch or a perforation for the guide wire 40 to pass through.

[0063] In some embodiments of the present invention, the adjustable bending sheath tube assembly 10 includes a handle portion 11, an adjustable bending sheath tube 12 and a first bending adjustment assembly. The adjustable bending sheath tube 12 is coaxially connected to the distal end of the handle portion 11. The first bending adjustment assembly includes a first bending adjustment wire 13 and a first bending adjustment knob 14. The first bending adjustment knob 14 is rotatably arranged on the handle portion 11. The first bending adjustment wire 13 is arranged in the adjustable bending sheath tube 12 and can move axially along the adjustable bending sheath tube 12. The two ends of the first bending wire 13 are fixedly connected to the first bending adjustment knob 14 and the distal end of the adjustable bending sheath tube 12 respectively. Along the radial direction of the adjustable bending sheath tube 12, the first bending adjustment assembly is used to drive the distal end of the adjustable bending sheath tube 12 to bend in a first direction.

[0064] It can be understood that the handle portion 11 can be a tubular structure with a cavity inside, and the adjustable bending sheath tube 12 is also a tubular structure with a cavity inside. The adjustable bending sheath tube 12 is coaxially connected to the handle portion 11, and one axial end of the adjustable bending sheath tube 12 can be fixedly connected to the handle portion 11 by means of a snap connection or a screw connection. The adjustable bending sheath tube 12 is a flexible tube and can be made of a tube body woven with steel wire to facilitate bending under the traction of the first bending wire 13. The first bending knob 14 can be coaxially arranged with the handle 11, and part of the first bending knob 14 is located inside the handle 11, and the part is connected to one end of the first bending wire 13, and the other part of the first bending knob 14 protrudes from the handle 11 to facilitate the operator to turn it, and the other end of the first bending wire 13 is fixedly connected to the distal end of the adjustable bending sheath tube 12, so that when the operator turns the first bending knob 14, the first bending knob 14 rolls up the first bending wire 13, and then pulls the distal end of the adjustable bending sheath tube 12 to bend. According to the bending direction of the blood vessel, the rotation angle of the first bending knob 14 can be controlled under the cooperation of positioning monitoring equipment such as extracorporeal ultrasound, and then the bending degree of the adjustable bending sheath tube 12 can be controlled, so that its bending degree adapts to the direction of the blood vessel. When the first bending knob 14 is rotated in the opposite direction, the first bending wire 13 can be restored to its original direction.

[0065] In some embodiments of the present invention, the adjustable bending sheath tube assembly 10 also includes a second bending adjustment assembly, which includes a second bending adjustment wire 15 and a second bending adjustment knob 16. The second bending adjustment knob 16 is rotatably arranged on the handle portion 11. The second bending adjustment wire 15 is passed through the adjustable bending sheath tube 12 and can move axially along the adjustable bending sheath tube 12. The two ends of the second bending adjustment wire 15 are respectively fixedly connected to the second bending adjustment knob 16 and the distal end of the adjustable bending sheath tube 12. Along the radial direction of the adjustable bending sheath tube 12, the second bending adjustment assembly is used to drive the distal end of the adjustable bending sheath tube 12 to bend in a direction away from the first direction.

[0066] It can be understood that in order to improve the adaptability of the adjustable bending sheath tube 12 to the direction of the blood vessel, the adjustable bending sheath tube 12 is designed as a bidirectional adjustable bending sheath tube 12 by setting a second bending adjustment component. Specifically, the second bending adjustment component includes a second bending adjustment wire 15 for pulling the adjustable bending sheath tube 12 and a second bending adjustment knob 16 for winding the wire. The second bending adjustment knob 16 can be coaxially arranged with the handle portion 11. The second bending adjustment knob 16 is located between the first bending adjustment knob 14 and the proximal end of the adjustable bending sheath tube 12, and part of the second bending adjustment knob 16 is located inside the handle portion 11. The part is connected to one end of the second bending adjustment wire 15, and the other part of the second bending adjustment knob 16 protrudes from the handle portion 11 to facilitate the operator to turn it. The other end of the second bending adjustment wire 15 is fixedly connected to the distal end of the adjustable bending sheath tube 12, and the connection position is spaced from the distal end of the first bending adjustment wire 13, so that when the operator turns the second bending adjustment knob 16, the second bending adjustment knob 16 The second bending knob 16 rolls up the second bending wire 15, and then pulls the distal end of the adjustable bending sheath tube 12 to bend. According to the bending direction of the blood vessel, the first bending knob 14 can be controlled to rotate at a certain angle under the cooperation of positioning monitoring equipment such as in vitro ultrasound, so that the distal end of the adjustable bending sheath tube 12 is bent to a certain extent, and then the second bending knob 16 is controlled to rotate at a further angle, so that the distal end of the adjustable bending sheath tube 12 is further bent at a position closer to the end, so that the adjustable bending sheath tube 12 is bent in an S shape, so that the bending degree of the adjustable bending sheath tube 12 is more adapted to the direction of the blood vessel. When the second bending knob 16 is rotated in the opposite direction, the second bending wire 15 can be restored to its original direction.

[0067] In some embodiments of the present invention, the mapping and ablation assembly 20 includes a handle portion 21, a catheter portion 22 and a plurality of electrodes 23. The catheter portion 22 is coaxially connected to the distal end of the handle portion 21. The plurality of electrodes 23 are arranged on the outer peripheral surface of the catheter portion 22. The electrodes 23 are used for mapping and thermally ablating the coronary vein 600.

[0068] It can be understood that another cavity independent of the cavity for inserting the guide wire 40 or the first bending wire 13 and the second bending wire 15 can be set in the adjustable bending sheath tube 12 to facilitate the insertion of the catheter portion 22 of the mapping and ablation component 20. The function of the mapping and ablation component 20 is to map the inside of the heart through the electrode 23, and after mapping, the target area is thermally ablated by the discharge of the electrode 23 to treat abnormal points of deep premature beats of the heart. Specifically, the catheter portion 22 is a tubular structure, and a plurality of electrodes 23 can be installed on the outer surface of the distal end of the catheter portion 22. The electrodes 23 can be distributed in a dotted manner on the outer surface of the catheter portion 22, or can be arranged in a ring shape around the axis of the catheter portion 22, and a plurality of electrodes 23 can be arranged at intervals along the axial direction of the catheter portion 22. The catheter portion 22 and the handle portion 21 can be coaxially arranged, and the catheter portion 22 is located inside the adjustable bending sheath tube 12. At least part of the handle portion 21 is located inside the handle portion 11. When in use, the handle portion 21 can be pushed to slide the catheter portion 22 along the axial direction of the adjustable bending sheath tube 12 and pass through the distal end of the adjustable bending sheath tube 12. During mapping, the electrode 23 moves to the coronary vein 600 through the adjustable bending sheath tube 12, and the electrode 23 is electrically connected to the electrocardiograph. When the heart muscle cells contract and relax, electrical signals are generated. These electrical signals can be captured by the electrode 23 and transmitted to the electrocardiograph for recording and analysis, thereby determining whether the patient has heart disease.

[0069] In some embodiments of the present invention, the mapping and ablation component 20 also includes a third bending adjustment component, which includes a third bending adjustment wire and a third bending adjustment knob 24. The third bending adjustment knob 24 is rotatably arranged on the handle portion 21, and the third bending adjustment wire is arranged in the catheter portion 22 in a manner that can move axially along the catheter portion 22, and the two ends of the third bending adjustment wire are respectively fixedly connected to the third bending adjustment knob 24 and the distal end of the catheter portion 22.

[0070] It can be understood that the handle portion 21 can be a tubular structure with a cavity inside, and the catheter portion 22 can also be a tubular structure with a cavity inside. The catheter portion 22 is coaxially connected to the handle portion 21, and one axial end of the catheter portion 22 can be fixedly connected to the handle portion 21 by snapping or screwing. The catheter portion 22 is a flexible tube and can be made of a tube body woven with steel wire to facilitate bending under the traction of the third bending wire. The third bending knob 24 can be coaxially arranged with the handle 21, and part of the third bending knob 24 is located inside the handle 21, and is connected to one end of the third bending wire. The other part of the third bending knob 24 protrudes from the handle 21 to facilitate the operator to turn it. The other end of the third bending wire is fixedly connected to the distal end of the catheter 22, so that when the operator turns the third bending knob 24, the third bending knob 24 rolls up the third bending wire, and then pulls the distal end of the catheter 22 to bend. According to the bending direction of the blood vessel, the rotation angle of the third bending knob 24 can be controlled under the cooperation of positioning monitoring equipment such as extracorporeal ultrasound, and then the bending degree of the catheter 22 can be controlled, so that its bending degree adapts to the direction of the blood vessel. When the third bending knob 24 is turned in the opposite direction, the third bending wire can be restored to its original direction.

[0071] In some embodiments of the present invention, the ablation needle assembly 30 includes an ablation needle 31 and an ethanol injection channel 32. The ethanol injection channel 32 is sequentially arranged in the adjustable bend sheath assembly 10 and the mapping ablation assembly 20. The distal end of the ethanol injection channel 32 is connected to the ablation needle 31, and the proximal end of the ethanol injection channel 32 is arranged on the handle 11 and has an injection port for infusing ethanol.

[0072] It can be understood that the ablation needle 31 can be set at the distal end of the mapping and ablation component 20, and the ablation needle 31 is supplied with anhydrous alcohol through the ethanol injection channel 32. The ethanol injection channel 32 can be a hose structure that is passed through the adjustable bend sheath component 10 and the mapping and ablation component 20. The distal end of the ethanol injection channel 32 can be fixedly connected to the distal end of the mapping and ablation component 20, and the ablation needle 31 is also set at the distal end of the mapping and ablation component 20. After the mapping and ablation component 20 completes thermal ablation, if abnormal myocardial discharge is still detected, the ablation needle 31 can be sent into the target blood vessel to continue chemical ablation, so that the anhydrous alcohol is transported to the ablation needle 31 through the ethanol injection channel 32, and then infused into the blood vessel through the pinhole on the ablation needle 31.

[0073] In some embodiments of the present invention, the ablation needle assembly 30 also includes a propulsion wire and a propulsion adjustment slider. The propulsion adjustment slider is slidably arranged on the handle portion 21. Both ends of the propulsion wire are respectively connected to the ablation needle 31 and the propulsion adjustment slider. The propulsion adjustment slider is used to adjust the length of the ablation needle 31 extending out of the mapping ablation assembly 20.

[0074] It can be understood that in order to reduce the damage of the ablation needle 31 to the blood vessel wall, the ablation needle 31 can be configured to be installed in the catheter part 22 in a retractable manner. Specifically, by providing a propulsion adjustment slider that can slide along the axial direction of the handle part 21 on the handle part 21, and passing a propulsion wire through the handle part 21 and the catheter part 22. The propulsion wire connects the propulsion adjustment slider and the ablation needle 31. When chemical ablation is not required, the ablation needle 31 is located inside the catheter part 22 and does not protrude from the distal end of the catheter part 22. When chemical ablation is required, the propulsion adjustment slider is pushed, and then the ablation needle 31 is driven forward and pushed out of the catheter part 22 by the propulsion wire, thereby realizing the retractable function of the ablation needle 31 to better protect the patient's blood vessels.

[0075] In some embodiments of the present invention, the device for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium also includes a balloon 50 and an inflation tube. The balloon 50 is installed at the distal end of the mapping and ablation component 20. One end of the inflation tube is connected to the balloon 50. The other end of the inflation tube is located at the proximal end of the adjustable bend sheath component 10 and is used to supply gas to enter. The part between the two ends of the inflation tube is fixed to the adjustable bend sheath component 10.

[0076] It is understandable that in order to reduce unnecessary damage to normal blood vessels caused by chemical ablation, the blood vessels can be isolated by setting up the balloon 50 so that the anhydrous alcohol only performs chemical ablation on the blood vessels on one side of the balloon 50, thereby reducing blood vessel damage during chemical ablation. Specifically, a balloon 50 is provided at the distal end of the mapping and ablation component 20, and the balloon 50 is located between the electrode 23 and the proximal end of the mapping and ablation component 20. The balloon 50 is coated on the outer peripheral wall of the catheter portion 22 and is arranged in a ring around the catheter portion 22. In the uninflated state, the balloon 50 is in a deflated state to reduce the volume for easy movement in the blood vessel. The balloon 50 is connected to the handle portion 11 through an inflation tube located in the adjustable bend sheath assembly 10. An inflation port is provided at the handle portion 11. Before chemical ablation, air can be inflated into the balloon 50 through the inflation port to inflate the balloon 50. After the balloon 50 abuts against the blood vessel wall, the blood vessel will be separated into two parts. At this time, anhydrous alcohol is injected into the deep blood vessel through the ablation needle 31 to achieve chemical ablation. At the same time, due to the barrier of the balloon 50, anhydrous alcohol will not affect the remaining blood vessels, thereby improving the safety of chemical ablation.

[0077] In some embodiments of the present invention, the adjustable bending sheath 12 comprises a first lumen 121, a second lumen 122, a third lumen 123 and an ethanol injection channel 32 extending along its axial direction. The first lumen 121 is used to accommodate the passage of the mapping and ablation component 20, the second lumen 122 is used for the passage of the first bending adjustment wire 13, the third lumen 123 is used for the passage of the second bending adjustment wire 15, and the ethanol injection channel 32 is used to deliver anhydrous alcohol to the ablation needle 31.

[0078] The second aspect of the present invention provides a method for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium, which is implemented by the device for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium provided by the first aspect of the present invention. The method for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium includes the following steps:

[0079] A guide wire 40 is passed through the femoral vein into the right atrium 100;

[0080] Under the guidance of the guide wire 40 , the adjustable bend sheath assembly 10 is delivered into the coronary vein 600 .

[0081] Adjust the direction of the adjustable bending sheath tube assembly 10 and deliver the mapping and ablation assembly 20 into the coronary vein 600;

[0082] Adjusting the position of the mapping and ablation component 20;

[0083] Mapping and thermally ablating the coronary vein 600 by the mapping and ablation assembly 20;

[0084] Re-map the coronary veins 600;

[0085] According to the presence of premature beat signals in the coronary vein 600 , chemical ablation is performed on the coronary vein 600 by the ablation needle assembly 30 .

[0086] The second aspect of the present invention proposes a method for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium, which combines an adjustable curved sheath tube assembly 10, a mapping ablation assembly 20, and an ablation needle assembly 30 for injecting anhydrous alcohol, and can be smoothly delivered to the distal end of a blood vessel, and enter small blood vessels at different distal ends through the mapping ablation assembly 20 to perform excitation mapping to find ablation targets and target blood vessels. After mapping, the mapping ablation assembly 20 seamlessly performs thermal radiofrequency ablation on the target blood vessel. When thermal ablation is ineffective, chemical ablation is performed by injecting anhydrous alcohol through the ablation needle assembly 30. The device for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium conforms to the anatomical structure, is easy to operate, and can enter the distal end of the blood vessel without much operation. The combination of mapping, thermal ablation, and chemical ablation avoids repeated delivery of instruments, reduces operation time and risks, and improves surgical efficiency.

[0087] The specific steps of the method for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium proposed in the second aspect of the present invention are as follows: first, the guide wire 40 is delivered into the right atrium 100 through the femoral vein, and the adjustable bend sheath tube assembly 10 is delivered under the guidance of the guide wire 40. Since the length of the tricuspid isthmus of the patient varies, the opening height of the coronary sinus 500 is uncertain. The adjustable bend sheath tube assembly 10 is accurately delivered into the coronary sinus 500 by adjusting the first adjustable bend knob, and contrast agent is administered into the coronary vein 600 through the injection hole 17 at the distal end of the adjustable bend sheath tube 12 to clarify the shape of the coronary vein 600, and the adjustable bend sheath tube 12 is further delivered to the distal end of the coronary vein 600. After entering the distal end of the coronary vein 600, contrast agent is administered to clarify the shape of the distal blood vessel, and then the mapping and ablation component 20 is delivered to adjust the direction of the catheter part 22 by adjusting the third bending knob 24, so that it enters the various branches of the anterior interventricular vein for mapping and finding the earliest target blood vessel and target point. First, thermal ablation is performed through the electrode 23 under saline perfusion. If ventricular premature beats still exist after ablation, the ablation needle 31 (the head end is visualized under X-ray to clarify the entry position) is pushed into the target blood vessel, and the balloon 50 is inflated at the opening of the blood vessel to seal the blood vessel, and then anhydrous alcohol is injected to perform chemical ablation.

[0088] The above is only a preferred specific embodiment of the present invention, but the protection scope of the present invention is not limited thereto. Any changes or substitutions that can be easily thought of by a person skilled in the art within the technical scope disclosed by the present invention should be included in the protection scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the claims.

Claims

1. A device for ablation of epicardial excitation of ventricular premature contractions originating from deep myocardium, characterized in that: include: An adjustable sheath tube assembly, wherein the proximal end of the adjustable sheath tube assembly is used for operation by a user, and the distal end of the adjustable sheath tube assembly is used for extending into a coronary vein; A mapping and ablation component is inserted into the adjustable sheath tube component, the mapping and ablation component can move along the axial direction of the adjustable sheath tube component and pass through the distal end of the adjustable sheath tube component, and the mapping and ablation component is used to map and thermally ablate the coronary vein; The ablation needle assembly is installed at the distal end of the mapping and ablation assembly in a telescopic manner and is used for chemically ablating the coronary vein.

2. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 1, characterized in that: The deep myocardial origin ventricular premature contraction epicardial excitation ablation device also includes a guide wire, the proximal end of the guide wire is used for user operation, the adjustable bend sheath tube assembly is slidably mounted on the guide wire, and the adjustable bend sheath tube assembly can move along the guide wire to the distal end of the guide wire.

3. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 1, characterized in that: The adjustable bending sheath tube assembly comprises: Handlebars; An adjustable bending sheath tube connected to the distal end of the handle; The first bending adjustment component includes a first bending adjustment wire and a first bending adjustment knob. The first bending adjustment knob is rotatably arranged on the handle portion. The first bending adjustment wire is arranged in the adjustable bending sheath tube and can move axially along the adjustable bending sheath tube. The two ends of the first bending adjustment wire are respectively connected to the first bending adjustment knob and the distal end of the adjustable bending sheath tube. The first bending adjustment component is used to drive the distal end of the adjustable bending sheath tube to bend radially toward the adjustable bending sheath tube.

4. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 3, characterized in that: The adjustable bending sheath tube assembly also includes a second bending adjustment assembly, which includes a second bending adjustment wire and a second bending adjustment knob. The second bending adjustment knob is rotatably arranged on the handle portion. The second bending adjustment wire is passed through the adjustable bending sheath tube and can move axially along the adjustable bending sheath tube. The two ends of the second bending adjustment wire are respectively connected to the second bending adjustment knob and the distal end of the adjustable bending sheath tube. Along the radial direction of the adjustable bending sheath tube, the second bending adjustment assembly is used to drive the distal end of the adjustable bending sheath tube to bend toward the radial direction of the adjustable bending sheath tube.

5. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 1, characterized in that: The mapping and ablation component comprises: handle part; A catheter portion connected to the distal end of the handle portion; A plurality of electrodes are arranged on the outer peripheral surface of the catheter portion, and the electrodes are used for mapping and thermally ablating the coronary veins.

6. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 5, characterized in that: The mapping and ablation component also includes a third bending adjustment component, which includes a third bending adjustment wire and a third bending adjustment knob. The third bending adjustment knob is rotatably arranged on the handle portion, and the third bending adjustment wire is arranged in the catheter portion in a manner that can move axially along the catheter portion, and both ends of the third bending adjustment wire are respectively connected to the third bending adjustment knob and the distal end of the catheter portion.

7. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 1, characterized in that: The ablation needle assembly comprises: Ablation needle; An ethanol injection channel is sequentially arranged in the adjustable bending sheath assembly and the mapping and ablation assembly. The distal end of the ethanol injection channel is connected to the ablation needle. The proximal end of the ethanol injection channel is arranged on the handle part and has an injection port for injecting ethanol.

8. The device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to claim 7, characterized in that: The ablation needle assembly further comprises: Propulsion wire; The advancement adjustment slider is slidably arranged on the handle portion, and the two ends of the advancement wire are respectively connected to the ablation needle and the advancement adjustment slider, and the advancement adjustment slider is used to adjust the length of the ablation needle extending out of the mapping and ablation component.

9. The device for ablation of epicardial activation of ventricular premature beats originating from deep myocardium according to any one of claims 1 to 8, characterized in that: The deep myocardial origin ventricular premature contraction epicardial excitation ablation device also includes a balloon and an inflation tube. The balloon is installed at the distal end of the mapping and ablation component. One end of the inflation tube is connected to the balloon, and the other end of the inflation tube is located at the proximal end of the adjustable bend sheath tube component and is used for gas entry. The part between the two ends of the inflation tube is fixed to the adjustable bend sheath tube component.

10. A method for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium, implemented by the device for ablation of epicardial excitation of ventricular premature beats originating from deep myocardium according to any one of claims 1 to 9, characterized in that: The method for ablation of epicardial excitation of ventricular premature contraction originating from deep myocardium comprises the following steps: A guide wire is passed through the femoral vein into the right atrium; The adjustable curved sheath tube assembly is delivered into the coronary vein under the guidance of the guide wire. Adjust the direction of the adjustable curved sheath assembly and deliver the mapping and ablation assembly into the coronary vein; Adjust the position of the mapping and ablation components; Coronary veins were mapped and thermally ablated using the mapping and ablation component; The coronary veins were remapped; Based on the presence of premature beat signals in the coronary veins, chemical ablation of the coronary veins is performed using an ablation needle assembly.

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