D3_電生理導(dǎo)管

1、5/24/2022Slide 1Biosense Webster EP Training 2003 The EP Catheter電生理培訓(xùn)電生理培訓(xùn)(三三)The anatomy of the heart 心臟解剖結(jié)構(gòu)The electrical conduction system 電傳導(dǎo)途徑The EP procedure 電生理手術(shù)過程The EP catheter 電生理導(dǎo)管簡(jiǎn)介The Biosense Webster product portfolio BW產(chǎn)品綜述5/24/2022Slide 2Biosense Webster EP Training 2003 The EP Cat

2、heter目錄目錄 電生理導(dǎo)管的整體特性 Biosense Webster 導(dǎo)管的獨(dú)特性 如何去讀懂貨號(hào)5/24/2022Slide 3Biosense Webster EP Training 2003 The EP Catheter電生理導(dǎo)管的組成電生理導(dǎo)管的組成: 導(dǎo)管頭端 特殊的形狀, 提供心內(nèi)信號(hào)或是放電消融的電極 管身 包含著傳導(dǎo)電信號(hào)的電纜 提供對(duì)導(dǎo)管的機(jī)械操縱性能 接頭端 提供同連線的接口方式（RT Redel-10)5/24/2022Slide 4Biosense Webster EP Training 2003 The EP Catheter固定彎形狀固定彎形狀H curve

3、H curveCournandCournandFFLevineLevineMultipurposeMultipurposeP curveP curveDamatoDamatoDDG curveG curveCoronary sinusCoronary sinus5/24/2022Slide 5Biosense Webster EP Training 2003 The EP Catheter競(jìng)爭(zhēng)者所用的彎度競(jìng)爭(zhēng)者所用的彎度DaigDaigBostonBoston5/24/2022Slide 6Biosense Webster EP Training 2003 The EP Catheter電極間

4、距電極間距2 mm2 mm5 mm5 mm10 mm10 mmSpacingSpacing2-5-22-5-22-8-22-8-22-10-22-10-22-13-22-13-22-14-22-14-2分辨率高分辨率高標(biāo)準(zhǔn)型標(biāo)準(zhǔn)型冠狀竇冠狀竇起搏起搏高分辨率高分辨率5/24/2022Slide 7Biosense Webster EP Training 2003 The EP Catheter電極間距電極間距 BW導(dǎo)管的電極間距是從兩個(gè)相鄰電極中心開始測(cè)量計(jì)算的。 而我們的競(jìng)爭(zhēng)對(duì)手所才用的方式是用電極的邊緣開始測(cè)量的。5/24/2022Slide 8Biosense Webster EP Tr

5、aining 2003 The EP Catheter電極數(shù)目電極數(shù)目必須2bipolar標(biāo)準(zhǔn)4quadrapolar冠狀竇10decapolar可選:希氏/冠狀竇6hexapolar希氏/冠狀竇8octapolar5/24/2022Slide 9Biosense Webster EP Training 2003 The EP Catheter頂端電極的形狀頂端電極的形狀 3mm 電極 5 F 可調(diào)and CRISTA CATH 界嵴導(dǎo)管 4mm 標(biāo)準(zhǔn)電極 6, 7 and 8 F 可調(diào)大頭導(dǎo)管 4 mm 花生頭 6, 7 and 8 F可調(diào)大頭導(dǎo)管 1 mm 電極 固定和可調(diào)彎標(biāo)測(cè)導(dǎo)管5/2

6、4/2022Slide 10Biosense Webster EP Training 2003 The EP Catheter管身管身(Shaft)直徑直徑以 French (F)為測(cè)量單位3 French equals 1 mm (1F = 0,33 mm)standardavailableFixed6(4),5MM6-NFD6-Deflectable Diagn.76, (5)Ablation76, (5)Navistar7-5/24/2022Slide 11Biosense Webster EP Training 2003 The EP Catheter影響操作的性能指標(biāo)影響操作的性能指

7、標(biāo) 扭力 創(chuàng)傷力直徑 管身長(zhǎng)度-電極數(shù)目 -電極間距-5/24/2022Slide 12Biosense Webster EP Training 2003 The EP Catheter連接頭連接頭導(dǎo)管接頭導(dǎo)管接頭連線接頭連線接頭2 24 46 6Tip PinsTip PinsPlugPlugRedelRedel(9) 15Pin-Molded(9) 15Pin-MoldedTip Pin BoxTip Pin Box5/24/2022Slide 13Biosense Webster EP Training 2003 The EP CatheterSection II 電生理導(dǎo)管的整體特性

8、Biosense Webster 導(dǎo)管的獨(dú)特性 如何去讀懂貨號(hào)5/24/2022Slide 14Biosense Webster EP Training 2003 The EP CatheterThe Biosense Webster 導(dǎo)管導(dǎo)管 Shaft Design管身設(shè)計(jì) Tip Design 頂端設(shè)計(jì) Braided Tip 加硬管 Special Design Features 特殊設(shè)計(jì)特點(diǎn) Temperature Sensor 溫度傳感器5/24/2022Slide 15Biosense Webster EP Training 2003 The EP Catheter管身設(shè)計(jì)管身設(shè)

9、計(jì)(Schematic)* *P Pellethane ellethane 是一種特殊合成的高分子聚脂材料。具備是一種特殊合成的高分子聚脂材料。具備很好的生物兼容性，柔軟而彈性好，是很好的生物兼容性，柔軟而彈性好，是 WebsterWebster的專利技的專利技術(shù)。術(shù)。生產(chǎn)流程： 第一層Pellethane 成型內(nèi)芯 鋼絲編制 32 股鋼絲 (16x2 不銹鋼絲) 第二層 Pellethane 覆蓋鋼絲層 表面成型5/24/2022Slide 16Biosense Webster EP Training 2003 The EP Catheter管身設(shè)計(jì)管身設(shè)計(jì)(Reality)單腔單腔shaf

10、t32 stainless steal wire braiding銅纜線銅纜線尼龍管尼龍管5/24/2022Slide 17Biosense Webster EP Training 2003 The EP Catheter頭端設(shè)計(jì)頭端設(shè)計(jì) Fixed catheters 固定彎導(dǎo)管 No difference to shaft Deflectable catheters 可調(diào)彎導(dǎo)管 Dual Lumen 雙腔5/24/2022Slide 18Biosense Webster EP Training 2003 The EP Catheter頭端設(shè)計(jì)頭端設(shè)計(jì)(機(jī)理)雙腔雙腔牽引鋼絲牽引鋼絲傳導(dǎo)電纜

11、傳導(dǎo)電纜頭端編織頭端編織1616根鋼絲編織根鋼絲編織5/24/2022Slide 19Biosense Webster EP Training 2003 The EP Catheter可調(diào)彎導(dǎo)管的頭端設(shè)計(jì)可調(diào)彎導(dǎo)管的頭端設(shè)計(jì)lumen A:pulling wirelumen B:copper wiresNon-braided tip5/24/2022Slide 20Biosense Webster EP Training 2003 The EP Catheter管身與頭端的內(nèi)部接合管身與頭端的內(nèi)部接合shafttipConed tip section glued with Coned tip

12、section glued with polyurethane into shaftpolyurethane into shaft5/24/2022Slide 21Biosense Webster EP Training 2003 The EP Catheter管身與頭端的內(nèi)部接合管身與頭端的內(nèi)部接合tipshaftpolyurethaneglue5/24/2022Slide 22Biosense Webster EP Training 2003 The EP Catheter特特 性性 內(nèi)腔 2F (0,58 mm) 傳導(dǎo)電纜: 銅線 牽引鋼絲: 鎳鈦合金 鎳鈦合金: 可以記憶形狀， 可塑性

13、強(qiáng) 由Teflon制成的鞘包裹使其移動(dòng)光滑 Compression Coil5/24/2022Slide 23Biosense Webster EP Training 2003 The EP Catheter電極設(shè)計(jì)電極設(shè)計(jì)Platinium-iridiumring electrodePolyurethaneglue1,3 mmPlatinium: Superior electrical conductivityPlatinium: Superior electrical conductivityIridium: highly radiopaqueIridium: highly radiopa

14、que5/24/2022Slide 24Biosense Webster EP Training 2003 The EP Catheter聚亞胺酯封口聚亞胺酯封口 封閉電極之間的接合 防止內(nèi)腔里的空氣進(jìn)入血液 防止血液進(jìn)入內(nèi)腔（會(huì)使電路短路） 使得頭端比較穩(wěn)固 提供導(dǎo)管貼靠穩(wěn)定5/24/2022Slide 25Biosense Webster EP Training 2003 The EP Catheter壓縮線圈壓縮線圈0,1 mm0,1 mm5/24/2022Slide 26Biosense Webster EP Training 2003 The EP Catheter使用意義使用意義

15、減少管身波動(dòng) 增強(qiáng)彎度調(diào)節(jié)的靈活性 1:1 彎度調(diào)節(jié)反應(yīng) 極好的頭端操控 直接將推送力傳輸?shù)綄?dǎo)管頭端 提高導(dǎo)管的跟蹤性Results in Results in ease-of-useease-of-use and lets the and lets the electrophysiologist concentrate on the electrophysiologist concentrate on the EP procedureEP procedure5/24/2022Slide 27Biosense Webster EP Training 2003 The EP Catheter16

16、x2 wires16x2 wires16 wires16 wiresshaftshafttiptipBraided Tip加硬管加硬管(大頭導(dǎo)管獨(dú)有)雙鋼絲編織一直延伸至頭端提高頭端與心壁貼靠穩(wěn)定性5/24/2022Slide 28Biosense Webster EP Training 2003 The EP Catheter可調(diào)彎導(dǎo)管的操作手柄可調(diào)彎導(dǎo)管的操作手柄Integrated Redel Integrated Redel Connector for ALL Connector for ALL deflectable catheters deflectable catheters since mid 1999since mid 19995/24/2022Sl