D3_電生理導(dǎo)管

1、12/26/2021Slide 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)管簡介The Biosense Webster product portfolio BW產(chǎn)品綜述12/26/2021Slide 2Biosense Webster EP Training 2003 The EP C

2、atheter目錄目錄 電生理導(dǎo)管的整體特性 Biosense Webster 導(dǎo)管的獨特性 如何去讀懂貨號12/26/2021Slide 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)信號或是放電消融的電極 管身 包含著傳導(dǎo)電信號的電纜 提供對導(dǎo)管的機械操縱性能 接頭端 提供同連線的接口方式（RT Redel-10)12/26/2021Slide 4Biosense Webster EP Training 2003 The EP Catheter固定彎形狀固定彎形狀H c

3、urveH curveCournandCournandFFLevineLevineMultipurposeMultipurposeP curveP curveDamatoDamatoDDG curveG curveCoronary sinusCoronary sinus12/26/2021Slide 5Biosense Webster EP Training 2003 The EP Catheter競爭者所用的彎度競爭者所用的彎度DaigDaigBostonBoston12/26/2021Slide 6Biosense Webster EP Training 2003 The EP Cathe

4、ter電極間距電極間距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12/26/2021Slide 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相鄰電極中心開始測量計算的。 而我們的競爭對手所才用的方式是用電極的邊緣開始測量的。12/26/2021Slide 8Biosense Webst

5、er EP Training 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8octapolar12/26/2021Slide 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

6、和可調(diào)彎標(biāo)測導(dǎo)管12/26/2021Slide 10Biosense Webster EP Training 2003 The EP Catheter管身管身(Shaft)直徑直徑以 French (F)為測量單位3 French equals 1 mm (1F = 0,33 mm)standardavailableFixed6(4),5MM6-NFD6-Deflectable Diagn.76, (5)Ablation76, (5)Navistar7-12/26/2021Slide 11Biosense Webster EP Training 2003 The EP Catheter影響操作

7、的性能指標(biāo)影響操作的性能指標(biāo) 扭力 創(chuàng)傷力直徑 管身長度-電極數(shù)目 -電極間距-12/26/2021Slide 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 Box12/26/2021Slide 13Biosense Webster EP Training 2003 The EP CatheterSection

8、 II 電生理導(dǎo)管的整體特性 Biosense Webster 導(dǎo)管的獨特性 如何去讀懂貨號12/26/2021Slide 14Biosense Webster EP Training 2003 The EP CatheterThe Biosense Webster 導(dǎo)管導(dǎo)管 Shaft Design管身設(shè)計 Tip Design 頂端設(shè)計 Braided Tip 加硬管 Special Design Features 特殊設(shè)計特點 Temperature Sensor 溫度傳感器12/26/2021Slide 15Biosense Webster EP Training 2003 The E

9、P Catheter管身設(shè)計管身設(shè)計(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12/26/2021Slide 16Biosense Webster EP Training 2003 The EP Catheter管身設(shè)計管身設(shè)

10、計(Reality)單腔單腔shaft32 stainless steal wire braiding銅纜線銅纜線尼龍管尼龍管12/26/2021Slide 17Biosense Webster EP Training 2003 The EP Catheter頭端設(shè)計頭端設(shè)計 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12/26/2021Slide 18Biosense Webster EP Training 2003 The EP Catheter頭端設(shè)計頭端設(shè)計

11、(機理)雙腔雙腔牽引鋼絲牽引鋼絲傳導(dǎo)電纜傳導(dǎo)電纜頭端編織頭端編織1616根鋼絲編織根鋼絲編織12/26/2021Slide 19Biosense Webster EP Training 2003 The EP Catheter可調(diào)彎導(dǎo)管的頭端設(shè)計可調(diào)彎導(dǎo)管的頭端設(shè)計lumen A:pulling wirelumen B:copper wiresNon-braided tip12/26/2021Slide 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

12、 glued with Coned tip section glued with polyurethane into shaftpolyurethane into shaft12/26/2021Slide 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tipshaftpolyurethaneglue12/26/2021Slide 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

13、: 鎳鈦合金 鎳鈦合金: 可以記憶形狀， 可塑性強 由Teflon制成的鞘包裹使其移動光滑 Compression Coil12/26/2021Slide 23Biosense Webster EP Training 2003 The EP Catheter電極設(shè)計電極設(shè)計Platinium-iridiumring electrodePolyurethaneglue1,3 mmPlatinium: Superior electrical conductivityPlatinium: Superior electrical conductivityIridium: highly radiopaq

14、ueIridium: highly radiopaque12/26/2021Slide 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（會使電路短路） 使得頭端比較穩(wěn)固 提供導(dǎo)管貼靠穩(wěn)定12/26/2021Slide 25Biosense Webster EP Training 2003 The EP Catheter壓縮線圈壓縮線圈0,1 mm0,1 mm12/26/2021Slide 26Biosense Webster EP Training 2

15、003 The EP Catheter使用意義使用意義 減少管身波動 增強彎度調(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 procedure12/26/2021Slide 27Biosense Webster EP Tr

16、aining 2003 The EP Catheter16x2 wires16x2 wires16 wires16 wiresshaftshafttiptipBraided Tip加硬管加硬管(大頭導(dǎo)管獨有)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12/26/2021Slide 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 199912/26/2021Sl