D3_电生理导管

1、5/24/2022Slide 1Biosense Webster EP Training 2003 The EP Catheter电生理培训电生理培训(三三)The anatomy of the heart 心脏解剖结构The electrical conduction system 电传导途径The EP procedure 电生理手术过程The EP catheter 电生理导管简介The Biosense Webster product portfolio BW产品综述5/24/2022Slide 2Biosense Webster EP Training 2003 The EP Cat

2、heter目录目录 电生理导管的整体特性 Biosense Webster 导管的独特性 如何去读懂货号5/24/2022Slide 3Biosense Webster EP Training 2003 The EP Catheter电生理导管的组成电生理导管的组成: 导管头端 特殊的形状, 提供心内信号或是放电消融的电极 管身 包含着传导电信号的电缆 提供对导管的机械操纵性能 接头端 提供同连线的接口方式（RT Redel-10)5/24/2022Slide 4Biosense Webster EP Training 2003 The EP Catheter固定弯形状固定弯形状H curve

3、H curveCournandCournandFFLevineLevineMultipurposeMultipurposeP curveP curveDamatoDamatoDDG curveG curveCoronary sinusCoronary sinus5/24/2022Slide 5Biosense Webster EP Training 2003 The EP Catheter竞争者所用的弯度竞争者所用的弯度DaigDaigBostonBoston5/24/2022Slide 6Biosense Webster EP Training 2003 The EP Catheter电极间

4、距电极间距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分辨率高分辨率高标准型标准型冠状窦冠状窦起搏起搏高分辨率高分辨率5/24/2022Slide 7Biosense Webster EP Training 2003 The EP Catheter电极间距电极间距 BW导管的电极间距是从两个相邻电极中心开始测量计算的。 而我们的竞争对手所才用的方式是用电极的边缘开始测量的。5/24/2022Slide 8Biosense Webster EP Tr

5、aining 2003 The EP Catheter电极数目电极数目必须2bipolar标准4quadrapolar冠状窦10decapolar可选:希氏/冠状窦6hexapolar希氏/冠状窦8octapolar5/24/2022Slide 9Biosense Webster EP Training 2003 The EP Catheter顶端电极的形状顶端电极的形状 3mm 电极 5 F 可调and CRISTA CATH 界嵴导管 4mm 标准电极 6, 7 and 8 F 可调大头导管 4 mm 花生头 6, 7 and 8 F可调大头导管 1 mm 电极 固定和可调弯标测导管5/2

6、4/2022Slide 10Biosense Webster EP Training 2003 The EP Catheter管身管身(Shaft)直径直径以 French (F)为测量单位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影响操作的性能指标影响操作的性能指

7、标 扭力 创伤力直径 管身长度-电极数目 -电极间距-5/24/2022Slide 12Biosense Webster EP Training 2003 The EP Catheter连接头连接头导管接头导管接头连线接头连线接头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 电生理导管的整体特性

8、Biosense Webster 导管的独特性 如何去读懂货号5/24/2022Slide 14Biosense Webster EP Training 2003 The EP CatheterThe Biosense Webster 导管导管 Shaft Design管身设计 Tip Design 顶端设计 Braided Tip 加硬管 Special Design Features 特殊设计特点 Temperature Sensor 温度传感器5/24/2022Slide 15Biosense Webster EP Training 2003 The EP Catheter管身设计管身设

9、计(Schematic)* *P Pellethane ellethane 是一种特殊合成的高分子聚脂材料。具备是一种特殊合成的高分子聚脂材料。具备很好的生物兼容性，柔软而弹性好，是很好的生物兼容性，柔软而弹性好，是 WebsterWebster的专利技的专利技术。术。生产流程： 第一层Pellethane 成型内芯 钢丝编制 32 股钢丝 (16x2 不锈钢丝) 第二层 Pellethane 覆盖钢丝层 表面成型5/24/2022Slide 16Biosense Webster EP Training 2003 The EP Catheter管身设计管身设计(Reality)单腔单腔shaf

10、t32 stainless steal wire braiding铜缆线铜缆线尼龙管尼龙管5/24/2022Slide 17Biosense Webster EP Training 2003 The EP Catheter头端设计头端设计 Fixed catheters 固定弯导管 No difference to shaft Deflectable catheters 可调弯导管 Dual Lumen 双腔5/24/2022Slide 18Biosense Webster EP Training 2003 The EP Catheter头端设计头端设计(机理)双腔双腔牵引钢丝牵引钢丝传导电缆

11、传导电缆头端编织头端编织1616根钢丝编织根钢丝编织5/24/2022Slide 19Biosense Webster EP Training 2003 The EP Catheter可调弯导管的头端设计可调弯导管的头端设计lumen A:pulling wirelumen B:copper wiresNon-braided tip5/24/2022Slide 20Biosense Webster EP Training 2003 The EP Catheter管身与头端的内部接合管身与头端的内部接合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管身与头端的内部接合管身与头端的内部接合tipshaftpolyurethaneglue5/24/2022Slide 22Biosense Webster EP Training 2003 The EP Catheter特特 性性 内腔 2F (0,58 mm) 传导电缆: 铜线 牵引钢丝: 镍钛合金 镍钛合金: 可以记忆形状， 可塑性

13、强 由Teflon制成的鞘包裹使其移动光滑 Compression Coil5/24/2022Slide 23Biosense Webster EP Training 2003 The EP Catheter电极设计电极设计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聚亚胺酯封口聚亚胺酯封口 封闭电极之间的接合 防止内腔里的空气进入血液 防止血液进入内腔（会使电路短路） 使得头端比较稳固 提供导管贴靠稳定5/24/2022Slide 25Biosense Webster EP Training 2003 The EP Catheter压缩线圈压缩线圈0,1 mm0,1 mm5/24/2022Slide 26Biosense Webster EP Training 2003 The EP Catheter使用意义使用意义

15、减少管身波动 增强弯度调节的灵活性 1:1 弯度调节反应 极好的头端操控 直接将推送力传输到导管头端 提高导管的跟踪性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(大头导管独有)双钢丝编织一直延伸至头端提高头端与心壁贴靠稳定性5/24/2022Slide 28Biosense Webster EP Training 2003 The EP Catheter可调弯导管的操作手柄可调弯导管的操作手柄Integrated Redel Integrated Redel Connector for ALL Connector for ALL deflectable catheters deflectable catheters since mid 1999since mid 19995/24/2022Sl