MEDICAL EXAMINATION AND TREATMENT DEVICE FOR PRODUCING AND/OR VISUALISING AND/OR TREATING ABLATION LESIONS ON TISSUE OR VESSEL SURFACES

Abstract

The invention relates to a medical examination and treatment device for producing and/or visualising and/or treating ablation lesions on tissue or vessel surfaces, in particular in the heart, comprising at least one catheter tube, which forms an elongate inner cavity within which at least one HF ablation wire is guided, wherein the catheter tube and/or the HF ablation wire is controllable in an open and/or closed-loop manner by an open and/or closed-loop control device such that heat and/or cold can act on the tissue or vessel surfaces in a targeted manner along the tissue or vessel surfaces by means of the HF ablation wire, in particular in order to obliterate said surfaces at least in part, at least one measurement and/or recording system designed and provided to measure electrical impulses of the tissue or vessel surfaces such that electrical impulses can additionally be measured at various sites on the tissue or vessel surfaces, in particular during treatment, more particularly simultaneously, wherein at least one means for measuring, monitoring and/or modifying electrical impulses and/or for measuring, monitoring and/or modifying a time delay of an electrical impulse sequence at at least two sites on the tissue or vessel surfaces, in particular in order to prevent undesirable damage to the tissue or vessel surfaces.

Claims

1. Medical examination and treatment device (100) for producing and/or visualising to and/or treating ablation lesions on tissue or vessel surfaces, in particular in the heart, comprising at least one catheter tube (1), which forms an elongate inner cavity within which at least one HF ablation wire (2) is guided, the catheter tube (1) and/or the HF ablation wire (2) being controllable in an open and/or closed-loop manner by an open and/or closed-loop control device (3) such that heat and/or cold can act on the tissue or vessel surfaces in a targeted manner along the tissue or vessel surfaces by means of the HF ablation wire (2), in particular in order to obliterate said surfaces at least in part, at least one measurement and/or recording system (4) designed and provided to measure electrical impulses of the tissue or vessel surfaces such that electrical impulses can additionally be measured at various sites on the tissue or vessel surfaces, in particular during treatment, more particularly simultaneously, characterised by at least one means (5) for measuring, monitoring and/or modifying electrical impulses and/or for measuring, monitoring and/or modifying a time delay of an electrical impulse sequence at at least two sites on the tissue or vessel surfaces, in particular in order to prevent undesirable damage to the tissue or vessel surfaces.

2. Examination and treatment device (100) according to claim 1, characterised in that the means (5) is designed and provided to reduce or completely interrupt an energy supply to the HF ablation wire (2) if it is noted that a time delay in the electrical impulse sequence exceeds a predeterminable threshold and/or if it is noted that an expected sequence signal has completely failed to materialise.

3. Examination and treatment device (100) according to either claim 1 or claim 2, characterised in that the measurement and/or recording system (4) is connected to the tissue or vessel surfaces such that one logical or haptic measurement input is installed in the measurement and/or recording system (4) per measurement point on the tissue or vessel surfaces, the means (5) being connected to each measurement input for data transmission.

4. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that the means (5) comprises at least one monitoring box (51), this monitoring box (51) being connected to both the open and/or closed-loop control device (3) and the measurement and/or recording system (4) for data transmission.

5. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that the means (5) compares selected measured impulses, which are each assigned, preferably uniquely, to different sites on the tissue or vessel surfaces, with one another in terms of their respective trigger times, durations and/or amplitude levels.

6. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that the means (5) displays at least one optical and/or acoustic alarm signal on its screen when the predetermined time delay is exceeded.

7. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that the means (5) indicates the precise site on the tissue or vessel surfaces at which an impulse time has changed and/or is absent.

8. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that various tissue or vessel surface types, for example a human heart and/or another tissue, are stored in the means (5) and, before and/or during treatment, a clinician can select the vessel types to be treated.

9. Examination and treatment device (100) according to at least one of the preceding claims, to characterised in that at least two impulse measurement sites along the tissue or vessel surfaces can be input into the means (5) and/or the means (5) can detect said impulse measurement sites autonomously before and/or during treatment, in particular by means of suitable measurement probes.

10. Examination and treatment device (100) according to at least one of the preceding claims, characterised in that if the time delay between two impulses at two different measurement sites on the tissue or vessel surfaces is exceeded, the means (5) issues at least one treatment recommendation for the clinician.

Description

[0039] The above-described invention will be described in more detail below on the basis of an embodiment and the associated drawings.

[0040] FIG. 1 shows a medical examination and treatment device 100 for producing and/or visualising and/or treating ablation lesions on tissue or vessel surfaces, in particular in the heart.

[0041] The medical examination and treatment device 100 being described here comprises a catheter tube 1, which forms an elongate inner cavity within which at least one HF ablation wire 2 is guided, wherein the catheter tube 1 and/or the HF ablation wire 2 is controllable in an open and/or closed-loop manner by an open and/or closed-loop control device 3 such that heat and/or cold can act on the tissue or vessel surfaces in a targeted manner along the tissue or vessel surfaces by means of the HF ablation wire 2, in particular in order to obliterate said surfaces at least in part.

[0042] In addition, the medical examination and treatment device 100 comprises at least one measurement and/or recording system 4 designed and provided to measure electrical impulses of the tissue or vessel surfaces such that electrical impulses can be measured at various sites on the tissue or vessel surfaces, in particular during treatment, more particularly simultaneously.

[0043] Furthermore, the examination and treatment device 100 comprises at least one means 5 for measuring, monitoring and/or modifying electrical impulses and/or for measuring, monitoring and/or modifying a time delay of an electrical impulse sequence at at least two sites on the tissue or vessel surfaces, in particular in order to prevent undesirable damage to the tissue or vessel surfaces.

[0044] In this case, the means 5 shown in FIG. 1 is designed and provided to reduce or completely interrupt an energy supply to the HF ablation wire 2 if it is noted that a time delay in the electrical impulse sequence exceeds a predeterminable threshold and/or if it is noted that an expected sequence signal has completely failed to materialise. It can also be seen in FIG. 1 that the means 5 is in the form of a separately arranged monitoring box 51. This monitoring box comprises at least two signal inputs, each signal input being assigned to one site on the tissue or vessel surface. Consequently, the monitoring box 51 measures at least two signals, the two measured signals thus representing an impulse sequence, the second signal being measured after a time delay compared with the first signal.

[0045] It can also be seen that the monitoring box 51 is connected to the HF generator for signal transmission and an energy supply of the HF generator to the ablation wire 2 can be reduced, increased or completely interrupted depending on the settings set by the clinician.

[0046] FIG. 2 shows that two measurement points A (corresponding for example to the sinus node) and V (corresponding for example to the AV node) have been triggered on the display of the means 5 at different times in the horizontal direction. The horizontal bar below these two signals is shown by the abbreviation SI. This delay bar SI can represent a maximum time delay between the two signals, predetermined by the user. If, in the vertical direction, the two signals A and V are still within the range in the horizontal direction defined by the signal SI, the tissue, in particular the conductive tissue, between the measurement points A and V has not yet been damaged or has at least not yet been significantly damaged. Therefore, as long as these two signals remain within the horizontal time bar, the operation or study may continue as normal.

[0047] However, if a horizontal distance between the two signals A and V is greater than a time length of the specified distance SI, as shown in FIG. 2, i.e. is greater than 209 ms for example, the means 5 can be set such as to interrupt or at least reduce the power supply to the ablation wire 2. As described above, a visual or an acoustic alarm function is also conceivable.

[0048] The invention is not limited by the description and the embodiments; instead, the invention covers any novel feature and any combination of features (including in particular any combination of features in the claims), even if this feature or combination is not explicitly disclosed in the claims or in the embodiment.

LIST OF REFERENCE NUMERALS

[0049] 1 Catheter tube [0050] 2 HF ablation wire [0051] 3 Open and/or closed-loop control device [0052] 4 Measurement and/or recording system [0053] 5 Means [0054] 51 Monitoring box [0055] 100 Medical examination and treatment device