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1、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1/6/20231Biosense Webster EP Training 2003 The EP Catheter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1/6/20232Biosense Webst
2、er 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)1/6/20233Biosense Webster EP Training 2003 The EP Catheter固定弯形状固定弯形状H curveH curveJosephsonJosephsonJosephsonJosephsonAAAACournandCournandFFLevineLevineMultipurposeMultipur
3、poseP curveP curveDamatoDamatoDDG curveG curveCoronary sinusCoronary sinus1/6/20234Biosense Webster EP Training 2003 The EP Catheter竞争者所用的弯度竞争者所用的弯度DaigDaigBostonBoston1/6/20235Biosense Webster EP Training 2003 The EP Catheter电极间距电极间距2 mm2 mm5 mm5 mm10 mm10 mmSpacingSpacing2-5-22-5-22-8-22-8-22-10-2
4、2-10-22-13-22-13-22-14-22-14-2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1/6/20236Biosense 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。1/6/20237Biosense Webster EP Training 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6he
5、xapolar希氏/冠状窦8octapolar1/6/20238Biosense 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1/6/20239Biosense 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 eq
6、uals 1 mm(1F=0,33 mm)standardavailableFixed6(4),5MM6-NFD6-Deflectable Diagn.76,(5)Ablation76,(5)Navistar7-1/6/202310Biosense Webster EP Training 2003 The EP Catheter影响操作的性能指标影响操作的性能指标 扭力 创伤力直径 管身长度-电极数目-电极间距-1/6/202311Biosense 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 6Ti
7、p PinsTip PinsPlugPlugRedelRedel(9)15Pin-Molded(9)15Pin-MoldedTip Pin BoxTip Pin Box1/6/202312Biosense Webster EP Training 2003 The EP CatheterSection II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1/6/202313Biosense Webster EP Training 2003 The EP CatheterThe Biosense Webster 导管导管Shaft Design管身设计Tip Des
8、ign 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1/6/202314Biosense Webster EP Training 2003 The EP Catheter管身设计管身设计(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
9、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1/6/202315Biosense Webster EP Training 2003 The EP Catheter管身设计管身设计(Reality)单腔单腔shaftshaft32 stainless steal 32 stainless steal wire braidingwire braiding铜缆线铜缆线尼龙管尼龙管1/6/202316Biosense Webster EP Training 2003 The EP Catheter头端设计头端设计Fixed catheters 固定弯导管No
10、 difference to shaftDeflectable catheters 可调弯导管Dual Lumen 双腔1/6/202317Biosense 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传导电缆头端编织头端编织1616根钢丝编织根钢丝编织1/6/202318Biosense 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-brai
11、ded tip1/6/202319Biosense 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 section glued with polyurethane into shaftpolyurethane into shaft1/6/202320Biosense 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tiptipshaftshaftpolyure
12、thanepolyurethaneglueglue1/6/202321Biosense 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，可塑性强由Teflon制成的鞘包裹使其移动光滑Compression Coil1/6/202322Biosense Webster EP Training 2003 The EP Catheter电极设计电极设计Platinium-iridiumring electrodePolyurethaneglue1,3 mmPlatinium:
13、Superior electrical conductivityPlatinium:Superior electrical conductivityIridium:highly radiopaqueIridium:highly radiopaque1/6/202323Biosense 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1/6/202324Biosense Webster EP Training 2003 The EP C
14、atheter压缩线圈压缩线圈0,1 mm0,1 mm1/6/202325Biosense Webster EP Training 2003 The EP Catheter使用意义使用意义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
15、 procedureEP procedure1/6/202326Biosense Webster EP Training 2003 The EP Catheter16x2 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1/6/202327Biosense 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 Conne
16、ctor for ALL Connector for ALL deflectable catheters deflectable catheters since mid 1999since mid 19991/6/202328Biosense Webster EP Training 2003 The EP CatheterSection III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1/6/202329Biosense Webster EP Training 2003 The EP Catheter固定弯1/6/202330Biosense Webster EP Training 2003 The EP Catheter可调弯导管可调弯导管1/6/202331Biosense Webster EP Training 2003 The EP Catheter