• Title/Summary/Keyword: Electrode of catheter

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Development of Numerical Model of Electrode for Radiofrequency Catheter Ablation Considering Saline Irrigation and Temperature-controlled Radiofrequency System (온도 조절형 고주파 시스템 및 식염수 분사를 고려한 전극도자절제술용 전극의 수치 모델 개발)

  • Ahn, Jin-Woo;Kim, Young-Jin;Lee, Seung-A;Jung, Ha-Chul;Kim, Kyung-Ah;Cha, Eun-Jong;Moon, Jin-Hee
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.285-290
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    • 2017
  • Radiofrequency catheter ablation is the interventional therapy that be employed to eliminate cardiac tissue caused by arrhythmias. During radiofrequency catheter ablation, The thrombus can occur at electrode tip if the temperature of tissue and electrode is excess $100^{\circ}C$. To prevent this phenomenon, we investigated numerical model of electrode for radiofrequency catheter ablation considering saline irrigation and temperature-controlled radiofrequency system. The numerical model is based on coupled electric-thermal-flow problem and solved by COMSOL Multiphysics software. The results of the models show that the dimensions of the thermal lesion are increased if the flow rate of the saline irrigation and the set temperature are increased. The surface width characterized to determine the thermal lesion isn't need to measure in temperature-controlled radiofrequency system due to convective heat transfer by saline irrigation at tissue-electrode interface.

Permanent Transvenous Endocardial Pacemaker Inevitably Implanted Two Electrode Leads (두개의 전극도자를 사용하게 된 Permanent Transvenous Pacemaker Implantation: 1례 보고)

  • Kwack, Moon-Sub;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.168-174
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    • 1981
  • Since cardiac pacemaker was first totally implanted by Chardack, Gage and Greatbatch [1966], the electrical circuity of the cardiac pacemaker has been improved, modified, and refined. The problem of transvenous electrodes, however, is still remained; this may be due to electrode displacement, exit and/or entrance block, lead fracture and insulation defects. In permanent cardiac pacing, Irreversible loss of function of the transvenous electrode catheter eventually requires insertion of new lead. Authors now report one case that disclosed easy displacement of electrode tip in early phase of implantation and then two years and five months later, malfunctioning electrode could not be withdrawn from the cardiovascular system because it has become firmly enclosed by fibrous tissue along its course from the vein tract to the right ventricle. Under such circumstances, the electrode catheter tip was left in tricuspid annulus after being sutured at its entrance and burying the loop of lead in generator pocket. New other one electrode was then reimplantation through left external jugular vein.

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Spatial reproducibility of complex fractionated atrial electrogram depending on the direction and configuration of bipolar electrodes: an in-silico modeling study

  • Song, Jun-Seop;Lee, Young-Seon;Hwang, Minki;Lee, Jung-Kee;Li, Changyong;Joung, Boyoung;Lee, Moon-Hyoung;Shim, Eun Bo;Pak, Hui-Nam
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.5
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    • pp.507-514
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    • 2016
  • Although 3D-complex fractionated atrial electrogram (CFAE) mapping is useful in radiofrequency catheter ablation for persistent atrial fibrillation (AF), the directions and configuration of the bipolar electrodes may affect the electrogram. This study aimed to compare the spatial reproducibility of CFAE by changing the catheter orientations and electrode distance in an in -silico left atrium (LA). We conducted this study by importing the heart CT image of a patient with AF into a 3D-homogeneous human LA model. Electrogram morphology, CFAE-cycle lengths (CLs) were compared for 16 different orientations of a virtual bipolar conventional catheter (conv-cath: size 3.5 mm, inter-electrode distance 4.75 mm). Additionally, the spatial correlations of CFAE-CLs and the percentage of consistent sites with CFAE-CL<120 ms were analyzed. The results from the conv-cath were compared with that obtained using a mini catheter (mini-cath: size 1 mm, inter-electrode distance 2.5 mm). Depending on the catheter orientation, the electrogram morphology and CFAE-CLs varied (conv-cath: $11.5{\pm}0.7%$ variation, mini-cath: $7.1{\pm}1.2%$ variation), however the mini-cath produced less variation of CFAE-CL than conv-cath (p<0.001). There were moderate spatial correlations among CFAE-CL measured at 16 orientations (conv-cath: $r=0.3055{\pm}0.2194$ vs. mini-cath: $0.6074{\pm}0.0733$, p<0.001). Additionally, the ratio of consistent CFAE sites was higher for mini catheter than conventional one ($38.3{\pm}4.6%$ vs. $22.3{\pm}1.4%$, p<0.05). Electrograms and CFAE distribution are affected by catheter orientation and electrode configuration in the in-silico LA model. However, there was moderate spatial consistency of CFAE areas, and narrowly spaced bipolar catheters were less influenced by catheter direction than conventional catheters.

Clinical Use of the Pace-maker in four cases (Pace-maker 사용 4예 경험)

  • 이성구
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.219-228
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    • 1980
  • The heart block and bradyarrhythmia with or without Stokes-Adams attacks are serious, usually terminal events and the immediate mortality is very high. Stimulation with an artificial pacemaker is now an accepted form of treatment in cases of Stokes-Adams syndrome in which medication in unable to produce any lasting improvement. Permanent pacemaker therapy is indicated in these circumstances. The purpose of this report is to describe the successful use of pacemaker in 3 cases of Stokes-Adams syndromes and a case of sinoatrial block with bradyarrhythmia at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine. Electrode catheter was passed through the right external jugular vein and attached to the endocardial surface of the right ventricle. In case 1, fixed type generator was used at first and for the case 2, 3, 4, and case 1 at second, demand type generators were used. The bipolar electrode catheters were used for the three cases and unipolar electrode catheter for case 4. The results of immediate and late period were satisfactory.

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Manufacturing of Metal Micro-wire Interconnection on Submillimeter Diameter Catheter (서브-밀리미터 직경의 카테터 표면 위 금속 마이크로 와이어 접착 공정)

  • Jo, Woosung;Seo, Jeongmin;Kim, Taek-Soo
    • Journal of the Microelectronics and Packaging Society
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    • v.24 no.2
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    • pp.29-35
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    • 2017
  • In this paper, we investigated a manufacturing process of metal micro-wire interconnection on submillimeter diameter catheter. Over the years, flexible electronic researches have focused on flexible plane polymer substrate and micro electrode manufacturing on its surface. However, a curved polymer substrate, such as catheter, is very important for medical application. Among many catheters, importance of submillimeter diameter steerable catheter is increasing to resolve the several limitations of neurosurgery. Steering actuators have been researched for realizing the steerable catheter, but there is no research about practical wiring for driving these actuators. Therefore we developed a new manufacturing process for metal micro-wire interconnection on submillimeter diameter catheter. We designed custom jigs for alignment of the metal micro-wires on the submillimeter diameter catheter. An UV curing system and commercial products were used to reduce the manufacturing time and cost; Au micro-wire, UV curable epoxy, UV lamp, and submillimeter diameter catheter. The assembled catheter was characterized by using an optical microscope, a resistance meter, and a universal testing machine.

Caudal Neuromodulation with the Transforaminal Sacral Electrode (InterStim): Experience in a Pain Center Regarding 12 Implants

  • Guardo, Laura Alonso;Gala, Carlos Cano;Poveda, David Sanchez;Juan, Pablo Rueda;Sanchez Montero, Francisco Jose;Garzon Sanchez, Jose Carlos;Lamas, Juan Ignacio Santos;Sanchez Hernandez, Miguel Vicente
    • The Korean Journal of Pain
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    • v.29 no.1
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    • pp.23-28
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    • 2016
  • Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

Development of Micro Wired pH Electrode for Real-Time Monitoring for Gastroesophageal Reflux (위식도 역류 실시간 모니터링 마이크로 와이어 pH 전극 개발)

  • Kim, Eung-Bo;Lee, Kyu-Jin;So, Sang-Kyun;Joung, Yeun-Ho;Park, Jung Ho;Kim, Nam Hee
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.277-284
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    • 2017
  • This paper presents an implantable pH measurement electrode for wireless gastroesophageal reflux measurement. Usually, gastroesophageal reflux is diagnosed by a catheter-type wire connection between the esophagus and the diagnostic device which brings many side effects such as restriction of daily living, pain, and discomfort in the nasal cavity and pharynx of patients. In order to solve these issues, researchers have been studied a wireless measurement method and a micro-sized pH electrode for human body insertion is necessary. Commercial glass packaged pH meter is formed by a sensing and a reference electrodes in a KCl solution. However, if the glass meter is inserted into the human body, there are risks of leakage of the solution, breakage of the glass package, injury of the body elements. Therefore, the solution should be solidified on the micro-sized noble metal wire which has a characteristic of biocompatible. After solidified wire fabrication, the designed meter was tested for feasibility of measurement and the result was well agreed with pH values of commercial pH meter. Potentials in pH 1 to 12 solution was measured to obtain the sensitivity of the sensor with linearity. And we have designed a simulation of gastroesophageal reflux with symptom frequency, interval, and duration time in pH 2 solution. The proposed sensor has capable to get the same potential for 24 measurements in 3 days, and it has sensed same pH values of 2 for one hour with every 10 minutes. Furthermore, the sensor was survived for 48 hours with reasonable potentials in the acid solution.

Provocative Discography Following Focal Selective Coagulation in a Patient with Chronic Lumbar Discogenic Pain (만성 요추간판성 통증 환자에서 선택적 조직 응고술 후 유발성 추간판조영술의 진단적 소견 변화)

  • Kim, Dahn;Kim, Nackhwan;Lee, Sang-Heon
    • Clinical Pain
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    • v.18 no.2
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    • pp.142-146
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    • 2019
  • This is a case report of the provocative discographic findings before and after focal selective coagulation of the major annular fissure using intradiscal navigable catheter. A 46-year-old woman had a 30-month history of axial low back pain and magnetic resonance imaging findings suspicious for painful L4/5 disc. The provocative discography confirmed painful disc before coagulation. The final electrode tip position in the coagulation procedure was at the largest fissure within the outer annular margin identified through the discography. Six months after the successful coagulation therapy, inadvertently performed discography resulted in decreased pressure rise over time. Neither evoked pain nor change in the integrity of outer annulus as compared with the previous results was reported. Such an interventional method has not been reported previously, and the analytic results suggest that it may be possible to relocate the pressure of the entire nucleus pulposus only by focal selective coagulation of the fissure.

Effects of Hemorrhage on the Electroencephalograms in Dogs Anesthetized with Ketamine, Propofol and Isoflurane (출혈이 Ketamine, Propofol, Isoflurane 마취견의 뇌파에 미치는 영향)

  • Yoon, In-Sub;Jang, Hwan-Soo;Lim, Jae-Hyun;Kwon, Young-Sam;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.539-546
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    • 2009
  • The effect of hemorrhage on the electroencephalogram(EEG) was investigated in fifteen mixed-breed dogs anesthetized with ketamine, propofol and isoflurane. Animals were randomly allocated to three groups (n = 5) by anesthetic agents; group 1 (ketamine 5 mg/kg, IV), group 2 (propofol $156\;{\mu}g$/kg/min, IV) and group 3 (isoflurane 2.0% end-tidal concentration). Medetomidine ($40\;{\mu}g$/kg, IM) was used in all dogs as a preanesthetic agent. Recording electrode for EEG was positioned at CZ. EEG, heart rate, systolic/diastolic blood pressure, $pCO_2$, $pO_2$ and blood pH were measured before anesthesia, after anesthesia and after every bleedings. Three bleedings were accomplished by drawing blood through the femoral artery catheter at a rate of 7 ml/kg (10% of total blood volume) for 10 minutes. In the course of hemorrhage, a systolic/diastolic pressure continuously decreased in all groups. The $pCO_2$ values and heart rates were increased in all groups. The $pO_2$ values were most significantly increased in group 1 compared with those in other groups. The pH values were not significantly changed. On statistical analysis of EEG, there was no significant changes in group 1 and 3. But in group 2, band 3, 4 and 7 were significantly altered after 2nd and 3rd bleeding. Power alterations of band 3, 4 and 7 were thought to be related with hemorrhage over 20% of total blood volume in group 2. In conclusion, the regulation of infusion rate would be considered when a dog, anesthetized with propofol, bleed over 20% of total blood volume.