(19)
(11)EP 2 893 896 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
06.06.2018 Bulletin 2018/23

(21)Application number: 14200169.2

(22)Date of filing:  23.12.2014
(51)International Patent Classification (IPC): 
A61B 18/12(2006.01)
A61B 18/14(2006.01)
A61B 18/00(2006.01)
A61B 90/00(2016.01)

(54)

Torsion reduction system

Torsionsreduktionssystem

Système de réduction de torsion


(84)Designated Contracting States:
AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

(30)Priority: 24.12.2013 US 201314139974

(43)Date of publication of application:
15.07.2015 Bulletin 2015/29

(73)Proprietor: Biosense Webster (Israel) Ltd.
20692 Yokneam (IL)

(72)Inventors:
  • Lichtenstein, Yoav
    4372706 Raanana (IL)
  • Krupnik, Ronen
    2168111 Karmiel (IL)
  • Urman, Roy
    3706315 Karkur (IL)
  • Katz, Natan Sharon
    Kiryat Bialik 2706710 (IL)
  • Cohn, Goren
    3467027 Haifa (IL)

(74)Representative: Carpmaels & Ransford LLP 
One Southampton Row
London WC1B 5HA
London WC1B 5HA (GB)


(56)References cited: : 
US-A1- 2012 184 955
US-A1- 2013 023 770
  
      
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description

    FIELD OF THE INVENTION



    [0001] The present invention relates generally to invasive probes, and specifically to a system that reduces cable torsion and prevents cable entanglement for an invasive probe having multiple cables connected to a proximal end of the probe.

    BACKGROUND OF THE INVENTION



    [0002] A wide range of medical procedures involve placing objects such as sensors, tubes, catheters, dispensing devices, and implants, within the body. An example of a medical procedure performed with a catheter is ablation of body tissue such as heart tissue. The ablation may be used to cure a variety of cardiac arrhythmia such as atrial fibrillation. Such procedures are known in the art. Other medical procedures using ablation of body tissue, such as treating varicose veins, are also known in the art. The ablation energy for these procedures may be in the form of radio-frequency (RF) energy, which is supplied to the tissue via one or more electrodes of a catheter used for the procedures.

    [0003] The application of the ablation energy to body tissue, if uncontrolled, may lead to an unwanted increase of temperature of the tissue. It is consequently important to monitor and control the temperature of the tissue during any medical procedure involving ablation. One method for control is to irrigate the tissue being ablated. Document US 2013/0023770 A1 discloses a catheter that includes an external sheath, a rotatable conduit housed within the external sheath, and a fluid rotary joint having a rotatable insert that places an inner lumen of the rotatable conduit in fluid communication with an external port under rotation of the rotatable conduit. The rotatable insert may include a channel structure including an external annular channel. The rotatable conduit is received within the channel structure such that the inner lumen is in fluid communication with the external port through the annular channel under rotation. The external sheath may define an outer lumen that may be in fluid communication with the inner lumen at a location remote from a proximal portion of the catheter, and the outer lumen may be in fluid communication with a secondary port. The rotatable conduit may be housed within a torque cable that is connected to the rotatable insert.

    [0004] Document US2012/0184955 A1 discloses a system for remotely controlling the positioning within the body of a patient of an elongated medical device optionally having a control handle, comprises a catheter position system and a remote controller configured to control the robotic device

    SUMMARY OF THE INVENTION



    [0005] There is provided, in accordance with an embodiment of the present invention an apparatus, including a flexible insertion tube including a proximal tube end and a distal tube end for insertion into a body cavity, and an electrode mounted at the distal tube end. The apparatus also includes a first irrigation line, including proximal and distal irrigation line ends, contained within the insertion tube, and configured to supply irrigation fluid from the distal irrigation line end through one or more apertures in the distal tube end. The apparatus additionally includes a first electrical line contained within the insertion tube and including a proximal electrical line end and a distal electric line end, which is coupled to the electrode. The apparatus further includes a slip ring unit including a stator connected to a second electrical line for connection to a console, a rotor connected to the proximal electrical line end, and a hollow channel extending through respective centers of the stator and the rotor along a longitudinal axis of the slip ring unit. The apparatus also includes a rotary joint in fluid communication with the proximal irrigation line end, and in fluid communication with the console via a second irrigation line, an angle sensor configured to detect torsion of the proximal irrigation line end and the proximal electrical line end, and a drive mechanism coupled to rotate the rotor responsively to the detected torsion so as to reduce the torsion of the proximal irrigation line end and the proximal electrical line end.

    [0006] In some embodiments, the body cavity may include a heart, and the probe may include an intracardiac catheter. In additional embodiments, the irrigation fluid may include a saline solution. In further embodiments, the apparatus may include a belt coupling the drive mechanism to the rotor.

    [0007] In supplemental embodiments, the angle may include a strain gauge. In alternative embodiments, the angle sensor may include a position sensor mounted in the flexible insertion tube, the position sensor configured to detect the torsion by measuring a change of orientation of the flexible insertion tube.

    [0008] In further embodiments, the apparatus may include a bearing including an internal ring surrounded by an external ring, wherein the internal ring encompasses the proximal irrigation line end, and wherein the angle sensor may include an angle encoder mounted on the external ring, and wherein the angle encoder is configured to detect the torsion by measuring an angle of rotation between the internal and the external rings. In additional embodiments, the angle encoder may include decoding electronics, and the apparatus may include a marked disk mounted on the internal ring.

    [0009] In supplemental embodiments, the console may include an ablation module and an irrigation module, and wherein the second electrical line connects the ablation module to the stator, and wherein the rotary joint is in fluid communication with the irrigation module via the second irrigation line. In additional embodiments, the proximal irrigation line end is threaded through the hollow channel and connected to the rotary joint.

    [0010] In some embodiments, the apparatus may include a handle coupled to the proximal tube end, and wherein the detected torsion corresponds to an angle of rotation of the handle, and wherein the drive mechanism is configured to responsively rotate the rotor by the angle of rotation. In supplemental embodiments, the angle sensor may include a position sensor mounted in the handle, the position sensor configured to detect the torsion by measuring a change of orientation of the handle.

    [0011] There is also provided, in accordance with an aspect of the disclosure a method, including inserting, into a body cavity, a distal end of a flexible insertion tube including a proximal end, the insertion tube containing an electrode mounted at the distal end, a first irrigation line including proximal and distal irrigation line ends, contained within the insertion tube, configured to supply irrigation fluid from the distal irrigation line end through one or more apertures in the distal end, and inserted through a hollow channel extending through a longitudinal axis of a slip ring unit including a stator and a rotor, and a first electrical line including a proximal electrical line end, which is connected to the rotor, and a distal electric line end, which is coupled to the electrode. The method also includes receiving, from an angle sensor, a signal indicating torsion of the proximal irrigation line end and the proximal electrical line end, and rotating, by a drive mechanism, the rotor responsively to the detected torsion so as to reduce the torsion of the proximal irrigation line end and the proximal electrical line end.

    [0012] There is further provided, in accordance with an embodiment of the present invention a computer software product, operated in conjunction with a probe that is configured for insertion into a body cavity of a patient and includes an electrode mounted at the distal tube end, a first irrigation line including proximal and distal irrigation line ends, contained within the insertion tube, configured to supply irrigation fluid from the distal irrigation line end through one or more apertures in the distal tube end, inserted through a hollow channel extending through respective a longitudinal axis of a slip ring unit including a stator and a rotor, a first electrical line contained within the insertion tube and including a proximal electrical line end, which is connected to the rotor, and a distal electric line end, which is coupled to the electrode. The computer software product includes a non-transitory computer-readable medium, in which program instructions are stored, which instructions, when read by a computer, cause the computer to receive, from an angle sensor, a signal indicating torsion of the proximal irrigation line end and the proximal electrical line end, and to rotate, via a drive mechanism, the rotor responsively to the detected torsion so as to reduce the torsion of the irrigation line and the electrical line.
    The invention is defined in claim 1 and claim 13. Further aspects and preferred embodiments are defined in the dependent claims.

    BRIEF DESCRIPTION OF THE DRAWINGS



    [0013] The disclosure is herein described, by way of example only, with reference to the accompanying drawings, wherein:

    Figure 1 is a schematic pictorial illustration of a medical system having a torsion management apparatus, in accordance with an embodiment of the present invention;

    Figure 2 is a schematic pictorial illustration of an exterior of the torsion management apparatus, in accordance with an embodiment of the present invention;

    Figure 3 is a schematic pictorial illustration showing interior elements of the torsion management apparatus, in accordance with an embodiment of the present invention;

    Figure 4 is a schematic cross-sectional longitudinal view showing details of a slip ring unit used in the torsion management apparatus, in accordance with an embodiment of the present invention;

    Figure 5 is a schematic cross-sectional latitudinal view of the slip ring unit, in accordance with an embodiment of the present invention;

    Figure 6 is a schematic pictorial illustration of an example of an angle sensor used in the torsion management apparatus, in accordance with an embodiment of the current invention; and

    Figure 7 is a flow diagram that schematically illustrates a method of reducing torsion in electrical and irrigation lines of the medical system, in accordance with an aspect of the disclosure.


    DETAILED DESCRIPTION OF EMBODIMENTS


    OVERVIEW



    [0014] Various therapeutic procedures such as cardiac ablation use an invasive medical probe such as a catheter that is inserted into a patient's body. During an ablation procedure on a heart, there may be local overheating of the heart surface being ablated, as well as of the heart tissue underlying the surface. The surface overheating may be manifested as charring, and the overheating of the underlying tissue may cause other damage to the tissue, even leading to penetration of the tissue. To control the temperature of the surface and the underlying tissue, the region being ablated may be irrigated with an irrigation fluid, typically saline, in order to prevent charring.

    [0015] In addition to the risk of charring, overheating of blood in the region being ablated may cause the formation of potentially dangerous blood clots, which can grow and potentially cause a heart attack or a stroke. In some cases the irrigation may reduce blood clot formation by cooling and diluting the blood.

    [0016] During an ablation procedure using an invasive probe, an operator (e.g., a physician) may rotate the probe's handle in order to position a distal tip of the probe within the body cavity at a desired location. The handle typically has a first end connected to an insertion tube comprising the distal end, and a second end coupled to an irrigation line and an electrical line. As the operator rotates the handle, there may be torsion that can cause entanglement of the electrical and the irrigation lines.

    [0017] Embodiments of the present invention provide an apparatus for reducing torsion in lines extending from a handle of an invasive probe such as an intracardiac catheter. The lines may comprise an irrigation line and an electrical line that are contained within the handle and the insertion tube, the irrigation line having proximal and distal irrigation line ends, and the electrical line having proximal and distal electrical line ends.

    [0018] In some embodiments, the apparatus comprises a slip ring unit, a rotary joint and a drive mechanism controlled by a console. As described hereinbelow, a proximal end of the electrical line is connected to a rotor of the slip ring unit, and a proximal end of the irrigation line is threaded through a channel extending through a center of the rotor along a longitudinal axis of the slip ring unit and in fluid communication with the rotary joint. The rotor is also coupled to the drive mechanism, thereby enabling the drive mechanism to rotate the rotor in response to commands received from the console.

    [0019] In operation, as the operator rotates the handle in order to position the distal tip of the probe within the body cavity, an angle sensor detects torsion of the electrical and the irrigation lines extending from the handle, and the drive mechanism rotates the rotor responsively to the detected torsion, so as to reduce the torsion.

    SYSTEM DESCRIPTION



    [0020] Figure 1 is a schematic pictorial illustration of a medical system 20 having a torsion management apparatus 70, in accordance with an embodiment of the present invention. System 20 may be based, for example, on the CARTO™ system, produced by Biosense Webster Inc. (Diamond Bar, California). System 20 comprises a probe 22, such as a catheter, and a control console 24. In the embodiment described hereinbelow, it is assumed that probe 22 is used for diagnostic or therapeutic treatment, such as performing ablation of heart tissue. Alternatively, probe 22 may be used, mutatis mutandis, for other therapeutic and/or diagnostic purposes in the heart or in other body organs.

    [0021] Probe 22 comprises a flexible insertion tube 28, and a handle 30 coupled to a proximal end 68 of the insertion tube. By manipulating handle 30, an operator 32 can insert probe 22 into a body cavity in a patient 34. For example, operator 32 can insert probe 22 through the vascular system of a patient 34 so that a distal end 36 of probe 22 enters a chamber of heart 26 and engages endocardial tissue at a desired location or locations. Distal end 36 may also be referred to herein as a distal tube end.

    [0022] System 20 typically uses magnetic position sensing to determine position coordinates of distal end 36 inside heart 26. Console 24 comprises a driver circuit 38 which drives field generators 40 to generate magnetic fields within the body of patient 34. Typically, field generators 40 comprise coils, which are placed below the patient's torso at known positions external to patient 34. These coils generate magnetic fields in a predefined working volume that contains heart 26. A magnetic field sensor 42 (also referred to herein as position sensor 42) within distal end 36 of probe 22 generates electrical signals in response to the magnetic fields from the coils, thereby enabling console 24 to determine the position of distal end 36 within the chamber.

    [0023] Although in the present example system 20 measures the position of distal end 36 using magnetic-based sensors, other position tracking techniques may be used (e.g., impedance-based sensors). Magnetic position tracking techniques are described, for example, in U.S. Patents 5,391,199 and 6,690,963 referenced above, and in in U.S. Patents 5,443,489, 6,788,967, 5,558,091, 6,172,499 and 6,177,792. Impedance-based position tracking techniques, are described, for example, in U.S. Patents 5,983,126, 6,456,864 and 5,944,022.

    [0024] A processor 44 processes these signals in order to determine the position coordinates of distal end 36, typically including both location and orientation coordinates. The method of position sensing described hereinabove is implemented in the above-mentioned CARTOTM system and is described in detail in the patents and patent applications cited above.

    [0025] Processor 44 typically comprises a general-purpose computer, with suitable front end and interface circuits for receiving signals from probe 22 and controlling the other components of console 24. Processor 44 may be programmed in software to carry out the functions that are described herein. The software may be downloaded to console 24 in electronic form, over a network, for example, or it may be provided on non-transitory tangible media, such as optical, magnetic or electronic memory media. Alternatively, some or all of the functions of processor 44 may be carried out by dedicated or programmable digital hardware components.

    [0026] Based on the signals received from probe 22 and other components of system 20, processor 44 drives a display 46 to present operator 32 with an image 48 showing the position of distal end 36 in the patient's body, as well as status information and guidance regarding the procedure that is in progress. Processor 44 stores data representing image 48 in a memory 50. In some embodiments, operator 32 can manipulate image 48 using one or more input devices 52.

    [0027] In the present embodiment, an electrode 54 is mounted on distal end 36. Electrode 54 typically comprises thin metal layers formed over an insulating sheath 56 of insertion tube 28. In the configuration shown in Figure 1, electrode 54 has one or more irrigation apertures 58, and irrigation line 66 is configured to supply irrigation fluid from the distal irrigation line end through the one or more apertures in distal end 36.

    [0028] Console 24 also comprises a radio frequency (RF) ablation module 60 and an irrigation module 62. Processor 44 uses the ablation module to monitor and control ablation parameters such as the level of ablation power applied via electrode 54. The ablation module may also monitor and control the duration of the ablation that is provided.

    [0029] Console 24 conveys power to position sensor 42 and electrode 54 via an electrical line 64 (also referred to herein as a first electrical line) that is contained within insertion tube 28 and handle 30. Electrical line 64 typically comprises a metallic conductor and has a proximal electrical line end and a distal electric line end that is coupled to electrode 54. While (for illustrative purposes) Figure 1 shows a single electrical line 64 coupling the electrode and the sensors, there can be multiple connecting cables contained within the insertion tube and the handle.

    [0030] Typically, during ablation, heat is generated in the electrode (or electrodes) providing the ablation, as well as in the surrounding region. In order to dissipate the heat and to improve the efficiency of the ablation process, system 20 supplies irrigation fluid to distal end 36 via an irrigation line 66 (also referred to herein as a first irrigation line) that has proximal and distal irrigation line ends. System 20 uses irrigation module 62 to monitor and control irrigation parameters, such as the pressure and the temperature of the irrigation fluid. The irrigation fluid is typically normal saline solution, and the rate of flow of the fluid, controlled by irrigation module 62, is typically in the range of approximately 10 - 20 cc/minute, but may be higher or lower than this range.

    [0031] Handle 30 is coupled to proximal end 68 of insertion tube 28. Proximal end 68 may also be referred to herein as a proximal tube end. In embodiments of the present invention, insertion tube 28 and handle 30 contain electrical line 64 and irrigation line 66, and the proximal ends of lines 64 and 66 extend from handle 30 and are connected to torsion management apparatus 70, as described hereinbelow. An electrical line 72 (also referred to herein as a second electrical line) couples, via torsion management apparatus 70, electrical line 64 to ablation module 60, and an irrigation line 74 (also referred to herein as a second irrigation line) couples irrigation line 66 to irrigation module 62 via the torsion management apparatus.

    [0032] In some embodiments, handle 30 may implement compression and/or sampling for magnetic analog signal (MAG) data, electrocardiography (ECG) data, and other data. In additional embodiments, probe 22 may communicate with console 24 via wireless digital communication or via optical communication.

    [0033] Figure 2 is a schematic pictorial illustration of the exterior of torsion management apparatus 70, in accordance with an embodiment of the present invention. The exterior comprises a casing 80, a removable cover 82 having an electrical connector 84 (the cover and the connector are also illustrated in Figure 6) that connects apparatus 70 to electrical line 64, a mounting clamp 86, and a rotary joint 88 that is affixed to casing 80 and is in fluid communication with the proximal end of irrigation line 66, and is in fluid communication with irrigation module 62 in console 24 via irrigation line 74.

    [0034] Operator 32 can use mounting clamp 86 to affix apparatus 70 to a fixture in proximity to the operator and the patient, such as console 24 (as shown in Figure 1) or the patient's bed. In some embodiments, rotary joint 88 comprises a ball and socket joint having a socket 90 holding a ball 92. In the configuration shown in Figure 2, the proximal end of irrigation line 66 is connected to ball 92 and a distal end of irrigation line 74 is connected to socket 90.

    [0035] Figure 3 is a schematic pictorial illustration showing interior elements of apparatus 70 comprising a slip ring unit 100, Figure 4 is a schematic cross-sectional longitudinal view showing details of the slip ring unit, and Figure 5 is a schematic cross-sectional latitudinal view of the slip ring unit, in accordance with an embodiment of the present invention. The internal elements comprise slip ring unit 100, a drive mechanism (e.g., a motor) 102 and a belt 104.

    [0036] A slip ring unit is an electromechanical device that allows the transmission of power and electrical signals from a stationary to a rotating structure, or vice versa. In the configuration shown in Figure 4, slip ring unit 100 comprises a stator 110 encompassing a rotor 112, and belt 104 is connected to drive mechanism 102 and the rotor, thereby enabling the drive mechanism to rotate the rotor, as shown by an arrow 120 in Figure 5.

    [0037] Typically, a conductive brush (not shown) is fixedly attached to rotor 112, and the brush makes contact with a conductive ring (not shown) mounted on the interior surface of stator 110. In operation, as rotor 112 rotates, the brush maintains contact with the ring, thereby maintaining an electrical connection between the rotor and the stator. Each ring-brush pair is typically referred to as a slip ring, and slip ring unit 100 may comprise multiple slip rings (i.e., ring-brush pairs) thereby enabling the slip ring unit to convey multiple signals between the stator and the rotor.

    [0038] Rotor 112 is connected to a proximal end of electrical line 64, and drive mechanism 102 is controlled by processor 44. In other words, the rotation of rotor 112 is controlled by processor 44. In addition to rotating rotor 112, apparatus 70 is configured to enable drive mechanism 102 to rotate the rotor and cover 82 at an identical angular phase as the rotor's rotation.

    [0039] As shown in Figure 3, a distal end of electrical line 72 is connected to stator 110, and a proximal end of the second electrical line is connected to ablation module 60. In some embodiments, electrical line 72 may be coupled to one or more other modules of console 24 (i.e., in addition to ablation module 60).

    [0040] Slip ring unit 100 comprises a hollow channel 114 extending through respective centers of stator 110 and rotor 112 along a longitudinal axis 116 of the slip ring unit. Hollow channel 114 is configured to allow the proximal end of irrigation line 66 to be threaded through the hollow channel and affixed to ball 92 of rotary joint 88.

    [0041] In embodiments of the present invention, processor 44 receives signals from an angle sensor that is configured to detect torsion of the proximal ends of electrical line 64 and irrigation line 66. The torsion is typically due to operator 32 rotating handle 30 along the handle's longitudinal axis, thereby rotating insertion tube 28 within patient 34.

    [0042] Figure 6 is a schematic pictorial illustration of an example of an angle sensor, in accordance with an embodiment of the current invention. In the example shown in Figure 6, the angle sensor comprises an angle encoder 130 mounted on a bearing 132. Angle encoder 130 typically comprises a printed circuit board having decoding electronics configured to detect an angular offset around longitudinal axis 116.

    [0043] In the configuration shown in Figure 6, bearing 132 comprises an internal ring 134 surrounded by an external ring 136 that is fixedly attached to casing 80. Internal ring 134 encompasses and holds the proximal end of irrigation line 66, thereby preventing any axial motion of the proximal end of the first irrigation line relative to the internal ring. In some embodiments, a marked disk is mounted on the internal ring, and the decoding electronics are mounted on the external ring. The marked disk typically comprises a disk having physical markings or slots embedded in the disk.

    [0044] Therefore, operator 32 rotating handle 30 causes a corresponding rotation of internal ring 134 (the internal ring is holding a portion of the proximal end of irrigation line 66), and angle encoder 130 can measure an angle of rotation between the internal ring and the external ring, and convey an angle encoder signal to processor 44 indicating the angle of rotation, thereby indicating torsion of the proximal irrigation line end and the proximal electrical line end.

    [0045] While the example in Figure 6 shows angle encoder 130 configured as an angle sensor, other types of angle sensors are considered to be within the spirit and scope of the present invention. For example, the angle sensor may comprise a strain gauge (not shown) configured to measure any strain on electrical line 64 and/or irrigation line 66, typically as a result of operator 32 rotating handle 30.

    [0046] As described supra, position sensor 42 can convey signals to processor 44 indicating location and orientation coordinates of distal end 36. As operator 32 rotates handle 30, there is a corresponding rotation of distal end 36, the proximal irrigation line end and the proximal electrical line end. Therefore, by measuring a change of orientation (i.e., a rotation) of distal end 36, and conveying, to processor 44, a position signal indicating the change of orientation, position sensor 42 may be configured to operate as an angle sensor in system 20.

    [0047] Additionally, while the configuration shown in Figure 1 shows position sensor 42 mounted in the distal end of insertion tube 28, the position sensor configured to function as an angle sensor may be positioned in other portions of probe 22. For example, position sensor 42 may be mounted in any part of insertion tube 28 and configured to detect the torsion by measuring a change of orientation of the insertion tube. Alternatively, position sensor may be mounted in handle 30 and configured to detect the torsion by measuring a change of orientation of the handle.

    [0048] Figure 7 is a flow diagram that schematically illustrates a method of reducing torsion of electrical line 64 and irrigation line 66, in accordance with an aspect of the disclosure. In a connection step 140, operator 32 connects the proximal end of electrical line 64 to connector 84, threads the proximal end of irrigation line 66 through hollow channel 114 of slip ring unit 100 in a threading step 142, and affixes the proximal end of the first irrigation line to ball 92 of rotary joint 88 in an affix step 144.

    [0049] In an insertion step 146, operator 32 inserts insertion tube 28 of probe 22 into patient 34, and rotates insertion tube 28 by rotating handle 30 in a first rotation step 148. As operator 32 rotates handle 30, the proximal ends of electrical line 64 and irrigation line 66 that extend from handle 30 to apparatus 70 start "twisting" due to the handle's rotation.

    [0050] In a receive step 150, processor 44 receives a signal from angle encoder 130 indicating torsion of the proximal irrigation line end. In some aspects, the torsion indicated in the signal corresponds to an angle of rotation of handle 30.

    [0051] Finally, in a second rotation step 152, processor 44 conveys a signal indicating the angle of rotation of handle 30 to drive mechanism 102, drive mechanism 102 rotates rotor 112 by the angle of rotation, and the method ends. By rotating rotor 112 by the angle of rotation, aspects of the disclosure reduce the torsion in proximal ends of irrigation line 66 and electrical line 64, thereby preventing a potential entanglement of the proximal irrigation line end and the proximal electrical line end.

    [0052] It will be appreciated that the embodiments described above are cited by way of example, and that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not disclosed in the prior art.


    Claims

    1. An apparatus, comprising:

    a flexible insertion tube (28) comprising a proximal tube end and a distal tube end for insertion into a body cavity;

    an electrode (54) mounted at the distal tube end;

    a first irrigation line (66), comprising proximal and distal irrigation line ends, contained within the insertion tube, and configured to supply irrigation fluid from the distal irrigation line end through one or more apertures in the distal tube end;

    a first electrical line contained within the insertion tube and comprising a proximal electrical line end and a distal electric line end, which is coupled to the electrode;

    a slip ring unit (100) comprising:

    a stator (110) connected to a second electrical line for connection to a console (24);

    a rotor (112) connected to the proximal electrical line end; and

    a hollow channel (114) extending through respective centers of the stator and the rotor along a longitudinal axis (116) of the slip ring unit;

    a rotary joint in fluid communication with the proximal irrigation line end, and in fluid communication with the console via a second irrigation line;

    an angle sensor (42, 130) configured to detect torsion of the proximal irrigation line end and the proximal electrical line end; and

    a drive mechanism (102) coupled to rotate the rotor responsively to the detected torsion so as to reduce the torsion of the proximal irrigation line (66) end and the proximal electrical line (64) end.


     
    2. The apparatus according to claim 1, wherein the body cavity comprises a heart, and the probe comprises an intracardiac catheter.
     
    3. The apparatus according to claim 1, wherein the irrigation fluid comprises a saline solution.
     
    4. The apparatus according to claim 1, and comprising a belt coupling the drive mechanism to the rotor.
     
    5. The apparatus according to claim 1, wherein the angle sensor comprises a strain gauge.
     
    6. The apparatus according to claim 1, wherein the angle sensor comprises a position sensor mounted in the flexible insertion tube, the position sensor configured to detect the torsion by measuring a change of orientation of the flexible insertion tube.
     
    7. The apparatus according to claim 1, and comprising a bearing comprising an internal ring surrounded by an external ring, wherein the internal ring encompasses the proximal irrigation line end, and wherein the angle sensor comprises an angle encoder mounted on the external ring, and wherein the angle encoder is configured to detect the torsion by measuring an angle of rotation between the internal and the external rings.
     
    8. The apparatus according to claim 7, wherein the angle encoder comprises decoding electronics, and comprising a marked disk mounted on the internal ring.
     
    9. The apparatus according to claim 1, wherein the console comprises an ablation module and an irrigation module, and wherein the second electrical line connects the ablation module to the stator, and wherein the rotary joint is in fluid communication with the irrigation module via the second irrigation line.
     
    10. The apparatus according to claim 1, wherein the proximal irrigation line end is threaded through the hollow channel and connected to the rotary joint.
     
    11. The apparatus according to claim 1, and comprising a handle coupled to the proximal tube end, and wherein the detected torsion corresponds to an angle of rotation of the handle, and wherein the drive mechanism is configured to responsively rotate the rotor by the angle of rotation.
     
    12. The apparatus according to claim 11, wherein the angle sensor comprises a position sensor mounted in the handle, the position sensor configured to detect the torsion by measuring a change of orientation of the handle.
     
    13. A computer software product, operated in conjunction with a probe that is configured for insertion into a body cavity of a patient and includes:

    an electrode mounted at the distal tube end,

    a first irrigation line comprising proximal and distal irrigation line ends, contained within the insertion tube, configured to supply irrigation fluid from the distal irrigation line end through one or more apertures in the distal tube end, inserted through a hollow channel extending through respective a longitudinal axis of a slip ring unit comprising a stator and a rotor,

    a first electrical line contained within the insertion tube and comprising a proximal electrical line end, which is connected to the rotor, and a distal electric line end, which is coupled to the electrode,

    the product comprising a non-transitory computer-readable medium, in which program instructions are stored, which instructions, when read by a computer, cause the computer:

    to receive, from an angle sensor, a signal indicating torsion of the proximal irrigation line end and the proximal electrical line end, and

    to rotate, via a drive mechanism, the rotor responsively to the detected torsion so as to reduce the torsion of the irrigation line and the electrical line.


     


    Ansprüche

    1. Vorrichtung, die Folgendes umfasst:

    ein flexibles Einführrohr (28), das ein proximales Rohrende und ein distales Rohrende zum Einführen in eine Körperhöhle umfasst;

    eine Elektrode (54), die am distalen Rohrende befestigt ist;

    eine erste Spülleitung (66), die ein proximales und ein distales Spülleitungsende umfasst, innerhalb des Einführrohrs enthalten ist und dazu konfiguriert ist, eine Spülflüssigkeit vom distalen Spülleitungsende durch eine oder mehrere Öffnungen im distalen Rohrende zu liefern;

    eine erste elektrische Leitung, die innerhalb des Einführrohrs enthalten ist und ein proximales elektrisches Leitungsende und ein distales elektrisches Leitungsende, das mit der Elektrode gekoppelt ist, umfasst;

    eine Schleifringeinheit (100), die Folgendes umfasst:

    einen Stator (110), der mit einer zweiten elektrischen Leitung zur Verbindung mit einer Konsole (24) verbunden ist;

    einen Rotor (112), der mit dem proximalen elektrischen Leitungsende verbunden ist; und

    einen hohlen Kanal (114), der sich durch jeweilige Zentren des Stators und des Rotors entlang einer Längsachse (116) der Schleifringeinheit erstreckt;

    eine Drehverbindung, die sich in Fluidkommunikation mit dem proximalen Spülleitungsende und in Fluidkommunikation mit der Konsole über eine zweite Spülleitung befindet;

    einen Winkelsensor (42, 130), der konfiguriert ist zum Detektieren einer Torsion des proximalen Spülleitungsendes und des proximalen elektrischen Leitungsendes; und

    einen Antriebsmechanismus (102), der so gekoppelt ist, dass der Rotor als Reaktion auf die detektierte Torsion gedreht wird, damit die Torsion des proximalen Spülleitungsendes (66) und des proximalen elektrischen Leitungsendes (64) reduziert wird.


     
    2. Vorrichtung nach Anspruch 1, wobei die Körperhöhle ein Herz umfasst und die Sonde einen intrakardialen Katheter umfasst.
     
    3. Vorrichtung nach Anspruch 1, wobei die Spülflüssigkeit eine Salzlösung umfasst.
     
    4. Vorrichtung nach Anspruch 1 und umfassend einen Riemen, der den Antriebsmechanismus zum Rotor koppelt.
     
    5. Vorrichtung nach Anspruch 1, wobei der Winkelsensor einen Dehnungsmesser umfasst.
     
    6. Vorrichtung nach Anspruch 1, wobei der Winkelsensor einen Positionssensor umfasst, der im flexiblen Einführrohr befestigt ist, wobei der Positionssensor konfiguriert ist zum Detektieren der Torsion durch Messen einer Veränderung der Ausrichtung des flexiblen Einführrohrs.
     
    7. Vorrichtung nach Anspruch 1 und umfassend ein Lager, das einen internen Ring umfasst, der durch einen externen Ring umgeben wird, wobei der interne Ring das proximale Spülleitungsende einschließt und wobei der Winkelsensor einen Winkelcodierer umfasst, der am externen Ring befestigt ist, und wobei der Winkelcodierer konfiguriert ist zum Detektieren der Torsion durch Messen eines Drehwinkels zwischen dem internen und dem externen Ring.
     
    8. Vorrichtung nach Anspruch 7, wobei der Winkelcodierer Decodierungselektronik umfasst, und umfassend eine markierte Scheibe, die am internen Ring befestigt ist.
     
    9. Vorrichtung nach Anspruch 1, wobei die Konsole ein Ablationsmodul und ein Spülmodul umfasst und wobei die zweite elektrische Leitung das Ablationsmodul mit dem Stator verbindet und wobei sich die Drehverbindung mit dem Spülmodul über die zweite Spülleitung in Fluidkommunikation befindet.
     
    10. Vorrichtung nach Anspruch 1, wobei das proximale Spülleitungsende durch den hohlen Kanal eingezogen wird und mit der Drehverbindung verbunden ist.
     
    11. Vorrichtung nach Anspruch 1 und umfassend einen Griff, der mit dem proximalen Rohrende gekoppelt ist, und wobei die detektierte Torsion einem Drehwinkel des Griffs entspricht und wobei der Antriebsmechanismus als Reaktion darauf konfiguriert ist, den Rotor um den Drehwinkel zu drehen.
     
    12. Vorrichtung nach Anspruch 11, wobei der Winkelsensor einen Positionssensor umfasst, der im Griff befestigt ist, wobei der Positionssensor konfiguriert ist zum Detektieren der Torsion durch Messen einer Veränderung der Ausrichtung des Griffs.
     
    13. Computersoftwareprodukt, das zusammen mit einer Sonde betrieben wird, die zur Einführung in eine Körperhöhle eines Patienten konfiguriert ist und Folgendes beinhaltet:

    eine Elektrode, die am distalen Rohrende befestigt ist,

    eine erste Spülleitung, die ein proximales und ein distales Spülleitungsende umfasst, innerhalb des Einführrohrs enthalten ist und dazu konfiguriert ist, eine Spülflüssigkeit vom distalen Spülleitungsende durch eine oder mehrere Öffnungen im distalen Rohrende zu liefern, und die durch einen hohlen Kanal eingeführt wird, der sich durch jeweils eine Längsachse einer Schleifringeinheit, die einen Stator und einen Rotor umfasst, erstreckt,

    eine erste elektrische Leitung, die innerhalb des Einführrohrs enthalten ist und ein proximales elektrisches Leitungsende, das mit dem Rotor verbunden ist, und ein distales elektrisches Leitungsende, das zur Elektrode gekoppelt ist, umfasst,

    wobei das Produkt ein nicht flüchtiges computerlesbares Medium umfasst, in dem Programmanweisungen gespeichert sind, wobei die Anweisungen, wenn sie durch einen Computer gelesen werden, bewirken, dass der Computer Folgendes durchführt:

    Empfangen, von einem Winkelsensor, eines Signals, das eine Torsion des proximalen Spülleitungsendes und des proximalen elektrischen Leitungsendes angibt, und

    Drehen, über einen Antriebsmechanismus, des Rotors als Reaktion auf die detektierte Torsion, damit die Torsion der Spülleitung und der elektrischen Leitung reduziert wird.


     


    Revendications

    1. Appareil comprenant :

    un tube d'insertion flexible (28) comprenant une extrémité proximale de tube et une extrémité distale de tube pour l'insertion dans une cavité corporelle ;

    une électrode (54) montée à l'extrémité distale du tube ;

    une première ligne d'irrigation (66), comprenant des extrémités proximale et distale de ligne d'irrigation, contenue dans le tube d'insertion, et configurée pour amener un fluide d'irrigation par l'extrémité distale de la ligne d'irrigation à travers une ou plusieurs ouvertures dans l'extrémité distale du tube ;

    une première ligne électrique contenue dans le tube d'insertion et comprenant une extrémité proximale de ligne électrique et une extrémité distale de ligne électrique, qui est couplée à l'électrode ;

    une unité formant bague collectrice (100) comprenant :

    un stator (110) connecté à une deuxième ligne électrique pour la connexion à une console (24) ;

    un rotor (112) connecté à l'extrémité proximale de la ligne électrique ; et

    un canal creux (114) s'étendant à travers les centres respectifs du stator et du rotor le long d'un axe longitudinal (116) de l'unité formant bague collectrice ;

    un joint rotatif en communication fluidique avec l'extrémité proximale de la ligne d'irrigation, et en communication fluidique avec la console via une deuxième ligne d'irrigation ;

    un capteur d'angle (42, 130) configuré pour détecter une torsion de l'extrémité proximale de la ligne d'irrigation et de l'extrémité proximale de la ligne électrique ; et

    un mécanisme d'entraînement (102) couplé de façon à faire tourner le rotor en réponse à la torsion détectée, afin de réduire la torsion de l'extrémité proximale de la ligne d'irrigation (66) et de l'extrémité proximale de ligne électrique (64).


     
    2. Appareil selon la revendication 1, dans lequel la cavité corporelle comprend un coeur, et la sonde comprend un cathéter intracardiaque.
     
    3. Appareil selon la revendication 1, dans lequel le fluide d'irrigation comprend une solution saline.
     
    4. Appareil selon la revendication 1, comprenant une courroie couplant le mécanisme d'entraînement au rotor.
     
    5. Appareil selon la revendication 1, dans lequel le capteur d'angle comprend un extensomètre.
     
    6. Appareil selon la revendication 1, dans lequel le capteur d'angle comprend un capteur de position monté dans le tube d'insertion flexible, le capteur de position étant configuré pour détecter la torsion en mesurant un changement d'orientation du tube d'insertion flexible.
     
    7. Appareil selon la revendication 1, comprenant un palier comprenant une bague interne entourée d'une bague externe, la bague interne incluant l'extrémité proximale de la ligne d'irrigation, et le capteur d'angle comprenant un encodeur d'angle monté sur la bague externe, lequel encodeur d'angle étant configuré pour détecter la torsion en mesurant un angle de rotation entre les bagues interne et externe.
     
    8. Appareil selon la revendication 7, dans lequel l'encodeur d'angle comprend des circuits électroniques de décodage, et comprenant un disque marqué monté sur la bague interne.
     
    9. Appareil selon la revendication 1, dans lequel la console comprend un module d'ablation et un module d'irrigation, dans lequel la deuxième ligne électrique connecte le module d'ablation au stator, et dans lequel le joint rotatif est en communication fluidique avec le module d'irrigation via la deuxième ligne d'irrigation.
     
    10. Appareil selon la revendication 1, dans lequel l'extrémité proximale de la ligne d'irrigation est enfilée dans le canal creux et connectée au joint rotatif.
     
    11. Appareil selon la revendication 1, comprenant une poignée couplée à l'extrémité proximale du tube, et dans lequel la torsion détectée correspond à un angle de rotation de la poignée, et dans lequel le mécanisme d'entraînement est configuré pour faire tourner le rotor selon un angle de rotation en réponse à celle-ci.
     
    12. Appareil selon la revendication 11, dans lequel le capteur d'angle comprend un capteur de position monté dans la poignée, lequel capteur de position étant configuré pour détecter la torsion en mesurant un changement d'orientation de la poignée.
     
    13. Produit de programme informatique, exécuté conjointement avec une sonde qui est configurée pour être insérée dans une cavité corporelle d'un patient et qui comprend :

    une électrode montée à l'extrémité distale d'un tube,

    une première ligne d'irrigation comprenant des extrémités proximale et distale de ligne d'irrigation, contenue dans le tube d'insertion, configurée pour amener un fluide d'irrigation par l'extrémité distale de la ligne d'irrigation à travers une ou plusieurs ouvertures dans l'extrémité distale du tube, insérée à travers un canal creux s'étendant à travers un axe longitudinal respectif d'une unité formant bague collectrice comprenant un stator et un rotor,

    une première ligne électrique contenue dans le tube d'insertion et comprenant une extrémité proximale de ligne électrique, qui est connectée au rotor, et une extrémité distale de ligne électrique, qui est couplée à l'électrode,

    le produit comprenant un support non transitoire lisible par ordinateur, sur lequel sont stockées des instructions de programme, lesquelles instructions, lorsqu'elles sont lues par un ordinateur, amènent l'ordinateur à :

    recevoir, en provenance d'un capteur d'angle, un signal indiquant une torsion de l'extrémité proximale de la ligne d'irrigation et de l'extrémité proximale de la ligne électrique, et

    faire tourner le rotor, via un mécanisme d'entraînement, en réponse à la torsion détectée afin de réduire la torsion de la ligne d'irrigation et de la ligne électrique.


     




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    Cited references

    REFERENCES CITED IN THE DESCRIPTION



    This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.

    Patent documents cited in the description