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Catheter Features Catheter Characteristics and Clinical Requirements.

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Presentation on theme: "Catheter Features Catheter Characteristics and Clinical Requirements."— Presentation transcript:

1 Catheter Features Catheter Characteristics and Clinical Requirements

2 BSC Confidential – For Internal Use only – Do Not Copy or distribute 2 Introduction What are the major features of an ablation catheter? handle proximal shaft distal shaft, including curves and steering mechanism tip electrode What are the differences between a Blazer II, Blazer XP, and CHILLI II ablation catheter? The difference is in the TIP ELECTRODE The difference is in THERAPY APPLICATION –Blazer II = AVNRT –Blazer XP = Flutter –Chilli II = AFib

3 BSC Confidential – For Internal Use only – Do Not Copy or distribute 3 Preparing a Catheter Presentation Ask yourself the following four important questions: What is the pathology the clinician is treating? –i.e. AVNRT, A Flutter, A Fib, etc. What does the physician need from a catheter in order to treat this pathology? –i.e lesion characteristics, anatomical considerations, etc. What BSC catheter features resolve the clinical needs? –i.e. curve reach, tip electrode size, etc. How do you plan on demonstrating these characteristics? –The following presentation focuses on how to demonstrate feature by feature. –You need to select the appropriate set of features you wish to present to the physician.

4 BSC Confidential – For Internal Use only – Do Not Copy or distribute 4 Catheter Features Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

5 BSC Confidential – For Internal Use only – Do Not Copy or distribute 5 Tip Electrode Size Available in 7f /4mm and 8f /8mm sizes. Increasing the size of the tip electrode allows more RF power to be delivered into the tissue thus increasing the volume of the lesion. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Distal Segment Length & Curve Shape Performance Active Steering Tip Electrode Tip Size Cooling Temperature Sensor

6 BSC Confidential – For Internal Use only – Do Not Copy or distribute 6 Tip Electrode STD:  7F/4MM  Provides sharp electrograms for evaluation of timing and morphhology of signals.  Conventional size lesions for SVTs Tip Electrode Size Blazer II™, Blazer II XP™, Chilli II™ Tip Electrode XP:  8f/8mm; 8f/10mm  Provides electrograms for evaluation of timing  Greater surface area allows more power to be delivered and creates larger volume lesions for Flutter  8f/8mm VM – conforms more easily to undulating surfaces such as the TV annulus Tip Electrode Cooled:  7F/4MM  Provides sharp electrograms for evaluation of timing and morphhology of signals.  Minimized thrombus/charring & deep lesions

7 BSC Confidential – For Internal Use only – Do Not Copy or distribute 7 Cooling PASSIVE COOLING is the conduction of heat from the tip electrode to the blood flowing around it. ACTIVE COOLING is the conduction of heat from the tip electrode to an injected sterile cooling fluid which passes through the tip. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

8 BSC Confidential – For Internal Use only – Do Not Copy or distribute 8 PASSIVE Cooling Blazer II™, Blazer II XP™ Blood Tissue Conductive Cooling via Blood Flow (37degC) Ohmic heated tissue conducts heat into cooler electrode and surrounding tissues Electrode heats up Heat conducted from warm electrode into cooler blood Heat conducted from warm tissue into cooler blood HOT Tissue (Lesion)

9 BSC Confidential – For Internal Use only – Do Not Copy or distribute 9 ACTIVE Cooling Chilli II™ Blood Tissue Conductive Cooling via Blood Flow (37degC) Ohmic heated tissue conducts heat into cooler electrode and surrounding tissues Electrode heats up Heat conducted from warm electrode into cooler blood Heat conducted from warm tissue into cooler blood HOT Tissue (Lesion) Cooling fluid Takes heat OUT of electrode

10 BSC Confidential – For Internal Use only – Do Not Copy or distribute 10 Temperature Sensor Temperature sensors are either Thermistor or Thermocouple and imbedded or exposed. For RF cardiac ablation the location (imbedded or exposed) rather than the type of temperature sensor effects the value of the temperature measured. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Passive/Active Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

11 BSC Confidential – For Internal Use only – Do Not Copy or distribute 11 Temperature Sensor Blazer II™ and Blazer II XP™ CHARACTERISTICS Thermistor Exposed Blood or Tissue Exposed Average Temperature Tip Blood or Tissue

12 BSC Confidential – For Internal Use only – Do Not Copy or distribute 12 Temperature Sensor Chilli II™ CHARACTERISTICS Thermocouple Embedded Cooling Fluid Exposed Average temperature Tip Cooling Fluid

13 BSC Confidential – For Internal Use only – Do Not Copy or distribute 13 Distal Length and Curve Shape Distal tubings come in various length and curve shape configurations to facilitate the access to various regions of the heart. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

14 BSC Confidential – For Internal Use only – Do Not Copy or distribute 14 Distal Length and Curve Shape Blazer II™ Tubing Lengths Standard: –Multipurpose offers the best combination of stability, reach and maneuverability. Medium: –For left sided retrograde access, tortuous anatomy, or need to maneuver catheter around chamber to access ablation site. Extended: –For older patients with much fibrosis; minimally traumatic distal. Tight Crevices or Small Hearts All-purpose or Average Hearts Long Reach or Large Hearts Unknown Arrhythimia or Unusual Anatomy = HTD Distal

15 BSC Confidential – For Internal Use only – Do Not Copy or distribute 15 Distal Length and Curve Shape Blazer II XP™ Tubing Lengths Standard: –Multipurpose offers the best combination of stability, reach and maneuverability. Medium: –For left sided retrograde access, tortuous anatomy, or need to maneuver catheter around chamber to access ablation site. All-purpose VT Long Reach Right A Flutter Unusual Anatomy VT

16 BSC Confidential – For Internal Use only – Do Not Copy or distribute 16 Distal Length and Curve Shape Chilli II™ Tubing Lengths Standard: –Multipurpose offers the best combination of stability, reach and maneuverability. All-purpose or Average Hearts Trackable For Large Hearts and Sheaths Unusual Anatomy

17 BSC Confidential – For Internal Use only – Do Not Copy or distribute 17 Distal Performance Distal tubing materials are designed either to minimize vascular/endocardial trauma or to maximize tip contact /manueverability. Ring electrode spacing is designed to maximize the quality of electrical signal information. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

18 BSC Confidential – For Internal Use only – Do Not Copy or distribute 18 Distal Performance Distal Tubing Firmness  Standard torque  Pallethane 35 – light blue segment color  Less traumatic for patients with thin or fibrotic vasculature and/or endocardium  Ring Spacing:  Quad 2.5 mm  provides sharp electrograms for evaluation of timing and morphology of signals. Distal Tubing Firmness:  High Torque  Pebax 40 – light grey segment color  High performance optimizes the torque transfer from proximal shaft to tip electrode (ie lateral contact force)  Ring Spacing:  Quad 2.5 mm  provides sharp electrograms for evaluation of timing and morphology of signals.

19 BSC Confidential – For Internal Use only – Do Not Copy or distribute 19 Active Steering Pull wires are attached to opposite sides of a steering plate and allow precise control of curve formation. ACTIVE STEERING is the ability of the tip electrode to press against the tissue either into or away from the direction of curvature. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

20 BSC Confidential – For Internal Use only – Do Not Copy or distribute 20 Active Steering Bi-Directional Into and Away from Curvature

21 BSC Confidential – For Internal Use only – Do Not Copy or distribute 21 Torqueability The steering coil and woven metal braid efficiently transfer rotation of the catheter handle to the tip for predictable movement, reducing twist or “whip” Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

22 BSC Confidential – For Internal Use only – Do Not Copy or distribute 22 Pushability The woven metal braid around the catheter shaft provides the flexibility to allow the catheter shaft to follow the tip as it is advanced into position and to follow through tortuous vasculature Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

23 BSC Confidential – For Internal Use only – Do Not Copy or distribute 23 Trackability The woven metal braid around the catheter shaft provides the flexibility to allow the catheter shaft to follow the tip as it is advanced into position and to follow through tortuous vasculature Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

24 BSC Confidential – For Internal Use only – Do Not Copy or distribute 24 Tubing Firmness  High Torque Proximal Shaft:  balances flexibility, torqueability and pushability  allowis the proximal shaft to follow the path of distal tip electrode while maximizing its contact during ablation. Inner Core Construction  Steering Coil:  minimizes buckling of proximal shaft during curve acutation  increasing the maneuverability and tip electrode contact of the catheter. Torqueability, Pushability & Trackability

25 BSC Confidential – For Internal Use only – Do Not Copy or distribute 25 Tension Control The tension control allows the physician to decide the amount of resistance or tension on the steering mechanism. Low tension maximizes the tactile response while high tension allows for hands-free curve retention. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

26 BSC Confidential – For Internal Use only – Do Not Copy or distribute 26 Tension Control Tension Control (Unlock & Lock) – restrains steering mechanism allowing hand- free curve retention and providing added security against tip contact slippage. + = Add More Friction - = Release Friction

27 BSC Confidential – For Internal Use only – Do Not Copy or distribute 27 Bi Wing Steering Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering Designed for maximum comfort while allowing fine micro movements and control with minimal effort. The Bi wing Steering wheel is also in plane with the distal catheter curve

28 BSC Confidential – For Internal Use only – Do Not Copy or distribute 28 Bi Wing Steering Tension Control (Unlock & Lock) – restrains steering mechanism allowing hand- free curve retention and providing added security against tip contact slippage. THUMB always points in the direction of the curvature

29 BSC Confidential – For Internal Use only – Do Not Copy or distribute 29 Handle Ergonomics The handle is designed for comfort as well as to provide tactile sensory information about the actuation of the catheter. Handle Tension Control Bi-wing Steering Handle Ergonomics Proximal Shaft Torqueability Pushability Trackability Tip Electrode Tip Size Cooling Temperature Sensor Distal Segment Length & Curve Shape Performance Active Steering

30 BSC Confidential – For Internal Use only – Do Not Copy or distribute 30 Handle Ergonomics Tension Control (Unlock & Lock) – restrains steering mechanism allowing hand- free curve retention and providing added security against tip contact slippage. Flats on the handle Align with plane of distal curvature Rest for palm during long cases Labeling type of catheter

31 EPT-10511_02/06 D. McGee © 2006 Boston Scientific Corporation or its affiliates. All rights reserved.


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