1. Chilli II™ Cooled Ablation Catheter
EP SALES TRAINING
Chilli II™ Cooled Ablation Catheter

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Chilli II™ Cooled Ablation Catheter
Agenda
Chilli II™ - Features
Atrial Fibrillation
Positioning
Internal vs. External
Brochure
Competition
Cabling Chart
Evaluation Model
How to Use
Generators Troubleshooting Guide
Clinical Evidence
Conclusion
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Chilli II™ Cooled Ablation 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
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4. Chilli II™ Cooled Ablation Catheter Feature Summary
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5. CircuCool ™ Pump Features
Settings
Flow Rate:
Constant: 0.6 ml/sec or 36ml/min
Pressure Limit:
Less than 300 psi
Dimensions and Weight
Height: 9.0” (22.9 cm)
Width: 11.0” (27.9 cm)
Depth: 11.80” (30.0 cm)
Weight: 9.6 pounds (4.4 kg)
Special Note: Pump comes with US power plug. Need to order appropriate EU country plug
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6. Chilli II™ Cooled Ablation Catheter Atrial Fibrillation
Anatomy & Conduction
Left Atrium
Four PVs enter the left atrium (left, right, superior and inferior)
A fib thought to originate in the PVs
Thought to be a triggered tachycardia
Three Types
Paroxysmal
starts and stops spontaneously
Variable durations
Persistent
starts spontaneously
stops only with electrical or medical cardioversion
Permanent
present all the time
restoring sinus rhythm is not possible
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7. Chilli II™ Cooled Ablation Catheter Atrial Fibrillation
Mapping Atrial Fibrillation
Dx placed in CS and in PVs
CS = to pace the left atrium
Decapolar
PVs = to check for electrical activity and isolation
Laso, Mesh, Constellation catheters
Rx in left atrium
Done with a transeptal puncture across the septum
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8. Chilli II™ Cooled Ablation Catheter Atrial Fibrillation
Ablating Atrial Fibrillation
Various techniques but essentially try to isolate the PVs by encircling and possibly making other connecting linear lesions
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9. Chilli II™ Cooled Ablation Catheter Atrial Fibrillation
Summary
Symptoms
Palpitations
Dizziness
Short of Breath
Rhythm
Narrow QRS
Irregular
Paroxysmal, Persistant and Permanent
Ablation
Encirclement of the Pulmonary Veins
Possible other left atrial connecting lesions
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Chilli II™ Cooled Ablation Catheter
Positioning
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Chilli II™ Cooled Ablation Catheter
Internal vs. External
Not a major safety concern in most patients…. BUT:
Consider that 1l of normal saline contains 9grams of sodium chloride, which includes 3.6grams of sodium – patients with heart failure (CHF) or hypertension are typically advised to reduce the sodium in their diet to 2.4 grams daily. In addition to the volume load, each liter of saline irrigation contains 1,000 units of heparin. Thus, there is the potential for greater anticoagulation that would be achieved without open- irrigation.
Factors that predispose to pulmonary edema:
Heart Failure (CHF)
Heart disease (AV disease, MV disease, EF<35%, miocardial infarction)
Renal insufficiency
Diabetes mellitus
Advanced age
Multi-system disease (i.e. Autoimmune disease) or aggressive therapy (chemiotherapy or radiotherapy)
“Irrigated RF ablation: power titration and fluid management for optimal safety and efficacy”, Stevenson et al.
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Chilli II™ Cooled Ablation Catheter
Internal vs. External
Consequences of Saline Administration during Irrigation:
Increase of venous pressure
increase in renal excretion
pulmonary edema:
increase respiratory rate
agitation
dyspnea
tachycardia
decrease of peripheral oxigen saturation
extremities edema
For this reasons eventual later treatment become necessary:
administration of oxygen
administration of intravenous diuretic drugs
administration of inotropic agents (i.e. dopamine)
endotracheal intubation and assisted ventilation
“Irrigated RF ablation: power titration and fluid management for optimal safety and efficacy”, Stevenson et al.
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13. Chilli II™ Cooled Ablation Catheter Brochure
Clinical
Benefits
POSITIONING
Technical
Info
Ordering
Info
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14. Chilli II™ Cooled Ablation Catheter Brochure
BSC Confidential. For Internal Use Only. Do not Copy or Distribute

15. Chilli II™ Cooled Ablation Catheter Brochure
Clinical
Benefits
Technical
Info
POSITIONING
Ordering
Info
BSC Confidential. For Internal Use Only. Do not Copy or Distribute

16. Chilli II™ Cooled Ablation Catheter Brochure
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17. Chilli II™ Cooled Ablation Catheter Brochure
Set Up Guide
Troubleshooting Guide
Ordering Info
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18. Chilli II™ Cooled Ablation Catheter Competition
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19. Chilli II™ Cooled Ablation Catheter Competition
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20. Chilli II™ Cooled Ablation Catheter Cabling Chart
Catheter can be connected to:
▪ EPT 1000XP™ generator (BSC)
Serial Number above
▪ Maestro 3000™ generator (BSC)
▪ Stockert generator
▪ Osypka generator
Chilli II™ cannot be used with
Medtronic and IBI generators.
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21. Chilli II™ Cooled Ablation Catheter Cabling Chart
Connection with Navx System (St Jude Medical)
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22. Chilli II™ Cooled Ablation Catheter Evaluation Model
When preparing the evaluation of new customer please follow the SIX easy steps outlined below:
STEP 1:
Schedule minimum two cases either the same or successive days:
Blazer - NO EXPERIENCE schedule one FLUTTER and one AFIB case;
Blazer - EXPERIENCED schedule two AFIB cases.
STEP 2:
The evaluation is to be performed with a BSC RF Generator Maestro 3000™.
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23. Chilli II™ Cooled Ablation Catheter Evaluation Model
STEP 3 (FOR FLUTTER ONLY):
Suggest to Physician to use the Blazer II XP™Large Curve with a high torque tubing, for added performance. If Physician is accustomed to using a sheath, comment HTD should eliminate this need but order a 5890ST just in case.
Reach
and
Large Hearts
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24. Chilli II™ Cooled Ablation Catheter Evaluation Model
STEP 4 (FOR AFIB ONLY): :
Suggest to the physician to use Chilli II™ Standard Curve and order a Large Curve as a backup for physicians with sheath manipulation and trackability issues.
All- Purpose
And
Most Robust
Large Hearts
And
Distal Flexibility
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25. Chilli II™ Cooled Ablation Catheter Evaluation Model
STEP 5:
Utilize the following
chart of part numbers to identify ALL of the
components that you
should order for
the evaluation.
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26. Chilli II™ Cooled Ablation Catheter Evaluation Model
STEP 6: Before doing the ablation make the test on Maestro 3000™ - as described in the following slide.
The test must be done in order to verify the compatibility of the generator with the recording system installed in the cat lab.
Tester required.
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27. Chilli II™ Cooled Ablation Catheter Evaluation Model
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28. Chilli II™ Cooled Ablation Catheter Evaluation Model
Connection with Navx System (St Jude Medical)
BSC Confidential. For Internal Use Only. Do not Copy or Distribute

29. Chilli II™ Cooled Ablation Catheter How to Use
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30. Chilli II™ Cooled Ablation Catheter How to Use
ECG keys
AFIB: PV isolation (no double potential where previously seen)
Ablation Problem
High impedance:
Char or coagulum on the catheter tip: wipe catheter
Poor contact: need better reposition for better tip contact
Noisy Signals during ablation
Verify amplification, clipping and filtering parameters of recording machine are properly set.
Verify cable connections are not loose or faulty
Verify generator on separate electric circuit from recording machine
Disconnect and turn off non-essential equipment.
Verify tip electrode is clean.
Consider changing AMP or POD
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31. Chilli II™ Cooled Ablation Catheter Maestro 3000™ Troubleshooting
11 error codes exist.
Here listed meaning
& solution.
Brochure available.
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32. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Clinical study of the efficacy of a cooled-tip catheter ablation system for common atrial flutter.” Okishige K et Al. Cardiovascular Center, Yokohama Red Cross Hospital, Japan. Circ J Jan;68(1):73-6.
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33. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Prospective randomized comparison of cooled radiofrequency versus standard radiofrequency energy for ablation of typical atrial flutter.” Atiga WL, et Al. University of Pittsburgh Medical Center, Pennsylvania, USA Pacing Clin Electrophysiol Aug;25(8):
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34. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Randomized comparison of efficacy of cooled tip catheter ablation of atrial flutter: anatomic versus electrophysiological complete isthmus block.” Madrid AH, et Al. Cardiology Department, Ramon y Cajal Hospital, Madrid, Spain. Pacing Clin Electrophysiol Oct;24(10):
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35. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Prospective randomized comparison of irrigated-tip versus conventional-tip catheters for ablation of common flutter.” Jais P et Al. Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France. Circulation Feb 22;101(7):772-6.
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36. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Pattern of isthmus conduction recovery using open cooled and solid large-tip catheters for radiofrequency ablation of typical atrial flutter.” Ventura R, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
J Cardiovasc Electrophysiol Oct;15(10):
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37. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Effect of isthmus anatomy and ablation catheter on radiofrequency catheter ablation of the cavotricuspid isthmus.” Da Costa A, et Al. University Hospital Jean Monnet, Saint-Etienne, France.
Circulation Aug 31;110(9):
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38. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Use of different catheter ablation technologies for treatment of typical atrial flutter: acute results and long-term follow-up.” Marrouche NF, et Al. Cleveland Clinic Foundation,Cleveland,USA.
Pacing Clin Electrophysiol Mar;26(3):743-6.
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39. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Prospective randomized comparison of closed cooled-tip versus 8-mm-tip catheters for radiofrequency ablation of typical atrial flutter.” Schreieck J, et Al. Deutsches Herzzentrum Munchen, Munich, Germany.
Cardiovasc Electrophysiol Oct;13(10):980-5
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40. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Primary closed cooled tip ablation of typical atrial flutter in comparison to conventional radiofrequency ablation.” Spitzer SG, et Al. Institute of Cardiovascular Research, Dresden, Germany.
Europace Jul;4(3):
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41. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Prospective randomised comparison of irrigated-tip and large-tip catheter ablation of cavotricuspid isthmus-dependent atrial flutter.” Scavee C, Jais P, Haissaguerre M, et Al. Hopital Cardiologique du Haut-Leveque, Bordeaux-Pessac, France.
Eur Heart J Jun; 25(11):
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42. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter.” Vasamreddy CR, et Al. Johns Hopkins University School of Medicine, Baltimore, USA. J Cardiovasc Electrophysiol Jun;15(6):692-7.
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43. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Saline-cooled versus standard radiofrequency catheter ablation for infarct-related ventricular tachycardias.” Soejima K, et Al. Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Circulation Apr 10;103(14):
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44. Chilli II™ Cooled Ablation Catheter Clinical Evidence
“Catheter ablation of ventricular tachycardia in patients with structural heart disease using cooled radiofrequency energy: results of a prospective multicenter study.” Calkins H, et Al. Johns Hopkins University School of Medicine, Baltimore, USA.
J Am Coll Cardiol Jun;35(7):
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45. Chilli II™ Cooled Ablation Catheter Conclusion
Positioning
AFIB
Clinical
Needs
Minimize Coagulum
Minimize secondary complications
Linear Ablation
Tip Contact
Access Anatomy
Deep Lesion
Catheter Features
Cooled 7f/4mm Tip
Closed loop cooling
Bi-wing Knob & mechanical steering
HT Distal and Proximal
Active Steering & proximal tubing
Cooled 7f/4mm
Customer
Evaluation
1 x AFL + 1 x AFIB Cases
BSC Generator
STD & K2 backup
Order per List
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