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Technologies to watch for,

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Presentation on theme: "Technologies to watch for,"— Presentation transcript:

1 Technologies to watch for,
What’s New in the EP Lab Technologies to watch for, Technologies already here Susan Williams RN Interim Director, Electrophysiology Lab Washington Hospital Center

2 Pulmonary Vein Isolation (PVI)
Majority of AF ablation procedures target PV isolation

3 3D Mapping Systems Endocardial Solutions Inc (ESI) Carto 3

4 EnSite™ Velocity Cardiac Mapping System
1999 Endocardial Solutions, Inc. (ESI) Array introduced to market, providing extraordinary ability to map complicated arrhythmias 2004 Introduction of contact mapping, expanding feasibility and ease-of-use of system 2005 ESI acquired by St. Jude Medical EnSite System Version 5.1: MultiPoint mapping, EnSite Verismo™ Segmentation Tool 2006 EnSite System Version 6: Multiple Surfaces, CFE mapping

5 EnSite™ Velocity Cardiac Mapping System
2007 EnSite System Version 7: Field scaling, catheter catalog EnSite Fusion™ Registration Tool 2008 EnSite System Version 8: Reentrant and propagation maps; Visualization tools 2009 EnSite Velocity™ System: New User Interface and hardware; OneMap™tool; Real Review™ function

6 EnSite™ Velocity Cardiac Mapping System
Map any arrhythmia EnSite NavX™ Navigation and Visualization Technology – for more conventional/anatomic procedures EnSite Array™ catheter – for more complex, non-sustained, multi-focal arrhythmias and for hemodynamically unstable patients Only the EnSite Velocity System supports both contact and non-contact mapping techniques Open platform 3D navigation of essentially all diagnostic and ablation EP catheters Compatible with leading ablation generators and recording systems Ideal for helping define optimal therapy delivery strategy High level of chamber model detail Flexibility to facilitate all popular treatment strategies Advanced tools to guide ablation

7 EnSite™ Velocity Cardiac Mapping System
Amplifier 128 channels – the most available in any cardiac mapping system Visualize and navigate more electrodes and catheters 2 kHz sampling rate – on par with leading recording systems Broad filters for improved signal acuity Display Workstation Twin quad processors for rapid system performance 1 TB hard drive with separate partitions for system and patient data Vibrant graphic display capabilities Multiple display monitor options

8 EnSite NavX™ Methodology
Surface-based 8 kHz current signal emitted from three pairs of surface electrodes Each catheter electrode located 102 times per second Simultaneously view up to 128 electrodes on virtually unlimited catheters Supports real-time catheter navigation in any chamber

9 EnSite Array Technology Summary
EnSite Array™ Catheter 9 French, 110cm body, open lumen 7.5ml balloon, stainless steel mesh 64 microelectrodes on a 1.8 x 4.5cm array

10 Pulmonary Vein Isolation (PVI)
Majority of AF ablation procedures target PV isolation

11 CARTO 3

12 CARTO 3 Uses 6 patches, 3 in front, 3 at the back
-Patches must surround the heart -should not overlap other patches or be on bones or ICD/Pacemaker

13 CARTO 3 Advanced Catheter Localization -able to see different catheters Fast Anatomical Mapping -able to map and draw contours as you move the catheters Connection of Choice – Any catheter can be used

14 Carto 3 PIU & COM in one unit

15 Advanced Catheter Location Fast Anatomical Mapping
Carto 3 ACL Advanced Catheter Location FAM Fast Anatomical Mapping Connection of Choice™ ACCURACY SPEED EFFICIENCY EFFICIENCY

16 Advanced Catheter Location
CARTO 3 ACL Advanced Catheter Location Magnetic Technology Linear fields Not affected by biological changes Current based + Magnetic navigation = Accuracy

17 Fast Anatomical Mapping
Carto 3 FAM Fast Anatomical Mapping Fast Anatomical Mapping (FAM) is a new and unique way of mapping CARTO® 3 System. Move the sensor catheter in the chamber, a volume info is taken with one push of a button No Freeze/Accept The entire chamber including veins can be created in one workflow FAM provides highly detailed maps with speed

18 Carto 3 Connection of choice To this From this….

19 Pulmonary Vein Isolation (PVI)
Majority of AF ablation procedures target PV isolation

20 ARCTIC Front CryoAblation
Arctic Front® is the world's first Cryoballoon catheter indicated for the treatment of paroxysmal atrial fibrillation. Arctic Front is inserted over a guide wire through the FlexCath®Steerable Sheath into the left atrium, where it can be inflated and advanced to the target vein. Nitrous oxide is delivered via an injection tube to the inner surface of the balloon. As the refrigerant vaporizes, it absorbs the heat from the surrounding tissue and is vacuumed back into the CryoConsole.

21 Outer balloon Safety feature to contain the refrigerant in the unlikely event that the inner balloon is compromised. The outer balloon is maintained under constant vacuum. Inner balloon Refrigerant is delivered into the inner balloon and vacuumed back into the console to achieve the freezing process. Pull wires Help deflect the catheter 45 degrees in either direction. Thermocouple Monitors the temperature of the vaporized refrigerant. Injection tube Refrigerant is delivered towards the balloon surface through the injection tube into the inner balloon.

22 How the CryoAblation System Works
Liquid N2O is Delivered from the CryoConsole Through an injection tube to the inner balloon Inside the balloon the liquid N2O vaporizes and absorbs heat from the surrounding tissue. The vapor is returned to the console through a lumen maintained under vacuum. The CryoConsole controls safe delivery of N2O to the catheter and return of the vapor. Numerous safety systems mitigate potential hazards.

23 Angel Med The Guardian System
Pacemaker-like device that monitors ST segment elevation only. Warns of an imminent or impending myocardial infarction. Does not pace the heart. The Guardian System The Product: An implantable device that monitors the heart 24-hours/day, 7-days/week. The Goal: Provide clear and timely notification to seek medical attention when conditions indicate that a heart attack may be imminent: even in the 30-35% of cases where symptoms are atypical or non-existent. For Whom: Patients who are at high risk of heart attack. Caution: Investigational Device. Limited by United States law to investigational use.

24 The Guardian System The AngelMed Guardian System is designed to:
Detect acute ST elevation changes Alert patients to seek medical attention Store ECG traces for later analysis Key Features of the AngelMed Guardian System: Engineered to detect ST shift - a rapid change in ST - deviation - which may indicate: Acute coronary occlusions Progression of heart failure Monitors ECG signals in real time, 24/7, for ischemic events at normal, low, and irregular heartbeat. Intended to warn patients to seek immediate medical care using vibratory, auditory, and visual alerts - often before symptoms manifest. Stores ECG traces and a wide spectrum of statistics including bpm, ST shift, ST deviation (instantaneous and long-term) for later retrieval and evaluation. Provides continuous ECG monitoring and analysis compared to patient's baseline signal, updated every 24 hours.

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26 Cameron Health Subcutaneous Implantable Defibrillator (S-ICD)
SQ-RX™ Pulse Generator  The SQ-RX Pulse Generator is a component of the Cameron Health S-ICD System, which is prescribed for patients when cardiac arrhythmia management is warranted. Implanted with the Q-TRAK Subcutaneous Electrode, the device detects cardiac activity and provides defibrillation therapy. Q-TRAK™ Electrode The Q-TRAK Subcutaneous Electrode is a component of the Cameron Health S-ICD System, which is implanted subcutaneously, with the distal portion positioned parallel to the left sternal border and the proximal end of the electrode connected to the SQ-RX Pulse Generator.

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28 Revo MRI SureScan Pacing System Now your patients can get proven cardiac pacing care with MRI access. Revo MRI™ is specifically engineered for MRI safety – the first MRI pacing system FDA-approved for use with MRI. The Revo MRI SureScan pacing system is MR Conditional designed to allow patients to undergo MRI under the specified conditions for use. A complete system, consisting of a Medtronic Revo MRI SureScan IPG implanted with two CapSureFix MRI™ SureScan leads is required for use in the MRI environment.


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