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EP Sales Training Summary Slide 2 BSC Confidential For Internal Use Only Do Not Copy or Distribute EP Summary - Agenda Diagnostic Catheters EP Study Ablation Catheter Features Blazer II Ablation Catheter AVNRT Blazer XP Ablation Catheter A Flutter Chilli II Cooled Ablation Catheter A Fib Slide 3 BSC Confidential For Internal Use Only Do Not Copy or Distribute P Q R S T P Q QRS Q - T Diagnostic Catheters EP Study Sinus Rhythm: regular slim QRS P before Q P: > 90 ms PQ: 120 200 ms QRS: < 120 ms QT: ca. 440ms Slide 4 BSC Confidential For Internal Use Only Do Not Copy or Distribute High Right Atrium (near sinus node) His (near AV node) Right Ventricle Apex Coronary Sinus (left AV groove) (used for left AVRT, Flutter and A fib) Diagnostic Catheters EP Study Slide 5 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters EP Study Slide 6 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters EP Study Slide 7 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters EP Study Slide 8 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters EP Study Slide 9 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters Clinical Applications Slide 10 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters Fixed Curve DISTAL TUBING CONNECTORS CURVE SHAPES Slide 11 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters Fixed Curve Features Slide 12 BSC Confidential For Internal Use Only Do Not Copy or Distribute POLARIS Dx STEEROCATH DX Diagnostic Catheters Steerable POLARIS X Slide 13 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters Steerable Features Slide 14 BSC Confidential For Internal Use Only Do Not Copy or Distribute Diagnostic Catheters Conclusion The purpose of diagnostic catheters is to facilitate understanding the mechanism of arrythmias and appropriate ablation location. Diagnostic Catheter can be classified into two main groups: Fixed Catheters Steerable Catheters Both type of catheters present a wide range of configurations (i.e. curve type, electrode numbers, electrode spacing etc.). The main difference between fixed and steerable catheters is the CLINICAL ease of use: the target for steerable catheters is mapping difficult sites, like the CS. Slide 15 BSC Confidential For Internal Use Only Do Not Copy or Distribute 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 Slide 16 BSC Confidential For Internal Use Only Do Not Copy or Distribute Blazer II Ablation Catheter AVNRT Summary Symptoms Lightheadedness Rapid palpitations Pulsations in the neck Regular rhythm with narrow QRS No visible P wave (may be buried at end of QRS) A and V stimulate simultaneously (reentry BSC Confidential For Internal Use Only Do Not Copy or Distribute EP Summary Clinical Summary Sinus RhythmAVNRTAVRTA FlutterV TachA fib Rate (average) 60 - 80 bpm160 - 200 bpm a=200- 250msec 150-250 bpm a >200 msecs Regular Rhythmyes regular in atriumyesirregular P before QRSyesnono (p after q)yesnono p wave Narrow QRSyes eitheryesnoyes TestingEP Study AH jump, AV < 50msecs AV time > 50 msecs Bidirectional blockEP Study Isolated PVs