EPi-Sense/ST
Why is saline perfused from the EPi-Sense?
What is Saline perfusion via device promotes cooling of both device and epicardial tissue during ablation?
For larger patients, where is an alternative location to place the grounding pad?
What is ...Grounding pad may be placed closer to the heart but should not be placed on shoulder blade or interfere with the vector of defibrillator pads?
What trial is aimed to determine the effectiveness of LAAE with AtriClip at the time of cardiac surgery?
What is Leaaps?
What are attributes of the LAA?
What is it is anatomically isolated and highly trabeculated?
What could a TEE discover that would halt the continuation of the Hybrid Afib Therapy procedure?
What is a thrombus in the LAA?
List the contraindications of the EPi-Sense ST?
What is include patients with Barrett’s Esophagitis, left atrial thrombus, a systemic infection, active endocarditis, or a localized infection at the surgical site at the time of surgery?
What is the patient positioning for the Hybrid Afib Therapy procedure?
What is supine position?
What are features of a V clip?
What is
Flat spring - resists lateral movement - nosplaying
Springs in line with bars - placement at base of LAA - flat ostium closure -trabeculation inclusion
No nitinol
What are treatment approaches of the LAA?
What is...
- Electrical isolation
- Exclusion (mechanical and electrical)
- Occlusion
- anticoagulants
What indicator is used to ensure the RF cable is connected accurately?
What is the cables are color coded and arrows need to line up?
What feature of the cannula assists in manipulation?
What is the guidewire?
What is being monitored by the esophageal temp probe? Be specific...
What is...
If esophageal temperature increases 0.5°C over baseline temperature (taken prior to EACH lesion) OR above 38.0°C
RF energy delivery should be stopped until the temperature returns to below 37°C or to baseline
After successful placement of the AtriClip, when does necrosis occur?
What is days 30-90?
Name 3 functions of the LAA.
What is... (3 to be named)
Acts as a reservoir during LV systole
Is a conduit for blood transiting from the pulmonary veins tothe LV during early diastole
Is an active contractile chamber that augments LV filling inlate diastole
A suction source that refills itself in early systole
May act as a volume reservoir in periods of increased LApressure.
May contribute to stroke volume, due to its intrinsiccontractile quality
Contains stretch-sensitive receptors that influence heartrate and ANP secretion in response to atrial pressure
Stores up to 30% of Atrial Natriuretic peptide-important insodium and fluid regulation
Identify the generator error...
The numbers on the display screen (Device, Time, etc) are showing as 0 while the device is in use but you've confirmed...
CSK-2000 cable is plugged into the Device.
CSK-2000 cable is plugged into the Generator.
Ground pad is plugged into the Generator.
What is Cable connected incorrectly to device handle?
On the EPi-Sense ST device, what indications do the LED indicator light provide?
What is...
Red - 50C temperature limit / compromised perfusion
yellow - low battery / RF cable warning
What is an advantage of the Subxiphoid approach?
What is... (one of the below)
Subxiphoid approach involves incision above the diaphragm inferior to the xiphoid process(standard pericardial window)
Provides direct visualization and access to beating heart
Allows direct access to posterior pericardial structures with minimal risk of hemodynamiccompromise
List the product codes for the AtriClip FLEX-Mini™LAA Exclusion System.
What is...
ACHM35
ACHM40
ACHM45
ACHM50
How can the LAA contribute to risk of stroke?
What is...
Remodeling associated with AF causes the LAA to enlarge and function as a static pouch. Stagnation of blood can contribute to thrombus formation. If the thrombus is ejected, it becomes an embolus. A common route for a dislodged LAA embolus is to travel through the left heart and eject to the aorta and through the cerebral arteries until it lodges, causing an ischemic stroke.
If all connections are achieved at the start of your Hybrid Afib Therapy procedure, when will the error light and flashing 'OC' stop?
What is the error light and flashing 'OC' will persist until the device is vacuumed onto the heart?
List the components of the EPi-Sense Guided Coagulation System.
What is...
-footswitch
-cannula
-Generator
-Rf cable
-coagulation device
-adapter cable
List the room setup steps for the Hybrid Afib Therapy procedure.
What is...
Surgeon typically stands on the patient’s right side
Video towers set up on each side of the patient at the head of the bed
Scrub table-same side as surgeon
Generator and laptop on the left side of the patient
Positioned where Surgeon can visualize
IV pole with 500cc bag 0.9% NaCl (normal saline solution, room temp) positioned within thesurgeon’s field of view
1000 cc bag normal saline or sterile water, room temp, pressurized OR ASEPTO™ (bulb)syringe for cannula irrigation
Two suction canisters
Wall suction (-200 to -250 mmHg)
High vacuum (-400mmHg) suction
What are the contraindications for the PRO Mini device?
What is...
Do not use this device as a contraceptive tubal occlusion device.
Do not use this device if the patient has a known allergy to Nitinol (nickel titanium alloy).
Do not use this device if evidence of systemic infection, bacterial endocarditis, or in presence of infectedoperating field.
What complications can occur when a patient is prescribed anticoagulats?
What is Bleeding, Frequent Blood Draws, Interactions with other Meds, Lifestyle Interference (high risk occupations or hobbies)?
What possible issues can result in perfusion not flowing?
Check to ensure the IV tubing/stopcock is completely open.
Ensure saline is connected to device handle.
Be sure the IV tubing nor perfusion tubing of nContact coagulation device are clogged, blocked, kinked, or otherwise obstructed.
Ensure entire device is in contact with tissue. If excess tissue is obstructing the proximal end of the coil, no saline will flow
Check to ensure device is completely in contact with tissue.