View source for UCD Cryo A-fib

==Open==

*EP Pack
*Flexcath
*28mm Arctic Advance
*Probe Cover
*2 - Ice Cover - Shockwave
*Copilot
*Manifold + dump bag
*Smart Ablate Tubing
*Micropuncture
*20ml syringes 2-4
*A-line set
*Pressure transducer kit x3
*7F locking
*8F locking
*8.5 Non-locking
*6fr CRD 2 quad



{| class="wikitable"
|+
!Pezeshkian
!Srivatsa
!Cortez
!Munir
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|'''Stockroom'''
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|Versacross D0
|Versacross D1
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|Soundstar 10Fr
|Soundstar 8Fr
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|DecaNav D
|DecaNav F
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|'''Lab'''
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|Octaray D 2-2-2
|Octaray F 3-3-3
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|Dynamic XT steerable quad
|CRD 2 Quad
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|Achieve 20mm
|Achieve 15mm
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|Long 11Fr
|Long 9Fr
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|14fr non-locking
|Zero Gravity drape
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|'''Standby'''
|colspan = 3 |''If needed for touch up post cryo or for redo afib''. 
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|Smart touch thermocool STSF DF
|Smart touch thermocool ST FJ
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|Perclose x1
Vascade x3
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|}

===Cables===

*Achieve cable
*Electrical umbilical cable
*Coaxial umbilical cable
*DecNav cable
*Pentaray cable
*Quad cable x 2
*Abalator cable

==Procedure (tech)==
===Pre===
Read [[UCD EP Role]] for pre and post procedural steps.
*Include CMAP when patching for phrenic pacing
**Cable located in C block #31-32
**Attach alligator clips to patches
*Set up pressure lines
**Double spike Hep saline bag under pressure
**Flush and connect blue pressure to transducer closest to patient on rack (P1)
*Zero A-line
*Assist with hooking up 
**Vascular US
**EP cables
***Achieve to pin block Blue 1-10
***Deca nav to Deca
***His Quad to Quad B (OK to unplug pin block quad plug)

===During case===
*Open ablation window on live screen
**right click in ablation window to change ablator. 
**Check dial for correct ablator. 
*Check that ablation switch behind ablation consoles is set to "Cryo"
*Physician will place catheters and access LA. 
*Be ready for backup pacing post cardioversion (usually HisD)
*Measure LA pressure
*Measure conduction intervals
*Once Cryo ballon is in LA and ablation starts do the following:
**Save and label freeze frame of fluoro with location of freeze and ablation number ex: "LUPV Cryo #1" copy this text and save
**Monitor ablation sequence
**After ablation ends, record ablation data including copied text to Ablation End log entry comment section ex: "LUPV Cryo #1 180sec -45C"
***If esophagus temp is affected, record this temp also "23C esoph"
**EP study is conducted during Cryo ablation phase of procedure
***Atrial Wenckebach, Atrial ERP, and VERP
**When phrenic nerve is involved. Prepare to pace CMAP
***Channel 4 800msec, 25mA
***When freeze is initiated, come on pacing as temp passes 0C
***When thawing, come off pacing as temp passes 0C

==Procedure (scrub)==
===Pre===
*Label pressure lines
**Blue - Transseptal line connected to P1. Swapped to manifold during cryo ablation. 
**Yellow - not transduced connected to flex cath sheath. 
**No color - used for Octaray drip. Keep manifold on table. 
**A-line setup. Pre labeled red. Connects to sheath for act draws. 
*Setup manifold
**Cap 2 middle ports for Srivasta. No dump bag
**Position 1 connects to blue pressure line. 
*Position 4 pass off spike for pressurized saline.