Difference between revisions of "UCD Cryo A-fib"
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| Line 112: | Line 112: | ||
*Abalator cable | *Abalator cable | ||
| − | ==Procedure== | + | ==Procedure (tech)== |
| + | ===Pre=== | ||
Read [[UCD EP Role]] for pre and post procedural steps. | Read [[UCD EP Role]] for pre and post procedural steps. | ||
*Include CMAP when patching for phrenic pacing | *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 | *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" | *Check that ablation switch behind ablation consoles is set to "Cryo" | ||
*Physician will place catheters and access LA. | *Physician will place catheters and access LA. | ||
| + | *Be ready for backup pacing post cardioversion (usually HisD) | ||
| + | *Measure LA pressure | ||
*Measure conduction intervals | *Measure conduction intervals | ||
*Once Cryo ballon is in LA and ablation starts do the following: | *Once Cryo ballon is in LA and ablation starts do the following: | ||
| Line 133: | Line 149: | ||
***When freeze is initiated, come on pacing as temp passes 0C | ***When freeze is initiated, come on pacing as temp passes 0C | ||
***When thawing, come off 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. | ||
Latest revision as of 20:34, 26 October 2023
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
| Pezeshkian | Srivatsa | Cortez | Munir |
|---|---|---|---|
| Stockroom | |||
| Versacross D0 | Versacross D1 | ||
| Soundstar 10Fr | Soundstar 8Fr | ||
| DecaNav D | DecaNav F | ||
| Lab | |||
| Octaray D 2-2-2 | Octaray F 3-3-3 | ||
| Dynamic XT steerable quad | CRD 2 Quad | ||
| Achieve 20mm | Achieve 15mm | ||
| Long 11Fr | Long 9Fr | ||
| 14fr non-locking | Zero Gravity drape | ||
| Standby | If needed for touch up post cryo or for redo afib. | ||
| Smart touch thermocool STSF DF | Smart touch thermocool ST FJ | ||
| Perclose x1
Vascade x3 |
|||
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.
