Difference between revisions of "UCD Cryo A-fib"

From TheInterWiki
Line 133: Line 133:
 
*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 LA pressure
 
*Measure conduction intervals
 
*Measure conduction intervals

Revision as of 16:52, 11 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

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
  • 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
  • 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