Difference between revisions of "UCD Cryo A-fib"
From TheInterWiki
(→Pre) |
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| Line 120: | Line 120: | ||
*Set up pressure lines | *Set up pressure lines | ||
**Double spike Hep saline bag under pressure | **Double spike Hep saline bag under pressure | ||
| − | **Flush and connect blue pressure to transducer closest to patient on rack | + | **Flush and connect blue pressure to transducer closest to patient on rack (P1) |
*Zero A-line | *Zero A-line | ||
*Assist with hooking up | *Assist with hooking up | ||
Revision as of 17:50, 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
- 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.
