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CARDIOVASCULAR
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Case Images

These case images show some of the imaging possibilities of the Advisor™ HD Grid Mapping Catheter, Sensor Enabled™:

Voltage and Fractionation Map
Voltage and Fractionation Map Close

Atrial Fibrillation (AF)

This case shows a patient who presented in AF for a cryoballoon PVI. After cardioversions failed to restore normal sinus rhythm (NSR) post-ablation, physicians used the Advisor HD Grid Mapping Catheter, SE to create a voltage and fractionation map.

Geometry collected with the Advisor HD Grid Mapping Catheter, SE revealed the cryoballoon ablation missed the RIPV. What appeared to be the RIPV during the cryoballoon ablation was actually a middle branch. Substrate modification of highly fractionated zones was performed with RF ablation and NSR was restored.

Image courtesy of Dr. Thomas Crawford (University of Michigan Hospital and Health Center | Ann Arbor, MI)

Voltage Map (Left) and Posterior Isolation of Right Veins RF Ablation (Right)
Voltage Map (Left) and Posterior Isolation of Right Veins RF Ablation (Right) Close
Post-Ablation Restored to NSR
Post-Ablation Restored to NSR Close

Atrial Fibrillation

This patient presented in persistent AF for a cryoballoon PVI. After four unsuccessful cardioversions post ablation, the Advisor HD Grid Mapping Catheter, SE was used to create a voltage map. The roof and right veins were still active, so a roof line and posterior isolation of right veins was performed with RF ablation. Patient was still in AF. A signal of 0.03 mV was picked up on the Advisor HD Grid Mapping Catheter, SE in the right carina, possibly from epicardial fibers. Upon ablation, the patient had a 12 sec conversion pause and restored to NSR.

Image courtesy of Dr. David Kenigsberg (Westside Regional Medical Center | Plantation, FL)

Reentrant LAT Map of the LA
Reentrant LAT Map of the LA Close

Left Atrial Atypical Flutter

This case shows a patient with a prior PVI who presented in atypical atrial flutter. Entrainment revealed the rhythm was most likely left atrial dependent. The Advisor HD Grid Mapping Catheter, SE was used to create a reentrant LAT map of the LA, and the critical isthmus was revealed on the anterior wall.

Image courtesy of Dr. Farhat Khairallah (Tallahassee Memorial Healthcare | Tallahassee, FL)

Reentrant LAT Map of the LA
Reentrant LAT Map of the LA Close

Left Atrial Atypical Flutter

This case shows a patient with left atrial atypical flutter who underwent a previous AF ablation with no prior posterior wall ablation. The Advisor HD Grid Mapping Catheter, SE was used to create a reentrant LAT map of the LA. The flutter terminated after anchoring the existing line of block (black line) to the LIPV.

Image courtesy of Dr. Bohuslav Finta (Lutheran Medical Center | Wheat Ridge, CO)

Atypical AFL & AT
Atypical AFL & AT Close

Atypical AFL & AT

This case shows a patient who had a prior cryoablation PVI. Using Advisor HD Grid (assumption), two maps were created to reveal a double loop reentry atrial flutter and a focal tachycardia with the same cycle length.

Image courtesy of Dr. Abdul Alawwa (McLaren Regional Medical Center | Flint, MI)

Reentrant LAT Map of the LA
Reentrant LAT Map of the LA Close

Left Atrial Antero-Septal Atypical Flutter

This case shows a patient with left atrial atypical flutter. The Advisor HD Grid Mapping Catheter, SE was used to create a reentrant LAT map of the LA, and the critical isthmus was revealed at the antero-septal aspect location.

Image courtesy of Dr. Rod Passman (Northwestern Memorial Hospital | Chicago, IL)

LAT Map of the LA
LAT Map of the LA Close

Left Atrial Microreentrant Tachycardia

This case shows a patient who presented with incessant tachycardia after two prior PVI ablations. The Advisor HD Grid Mapping Catheter, SE was used to create an LAT map of the LA, which revealed a microreentrant circuit on the anterior wall of the LA. The tachycardia was terminated with the first RF lesion, and NSR was restored in the patient.

Image courtesy of Dr. Jeffrey A. Olson (St. Vincent Hospital | Indianapolis, IN)

Reentrant LAT Map of the LA with SparkleMap
Reentrant LAT Map of the LA with SparkleMap Close

Redo Mitral Flutter

This case shows a patient who had a previous mitral isthmus line ablation. The patient presented in atrial flutter, and the Advisor HD Grid Mapping Catheter, SE was used to create a reentrant LAT map of the LA. SparkleMap was used to rapidly interpret the conduction dynamics of the circuit and to identify lines of block. SparkleMap helped to identify a critical deceleration zone (circled in yellow), which was a gap in the original lesion set.

The flutter terminated with RF ablation in the deceleration zone (orange lesion), starting at the mitral annulus and pulling back through the gap to anchor the lesion set to scar.

Image courtesy of Dr. Shaun Cho (El Camino Hospital | Palo Alto, CA)

LAT Map Showing Point Density - RA
LAT Map Showing Point Density - RA Close
LAT Map of the RA: Right Atrial Focal AT
LAT Map of the RA: Right Atrial Focal AT Close

Right Atrial Focal AT

This case shows a patient who presented with AT. During pulmonary vein isolation (PVI) ablation, the Advisor HD Grid Mapping Catheter, SE was used to create an LAT map of the LA. The LAT map showed the AT was originating from the RA. The Advisor HD Grid Mapping Catheter, SE was then used to create an LAT map of the RA, which showed the earliest activation at the mid-lateral location of the RA. The focal AT was terminated with the first RF lesion, and NSR was restored in the patient.

Image courtesy of Dr. Steven Fowler (Community Hospital of the Monterey Peninsula | Monterey, CA)

LAT Map with the Last Deflection Algorithm
LAT Map with the Last Deflection Algorithm Close
Voltage Map
Voltage Map Close

Ischemic VT

This case shows a patient with a CRT-D device and ischemic VT. With RV only pacing, the Advisor HD Grid Mapping Catheter, Sensor Enabled was used to create a local activation timing (LAT) map with the Last Deflection algorithm (left) and voltage map (right). The maps show local abnormal ventricular activities (LAVA) EGMs on the basal septum in the LAT map (left) correlating with a posterior voltage channel in the voltage map (right).

Image courtesy of Dr. John Nguyen (Mercy Hospital | Coon Rapids, MN)

This device is commercially available for use in select international markets.

Indications, Safety & Warnings

MAT-2009611 v2.0

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DO YOU WISH TO CONTINUE AND EXIT CARDIOVASCULAR.ABBOTT?

CONTENTS OF THE SITE ARE NOT UNDER THE CONTROL OF ABBOTT.