CARDIOVASCULAR
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CONFIRM ACUTE PULMONARY
VEIN ISOLATION1

SEE THINGS DIFFERENTLY IN AF ABLATION WITH THE ADVISOR™ HD
GRID MAPPING CATHETER, SENSOR ENABLED™ AND THE HD WAVE
SOLUTION™ ALGORITHM

SUCCESSFUL TREATMENT OF ATRIAL FIBRILLATION (AF) IS DEPENDENT ON CLOSING THE GAP BETWEEN PULMONARY VEIN ISOLATION (PVI) AND PULMONARY VEIN RECONNECTION (PVR).

With HD Grid mapping technology, you are able to collect more data for insight into activity that may not be visible for standard configuration catheters.

Greater mapping density could create more opportunities for rapid,2 accurate3 mapping and confirmation of PVI during AF ablation procedures.

The Advisor HD Grid Mapping Catheter, Sensor Enabled offers a high-density mapping catheter able to rapidly2 collect a high density of voltage points to confirm acute pulmonary vein isolation.1



advisor hd grid waveform
Advisor hd grid waveform graph

By “being able to show only the highest amplitude signals from orthogonal recordings, the HD grid may be able to detect local EGM signals which previously would have been missed and thus may offer more effective therapeutics.”

– Colin Yeo et al4

WHEN USED COLLECTIVELY, OUR INTEGRATED ELECTROPHYSIOLOGY SOLUTIONS HAVE THE POTENTIAL TO TRANSFORM CARDIAC ABLATION PROCEDURES.

 

REFERENCES

*In an independent head-to-head bench test comparison with the ThermoCool SmartTouch SF catheter, TactiCath Quartz contact force ablation catheter showed higher accuracy in both axial (perpendicular) and parallel (lateral) orientations.8
** The open-platform feature of the EnSite Precision™ cardiac mapping system allows for use of almost any catheter, thus offering superior flexibility as compared to the CARTO‡ system by Biosense Webster, which limits use to Biosense Webster catheters only.
***Effortless handling is based on how physicians scored catheter handling characteristics during an initial market release.

1. Karim, N., Srinivasan, N., Garcia, J., Providencia, R., Ang, R., Dhinoja, M., . . . Chow, A. (2018). Early experience using the Advisor HD Grid catheter to map atrial fibrillation. European Heart Rhythm Association, 20(4). Retrieved March 7, 2019.
2. Abbott. Report on file. 90299533.
3. Abbott. Report on file. 90262900.
4. Yeo C, Tan VH, Wong KCK. Pulmonary vein reconnection mapping with Advisor HD Grid demonstrating local EGM which were not visible on Tacticath ablation catheter. J Arrhythmia. 2018; 00: 1–3. https://doi.org/10.1002/joa3.12144.
5. Abbott. Report on file. 90355919.
6. Abbott. Report on file. 90264963.
7. Abbott. Report on file. 90283998.
8. Bourier F, Deisenofer I, Hessling G, et al. Contact-force sensing electrophysiological catheters: How accurate is the technology? [Abstract PO03-170]. Presentation at HRS 2016, San Francisco, CA, May 4-7, 2016. Heart Rhythm. 2016; 13(5 Suppl 1): S318-S319.
9. Bourier F, Gianni C, Dare M, et al. Fiberoptic Contact-Force Sensing Electrophysiological Catheters: How Precise Is the Technology? J Cardiovasc Electrophysiol. 2017; 28(1):109-114. https://dx.doi.org/10.1111/jce.13100
10. Ptaszek L, Moon B, Sacher F, et al. A novel automated point collection software facilitates rapid, high density electroanatomic mapping with multiple catheter types. J Cardiovasc Electrophysiol. 2017; 29(1): 186-195. https://doi.org/10.1111/jce.13368
11. Abbott. Data on File. Report 90237452.
12. Abbott. Data on File. Report 90430651.
13. Abbott. Data on File. LMR Memo #90349982.
14. Abbott. Data on File. Report 90214738.
15. Abbott. Data on File. Report 90253949.

IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

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CAUTION: This product is intended for use by or under the direction of a physician. Prior to use, reference Instructions for Use, inside the product carton (when available) or at manuals.sjm.com or eifu.abbottvascular.com for more detailed information on Indications, Contraindications, Warnings, Precautions and Adverse Events.

The Advisor™ HD Grid Mapping Catheter, Sensor Enabled™

Indications: The Advisor™ HD Grid Mapping Catheter, Sensor Enabled™, is indicated for multiple electrode electrophysiological mapping of cardiac structures in the heart, i.e., recording or stimulation only. This catheter is intended to obtain electrograms in the atrial and ventricular regions of the heart.

Contraindications: The catheter is contraindicated for patients with prosthetic valves and patients with left atrial thrombus or myxoma, or interatrial baffle or patch via transseptal approach. This device should not be used with patients with active systemic infections. The catheter is contraindicated in patients who cannot be anticoagulated or infused with heparinized saline.

Warnings: Cardiac catheterization procedures present the potential for significant x-ray exposure, which can result in acute radiation injury as well as increased risk for somatic and genetic effects, to both patients and laboratory staff due to the x-ray beam intensity and duration of the fluoroscopic imaging. Careful consideration must therefore be given for the use of this catheter in pregnant women. Catheter entrapment within the heart or blood vessels is a possible complication of electrophysiology procedures. Vascular perforation or dissection is an inherent risk of any electrode placement. Careful catheter manipulation must be performed in order to avoid device component damage, thromboembolism, cerebrovascular accident, cardiac damage, perforation, pericardial effusion, or tamponade. Risks associated with electrical stimulation may include, but are not limited to, the induction of arrhythmias, such as atrial fibrillation (AF), ventricular tachycardia (VT) requiring cardioversion, and ventricular fibrillation (VF). Catheter materials are not compatible with magnetic resonance imaging (MRI).

Precautions: Maintain an activated clotting time (ACT) of greater than 300 seconds at all times during use of the catheter. This includes when the catheter is used in the right side of the heart. To prevent entanglement with concomitantly used catheters, use care when using the catheter in the proximity of the other catheters. Maintain constant irrigation to prevent coagulation on the distal paddle. Inspect irrigation tubing for obstructions, such as kinks and air bubbles. If irrigation is interrupted, remove the catheter from the patient and inspect the catheter. Ensure that the irrigation ports are patent and flush the catheter prior to re-insertion. Always straighten the catheter before insertion or withdrawal. Do not use if the catheter appears damaged, kinked, or if there is difficulty in deflecting the distal section to achieve the desired curve. Do not use if the catheter does not hold its curve and/or if any of the irrigation ports are blocked. Catheter advancement must be performed under fluoroscopic guidance to minimize the risk of cardiac damage, perforation, or tamponade.

The TactiCath™ Quartz Contact Force Ablation Catheter and TactiCath™ Ablation Catheter, Sensor Enabled™

Indications: The TactiCath™ Quartz Contact Force Ablation Catheter and TactiCath™ Ablation Catheter, Sensor Enabled™ are indicated for use in cardiac electrophysiological mapping and for the treatment of drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used in conjunction with a compatible RF generator and three-dimensional mapping system.

Contraindications: Do not use for any of the following conditions: certain recent heart surgery; prosthetic valves; active systemic infection; use in coronary vasculature; myxoma or intracardiac thrombus, or an interatrial baffle or patch; retrograde trans-aortic approach in patients with aortic valve replacement.

Warnings: It is important to carefully titrate RF power; too high RF power during ablation may lead to perforation caused by steam pop. Contact force in excess of 70 g may not improve the characteristics of lesion formation and may increase the risk for perforation during manipulation of the catheter. Patients undergoing septal accessory pathway ablation are at risk for complete AV block which requires the implantation of a permanent pacemaker. Implantable pacemakers and implantable cardioverter/defibrillator may be adversely affected by RF current. Always verify the tubing and catheter have been properly cleared of air prior to inserting the catheter into the vasculature since entrapped air can cause potential injury or fatality. The temperature data transmitted by the sensor in this catheter is representative of the irrigated electrode only and does not provide tissue temperature data.

Precautions: The long-term risks of protracted fluoroscopy and creation of RF induced lesions have not been established; careful consideration must be given for the use of the device in prepubescent children. When using the catheter with conventional EP lab system or with a 3-D navigational system, careful catheter manipulation must be performed, in order to avoid cardiac damage, perforation, or tamponade. Always maintain a constant saline irrigation flow to prevent coagulation within the lumen of the catheter. Care should be taken when ablating near structures such as the sino-atrial and AV nodes.

Potential Adverse Events: Potential adverse events include, but are not limited to, cardiovascular related complications, including groin hematoma, pericardial effusion and infection. More serious complications are rare, which can include damage to the heart or blood vessels; blood clots (which may lead to stroke); tamponade; severe pulmonary vein stenosis; heart attack; esophageal fistula, or death.

The EnSite Precision™ Cardiac Mapping System

Indications: The EnSite Precision™ Cardiac Mapping System is a suggested diagnostic tool in patients for whom electrophysiology studies have been indicated. The EnSite Precision™ System interfaces to either the MediGuide™ Technology System or the EnSite Precision™ Module to combine and display magnetic processed patient positioning and navigation mapping information. When used with the EnSite™ Array™ Catheter, the EnSite Precision™ Cardiac Mapping System is intended to be used in the right atrium of patients with complex arrhythmias that may be difficult to identify using conventional mapping systems alone. OR, when used with an EnSite Precision™ Surface Electrode Kit, the EnSite Precision™ Cardiac Mapping System is intended to display the position of conventional electrophysiology (EP) catheters in the heart.

Warnings: Refer to the ablation catheter labeling for a listing of adverse events related to the use of this device in conjunction with radio frequency ablation, as a part of the diagnosis and treatment of cardiac arrhythmias. For patient safety, any connections that directly connect the patient to the EnSite Precision Cardiac Mapping System must be routed through the appropriate module: EnSite Precision Link, Sensor Enabled™ NavLink, EnSite Precision Field Frame, ArrayLink, CathLink, SJM ECG Cable, RecordConnect, or GenConnect. When using the EnSite Precision Module full protection against the effects of cardiac defibrillator discharge and other leakage currents is dependent upon the use of appropriate cables. Refer to the ablation catheter labeling for a listing of adverse events related to the use of this device in conjunction with radio frequency ablation, as a part of the diagnosis and treatment of cardiac arrhythmias. For patient safety, any connections that directly connect the patient to the EnSite Precision Cardiac Mapping System must be routed through the appropriate module: EnSite Precision Link, Sensor Enabled™ NavLink, EnSite Precision Field Frame, ArrayLink, CathLink, SJM ECG Cable, RecordConnect, or GenConnect. When using the EnSite Precision Module full protection against the effects of cardiac defibrillator discharge and other leakage currents is dependent upon the use of appropriate cables.

Precautions: Do not operate the EnSite Precision Field Frame within 10 meters (m) of another operating Field Frame. Do not place the EnSite Precision Field Frame cable inside the measurement volume or wrap it around the Field Frame, as it may create a magnetic interference. Do not coil the EnSite Precision Field Frame cable. The cable carries enough electric current that a magnetic field will be created when the cable is placed in a circular formation. This magnetic field may disturb the Field Frame’s magnetic field. Do not place the EnSite Precision Link, Sensor Enabled™ within 1 m of the EnSite Precision Field Frame - Do not place tool cables within 30 millimeters (mm) of the EnSite Precision Field Frame cable. If placed this close—particularly if the cables are parallel to each other—the tool cable may become subject to electromagnetic interference. Metallic equipment used in close proximity to the magnetic field during the procedure, such as a sterile drape holder, may affect Sensor Enabled (SE) points and SE field scaling accuracy. Do not use the EnSite Precision Cardiac Mapping System in the presence of other magnetic fields. Do not drop the EnSite Precision Field Frame or subject it to impact. Physical damage to the Field Frame may alter the Field Frame’s factory calibration.

 

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