BWI Foundations Quiz 2

V-tach

2 types: Idiopathic: focal type; can occur in the RVOT, LVOT, aortic cusps, or papillary muscles Ischemic: reentrant type that uses scar tissue

AVNRT

Atrioventricular Nodal Reentry Tachycardia Dual AV physiology: 2 conduction pathways (1 fast, 1 slow) between A and V; small confined loop -> micro* reentrant arrhythmia; causes simultaneous contraction of A and V

AVRT

Atrioventricular Reentry Tachycardia Needs an accessory pathway, which can conduct in to directions: antegrade and retrograde; locations: Left lateral ~50% of accessory pathways - most common Posteroseptal ~>20% Anteroseptal ~10% Right lateral ~10%

PASO

BENEFITS: delivers automated template matching for targeting complex VT procedures; compares pace mapping and arrhythmia signals; quickly locates and catalogs multiple VT signals; displays pace mapping points directly to the map FEATURES: speed of automation vs visual comparison; easy identification of VT site

Atypical Atrial Flutter

Does not use CTI; macro reentrant arrhythmia; can occur in either atria; typically uses scar tissue

Version 7

FEATURES: ARA = accurate reference annotations; coherent mapping displays conduction barrier zones, such as scar, slow conduction zones, and anatomical features; LAT hybrid combines SR map with PVC signal; Map replay is retrospective map creation; parallel mapping is creating up to 4 maps (4 arrhythmias) at the same time prospectively BENEFITS: coherent mapping: ease of diagnosing arrhythmia with global activation map and not local LAT info; LAT hybrid: improved location accuracy by combing PVC location data with SR location; Map replay & parallel mapping: efficiency gained

Cartomerge

FEATURES: accurate anatomical registration; minimal point acquisition; processing of pre-acquired images (CT scan) into multiple cardiac structures BENEFITS: save time by importing accurate, patient specific geometry; aids navigation and may help physician plan therapy; improved confidense in navigation

Accuresp

FEATURES: acquire electroanatomical data during a consistent and repeatable phase of the respiratory graph; creates respiratory graph BENEFITS: increased confidense in mapping precision; visual confirmation of end expiration phase, eliminating need to repeat sampling and save time

Cartoseg

FEATURES: automated segmentation of cardiac structures; detailed patient specific geo can be imported to carto 3; greater understanding with CT image integration BENEFITS: save time building patient specific geo; aids navigation and may help physician plan therapy

CONFIDENSE

FEATURES: automatically acquires points that meet physicians filters; only acquires points in contact with tissue (TPI); automatically analyzes bipolar and corresponding unipolar signals to detect max -dV/dt (wavefront); identifies and evaluates points who are inconsistent BENEFITS: customized workflows for point acquisition; decreases the advent of internal points; allows for automatic and faster electrogram acquisition with multi electrode caths

Cartoreplay

FEATURES: automatically begins recording data from beginning of case; available throughout the entire procedure; data available for 18 h after study start BENEFITS: provides means to review retrospective and procedural events; incorporate retrospectively electroanatomical data to the map at any time

Smartouch

FEATURES: catheter vector indicates force direction; force graph displays force magnitude over time; Force dashboard displays current force, current angle, and percentage force above threshold BENEFITS: reduce ablation time with consistent contact; reduce fluoro utilizing dashboard & vector; reduce procedure time and total energy delivery

Pattern matching

FEATURES: compares real time 12-lead BS ECG to template (takes data only when the BS ECG matches template); filters out 99.7% of beats unrelated to target rhythm; additional continuous mapping filter in confidense module BENEFITS: w/ pentaray allows EP to efficiently map and determine the mechanism of complex ventricular arrhythmias; reduce margin of error in subject morphology comparisons

Visitag Surpoint

FEATURES: considers rf power, time, and contact force to provide index; distance measurement tool; anatomical presets for tissue variability; continuous real time progress display BENEFITS: decreased RF time; decreased case time; simplified ablation procedure; yields consistency in workflow

A-fib

LA or RA quiver (fibrillate) due to multiple beats occuring in them; most commonly trigger from pulmonary veins ostium, or posterior wall of LA

Typical Atrial Flutter

Occurs in RA and uses CTI (cavotricuspid isthmus) (area of slow conduction = critical) and travels around tricuspid valve annulus; macro reentrant arrhythmia

A-tach

focal arrhythmia that can occur in LA or RA; occurs usually near transitional tissue