EP SALES TRAINING
Diagnostic Catheters
Diagnostic Catheters
Diagnostic catheters are used to obtain
information about the morphology and timing
of the electrical conduction of the heart.
High Right Atrium
– Surragate for SA Node
– Timing relative to other locations
Coronary Sinus
– Surrogate for Left Atrial and Ventricular
conduction
– Morphology and timing of conduction
from Left Arium to Left Ventricle
HIS
– Surrogate for AV Node
– Morphology and timing of conduction
from Right Atrium to Right Ventricle
Right Ventricular Apex
– Surrogate for Purkinje
– Timing relative to other locations
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For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
Agenda
• Fixed Curve
–
–
–
–
General Features of Catheter Type
Features of BSC products
Clinical Needs and BSC Catheter Solutions
Brochure with positioning statement
• Steerable Curve
–
–
–
–
General Features of Catheter Type
Features of BSC products
Clinical Needs and BSC Catheter Solutions
Brochure with positioning statement
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
General Characteristics
CHARACTERISTICS
FIXED CURVE
Distal Tubing
• French Size
– 5f or 6f --- 5f for pediatrics or minimize vascular
trauma
•
Construction
– Braided or Durometer -- Enhances performance or
minimizes trauma
•
Ring and Tip Electrode
– Spacing and Number
•
•
•
•
Wide interelectrode spacing = timing
Narrow interelectrode spacing = morphology
2, 4, 6, 8 , 10 Electrodes = more information
Curve
–
Access and Stability
•
•
Access CS or cross the TV
Stability at HRA, HIS, and RVA for sensing and/or capture
for pacing
Proximal Tubing
• Construction
– Braided or Durometer --- Enhanced performance
Connector
•
Ease of use --- Signal fidelity and easy to
connect/disconnect
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Diagnostic Catheters
Fixed Curve -- Features
EXPLORER
EXPLORER 360/360jr
5f/6f EXPLORER ST
Distal Tubing
Continuous Braid
Distal Tubing
Continuous Braid
Distal Tubing
Polyurethane 50D
Electode Number
Quadripolar
Electode
Number
Quadripolar
Electode
Number
various (see catalog)
Curve
Conduction
Curve
various (see catalog)
Curve
various (see catalog)
Proximal Tubing
Continuous Braid
Proximal
Tubing
Continuous Braid
Proximal
Tubing
Continuous Braid
Connector
Rotary
Connector
Rotary
Connector
Quick Connect
Positioning
Cost Effective
Positioning
Enhanced
Performance
Positioning
Less Traumatic
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Feature Summary
Fixed Curve Catheters
CURVE SHAPES
DISTAL TUBING
CONNECTORS
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Diagnostic Catheters
Clinical Requirements – HRA
HRA
CLINICAL REQUIREMENTS
CATHETER FEATURES
Access from the femoral vein
Pushablity and trackability of proximal tubing.
Stability upper posterior of RA for signal fidelity and
pacing capture
Distal tubing material and braid reinforcement
Timing of conduction at HRA
5mm or 10mm bipoalr or quadripolar spacing
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Diagnostic Catheters
Clinical Requirements – CS
CS
CLINICAL REQUIREMENTS
CATHETER FEATURES
Access to the CS ostium via the IVC or SVC
Cournand curve
Trackability over the "lip" at the entrance to the CS
Pushability and torqueability of proximal tubing
Trackability to push the catheter to the distal posterior
section of the CS
Morphology and timing along the length of the CS,
including the CS ostium
Pushablity and trackability of proximal tubing.
2 - 5 - 2 or similar decapolar spacing
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
Clinical Requirements – HIS
HIS
CLINICAL REQUIREMENTS
CATHETER FEATURES
Access from femoral vein
Pushablity and trackability of proximal tubing.
Access to the septal portion of the TV from the IVC
Multipurpose curve
Stablity at the TV for signal fidelity
Distal tubing material and braid reinforcement
Minimal trauma to the AV Node and HIS
Non braided distal tubing
Timing and Morphology of conduction from RA to RV,
including HIS signal
2 mm quadripolar or hexapolar spacing
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Diagnostic Catheters
Clinical Requirements – RVA
RVA
CLINICAL REQUIREMENTS
CATHETER FEATURES
Access from the femoral vein
Pushablity and trackability of proximal tubing.
Cross the TV from the IVC
Josephson/Cournand Curve
Stability at the Apex of the RV for signal fidelity and
pacing capture
Distal tubing material and braid reinforcement
Minimize perforation of the RV Apex
Non braided distal tubing
Timing of conduction at RVA
5mm or 10mm bipoalr or quadripolar spacing
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Explorer 360 and 360Jr
Brochure
Clinical
Benefits
Technical
Info
POSITIONING
Ordering
Info
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Explorer 360 and 360Jr
Brochure
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Explorer ST
Brochure
Clinical
Benefits
Technical
Info
POSITIONING
Ordering
Info
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Explorer ST
Brochure
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Fixed Curve Diagnostic Catheters
Competition
COMPETITOR
PRODUCT
BSC SOLUTION
BARD
Viking™
Viking™ Soft
Woven™
Woven Flexie™
Orbiter™
Explorer 360™
Explorer ST™
Explorer 360™
Explorer ST™
Explorer 360™
St Jude Medical / IBI
Inquiry™ Fixed Curve
Evaluator™
Response™
Supreme™
Explorer 360™
Explorer 360™
Explorer ST™
Explorer ST™
Biosense Webster
Johnson & Johnson
Standard Fixed Curve
Standard Fixed Curve Soft Tip
Small Anatomy Fixed Curve
Explorer 360™
Explorer ST™
Explorer 360 JR™
Medtronic
Soloist™
TORQR™
Explorer 360™
Explorer 360™
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Diagnostic Catheters
General Characteristics
STEERABLE
Distal Tubing
• French Size
– 6f or 7f --- 6f for pediatrics and minimize vascular
trauma
•
Construction
– Tubing Durometer ---Enhanced performance or
minimize trauma
•
Steering Mechanism
– Tubing or Metal --- Reproduceability of curve,
access, and stability
•
Ring and Tip Electrode
– Spacing and Number
•
•
•
•
Wide interelectrode spacing = timing
Narrow interelectrode spacing = morphology
2, 4, 6, 8 , 10 Electrodes = more information
Curve
– Access and Stability
•
•
Access CS or cross the TV
Stability at HRA, HIS, and RVA = sensing and
capture for pacing
Proximal Tubing
• Construction
– Braided or Durometer --- Enhanced performance
Handle
• Piston or Lever
– Ergonomics
•
Connector
– Ease of use --- Signal fidelity and easy to
connect/disconnect
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
Steerable Curve -- Features
MIGRATE OUR CUSTOMERS
TO THE SteeroCath-Dx
Polaris Dx
Polaris X
POLARIS X
Distal Tubing
35D Pebax 6f
Electode Number
Decapolar
Steering
Mechanism
Metal Unidirectional
Steering
Mechanism
Tubing Unidirectional
Steering
Mechanism
Metal Bidirectional
Curve
Standard
Curve
Various (see catalog)
Curve
Standard
Proximal Tubing
Continuous Braid 6f
Proximal Tubing
Continuous Braid 6f
Proximal Tubing
Continuous Braid 7f
Handle
Piston
Handle
Piston
Handle
Lever
Connector
Quick Connect
Connector
Connector
Quick Connect
Positioning
Uni Directional CS
Access
Positioning
Positioning
Bi Directional CS
Access
Distal Tubing
50D Polyurethane 6f
Distal Tubing
Electode Number
PLATFORM
Electode Number Various (see catalog)
Rotary & Quick
Connect
Enhanced Stability &
CS Access
30D Polyurethane 7f
Octopolar
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Feature Summary
BSC Steerable Diagnostic Catheters
POLARIS X
STEEROCATH DX
POLARIS Dx
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Diagnostic Catheters
Clinical Requirements – CS
CS
CLINICAL REQUIREMENTS
CATHETER FEATURES
Access from the femoral vein
Pushablity and trackability of proximal tubing.
Access to the CS ostium from IVC
Standard Steerable Curve
Trackability over the "lip" at the entrance to the CS
Pushability and torqueability of proximal tubing &
steering of catheter.
Trackability to push the catheter to the distal posterior
section of the CS
Morphology and timing along the length of the CS,
including the CS ostium.
Pushablity and trackability of proximal tubing.
2.5 - 5 - 2.5 or similar decapolar spacing
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Polaris X
Brochure
Clinical
Benefits
Technical
Info
POSITIONING
Ordering
Info
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Polaris X
Brochure
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Polaris DX
Brochure
Clinical
Benefits
Technical
Info
POSITIONING
Ordering
Info
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Polaris DX
Brochure
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Steerocath DX
Brochure
Clinical
Benefits
POSITIONING
Technical
Info
Ordering
Info
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
SteeroCath DX
Brochure
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Polaris X
Distal Tip Softness Comparison
Excellent tool to use to show:
 Why is distal softness
and lenght important to
clinical performance
 What makes the Polaris
X catheter superior
 Comparison to St
Judes and Biosense
Websters decapolar
catheters
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Steerable Curve Diagnostic Catheters
Competition
COMPETITOR
PRODUCT
BSC Differentiation
Bard
Dynamic Tip™
Dynamic XT™
EP·XT™
Orbiter ST™
Polaris X™ / Polaris DX™
Polaris X™ / Polaris DX™
Polaris X™ / Polaris DX™
Steerocath DX™
St Jude Med./IBI
Inquiry Steerable™
Livewire™
Reflexion™
IBI Inquiry™
Polaris
Polaris
Polaris
Polaris
X™
X™
X™
X™
/
/
/
/
Polaris
Polaris
Polaris
Polaris
DX™
DX™
DX™
DX™
Biosense Webster
Std Deflectable Curve
Johnson & Johnson
Small Anatomy
Deflectable Curve
Parahissian
Porterfield
Polaris X™ / Polaris DX™
Medtronic
Polaris X™ / Polaris DX™
Polaris X™
Stablemapr™
Marinr™ CS
Polaris X™ / Polaris DX™
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Advanced Diagnostic Catheters
Flutter
Catheters used for mapping
during flutter procedures.
BSC Solution:
• Polaris X™
• Map Freewall (1/2 Halo)
• Pace from Polaris X and
capture from Ablation
catheter
Biosense Webster
Halo™
Decapolar along CT
Data coming from Biosense Webster website – www.biosensewebster.com
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Advanced Diagnostic Catheters
HALO vs Decapolar Mapping
DECAPOLAR SIGNALS
DECAPOLAR SIGNALS
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Advanced Diagnostic Catheters
AFIB Circular Mapping Catheters
Pulmonary Vein Mapping
•10 or 20 (high density)
electrode diagnostic
catheter.
•Shaped like a ring
•Two versions
•Steerable fixed
diameter
•Steerable with
variable diameter
St Jude Medical / IBI
AFocus™
Biosense Webster Lasso™
Utilized to map the PV
before, during and after RF
Ablation
Data coming from IBI website – www.ibiep.com
Data coming from Biosense Webster website – www.biosensewebster.com
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Advanced Diagnostic Catheters
AFIB Circular Mapping Catheters
PVs showing fractionated
potentials
PVs showing no
fractionated potentials
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Advanced Diagnostic Catheters
AFIB PV Anatomical Mapping
Pulmonary Vein Mapping
BSC solution Constellation 32
electrodes (available 2008):
•
•
•
Map the ostium as well as the
length of the PV
31mm size conforms to all PV
diameters
Under fluroscopy provides
visual confirmation of PV
Constellation™
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Advanced Diagnostic Catheters
AFIB PV Anatomical Mapping
Constellation™
PVs with fractionated
potentials prior to ablation
PVs with no fractionated
potentials after ablation
BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
Summary Clinical Applications
HEART LOCATION
CATHETER FAMILIES
Fixed
Explorer
Explorer 360
Explorer 360jr
Explorer 5f ST
Explorer 6f ST
Steerable
Polaris Dx
Polaris X
SteeroCath-Dx
CURVE SHAPES
Fixed
Josephson
Cournand
Multipurpose
Conduction
Steerable
Standard (180º)
Standard (270º)
Longest
HRA
CS
HIS
RVA





-----------------------------
--------
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
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----------------------
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---------------
----------------------
HRA
CS
HIS
RVA






--------
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BSC Confidential. For Internal Use Only. Do Not Copy or Distribute
Diagnostic Catheters
Summary Steerable Curve
Features
STEERABLE FAMILIES
Polaris Dx
Polaris X
Steerocath - Dx
7f
--------
--------

6f


--------


--------
--------
--------

----------------------
---------------
Octapolar



Decapolar
--------

--------
--------




---------------
---------------
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

----------------------
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QC - 8 pin



QC - 10 pin
--------

--------
TUBING FRENCH SIZE
DISTAL TUBING FIRMNESS
High Performance
Less Traumatic
RING ELECTRODE SPACING
Quadripolar
Hexapolar

DISTAL FIXED CURVE SHAPES
Standard (270º)
Standard (180º)
Longest
PROXIMAL TUBING
High Performance
CONNECTOR
Rotary - 4 pin
QC - 6 pin

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Diagnostic Catheters
Summary Fixed Curve
FIXED CURVE FAMILIES
Features
Explorer
Explorer Explorer Explorer Explorer
360
360 Jr
5f ST
6f ST
TUBING FRENCH SIZE
6f


--------
--------

5f
--------
--------


--------



--------
--------
--------
--------
--------



--------
--------
--------
--------
---------------
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

--------
--------
--------


DISTAL TUBING FIRMNESS
High Performance
Less Traumatic
RING ELECTRODE SPACING
Bipolar
Quadripolar
Decapolar
DISTAL FIXED CURVE SHAPES
----------------------






--------


---------------
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--------
High Performance





Pins

--------
--------
----------------------
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
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


Josephson
Cournand
Multipurpose
Conduction



PROXIMAL TUBING
CONNECTOR
Rotary - 4 pin
QC - 4 pin
QC - 10 pin
--------
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