Stylets, Attain Command Catheters, LV Leads Flashcards
Which stylet is used to position the RV lead on the septum?
- a multipurpose curved shape or Amplatz curved stylet for mid to high septal placement
- a lesser J-curve for lower septal placement
Which stylet is best for placing the RA lead into the Right Atrial Appendage (RAA)?
J-shaped for placement into the RAA or high RA septum
What are the outer (OD) and inner (ID) dimensions for the Attain Command family of catheters?
- 9.0 Fr OD
- 8.5 Fr (tapered distal end if applicable)
- 7.2 Fr ID
What does the “X” mean for the following Attain Command catheters:
- Multipurpose X and MB2 X
- an “X” identifies the catheter as having a tapered distal end
- goes from 9.0 (proximal) to 8.5 Fr (distal tip)
What are the lengths in cm for the Straight Attain Command family of catheters?
- 45 cm
- 50 cm (most)
- 57.5 cm
What is the length in cm for the Multipurpose X Attain Command catheters?
- 50 cm; also has a tapered distal end
What is the length in cm for the Multipurpose Attain Command catheter?
45 cm
What is the length in cm of the Extended Hook Extra Large Attain Command catheter?
57.5 cm
What is the length in cm of the Extended Hook Attain Command catheter?
50 cm
What is the length in cm of the Amplatz Attain Command catheter?
- 50 cm
- catheter has a double curve
What is the length in cm of the Multipurpose Right Attain Command catheter?
45 cm; needed if access is on the patient’s right
What is the length in cm of the 3D Attain Command catheter?
45 cm
What shape is a 6250-45S, 50S or 57.5S and can it be deep seated in the CS?
- straight shaped and yes, it can be deep seated in the CS
- need a steerable EP or Attain Select catheter to cannulate the CS
Can a 6250-MP or 6250-MPX be deep seated in the CS?
only the 6250-MPX can be deep seated into the CS or used to sub-select a CS branch due to its tapered end
Which of the 6250 Attain Command catheters can be deep seated into the CS?
- straight
- Multipurpose (MPX)
- MB2X
- extended hook
Which of the 6250 Attain Command catheters can be used as a sub-selector for CS cannulation?
- straigtht
- Multipurpose (MPX)
- MB2X
Which Attain Command catheter should be used to gain CS access in patients with atrial enlargement or has a CS with a vertical take-off?
6250-EH or 6250-EHXL
- extended hook
In which patients is the Extended Hook (6250-EH or 6250-EHXL) Attain Command catheter a good choice for CS cannulation/access?
patients with atrial enlargement or who have a CS with a vertical take-off?
Which Attain Command catheter should be used to gain CS access in patients where the CS is obstructed by the Thebesian Valve?
6250-AM
- amplatz catheter
- lead with a guidewire so the tip does not prolapse
Which Attain Command catheter should be used to gain CS access in patients where a right sided approach is being used?
6250-MPR
- Multi-purpose Right
In which patients is the 6250-AM (amplatz) Attain Command catheter a good choice for CS cannulation/access?
patients where the CS is obstructed by the Thebesian Valve
In which patients is the 3D curve Attain Command Surevalve catheter a good choice for CS cannulation/access?
use when the CS is more posterior than normal
The Attain Perform 4598 is recommended for what size vessels?
Medium to Large diameter vessels
The Attain Perform 4298 is recommended for what size vessels?
Medium vessel diameter
The Attain Perform 4398 is recommended for what size vessels?
Small diameter vessels or with acute curvatures
What is the model number for there Attain Stability Quad LV lead?
4798
What type of lead is the 4798?
Active fix LV lead
-> has helix in between poles 2-3 with a mechanical stop to prevent over fixating and possible vessel trauma
How is the Attain Stability Quad (4798) fixated to the vessel wall?
A helix in between poles 2-3
-> 0.2mm in diameter
-> is electrically inactive
-> has mechanical stop to prevent over rotation
What are the distances for the following on an Attain Performa family of the quadripolar leads:
1) LV1 to LV2
2) LV2 to LV3
3) LV3 to LV4
1) 21mm
2) 1.2mm
3) 21mm
What is important to remember when inserting/advancing the Attain Stability Quad (4798) lead through the Surevalve of the attain command catheter?
Rotate the lead counterclockwise as it is advanced thru the Surevalve
When should lead testing be done when implanting a 3830 Attain Stability Quad lead?
After the lead is fixated because the position of the electrodes will change/move as the lead is screwed in place
What is done to ensure the helix of the 3830 Attain Stability Quad lead is properly fixed?
- retract the guide wire to appx LV4 and perform the Push and Pull test under live fluoroscopy
Should the 3830 Attain Stability Quad lead be wedge into place?
No, wedging the lead may prevent helix rotation and fixation
What items are included with the 3830 Attain Stability Quad packaging?
- 4 straight stylets (2 grey, 2 purple)
- 2 j-shaped stylets
- guidewire insertion tool
- 1 torque tool
- 1 guidewire clip
What is the purpose of the j-shaped stylets that come with the 3830 Attain Stability Quad lead?
Stylets are used to pressed the helix against the vessel wall when screwing into place
