Affera Module 2: Mapping Software

settings cog

defines if pacing parameters are programmed through the mapping system or external EP stimulator

vein mode

acquiring and delineating geomtry within a distinct anatomical region

euclidean distance

shortest possible distance bw two points

pace all

routes stimuli to both sphere 9 catheter lattice and mini surface electrodes in a rapid burst once every pacing period

geodesic distance

measures distance following curvature of map

what is pace all useful for

testing phrenic nerve capture

pace minis

routes pacing stimuli to all sphere 9 catheter mini surface electrodes in a rapid sequential burst once every pacing period

what are pace minis useful for

testing for exit block from a PV

STIM

delivers pacing as programmed

what are these

atrial trigger

ventricular trigger

stim trigger

what does new map do

creates capability for a new geometry and EA information

what does remap do

initializes the map using the chamber and geometry from an existing source map

what does clone do

creates a full copy of an existing source map including chamber, rhtyhm, WOI, geo, and electrogram data

what does import do

creates a geo shell from a surface file saved on an external usb drive

respiration gating

the % of stable respiratory cycle that geometry and electrogram data is collected

voltage threshold

min voltage required for activation timing to be assigned to the point

activation threshold

how sharp a signal must be to be annotated, measured in V/s with the purpose to discriminate between near-field and far-field activity

which part is when info is collected and which part is when info is not collected

collected: white portion

not collected: orange portion

fast remap

initializes a map using the active map’s geometry, chamber, rhythm, and WOI

what does it mean when the outer ring is smaller? when larger?

the displayed cath location is near the surface of the map

displayed cath location is further from the surface of the map

dashed line vs solid line around the catheter

dashed: reduced local impedance

solid: increased local impedance

what do the orange and blue outlines mean on the sphere globe

orange: F curve deflection

blue: D curve deflection

if the ablation button is gray or black, what could that be due to?

poor location quality

rapid cath movement

respiration gating

triggers not detected

V trigger signals are inconsistent with stim trigger

errors on patches/displacement

Tag Connect Thresholds for PFA and RF

RF: 7-8mm

PFA: 5 mm

describe these

1.utilizes integral sensor temp rise above baseline value to determine ablation tags

2.when checked, ablation tags are shaped, positioned, and oriented based on sensors meeting temp criteria

3.when checked, ablation tags are displayed as transparent shapes with a white border

4.when checked, ablation tags within geo shell are obstructed

RF temp threshold

50 degrees C

PF temp threshold

one or two degrees above pt’s temp

impedance measurement

measured between the ablation electrode and the return electrodes

flow

real time flow rate ml/min being delivered by the HexaFlow irrigation pump, with target flow shown in bottom left

temperature measurement in treat mode

real time temp in C measured with the ablation catheter; max temp across all temp sensors

level measurement in treat mode

real time current level % being delivered by the HexaGen RF generator or the PFA generator

during RF, level is reported as?? what about PFA??

RF: % of the max current squared

PFA: % of the max current

blue tag connect line

inter - ablation distance is greater than the user defined criteria

blue ablation tag

temp criteria for an ablation was not met

grey tag connect line

interablation distance is lower than the manually set criteris

what do the two orange lines mean?

bright orange: max temp for al 9 sensors

dark orange: other temp sensors

what is the hierarchy of triggers when multiple are selected?

stim

atrial

Ventricle

is it an appropriate WOI if it spans 250ms but the TCL is 256ms?

yes because the WOI covers approximately 100% of the TCL

rec triggers selected for sinus

A and V

rec triggers selected for internally paced

S and V

rec triggers selected for Afib

V

rec triggers selected for aflutter or tach

A

WOI boundaries for sinus

left boundary: pre p wave

right boudnary: pre QRS

WOI boundaries for internally paced

left boundary: post pacing spike +10ms

right: pre QRS

WOI boundaries for afib

left: ~300ms pre QRS

right:pre QRS

WOI boundaries for aflutter or tach

physician preference or 100% TCL or 50/50 around trigger

where is the ablation

when 1 sensor exceeds the user defined threshold, the ablation tag is flattened into a disc centered on the sensor that met criteria

inter ablation distance

distance between the closest temp sensore that have met the user defined temp threshold