EP Sale’s Training Summary

BSC Confidential – For Internal Use Only – Do Not Copy or Distribute EP Summary - Agenda Diagnostic Catheters EP Study Ablation Catheter Features Blazer II™ Ablation Catheter AVNRT Blazer XP™ Ablation Catheter A Flutter Chilli II ™ Cooled Ablation Catheter A Fib BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study Sinus Rhythm: regular slim QRS P before Q P: > 90 ms PQ: 120 – 200 ms QRS: < 120 ms QT: ca. 440ms T P Q S P – Q QRS Q - T BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study High Right Atrium (near sinus node) His (near AV node) Coronary Sinus (left AV groove) (used for left AVRT, Flutter and A fib) Right Ventricle Apex BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters EP Study BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Clinical Applications BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Fixed Curve CURVE SHAPES DISTAL TUBING CONNECTORS BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Fixed Curve Features BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Steerable STEEROCATH DX POLARIS Dx POLARIS X BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Steerable Features BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Diagnostic Catheters Conclusion The purpose of diagnostic catheters is to facilitate understanding the mechanism of arrythmias and appropriate ablation location. Diagnostic Catheter can be classified into two main groups: Fixed Catheters Steerable Catheters Both type of catheters present a wide range of configurations (i.e. curve type, electrode numbers, electrode spacing etc.). The main difference between fixed and steerable catheters is the CLINICAL ease of use: the target for steerable catheters is mapping difficult sites, like the CS. BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

BSC Confidential – For Internal Use Only – Do Not Copy or Distribute Ablation Catheter Features Distal Segment Length & Curve Shape Performance Active Steering Handle Tension Control Bi-wing Steering Handle Ergonomics Tip Electrode Tip Size Cooling Temperature Sensor Proximal Shaft Torqueability Pushability Trackability BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II™ Ablation Catheter AVNRT Summary Symptoms Lightheadedness Rapid palpitations Pulsations in the neck Regular rhythm with narrow QRS No visible P wave (may be buried at end of QRS) A and V stimulate simultaneously (reentry <50msecs) Ventricular rates between 160 – 200 bpm Paroxsysmal Starts and stops suddenly Most common SVT Treated by ablating the slow pathway of the AV Node BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II™ Ablation Catheter Feature Summary BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

BSC Confidential – For Internal Use Only – Do Not Copy or Distribute Blazer II™ Ablation Catheter Positioning BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II™ Ablation Catheter How to Use General Settings for AVNRT: Fluro 9 o’clock on LAO view ECG keys AVNRT is successfully treated (fast pathway ablation) when A-H Jump is absent BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II™ Ablation Catheter Conclusion Positioning AVNRT Clinical Needs Sharp Electrograms Micromovement Tip Contact Reach Anatomy Catheter Features 7f/4mm tip electrode Bi-wing knob and steering mechanism HTD distal & proximal St’d curve = normal & K2 = Large Customer Evaluation Min 2 AVNRT Cases BSC Generator STD or HT Distal? STD or K2 Curve? Order per List BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II XP™ Ablation Catheter Atrial Flutter Summary Symptoms Palpitations Dizziness Short of Breath Rhythm Narrow QRS Variable conduction between the atrium and ventricle Atrial cycle length of 200 - 250 msecs Typical = counter clockwise around the right atrium Paroxysmal Initiates and terminates spontaneously Ablation Line from the TV to the IVC through the Eustachian ridge Bi-directional block along with cycle lengths confirms success BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II XP™ Ablation Catheter Feature Summary BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

BSC Confidential – For Internal Use Only – Do Not Copy or Distribute Blazer II XP™ Ablation Catheter Positioning BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II XP™ Ablation Catheter How to Use General Settings for FLUTTER: Fluro 6 o’clock on LAO view ECG keys Bidirectional isthmus block EP Marketing International BSC Confidential - For internal use Only -Do not copy or distribute BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Blazer II XP™ Ablation Catheter Conclusion Positioning Flutter Clinical Needs Deep Lesion Linear Ablation Tip Contact Reach Anatomy Catheter Features 8f/8mm Tip Electrode Bi-wing knob and mechanical steering HT distal and proximal tubings Large Curve Customer Evaluation Min 2 AFL Cases BSC Generator Straight or VM Tip? STD or HT Distal? K2 or STD Curve? Order per List BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Chilli II™ Cooled Ablation Catheter Atrial Fibrillation Summary Symptoms Palpitations Dizziness Short of Breath Rhythm Narrow QRS Irregular Paroxysmal, Persistant and Permanent Ablation Encirclement of the Pulmonary Veins Possible other left atrial connecting lesions BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Chilli II™ Cooled Ablation Catheter Feature Summary BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

BSC Confidential – For Internal Use Only – Do Not Copy or Distribute Chilli II™ Cooled Ablation Catheter Positioning BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Chilli II™ Cooled Ablation Catheter How to Use BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

Chilli II™ Cooled Ablation Catheter Conclusion Positioning AFIB Clinical Needs Minimize Coagulum Minimize secondary complications Linear Ablation Tip Contact Access Anatomy Deep Lesion Catheter Features Cooled 7f/4mm Tip Closed loop cooling Bi-wing Knob & mechanical steering HT Distal and Proximal Active Steering & proximal tubing Cooled 7f/4mm Customer Evaluation 1 x AFL + 1 x AFIB Cases BSC Generator STD & K2 backup Order per List BSC Confidential – For Internal Use Only – Do Not Copy or Distribute

EP Summary Clinical Summary   Sinus Rhythm AVNRT AVRT A Flutter V Tach A fib Rate (average) 60 - 80 bpm 160 - 200 bpm a=200-250msec 150-250 bpm a >200 msecs Regular Rhythm yes regular in atrium irregular P before QRS no no (p after q) no p wave Narrow QRS either Testing EP Study AH jump, AV < 50msecs AV time > 50 msecs Bidirectional block Isolated PVs BSC Confidential – For Internal Use Only – Do Not Copy or Distribute