1. Blazer II XP™ Ablation Catheter
EP SALES TRAINING
Blazer II XP™ Ablation Catheter

2. Blazer II XP™ Ablation Catheter Agenda
Blazer II XP™- Features
Atrial Flutter
Positioning
Brochure
Competition
Cabling Chart
Evaluation Model
How to Use
Generators Troubleshooting Guide
Clinical Evidence
Conclusion

3. Blazer II XP™ Ablation Catheter Features
Handle
Tension Control
Bi-wing Steering
Handle Ergonomics
Proximal Shaft
Torqueability
Pushability
Trackability
Tip Electrode
Tip Size
Cooling
Temperature Sensor
Distal Segment
Length & Curve Shape
Performance
Active Steering

4. Blazer II XP™ & Blazer II XP™ HTD Feature Summary

5. Blazer II XP™ Ablation Catheter Atrial Flutter
Anatomy & Conduction
Right Atrial Conduction
Travels from SA node to the AVNODE
Flutter
A re-entry circuit
Classified as Typicial or Atypical
Typical is circuit around right atrium traveling counterclockwise and is CTI dependent.
Other forms include scar re-entry, TV dependent, and LV dependent.
Right Atrial Typical Flutter
Ventricular response is slower due to the AV node blocking some of the circuits (i.e. 3:1)
“Saw tooth” pattern on 12-lead

6. Blazer II XP™ Ablation Catheter Atrial Flutter
Ablating Flutter
Dx placed in CS and around RA
CS = to pace medially and determine if origin is left or right
Decapolar
Around RA = confirm circuit is counterclockwise
Halo & Duo-Deca catheters
Rx placed at TV
Linear lesion from TV to IVC through the Eustachian ridge
Eustachian ridge very thick requires deep lesion
Rx typically used to confirm bi-directional block on either side of ablation line.
Halo or Duo-Deca does the same thing.

7. 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 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

8. Blazer II XP™ Ablation Catheter
Positioning

9. Blazer II XP™ Ablation Catheter Brochure
Clinical
Benefits
POSITIONING
Technical
Info
Ordering
Info

10. Blazer II XP™ Ablation Catheter Brochure

11. Blazer II XP™ Ablation Catheter Competition

12. Blazer II XP™ Ablation Catheter Cabling Chart
Catheter can be connected to:
▪ EPT 1000XP™ generator
▪ Maestro 3000™ generator
▪ Stockert generator
▪ Osypka generator
▪ IBI generator (not in the chart,
model number 1684-TH
item 85864)
Blazer II XP™ (thermistor sensor)
cannot be used with Medtronic
generator ATAKR™.

13. Blazer II XP™ Ablation Catheter Evaluation Model
When preparing the evaluation of new customer please follow the SIX easy steps outlined below:
STEP 1:
Schedule minimum 2 Flutter cases during the same day for the evaluation.
STEP 2:
The evaluation is to be performed with Maestro 3000™
generator.

14. Blazer II XP™ Ablation Catheter Evaluation Model
STEP 3:
Suggest to the Physician to use high torque distal segment for the superior performance. Depending on the physician also mention we offer a standard torque distal segment which is less traumatic

15. Blazer II XP™ Ablation Catheter Evaluation Model
STEP 4:
Suggest to Physician to use the Large Curve with a high torque tubing, for added performance. If Physician is accustomed to using a sheath, comment HTD should eliminate this need but order a 5890ST just in case.

16. Blazer II XP™ Ablation Catheter Evaluation Model
STEP 5:
Utilize the following chart of part numbers to identify ALL of the components that you should order for the evaluation. DO NOT FORGET TO SCHEDULE 2 FLUTTER CASES!

17. Blazer II XP™ Ablation Catheter Evaluation Model
STEP 6: Before doing the ablation make the test on Maestro 3000™ - as described in the following slide.
The test must be done in order to verify the compatibility of the generator with the recording system installed in the cat lab.
Tester required.

18. Blazer II XP™ Ablation Catheter Evaluation Model

19. Blazer II XP™ Ablation Catheter How to Use
General Settings for FLUTTER:
Fluro
6 o’clock on LAO view
ECG keys
Bidirectional isthmus block

20. Blazer II XP™ Ablation Catheter How to Use
Ablation Problem
High impedance:
Char or coagulum on the catheter tip: wipe catheter
Poor contact: need better reposition for better tip contact
Measured temperature BELOW Set Temperature
Verify power settings
Verify tip contact and measured impedance value
Verify cable connections are not loose or faulty
Measured temperature ABOVE Set Temperature
Transient measured above is acceptable
Verify no coagulum
Turn OFF/ON generator to verify proper function

21. Blazer II XP™ Ablation Catheter How to Use
Ablation Problem
Measured Power BELOW Set Power
Verify power and temperature settings
Verify cable connections are not loose or faulty
Noisy Signals during ablation
Verify amplification, clipping and filtering parameters of recording machine are properly set.
Verify generator on separate electric circuit from recording machine
Disconnect and turn off non-essential equipment.
Verify tip electrode is clean.
Consider changing APM or POD

22. Maestro 3000™ Troubleshooting Guide
11 error codes exist.
Here listed meaning
& solution.
Brochure available.

23. Blazer II XP™ Ablation Catheter Clinical Evidence
Blazer II XP™ - Clinical study for FDA approval
“Radiofrequency catheter ablation of type 1 atrial flutter using large-tip 8- or 10-mm electrode catheters and a high-output radiofrequency energy generator: results of a multicenter safety and efficacy study.”
Feld G, et Al. UCSD Medical Center, University of California, San Diego, USA.
Blazer II XP™ (8mm and 10mm) was used in order to determine the safety and efficacy in the treatment of atrial flutter.

24. Blazer II XP™ Ablation Catheter Clinical Evidence
Blazer II XP™ - Clinical study for FDA approval
250th patient enrolled
21 active sites
Max number of cases per site 30
Technique
Success Rates:
Acute: 94%
Recurrence rate (6 months): 4%
Adverse Event Rates
Major: 8%

25. Blazer II XP™ Ablation Catheter Clinical Evidence
FLUTTER Publications:
“Effect of isthmus anatomy and ablation catheter on radiofrequency catheter ablation of the cavotricuspid isthmus.” Da Costa A, et Al. University Hospital Jean Monnet, Saint-Etienne, France.
Circulation Aug 31;110(9):

26. Blazer II XP™ Ablation Catheter Clinical Evidence
FLUTTER Publications:
“Use of different catheter ablation technologies for treatment of typical atrial flutter: acute results and long-term follow-up.” Marrouche NF, et Al. Cleveland Clinic Foundation,Cleveland,USA.
Pacing Clin Electrophysiol Mar;26(3):743-6.

27. Blazer II XP™ Ablation Catheter Clinical Evidence
FLUTTER Publications:
“Prospective randomized comparison of closed cooled-tip versus 8-mm-tip catheters for radiofrequency ablation of typical atrial flutter.” Schreieck J, et Al. Deutsches Herzzentrum Munchen and 1. Medizinische Klinik, Munich, Germany.
Cardiovasc Electrophysiol Oct;13(10):980-5

28. Blazer II XP™ Ablation Catheter Clinical Evidence
FLUTTER Publications:
Is 8-mm more effective than 4-mm tip electrode catheter for ablation of typical atrial flutter? Tsai, et Al. National Yang-Ming University, School of Medicine, and Veterans General Hospital-Taipei, Taiwan.
Circulation Aug 17;100(7):

29. 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