Vanguard BW Mode D'emploi page 32

Under consideration of the aseptic rules, access a large central vessel through which you can push the
→
catheter in.
Connect the catheter to a suitable RF surgical unit and/or generator and the recording unit using the
→
appropriate cables. Catheters with navigation function will be connected like described in the user
manual of the Carto® system.
Connect a suitable irrigation pump to a bag of heparinised normal saline solution (1IU heparin/ml) and
→
use it to fill the irrigation tube. The irrigation tube may not contain air bubbles once the shut-off valve
is closed.
Insert the irrigation tube into the pumps and irrigate until the air escapes from the open end of the
→
tube.
Connect the catheter to the irrigation pump or the irrigation tube respectively.
→
Using X-ray control and electrocardiogram as guidance, insert and push the catheter forward and
→
position it in the required place in the endocardium.
NOTE: To simplify positioning of the catheter tip from catheters with bi-directional curvature adjustment, you
can bend it using the curvature control unit (rocker lever and locking screw). By activating the rocker lever to
one side, the catheter tip is also bent to that side. The position of the rocker lever determines the curvature of
the tip. The catheter is straight and can be inserted or retracted when the rocker lever is in neutral position.
Curvature mobility is adjusted via the locking screw. Mobility can be reduced by turning the locking screw in
clockwise direction and increased by turning it in anti-clockwise direction.
NOTE: To simplify positioning of the catheter tip from catheters with uni-directional curvature adjustment,
you can bend it using the curvature control unit (thumb switch) on the handle. The catheter tip is bent by
pushing the thumb switch in distal direction. The position of the thumb switch determines the curvature of the
tip. The catheter is straight and can be inserted or retracted when the thumb switch is in neutral position
(proximal end position).
NOTE: If resistance occurs, the catheter must not be pulled back with force. In this case, an X-ray must be
used to check the position of the catheter.
NOTE: In order to perform ablation under RF current, a secure connection of the catheter and the RF
generator is necessary. Use only the connection cable from the Biosense Webster Inc. and also read the user
manual of the RF generator.
NOTE: To close the electric circuit, the neutral electrode must be connected to the reference electrode input
of the RF generator. Prior to ablation, the circuit impedance should be within the range of standard values for
ablation. The RF generator should display a temperature of approx. 37 °C for catheters with a temperature
sensor after introduction in the cardiovascular system and before starting ablation.
NOTE: The multiple supply of RF current can lead to coagulation residues on the catheter tip. This is
noticeable by the increase in temperature and impedance, and can also lead to the generator's automatic
deactivation. In this case, the catheter must be removed in order to clean the electrode. In this regard, use
sterile saline solution. You can also use a sterile swab. Carefully clean just the tip and do not rub, twist or
bend it to avoid damaging or loosening the tip. Please also read the sections "Safety instructions" and
Precautions". Before continuing with surgery, ensure that the irrigation system (catheter and irrigation tubes)
are free of trapped air and that irrigation is functional.
NOTE: For irrigation, use heparinised (1 IU heparin/ml) normal saline solution at room temperature. Trapped
air in the irrigation system (catheter and irrigation tubes) must be removed by irrigating. Ensure that all
©Vanguard AG 1000001805_REV_A_25.09.2020 32