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Mahmoud Sakr

Ain Shams University

What is Electrophysiology?

Electrophysiology: The science of the study of flow of electricity controlling the movement of the heart

The heart is a pump responsible for the blood flow inside the artery and veins

Any upset or malfunction of electricity Organization certainly cause trouble and energizes the contraction of the heart muscle and therefore disturbed blood flow to organs of the body, which may cause death in cases of continuous turmoil and rapid

The Conducting system . . .

The Conducting System

Blood Supply

Devices used in diagnosis

• ECG

• Stress test ECG

• Holter

• Echo Ultrasound

• EP study

• Cardiac stimulator

• DC shock

What we need for EPS:

(Team work, what is the role?, systems, equipments… ).

Equipments of EP lab and instruments

• EP Recording System

•Cardiac Stimulator

•Abaltor & Pump

•3D Mapping Device

EP Recording system

Cardiac Stimulator

• Block for the four channels

• Stimulator

• Touch screen

Ablator & Pump

• Foot switch

• Back patch

• ECG Stimulator

• RF connection cable

• Serial Connection

• Saline Tube

3D Mapping System(Carto)

• Work Station

• PIU

• Location Pad

• COM Unit

Connections

VGA

USB

PROCEDURE

ROOM

CONTROL

ROOM

VGA (To VGA Capture Board in MLCL)

-005 configuration

Remote Control

Screen

fluoro Signal

(To Image Capture Board in MLCL)

Hospital

LAN /

HUB

Data files (wmv) snapshots, movies

EnterprisePACS

USB / RS485

Single Lead ECG

What we need for EPS:

(Team, what is the role?, systems, equipments… ).

Global Properties of an EP Catheter

• Sizes

Shaft and Tip ( French size ).

• Spacing

Between Electrodes ( mm spacing ).

• Curves (Fixed, Deflectable)

Different Access and anatomical selection.

• Number of electrodes

Different Mapping Selections

Tip electrode

• Tip length per catheter type• Ablation catheters

• 3,5mm/4mm/8mm

• Diagnostic catheters• 1,3mm or plastic dome

1,3mm - diagnostic

3,5/4/8mm - ablation

Electrode Spacing

Spacing

2-5-2mm

2mm High Resolution

5mm Standard

10mm Pacing

A curve, Josephson type

F curve, Cournand type

D curve, Damato type

4.1cm

6.4cm

Fixed catheters Curves

2.5cm

Deflectable catheters Curves

• Puller wire

• Push & pull handle mechanism

Speciality

CurvesPostroseptal D

Halo

Isthmus

Lasso

Postroseptal AP

A Flutter

Isthmus MapPENTARAYTM

PV Map

Multielectrode Map

Catheter Position

RAO LAO

Baseline IC recording

Thank You