Detailed Device Description - Medtronic ATTAIN COMMAND 6250C Manuel Technique

M706639B_ch.fm 4/24/09 11:13 am
UC2005xxxxx EN
4.875 x 7.125 inches (123.825 mm x 180.975 mm)
M706639B001D.book
2. Keep the guide-catheter dilator extended beyond the distal end of
the guide catheter to facilitate passage through the upper
vasculature. Retract the guide-catheter dilator within the guide-
catheter tip when advancing into the right chambers of the heart.
Warning: The guide-catheter dilator must be removed or retracted
within the guide-catheter tip to minimize the risk of perforation when
in the right chamber of the heart.
3. Leaving the guide wire in place, remove the guide-catheter dilator
from the guide catheter assembly to allow the catheter tip to resume
the pre-formed shape.
4. Rotate the guide-catheter body to position the guide catheter tip
posteriorly and to the patient's left. While extending the guide wire
beyond the guide-catheter tip, achieve entry into the coronary sinus
using fluoroscopy to facilitate placement.
5. Advance the guide catheter into the coronary sinus.
6.3.2 Using a straight guide catheter
1. Place the guide-catheter assembly through the lumen of the
introducer sheath. The steerable catheter should be extended
beyond the distal end of the guide catheter throughout the
procedure.
2. Keeping the steerable catheter extended beyond the tip of the guide
catheter, advance the steerable catheter to the right atrium.
3. Manipulate the steerable catheter to obtain coronary sinus access
using fluoroscopy and ECG guidance to facilitate placement.
4. Advance the guide catheter into the coronary sinus.
6.4 Obtaining a venogram
Before placing a lead in the coronary sinus, venograms should be
obtained to indicate the anatomy of the coronary vasculature.
Refer to the technical manual packaged with a 2 mm (6 Fr) or smaller
venogram balloon for further instructions on obtaining a venogram.
6.5 Accessing the cardiac vein with a straight guide catheter
1. Gain access to the target site with the steerable catheter.
2. Advance the straight guide catheter over the steerable catheter into
the target site.
3. Remove the steerable catheter while maintaining the placement of
the guide catheter.
6.6 Inserting a transvenous device or the lead
If using a transvenous device, refer to the technical manual packaged
with the device.
1. Verify that a straight stylet or a lead-compatible guide wire is
inserted in the lead.
Note: Medtronic recommends using the stylet with the valve-
compatible knob with the left-heart delivery system because the
valve can pass over the stylet knob while the stylet remains in the
lead. A stylet with a regular size knob may be used with the left-
heart delivery system; however, the stylet must be removed from
the lead before removing the valve.
2. If an incompatible guide wire is in place, remove it at this time.
Advance the lead through the valve and into the lumen of the guide
catheter.
3. With the guide-catheter tip within the coronary sinus, slowly
advance the lead through the guide catheter until the lead tip passes
the end of the guide catheter. Adjust the valve, as necessary, to
maintain hemostasis.
4. Refer to the technical manual packaged with the lead for further lead
positioning and electrical measurement instructions.
6.7 Removing the guide catheter
When the lead is in final position, the guide catheter must be removed
from the lead before surgical closure. The guide catheter is removed
from the lead using a slitter.
Caution: During and after slitting the guide catheter, handle the slit
edges of the guide catheter carefully to prevent lead damage.
Note: Removing the guide catheter may dislodge the lead. If the lead
dislodges, refer to the technical manual supplied with the lead for
positioning instructions.
1. Remove the valve from the guide catheter hub (Figure 2).
Figure 2. Removing the valve
M706639B001 Rev D
US/OUS EE MR
Page 7 Friday, April 24, 2009
6.8 Removing the introducer sheath
Remove the introducer sheath as described in the technical manual for
the percutaneous introducer.

7 Detailed device description

7.1 Specifications
Parameter
Guide wire
Valve
Guide-catheter slitter
Guide-catheter
dilator
Guide catheters
Compatible Leads
Compatible Inner Transvenous Devices
Model number
Guide catheter Usable Length
8 Medtronic disclaimer of warranty
For complete disclaimer of warranty information, see the accompanying
disclaimer of warranty document.
9 Service
Medtronic employs highly trained representatives and engineers located
throughout the world to serve you and, upon request, to provide training
to qualified hospital personnel in the use of Medtronic products.
Medtronic also maintains a professional staff to provide technical
consultation to product users. For more information, contact your local
Medtronic representative, or call or write Medtronic at the appropriate
address or telephone number listed on the back cover.
7
Medtronic Confidential
Acc_DVD_R02
11:12 AM
2. Follow the appropriate directions as provided in Appendix A for
information on slitting.
3. Discard the guide catheter and slitter after the guide catheter has
been removed from the lead.
Material:
Length:
Diameter:
Inner diameter: 5.1 mm (15.2 Fr, 0.2 in)
Material:
Inner diameter:
Outer diameter:
Usable Length:
Material:
Inner diameter:
Outer diameter:
Outer diameter
proximal:
Outer diameter distal:
6250-MB2
6250-45S
45 cm (17.7 in)
Refer to the "Acc_DVD" category in
doc#163256 for Printing Instructions.
Model 6250C, 6250S
Stainless steel
120 cm
0.9 mm (0.035 in)
maximum
4 Fr - 6 Fr
Polyethylene
0.9 mm (2.8 Fr; 0.038 in)
minimum
2.4 mm (7.1 Fr; 0.093 in)
maximum
59.4 cm (23.4 in)
Polyether block amide,
polyamide 12
2.4 mm (7.2 Fr; 0.095 in)
minimum
6250-MB2, 6250-MP,
6250-EH
3.0 mm (9.0 Fr; 0.118 in.)
maximum
6250-45S, 6250-50S,
6250-MB2X, 6250-MPX
3.0 mm (9.0 Fr; 0.118 in.)
maximum
2.9 mm (8.6 Fr; 0.112 in)
maximum
2.1 mm (6.2 Fr, 0.082 in)
or smaller
2.4 mm (7.1 Fr, 0.093 in)
or smaller
6250-EH
6250-MP
6250-50S
6250-MB2X
6250-MPX
50 cm (19.7 in)