Afocus 2

Manufactured by Abbott

Sourced in United States

The AFocus II™ is a high-precision laboratory instrument designed for advanced microscopy and imaging applications. It offers precise and reliable focusing capabilities to support a wide range of research and analysis tasks.

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Lab products found in correlation

Ensite velocity, by Abbott (2 mentions) Ensite precision, by Abbott (1 mentions) Lasso catheter, by Johnson & Johnson (1 mentions) Carto 3, by Johnson & Johnson (1 mentions) Tacticath, by Abbott (1 mentions)

4 protocols using afocus 2

Electroanatomical Mapping of Left Atrium

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We used EnSite Precision™ (Abbott Inc, St Paul, MN, USA), a non-fluoroscopic navigation system through which all electrodes in the heart are visualized within the electric field generated via six surface electrodes creating three orthogonal axes with the heart in their centre.33 (link) LA electroanatomical data were collected using the AFocus II™ spiral mapping catheter with 20 poles and a 4 mm spacing with a 20 mm loop diameter (Abbott Inc, St Paul, MN, USA). Complete LA maps were created prior to PVI in non-cardiac triggered mode, that enables the user to collect up to 8 s of electrogram data for every bipole. Recording was automatically started in stable catheter positions (< 10 mm catheter movement). Eight-second electrograms were collected for all 19 bipoles of the AFocus II. Points within 7 mm of the geometry shell were included in the map and the minimum interpolation distance for map colour was set at 7mm.

Nagy S.Z., Kasi P., Afonso V.X., Bird N., Pederson B., Mann I.E., Kim S., Linton N.W., Lefroy D.C., Whinnett Z.I., Ng F.S., Koa-Wing M., Kanagaratnam P., Peters N.S., Qureshi N.A, & Lim P.B. (2021). Cycle Length Evaluation in Persistent Atrial Fibrillation Using Kernel Density Estimation to Identify Transient and Stable Rapid Atrial Activity. Cardiovascular Engineering and Technology, 13(2), 219-233.

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Anticoagulation and Catheter Ablation Protocol

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Patients were efficiently anticoagulated for more than 3 weeks. The antiarrhythmic drugs (AADs) were interrupted for ≥5 half-lives before catheter ablation. Thus, amiodarone was discontinued 3 weeks before the procedure. Electrophysiological studies and catheter ablation procedures were performed under general anesthesia using a 3D electroanatomical mapping (3D-EAM) system (CARTO 3, Biosense Webster, Diamond Bar, CA, USA, or EnSite Velocity, Abbott, St Paul, MN, USA) and a deflectable decapolar circular mapping catheter (Lasso catheter of variable diameter size (15–25 mm), interelectrode spacing 6 mm (Biosense Webster, Diamond Bar, CA, USA, or a spiral multipolar pulmonary vein catheter, Afocus II, diameter 20 mm, electrode spacing 5 mm, Abbott, St Paul, MN, USA). A transesophageal echocardiography was performed at the beginning of the procedure, to both exclude any thrombi in the left atrial appendage (LAA) and guide the transseptal puncture.

Marzak H., Fitouchi S., Labani A., Hammann J., Ringele R., Kanso M., Cardi T., Schatz A., Ohlmann P., Morel O, & Jesel L. (2024). Left atrial remodeling and voltage-guided ablation outcome in obese patients with persistent atrial fibrillation. Frontiers in Cardiovascular Medicine, 11, 1362903.

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Voltage Mapping of Atrial Fibrillation

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All patients presented in AF on the day of the procedure. Left atrial (LA) geometry and subsequent data were acquired using a double-loop catheter (AFocusII™, Abbott) with 20-ring electrodes (1-mm length, 4-mm spacing). For comparative assessment of AF vs SR voltage in the LA, baseline AF maps were collected in 14 patients via 8-second complex fractionated EGM mapping (EnSite™ Velocity™, Abbott). In a subset of 13 of 14 patients, SR was additionally maintained after external DC cardioversion, and SR voltage maps were created. Before each acquisition, the AFocusII catheter was held tangentially to the endocardial surface, enabling stable tissue contact. EGMs >5 mm from the geometry surface were automatically excluded. For subsequent quantitative analysis, all points within the pulmonary veins and LA appendage were excluded (Table 1).

Qureshi N.A., Kim S.J., Cantwell C.D., Afonso V.X., Bai W., Ali R.L., Shun-Shin M.J., Malcolme-Lawes L.C., Luther V., Leong K.M., Lim E., Wright I., Nagy S., Hayat S., Ng F.S., Wing M.K., Linton N.W., Lefroy D.C., Whinnett Z.I., Davies D.W., Kanagaratnam P., Peters N.S, & Lim P.B. (2019). Voltage during atrial fibrillation is superior to voltage during sinus rhythm in localizing areas of delayed enhancement on magnetic resonance imaging: An assessment of the posterior left atrium in patients with persistent atrial fibrillation. Heart Rhythm, 16(9), 1357-1367.

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Swine Model of Myocardial Infarction

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Animal experiments were approved by the Institutional Animal Care and Use Committee. Swine were initially anesthetized with mechanical ventilation using a combination of ketamine and xylazine, and maintained under sedation using 1–2% isoflurane. We created MIs in eight swine (35–45 kg) by occluding the mid-left anterior descending coronary artery for two hours using an angioplasty balloon (13 (link)).
We performed electrophysiological study 8 weeks after MI. In heparinized animals, endocardial mapping of the left ventricle (LV) was performed during sinus rhythm via retrograde approach using a duodecapolar catheter (AfocusII, Abbott Inc, Minnetonka, MN) with the EnSite Velocity mapping system (Abbott, Inc). Bipolar voltage map was created, where normal myocardium voltage was >1.5 mV, scar <0.5 mV, and border zone (BZ) 0.5–1.5 mV (3 (link)). Endocardial RFCA in the LV was performed at 2–3 sites each in scar, BZ, and normal tissue using an irrigated 3.5 mm-tip contact-force (CF) sensing ablation catheter (TactiCath, Abbott). Each RFCA application was delivered at 30 W for 60 sec (17 ml/min irrigation) with a temperature limit of 48°C, and targeting CF was 10–40 g. Force-time integral and changes of local impedance and amplitude of bipolar electrograms were measured during each ablation.

Tao S., Guttman M.A., Fink S., Elahi H., Patil K., Ashikaga H., Kolandaivelu A.D., Berger R.D., Halushka M.K., Schmidt E.J., Herzka D.A, & Halperin H.R. (2018). Ablation Lesion Characterization in Scarred Substrate Assessed Using Cardiac Magnetic Resonance. JACC. Clinical electrophysiology, 5(1), 91-100.

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