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Published bySharlene White Modified over 6 years ago
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50 yr old man Recurrent tachy episodes since a few years
Normal echo Inputs from Chandrashekhar and Tahmeed
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Basal ECG- normal
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Any D/D. – No. Clearly MMVT, note the slow downstroke of QRS in V1
Any D/D? – No. Clearly MMVT, note the slow downstroke of QRS in V1. Likely AV dissociation (note the changing T waves in V2)
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And now? RF unipolar signal looks good with early QS deflection What next?
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Use a smaller French size, small curve, easily deflectable catheter
It was difficult to manipulate the mapping catheter in the area of interest-options? Use a smaller French size, small curve, easily deflectable catheter
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Comment on the RF signal- Fragmented bipolar signal, remarkably early
55 ms
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RF energy- clean VT termination
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RF site- LAO 40. Note the double curve needed in the ablation catheter to reach the desired site at the septal-free wall interface in the RVOT. A 6F small (A) curve mapping catheter was used.
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RF site- RAO 30
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After ablation-comment: No tachy induced with rapid atrial pacing; no inducible tachy with V pacing
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