(FIT)-Module 2 Workshop 3: SVT Mechanisms and Maneuvers-Miles Workshop 3

Miles Workshop 3

Pdf Summary

In this workshop, various cases related to SVT mechanisms and maneuvers were discussed. <br /><br />In the first case, the best strategy for ablation of an accessory pathway was discussed. The correct approach was to deliver RF energy at the appropriate location. It was important to ensure that the ablation catheter was in the right position before proceeding. <br /><br />In the second case, mapping performed in orthodromic RT was discussed. The goal was to identify the most likely site for a successful ablation. Panel A was identified as the most suitable site based on the electrograms obtained. <br /><br />The third case focused on electrograms recorded during catheter manipulation. It was determined that the best course of action was to note the location of the ablation catheter on the electroanatomic map. Additionally, if catheter trauma occurred, conduction would usually return within a few minutes, and ablation could be resumed. <br /><br />The fourth case involved a manifest right anterior accessory pathway. After the delta wave disappeared following ablation, it was necessary to monitor for any evidence of recurrent AP conduction. <br /><br />In the fifth case, mapping of a mid-septal accessory pathway was performed. The site was considered risky, but cautious RF ablation could be done safely. Intubation/jet ventilation could enhance catheter stability, and monitoring AV conduction was crucial during ablation. <br /><br />The sixth case dealt with ablation of an anteroseptal accessory pathway. The focus was on enhancing freedom from AV block. Pacing from the para-His region during mapping and monitoring AV conduction were important considerations. <br /><br />The final case involved a 22-year-old patient with palpitations and presyncope. The appropriate ablation procedure was determined to be accessory pathway ablation. The patient had AV reentry that degenerated into atrial fibrillation, and ablation of the accessory pathway was recommended.

Keywords

SVT mechanisms

accessory pathway ablation

RF energy delivery

orthodromic reentrant tachycardia

electrogram mapping

electroanatomic mapping

right anterior accessory pathway

mid-septal accessory pathway

anteroseptal accessory pathway

AV conduction monitoring