(FIT)-Module 4 Workshop 7: Electrocradiogrpahic and Electrophysiological Correlations, Atrial Fibrillation, Clinical Scenarios and Syndromes-Poole Case 5 Answer

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Video Summary

The best choice for the patient, who has pulmonary disease and left bundle branch block with a prolonged QT interval, is catheter ablation for atrial fibrillation (answer D). Dofetilide is unsuitable due to its potential to prolong the QT interval beyond safe limits, particularly in the presence of conduction abnormalities. While it primarily affects renal excretion, it requires dose adjustments based on creatinine clearance. Alternative recommendations, like altering to a fetile with normal renal function or considering dofetilide (which is contraindicated given the patient's cardiac profile), are not appropriate. Safety data for measuring JTC in bundle branch block is limited.

Keywords

pulmonary disease

left bundle branch block

prolonged QT interval

catheter ablation

atrial fibrillation