Challenging Recorded Cases of Ablation From the MENA Region (Joint Session)-Challenging Recorded Cases of Ablation From the MENA Region (Joint Session)

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Video Summary

The presented medical conference cases concern challenging cardiac arrhythmias in young patients and their diagnosis and management through advanced electrophysiological studies (EPS) and catheter ablation techniques. Key cases discussed include a 12-year-old girl, originally ablated for PJRT in infancy, later presenting with WPW pattern; a young patient with continuous wide complex tachycardia, managed through multiple EPS to uncover an automatic focal VT origin near the HISS bundle; and numerous complex tachycardias, notably left ventricular fascicular VT, which required detailed mapping to locate reentrant circuits, often involving the Purkinje network. Emphasis was on precision targeting of arrhythmic substrates to avoid iatrogenic complications, like left upper septal VT that can arise after previous ablations, which share the pseudo-QRS morphology and sensitivity to verapamil, misleading initial interpretations. Both procedural insights and diagnostic challenges were shared, illustrating the iterative approach necessary for precise arrhythmia interpretation and effective, minimal-impact intervention — reflecting the series' overarching theme on electrophysiological complexity and procedural refinement in the face of intricate cardiac arrhythmias. The cases underscore ongoing needs for careful pre-procedural assessment and innovative intra-procedural strategies in electrophysiology.

Keywords

cardiac arrhythmias

electrophysiological studies

catheter ablation

WPW pattern

ventricular tachycardia

Purkinje network

pre-procedural assessment

electrophysiology strategies