Session II: Invasive Diagnosis and Treatment-6154-Workshop #3 SVT Mechanisms

Video Transcription

Video Summary

In this video, Dr. William Miles presents several cases of tachycardias and discusses the best next steps for each case. He provides electrograms and tracings to guide the decision-making process.<br /><br />The first case involves a patient with palpitations and pre-excitation on EKG. The correct next step is to reassess catheter position, as the tracing suggests that ablation near the AV node could lead to heart block.<br /><br />In the second case, a tachycardia is induced and pacing from the right ventricular apex accelerates the atrial electrograms and QRS complexes. The likely diagnosis is AV re-entry using a left lateral accessory pathway.<br /><br />In the third case, cryoablation is performed, but the tracing suggests the need to stop cryoablation due to potential risk to the fast pathway.<br /><br />The fourth case involves a patient whose tachycardia is terminated after spontaneous conversion of atrial fibrillation. The correct next step is to map the activation sequence of the left atrium to determine the diagnosis.<br /><br />In the fifth case, the patient's tachycardia is terminated and pacing is performed. The correct next step is to perform ventricular pacing to further evaluate the tachycardia.<br /><br />In the sixth and seventh cases, the tachycardias terminate spontaneously. The correct next step in both cases is to administer isoproterenol and repeat program stimulation to induce sustained tachycardia for further evaluation.<br /><br />Throughout the video, Dr. Miles explains the tracings and electrograms in each case to provide a better understanding of the correct next steps.

Keywords

tachycardias

next steps

cases

electrograms

tracings

palpitations

ablation

AV node

heart block

induced tachycardia

pacing

atrial electrograms

QRS complexes

AV re-entry

left lateral accessory pathway