Session IV: Noninvasive Diagnosis and Treatment-6156-Workshop #7- Electrocardiographic-Electrophysiological Correlations, Atrial Fibrillation, Clinical Scenarios and Syndromes FULL

Workshop #7- Electrocardiographic-Electrophysiological Correlations, Atrial Fibrillation, Clinical Scenarios and Syndromes FULL

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Video Summary

The first case presented a 48-year-old female with frequent palpitations and a history of fast heart rate episodes in her teen years. The ECG showed positive predictive value for ablation within the coronary sinus or the middle cardiac vein. The best acute treatment was intravenous procainamide. In the second case, a 20-year-old male presented to the ED with rapid palpitations and chest pressure. Adenosine was administered, which converted the tachycardia to pre-excited atrial fibrillation. The recommended acute treatment in this case was intravenous procainamide. In the third case, a 30-year-old female with an ICD placement presented with a prolonged QT interval on her ECG. The most likely genetic mutation to explain the findings was CACNA1C. In the fourth case, a 33-year-old male with a history of syncope had an episode of syncope while urinating and fell, injuring his arm. An Iolar interrogation showed an atrial arrhythmia and the patient was recommended conservative management with careful attention to fluids and mitigating risk. In the fifth case, a 40-year-old male with muscular dystrophy had an ECG with a prolonged QT interval. The most likely genetic mutation was MYH7. In the sixth case, a 23-year-old female basketball player had episodic near syncope. An ECG showed prolonged PR interval, suggesting a delay in the AV node. The best explanation for the findings was reverse use dependence. In the seventh case, a patient was started on self-tolerance and experienced an episode of syncope. The most likely explanation for the finding was flecainide toxicity due to acute renal failure. In the eighth case, a 46-year-old female had an ECG suggestive of left bundle branch block. The best explanation for the finding was disruption of desmosomal proteins, indicating a possible diagnosis of arrhythmogenic right ventricular cardiomyopathy. Overall, these cases presented a variety of arrhythmias and syndromes, and provided insights into their diagnosis and management.

Keywords

palpitations

fast heart rate

ECG

ablation

procainamide

pre-excited atrial fibrillation

prolonged QT interval

syncope

arrhythmia

cardiomyopathy