(FIT)-Module 5 Workshop 9: Arrhythmia Case Studies (Putting It All Together for the Boards)-Miller Case 4 Answer

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The discussion centers on analyzing a patient's arrhythmia post-atrial septal defect repair. The arrhythmia resembles a focal tachycardia rather than the expected reentrant type. Identical P waves and absence of atrial fibrillation imply it's not typical reentry, despite irregularity in Vs. The suggestion is to avoid using entrainment mapping or inappropriate interventions like pulmonary vein isolation, as it's not an entrainable arrhythmia and can lead to errors. Instead, ablating in the left atrium on the septum's opposite side is recommended, with cautious mapping beforehand and consideration of pacing proximity to the His bundle.

Keywords

atrial septal defect repair

focal tachycardia

arrhythmia analysis

left atrial ablation

entrainment mapping avoidance