Dr R Beynon University Hospital of North Staffordshire

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Clinical course • Pt spontaneously went into AF again soon after cardioversion from VF • 100mg Flecainide given – AF rate slowed • Phoned a friend ………… – Colleague found to give a hand
Management • Consultant anaesthetist found unwilling to commit to supporting the case for prolonged period due to staffing issues – options • 1. Attempt to ablate pathway in AF • 2. Ask anaesthetist for short GA to cardiovert to SR accepting he may well go into AF again • 3. Stop case and admit until full GA case a possibility
Page 1 and 2: A challenging case early on Rhys Be
Page 3 and 4: 12 Lead ECG
Page 5 and 6: Anterograde curve
Page 7 and 8: Antidromic tachycardia with CL 230m
Page 9 and 10: Shortest RR interval in AF 160 msec
Page 12 and 13: Management • 3 External DC shocks
Page 16 and 17: Management • Initial attempt to a
Page 18 and 19: Pathway mapped to between 6 and 7 o
Page 20 and 21: Management • Pt discharged with r
Page 22 and 23: Epicardial access gained
Page 24 and 25: Endocardial mapping extended AGAIN
Page 26 and 27: Eventual ablation site
Page 28: Conclusions • EP studies and abla

Dr R Beynon University Hospital of North Staffordshire

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