CRF on hemodialysis since 10 years Recurrent drugrefractory SVT since a few years increasing frequency interfering with dialysis Normal ventricular contractility Patient position during EP study propped up with pillows knees flexed ID: 935037
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Slide1
46 yr old manSevere ankylosing spondylitis with fixed flexion deformity of knees and thoracic kyphoscoliosis, inability to lie supineCRF, on hemodialysis since 10 yearsRecurrent, drug-refractory SVT since a few years, increasing frequency, interfering with dialysisNormal ventricular contractility
Slide2Patient position during EP study- propped up with pillows, knees flexed
IVC interruption, continuing via azygous vein
LAO 40
CS position- venous phase of left
coronarogram
Catheters in RA (
decapolar
) and His. CS could not be cannulated
LAO 40
Slide3Interpret. What next?
Slide4RA catheter moved away far from the His catheter. VOP during tachy. Diagnosis?
Slide5Ablate here?
LAO 40 CAUDAL 10
AP
RAO 30