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1st Live Case
Potential conflicts of interest
▪ I have the following potential conflicts of interest to report:
Devdas Inderbitzin
Received educational grant from St. Jude Medical
Case
• 70-year-old male
• Functional status: NYHA III and EHRA II
• CHA2DS2-VASc: 3, HAS-BLED: 4
• Chronic Obstructive Pulmonary Disease under C-PAP
• Alcohol and nicotine consumption
• No coronary artery disease
Weight 116 kg, BMI 35.6 kg/m2 (preop weight reduction of 6 kg)
Case
Arrhythmic History
• First onset of AF in 1998 (>19 years), uptake Amiodarone
• Intermittent right atrial flutter in 2008
• 2 Electro-conversions
• Tachyarrhythmias despite rate control with Bisoprolol
• Amiodarone (interrupted 2015 due to intolerance)
• On Rivaroxaban
ECG
Case
Transthoracic Echocardiography (01.11.2017)
Normal EF (LVEF 61%)
LA dilated: ESD 4.6cm (M-Mode), 2 cm/m2
No LAA thrombus
RA dilated: ES long axis 5.7cm
Valves: all valves with trace of regurgitation
TTE
TTE
CT Scan
Question
What would be the best treatment?
A Catheter ablation of the pulmonary veins
B Thoracoscopic left atrium ablation
C Thoracoscopic ablation + epicardial LAA exclusion
D Stand alone epicardial LAA exclusion
E Percutaneous LAA closure
Question
Now please VOTE !
A Catheter ablation of the pulmonary veins
B Thoracoscopic left atrium ablation
C Thoracoscopic ablation + epicardial LAA exclusion
D Stand alone epicardial LAA exclusion
E Percutaneous LAA closure
votyng.com
Question
What would be the best treatment?
Lets connect to our colleagues treating the patient …
&
… discuss the options.
Question
What would be the best treatment?
A Catheter ablation of the pulmonary veins
B Thoracoscopic left atrium ablation
C Thoracoscopic ablation + epicardial LAA exclusion
D Stand alone epicardial LAA exclusion
E Percutaneous LAA closure
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