In this case, Dr. Alan Johnson successfully treats AFIB and then an onset of atypical atrial flutter by cryoablation.
Hi, my name is Ellen Johnson. I'm one of the uh cardiac electrophysiologist here at uh Center R Mh in Harrisonburg, Virginia. I thought I'd share with you guys a case of an A FB ablation that we did recently and, and see if we could walk through it together. So this is a case of an A FB ablation. We uh start in an EP lab. It's a specialized Cath lab that uh has a lot of special electrical equipment to allow us to do the procedure. We have multiple different screens that allow us to see what's going on with the patient at any given time. Uh We have an ultrasound, uh which is the middle of the screen there that's really crucial in helping us get the catheters up from the femoral vein up to the uh to the heart and then cross the heart from the right atrium into the left atrium. And this allows us to uh actually perform in atrial fibrillation ablation. Right now, we're getting all the catheters ready and uh set to, to cross and shortly we'll use a, a small uh needle to go across the uh the thinnest part of the septum and head us towards the pulmonary veins. Once we get over into the left atrium, we make a map on the right is AC T scan uh on the left is our map showing the the pulmonary veins. We get a freezing balloon uh called a cryo catheter or cryo balloon into the. This one's the left superior pulmonary vein. We will make sure we have good signal with the achieve the little uh halo catheter there. And then we put some contrast in to make sure we have seal. We do that for both the left uh superior and inferior vein. And then we move over to the right, we put a catheter up into the um SVC to paste the fren nerve, that's the four pole catheter you see there. And then we make sure we have seal again in the right inferior vein and then freeze it uh again. Uh the freeze thaw cycle is what isolates the veins. If you look at the left panel, now, you see we have gray signal uh in all four pulmonary veins, which means we've gotten durable isolation. This case, uh actually ended up taking a turn for us. After we um got isolation of all four veins, we ended up in an atypical atrial flutter uh where the circuit was going over the roof of the, of the left atrium and then down around the CS and, and back. And so we actually needed to ablate from the left superior pulmonary vein to the right, superior pulmonary vein and from the right, inferior to the uh left inferior. And those are the red lesions you see there. Finally, we finished up with a typical flutter ablation and that was the case.
Related Presenters
