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Who are suitable patients for catheter ablation?

Who are suitable patients for catheter ablation?

  • Symptomatic paroxysmal or persistent AF AND
  • Failed at least 1 anti-arrhythmic medication OR
  • Unwilling or unable to take anti-arrhythmic therapy
  • Atrial fibrillation with concurrent heart failure

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  • Symptomatic episodes of palpitations with one or more:
  • ED presentations with documented narrow complex tachycardia reverting with Valsalva, carotid massage or adenosine administration
  • Reliable termination of symptoms with Valsalva manoeuvre
  • Documentation of arrhythmia on 12 lead ECG, holter or iPhone monitoring device.

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  • Significant VE burden (usually single morphology) associated with one or more of the following:
  • Troublesome symptoms such as palpitations
  • Reduced LV function
  • Sustained VT
  • Impairment of Bi-Ventricular Pacemaker function

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  • One or more of:
  • Recurrent symptomatic VT unresponsive to anti-arrhythmic medications
  • Recurrent VT with intolerance to antiarrhythmic therapy
  • Recurrent VT leading to ICD shocks

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  • Atrial fibrillation where rhythm control has failed or is otherwise unsuitable for AF ablation AND
  • Rapid ventricular rates despite medical rate control OR
  • Poor toleration of rate control medications OR
  • Symptomatic heart failure

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Who are suitable candidates for cardiac devices?

  • Complete or high grade atrio-ventricular block
  • Bradycardia associated with:
  • Syncope or collapse
  • Dizziness
  • Conduction abnormalities associated with:
  • Syncope or collapse
  • Dizziness
  • Prior to planned AV node ablation
  • Heart failure with left bundle branch block and LVEF <35% (Bi-ventricular pacemaker)

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  • Persistent LVEF <35% despite medical therapy
  • Survivors of cardiac arrest due to VT of VF
  • Non-sustained VT in certain high risk patients

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  • Patients with unexplained syncope or collapse
  • Patients with unexplained stroke (monitoring for AF detection)

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• Smart phone risk factor management and AF monitoring

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