PIG Meeting: 22nd April 2021

78-year-old lady with history of SVT.

Background

• 40-year history of episodes of SVT
• Self-limiting but symptomatic. Last episode March 2021, came to ED but had self-terminated
• Reviewed by cardiologist 10+ years ago. Normal echo and angiogram.
• On metoprolol, no decrease in frequency of episodes
• Multiple previous surgeries with no issues

Discussion

1. Preoperative Investigations

• Should we organise Holter monitor and cardiology review pre-op?
• Useful in setting of deciding on requirement for post-operative telemetry bed
• No cardiology review for many years, may be offered different therapy. See AHA algorithm below.
• Treatment of SVT in perioperative setting discussed

2. Postoperative care

• ? Cardiac monitoring required post-operatively
• Telemetry bed may be preferred

Plan

• Outpatient Holter monitor
• Discuss at cardiology meeting with results
• Consider telemetry monitoring post-operatively in consultation with Cardiology
• Check electrolytes and TFT’s