PIG Meeting: 22nd April 2021

53-year-old lady for meniscal repair

Background:

• History of open cardiac procedure/ablation in early 20’s for arrhythmia.
• No medical records and patient uncertain of cardiac history
• Sternotomy scar

Issues:

• Recent new onset palpitations with presyncope
• No cardiologist or GP review
• Complex social history and knee injury making it difficult for patient to attend appointments
• Difficult to ascertain history

Discussion:

1. Cause of original arrhythmia

• Likely condition requiring ablation in age group is Wolff-Parkinson-white
• Some suggestion of WPW in old notes on DMR
• Could be any number of other conditions requiring ablation, SVT, AF

2. Management of current symptoms

• ECGs from consult and 2019 reviewed (see below) and discussed – ? pre-excitation
• How likely are arrhythmias to recur post-ablation or is it a second pathology? See abstract below – BMJ open (2019) – Discussion of recurrence rates after EP ablation and risk factors

Plan:

• Await Holter monitor results
• Contact GP for further information on original procedure
• Discuss at cardiology meeting or refer to cardiologist with Holter results.