Ablation for AFL & AT
Case #4

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8 year-old boy with tachycardia, DCM, and cardiogenic shock.
Adenosine response is as shown; consistent with AT/AFL.
RA map shows the earliest signal at interatrial septal area. Is it early enough?
Noted that CS activation pattern is more of septal rather than left-to-right or right-to-left.
LA map shows the earliest signal at RIPV. The signal is >50ms earlier than the signal in proximal CS. Ablating here terminates the tachycardia.
In this case, the patient is hemodynamically unstable. Focus mapping, rather than detailed mapping, was performed.
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