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PACs Ablation

Date: Oct 18, 2021

Question:

How should I report PACs ablation? Patient was admitted originally for redo AF ablation. However, according to report, "We noticed that the prior PVI lesion set of all four veins was electrically still isolated from prior. Next, we then started the patient on Isuprel and noticed consistent presence of unifocal PACs (these had CS 5,6 to be the earliest dipoles of activation). Given this, we then proceeded to perform mapping of these PACs. We noticed these to be mapped to the inferoposterior aspect of the LA. After confirming these findings, ablation was then begun. A total of two set of lesion sets were applied and the RF ablation was guided by contact verified on ICE image, EGM appearance and impedance changes. After these set of RF ablation lesion sets, we then started the patient back again on Isuprel and despite burst pacing in combination, we did not observe any evidence of AF. We did observe multifocal PACs which subsided by the end of the case. At this point of time, the procedure was concluded."

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