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RUMAH SAKIT JANTUNG & PEMBULUH DARAH HARAPAN KITA

Instalasi Diagnostik Invasif & Intervensi Non Bedah
JAKARTA 11420

AVRT ABLATION REPORT

Patient Name Tendessy Musian Bahry, Mr Age 52 years old Sex M
MR No 2018439268 Insurance Coverage JKN
Case No 1183-02-19-I-ABL Date 19-02-2019
Hospital PJN Harapan Kita Jakarta

Clinical Diagnosis SVT

Procedure :
1. ECG showed sinus rhythm
2. Antiseptic procedure at right inguinal areas and right internal jugular area.
3. One uncomplicated right internal jugular and three right femoral vein puncture were done. Two 7F and one 6F
sheath were inserted.
4. Two quadripolar electrode catheters were inserted via one 6F and one 7F sheaths and placed in HIS and right
ventricle (RV) apex. One 7F 4mm non-irrigating ablation catheter was inserted via 7F sheath and placed at the
HRA. One decapolar catheter was inserted via 6F sheath and placed at the CS.
5. Electrophysiology study was conducted. Basic Interval measurement : P-P 697 ms, AH 65 ms, HV 47 ms, PR 150
ms, QRS 95 ms, QT 345 ms, RR 697 ms, QTc 413 ms.
6. Programmed ventricle stimulation showed WP retro 300ms. Tachycardia induced with programmed ventricle
stimulation. HVOP showed reset. VA interval 110ms, PPI-TCL > 115ms
7. Programmed atrial stimulation not done
8. Diagnosis of Parahisian AVRT was made, ablation of fusion beat very close to HIS. Multiple pulse ablation at 20w,
45C given failed to terminate AP.
9. Post ablation RV ERP 200ms, AP ERP retrograde 270ms,AVN ERP retro 250ms
10. Measurement of sinus node function were as followed:

PCL (ms) BCL (ms) SNRT (ms) CSNRT (ms)

500 640 1090 450
Not able to do
subsequent as
will induce
tachy

11. Procedure was stopped with no complication. Explained to patient regarding risk of TAVB and PPM if ablation
continued. Offered medical therapy.

Conclusions :
1. AVRT with concealed Parahisian AP
2. Unsuccessful ablation due to very close to HIS
3. Normal SA and AV node function

Suggestion
1. medical therapy – propafenone
2. if failed medical therapy, need to explain high risk ablation and PPM

Attending Physician dr. Dony Yugo , Sp.JP (K) / dr. Dicky AH Sp.JP (K)
Fellow dr. M. Muqsith SpJP/ dr Ahmad Suhaimi Sp.JP
Residence dr. Sigit/ dr. Novita