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Case Reports
. 2018 Dec 31;11(4):2112.
doi: 10.4022/jafib.2112. eCollection 2018 Dec.

SANS FLUORO Supersized: A case report of Fluoroless Ablation in a Super Morbidly Obese Patient

Robert Lee Percell  1 , Erin Sharpe  2 , Timothy Allison  3 , Shirley Mohr Burt  2 , Rhonda Olmsted  2 , Chad Travers  2
Affiliations
Case Reports

SANS FLUORO Supersized: A case report of Fluoroless Ablation in a Super Morbidly Obese Patient

Robert Lee Percell et al. J Atr Fibrillation. .

Abstract

We present the first ever reported case of a super morbidly obese patient (BMI > 70) with drug refractory, symptomatic atrial flutter who underwent a successful, uncomplicated ablation procedure using a zero fluoroscopy technique. This case demonstrates the following two critical points: (1) difficulties in the treatment of massively obese patients with arrhythmias; (2) increased use of fluoroless ablation techniques.

Keywords: Atrial Flutter Ablation; Fluoroless Ablation; Obesity.

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Figures

Figure 1.
Figure 1.. Initial electrocardiogram revealing tachycardia with rate of 150 bpm and probable 2:1 conduction.
Figure 2.
Figure 2.. Bariatric bed upon which the patient had the ablation.
Figure 3A.
Figure 3A.. RAO view of 3 Dimensional Electro-anatomic map of the right atrium (RA), right ventricle (RV), His Bundle (His), coronary sinus (CS), superior vena cava (SVC), inferior vena cava (IVC). Green, blue, yellow and white small points represent impedance drops of < 20%, 15%, 10%, and 5% respectively. Red larger points denote time > 20 seconds.
Figure 3B.
Figure 3B.. LAO rock up view of 3 Dimensional Electro-anatomic map of the right atrium (RA), right ventricle (RV), His, coronary sinus (CS), superior vena cava (SVC), inferior vena cava (IVC). Green, blue, yellow and white small points represent impedance drops of >20%, 15%, 10% and 5%, respectively. Red larger points represent time > 20 seconds.
Figure 4
Figure 4. ECG from the patient 2 weeks ago revealing sinus rhythm.
See this image and copyright information in PMC

References

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