When Arrhythmias Defy the Obvious: 12 Complex Cases Take the Mini Stage

The Mini Stage came alive with complex electrophysiology cases through Case Corner 1, featuring Agung Fabian Chandranegara, MD, Beny Hartono, MD, and Agus Harsoyo, MD, PhD, who served as panelists. Each case was presented in seven minutes, followed by three minutes of discussion and questions from the panel.

The cases covered a broad spectrum of challenging arrhythmias and electrophysiological scenarios. Andhika Abhiyantara presented cardioneuroablation for persistent vasovagal syncope, while Fredy Tandri discussed a pseudo-Wellens pattern associated with cardiac memory. Other presentations addressed ventricular standstill as a potential clue to silent NSTEMI, multiple concealed accessory pathways, multisite mapping for left ventricular summit PVCs, functional substrate mapping for scar-related VT, and sequential macro-reentrant atrial flutter circuits.

The discussion continued in Case Corner 2, moderated by Hazleena Mohamed Hasnan, MD, Irnizarifka, MD, and Faris Basalamah, MD, PhD. The cases explored rhythm and rate control to optimize LOT-CRT in heart failure with persistent AF, HV mapping for fascicular PVCs, acute coronary events during transseptal catheterization before pulsed field ablation, lower common pathway block in AVNRT, and epicardial isochronal late-activation mapping in cardiac sarcoidosis-related VT.

Across the two sessions, 12 challenging cases highlighted the breadth and complexity of contemporary electrophysiology. From advanced mapping techniques to difficult diagnostic dilemmas and procedural complications, Case Corner provided an engaging platform for exchanging clinical perspectives and discussing strategies for managing complex arrhythmias.