Assuming that they have not responded to drug therapy, which of the following clients is likely to be the best candidate for surgical cardiac ablation?
A)
A 62-year-old woman with peripheral vascular disease who has experienced multiple episodes of torsade des pointes
B)
A 75-year-old man with diabetes but no previous heart disease that suddenly develops syncope due to sick sinus syndrome
C)
A 46-year-old man with unstable angina and a history of myocardial infarction who is found to have long QT syndrome and episodes of frequent ventricular arrhythmias
D)
A 22-year-old woman with an atrial septal defect who has recurrent paroxysmal atrial flutter with rapid ventricular rate associated with her caffeine intake.
Ans:
C
Feedback:
Due to his history of MI, the 46-year-old man probably has several areas of necrotic tissue that are interfering with conduction and ventricular function and would probably benefit from having them removed. The 62-year-old woman may have little or no myocardial tissue damage, so a less invasive procedure to improve her cardiac circulation would be a better choice for her. The 75-year-old man may not have any areas of infarction and is a risky surgical candidate because of his age and diabetes. The 22-year-old woman's tachycardia is likely to be nonischemic in origin.
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