334 - IMPORTANT QUESTIONS REQUIRING ANSWERS - ARRHYTHMIA CHALLENGES

• “Lost in translation”- Challenging the guidelines with imperfect evidence
I. Renaissance for class 1c anti arrhythmia in CAD & LV dysfunction?
69 yr. female with well controlled symptomatic PAF on flecainide for 5 years had recent ACS and PCI for LAD/normal EF-“Renaissance” for Class 1c anti-arrhythmic in CAD & LV dysfunction?
II. Guidelines recommend CRT BUT does CRT actually benefit patients with QRS <150 msec?
73 yr. female with symptomatic HFrEF and LBBB QRS 130 msec.
III. ICD & preventing sudden death-The unrealistic expectations of “Doc & patient” on benefits vs. harm
IV. 75 yr. female with a non-ischemic DCM/AF, GDMT and EF 33%

• “I do not want a stroke” - the water still is “muddy”
I. Dialysis dependent renal failure and atrial fibrillation – equipoise for DOAC, Warfarin or nothing?
II. “Cryptogenic embolic MCA stroke” with sinus rhythm and normal echo in my 49 yr. female
III. “I need help!” - Device detected asymptomatic AF & OAC - the hazards, guarantees and natural history of SCAF