A 68-Year-Old Man with a History of Permanent Atrial Fibrillation

question 26

Multiple Choice

A 68-year-old man with a history of permanent atrial fibrillation comes to the office for follow-up.  He has been having symptoms due to ineffective ventricular rate control despite aggressive medical therapy.  On examination, the patient's heart rate is 125/min and irregular.  ECG shows atrial fibrillation with rapid ventricular response.  A catheter-based radiofrequency ablation of the atrioventricular node with placement of a permanent ventricular pacemaker is planned.  The ablation tip should be positioned at which of the following locations?

• A)Between the tricuspid valve and the inferior vena cava opening
• B)Interatrial septum near the opening of the coronary sinus
• C)Left atrium near the opening of the pulmonary veins
• D)The posterior border of the fossa ovalis
• E)Upper part of crista terminalis near the superior vena cava opening

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Definitions:

Manipulation

In psychology, refers to the attempt to influence or control others' behaviors or emotions for one's own purposes, often without their awareness.

Hypothesis

A proposed explanation for a phenomenon made as a starting point for further investigation.

Experimental Method

A systematic and scientific approach to research in which the researcher manipulates one or more variables to observe the effect on some behavior or mental process.

Correlational Method

A research approach used to determine the relationship between two variables without manipulating them.