Clinical problem solving: Maneuvering around a narrow complex tachycardia in a patient with Mustard repair for transposition of the great arteries
Bibliographic record
Abstract
Tabled 1KEY TEACHING POINTS•Owing to atrial dilatation and fibrosis following surgical incisions and baffle creation, intra-atrial reentrant tachycardia is by far the most common arrhythmia seen following Mustard repair for dextro-transposition of the great arteries (d-TGA).•Typical AV nodal reentrant tachycardia has been reported following Mustard repair and, although accessory pathways are more common in patients with congenitally corrected transposition of the great arteries and Ebstein’s anomaly, this case shows AV reentry tachycardia is possible in a patient with d-TGA.•Advancing atrial activation during supraventricular tachycardia when the His bundle is refractory proves the presence of an accessory pathway. Other observations/maneuvers such as the change in VA interval with ipsilateral bundle branch block and the capacity to entrain the tachycardia from the site of the pathway with a short post-pacing interval help to prove accessory pathway participation and define the target for ablation. Open table in a new tab
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".