How would you manage this patient? (Case 12-02)

This 49 year old man who underwent closure of an atrial septal defect (ASD) 9 years before admission complains of recurrent paroxysmal tachycardias resistant to antiarrhythmic drug therapy.

Tracings 1 and 2 were recorded during episodes of tachycardias.

Tracing 1

Tracing 2

Limb leads: From top to bottom 1, II, III aVF, aVL, aVF

What is your interpretation of the ECG tracings?
How would you manage this case?

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