This is basically a tank and spank. It's a simple straight forward tank and spant with a DPS race. See the details below the video.
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Recommend watching this in HD by clicking the "HD" button and fullscreen by clicking the "Fullscreen" button in the video controls.
Patchwerk How To
Requires two tanks: One to Main Tank Patchwerk and his normal melee attacks, and an Off Tank to take the Hateful Strikes.
Hateful Strikes will do between 27750 to 32250 damage on a normal fight. On Heroic Hateful Strike will do between 79000 to 81000. This damage is mitigated by armor and raid buffs/debuffs. Typically, in my guild runs, he does anywhere from 7000 to 9000 per Hateful Strike. I've seen them go up to 14,000 when he soft enrages.
When Patchwerk is down to 5% health, he will go in a frenzy (a soft enrage). All damage, including Hateful Strikes will be increased by 25% and his attack speed will increase by 40%. He will also begin casting an AOE Slime Bolt which will do a lot of damage raid wide.
If the Off Tank should die it will cause a domino effect with the Hateful Strikes. Patchwerk will begin targeting the melee DPS with the Hateful Strikes, which they cannot handle. This will eventually lead to a wipe. So the point is if the Main Tank or Off Tank dies, its a wipe.
Tanks
The Main Tank will be tanking Patchwerk's normal melee attacks and should be the tank that pulls. After the initial pull, the Off Tank should stand directly on top of the Main Tank (Stack up). The Off-Tank should be taking the heavier damage than the main tank due to the Hateful Strikes.
Healing
Patchwerk will be hitting hard so the healers should be pre-healing just before Patchwerk starts hitting the tanks. At most this fight will last 6 minutes, and you will have to heal the entire time. If DPS has not killed him by then he will enrage and wipe the raid. Also take note that at 5% he will soft enrage so be prepared to pour on the healing for the last 5% of his life.
DPS
This is simple. Nuke him, but don't pass the Main Tank's threat. You have 6 minutes to kill him. If you don't kill him before he enrages, its a wipe.
Suggested Viewing
If you want to see the type of damage that Patchwerk is doing to our tanks in Heroic mode, I recommend you do this: Watch the video velow in the Large HD format. Then in the bottom right of the YouTube player click the watch in full screen button (right beside the volume button). You'll be able to see Patchwerk's Hateful Strikes in the bottom left side chat panel, and give you an idea of what to be prepared for.
Patchwerk: Normal Mode (10-Man) Recommend watching this in HD by clicking the "HD" button and fullscreen by clicking the "Fullscreen" button in the video controls.