LV summit PVC healthy 26 y.o. Earliest 34 ms pre-QRS from LCC 2 lesions with good suppression. Below LVS 1.5 cm away 98% pace match 2 additional lesions. No PVC for 16 hours observation. Ensite X Tactiflec DF excellent mapping ⁦George Crowell⁩ ⁦Brock Gambill⁩

Interesting PVC at MUSC Health with Jeffrey Winterfield. PVC was quickly mapped to lateral wall near ALPM insertion. A False Tendon was seen on ICE connecting from PM to basal Septum. LAT there was earlier than rest of septum. Are we seeing the FT activation? #Epeeps Abbott Cardiovascular 1of3

#EPeeps Is it possible to capture / conceal into slow pathway? Are there other explanations for what’s happening here? No lines of block in atrium. Pacing from abl at 4 o’clock at 10mA on TA. #PMA Syamkumar Brock Gambill

How to avoid AF recurrence in atrial fibrillation?

Lesion formation geometry is crucial, resistive vs. conductive heating lesion durability.

More to come in LAHRS 2023.

Thanks to Jose Osorio for being a great educator and Elad Anter for publishing disrupting science.

In the setting of redo accessory pathways, the tricuspid annular variety hosts highly complex atrial & ventricular electrograms. This stability-limited location makes for the unique signal characteristics seen here in ORT. Jaylynn Markey Austin Cummings Abbott Cardiovascular

.Philipp Sommer We need a new classification for #AFib !

There is a disconnect between current classification / phenotype and underlying substrate.

➡️PVI-dependent vs non-PVI dependent may be more accurate and more predictive of success

Need mechanistic understanding!

#WAFib2023

Neat addition to localization algorithms for R/L manifest accessory pathways. Using P-Delta Interval, R/S ratio, and QRS onset polarity in lead V1. Proved consistent with this #WPW . Journal of Cardiovascular Electrophysiology onlinelibrary.wiley.com/doi/abs/10.111… #HDGrid Mapping credit Mason McNeil Abbott Cardiovascular

Thank you to Abbott Cardiovascular, director Jeffrey Winterfield & program faculty. Exceptional agenda with approachable & practical applications. #AblateVT In-Depth by Andre d’Avila Henry D. Huang Joshua Moss MD Matthew Hyman Patrick Badertscher Nuno Cortez-Dias, MD PhD Usha Tedrow MUSC Health

Challenging case of PMpap VT runs/PVC’s with marked TCM( EF:15%) in a young male; large LV ; TS approach;so catheter stability was a problem!( was not better with TA as well) finally we got it here👇!😰 40-45wts/ HNS/120s with consolidation burns! #Epeeps

The anterior right pulmonary vein antrum, an under appreciated topography? Atrial diverticulum seen here, perhaps culprit of temperature & impedance limiting during Radiofrequency #Ablation . Imaged during unrelated, Focal Atrial #Tachycardia #Ultrasound #EPeeps credit Ashit Patel

Based on the twitter posted by Syamkumar
How can we make a accurate diagnosis from a challenge telemetry tracing of Wide complex tachycardia?

Labadet et. al. from Argentina found this interesting finding.
It worths reading it.

doi: 10.1093/europace/eux103.

Authors share their view about ICE; #EPeeps may share yours? #echofirst
Henry D. Huang Paul Zei AGEP Arash Arya Pasquale Santangeli Piotr Futyma, MD ALBERTO ALFIE Kamala Tamirisa MD Shanta Chakrabarti Robert Schaller Pablo Sánchez Millán Jeffrey Winterfield Amin Al-Ahmad, MD Sanjiv Narayan Luigi Di Biase Elad Anter Prof Marwan Refaat

Architecture of the left atrial wall : the “septopulmonary bundle”. ISCAT october 12th in Paris

Redo with Hx PVI, CTI & Roof dependent AFL. Mapping revealed narrow passage through roof encompassing 80% of TCL. Linear #TactiCathSE was unable to appreciate isthmus EGM’s by #HDGrid . Unipolar Voltage complimented LAT and #Entrainment maps. Successful endpoint D Randy Jones

Successful ablation of #WPW localized to right lateral tricuspid annulus. #ECG delta showed double transition with isoelectric sum of QRS at V2 as described in academic.oup.com/europace/artic… Mason McNeil Abbott Cardiovascular

An EP study in 3 slides.

#EPeeps #CardioTwitter Penn Cardiology

PMA Maneuver Entry with a BONUS: ErPVC showed extranodal response (H1H2 - A1A2 < 35) AND HRPVC delayed subsequent A, showing post-excitation and confirmation of a #decremental concealed #pathway Ashit Patel Brock Gambill Paige Reisman - EP twitter.com/forkknifecab_e…

Mapping VAs from Pap Muscle with #PDX Clever feature described by Babak Nazer Brock Gambill #Epeeps Kevin Brady javad mikaeili Óscar Cano CarinaHardyEP ALBERTO ALFIE Daniel Alyesh Monica Korzon Jeffrey M Vinocur Newton Wiggins

Old school pacing meets new school fluoroless ablation. #Oxford #RuralMississippi #EPeeps

Redo PVI pt. presented to @dsabayon at UTMB Health with roof dependent LAFL. INTELLAMAP ORION™ collected 7500 EGMs in 5 min. The arrhythmia was terminated with DIRECTSENSE™ with a line of block across the high voltage area between the LIPV & RIPV.