EP in Philadelphia

Philadelphia, PA
Joined September 2018
We hoped this would happen but did not expect it...termination of left atrial flutter during VOM ethanol infusion. Hopefully it helps this patient. Nice maps @ryancolemaps @maddyferraro1 @arcampado @MiguelVldrbno @TJHeartFellows
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Never a dull moment rounding on EP with Dr. @FrischMd. Great teaching with some comedy mixed in. What more could you ask for ??? – at Philadelphia, PA
645pm on a Friday. EP rounds with @FrischMd. All the device interrogations. Been an awesome week - might have to consider EP now 🤔🤔🤔 (see below for what really happened…) Cc @kellyarps @drjohnm @JagSinghMD @netta_doc @hafizakmd @narrowQRS @YevgeniyBr @TJHeartFellows
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Unusual redo because the previous ablation was intact (PVI, roof, anterior mitral line) yet 2 distinct ATs came from areas near the previous ablation🤔. Termination (x2) was quick, but we decided on linear ablation #CS2OS. Thanks @ryancolemaps @TJHeartFellows @AbbottCardio
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Daniel Frisch, MD retweeted
In our editorial, we argue that stroke risk might diminish after a period of AF-free time. Thus, there is value to investigating the time since the last AF event to the future risk of stroke. @FrischMd @SDikdan @DrHowardWeitz @LiverpoolCCS @TJHeartFellows pubmed.ncbi.nlm.nih.gov/3524…
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Nice example of propagation from a focal LAA-AT that also shows lateral to septal block across the anterior mitral line (and roof line too). Thanks @ryancolemap and your colorful EnSite X system and @MichaelCoMD (@TJHeartFellows) #EnsiteX
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In this interesting case of mitral flutter we were surprised by how proximal the VOM was in the CS with venography. Luckily we had a guide! Thanks @MiguelVldrbno @MichaelCoMD @AbbottCardio @TJHeartFellows sciencedirect.com/science/ar…
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1/ ⚡️Want to up your EP game?⚡️ Here is a case-based tweetorial teaching a simple trick to make you look like a pro. #ACCFIT #EPeeps #Cardiotwitter By @TJHeartFellows @NoahHaroian @AHajduczok + EP attending @FrischMd Cardiac surgery consult - post op, stable, and this #ECG
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I wonder if ablation here (is safe and) would work for a refractory roof line/flutter @AbbottCardio @maddyferraro1
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This patient had PAF after prior abl for Persistent AF. PVI was intact. We targeted the posterior wall (PW). An interesting EGM was seen on the grid as the remaining connection and (unusually) we were able to show exit block from the PW @ryancolemaps @AbbottCardio
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This was an unusual opportunity to record (slow) VT using a Kardia 6L and show the corresponding ECGs. Choose your algorithm… @DrDave01 @narrowQRS @TJHeartFellows
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ICE was essential in recognizing the variant anatomy in this patient. Subsequently, we appreciated it in the other imaging modalities. Thanks @ryancolemaps @AbbottCardio
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This pt presented for incessant atypical AFL after prior PVI, roof, mitral, and CTI abl. The entrainment observation was helpful in determining reentry as the mechanism. Thanks for the high-density map and high-level insights! @DrGregMichaud @AbbottCardio @maddyferraro1
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Strong work team! Nice job reviewing our experience with high power short duration ablation for AF (dx.doi.org/10.1111/jce.14868) @Med_Lit_Review @TJHeartFellows @arcampado @AbbottCardio
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Congratulations to all the fellows who passed their general cardiology boards. Welcome to the club! @TJHeartFellows
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Given how anatomically close the RSPV and SVC are, it's no surprise that far-field SVC signals can be recorded from the RSPV. Yet it still can be confusing (to me) @ryancolemaps @AbbottCardio
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