Zachary Hale

Dear @ACCinTouch @AHAScience @HRSonline — Please follow the lead of SCAI — in advocating for YOUR members in opposing over reach from ABIM 👇🏻👇🏻

Please keep sharing! The vast majority of physicians want to see MOC come to an end. #EndMOC

@rdschaller Bluey is always spot on

The most accurate dad scene in TV history m.youtube.com/watch?v=RDYe2v…

@PatDillonMD Very Nice case, Pat. That HRPVC would have messed with my head—good catch on the subtle slowing. I like Delta AH for this ddx.

Final slide:

Long RP interval SVT, see 🧵below. Slide 1/n showing the SVT, concentric CS. #EPeeps

#EPeeps If you’re hungry for another #oneburnterm flex, keep scrolling, cause this ain’t one. ILR tracing causing abrupt syncope in 45ish yo man otherwise healthy

Great case with @JorgeI_Hernand. Patient with de novo flutter not quite what I was expecting. Orion @RhythmiaMedical map was very efficient. Scar related to aorta/HTN presumably? Would your lesion set look different? #EPeeps

Redo PVI. First glance rights reconnected and voltage suggested need for redo WACA. Noted wide doubles in most places and “open” activation told the story. Single🔥isolation. #EPeeps thanks to @jcoop556 for the mapping prowess

@AveragingBogey My thought would be a nice juicy slow pathway. First retrograde beat has a really long VA

#EPeeps recent CRT implant, hook up device and this tachy within 3-5 first few AV paced beats. Reproducibly terminates immediately w ODO programming indicating PMT. Ever seen PMT initiate seemingly spontaneously? RA threshold 0.5V@0.4ms, confirmed in AAI mode.

Can I retweet my own tweet? CMS proposes another cut to reimbursement? Do we have any lobbying? @HRSonline

OctaRay has been primarily marketed as an atrial mapping catheter, but I think it may be undersold in it's role in the ventricle. 2Fr splines, much softer than PentaRay with noticeably less ectopy. Rapid mapping and beautiful signals using indwelling reference electrode.

@BurklandMD @MiguelVldrbno Well done Burkland. Great case. AoV was a great landmark. Near immediate suppression is so gratifying. How many mLs total injection did you do?

1. First EtOH PVC ablation with a big assist from Amish Dave and @MiguelVldrbno. LV summit PVCs, mechanical aortic valve and persistent L-SVC. True CS small caliber, could not accommodate even CS catheter for mapping. Cannulated with 6Fr IM guide via preface from groin. Venogram:

Other than stop Kratom, how would you manage? jacc.org/doi/10.1016/S0…

24M using Kratom, syncope while standing, no prodrome, w “seizure” during LOC. Awoke to EMS -> No CPR-> ER. Labs unremark. ER ECG w Br Pat and BL ECG below. No FH SCD, No prior syncope. #EPeeps @MJAckermanMDPhD @AveragingBogey @jason_lappe @zapzaplunch @BurklandMD @DarthAblater

@AveragingBogey @danealson @AnandShah_MD @jason_lappe @zapzaplunch @JPayne_EP @JRWinterfield @docAnneSquared @SchakrabartiEP @rdschaller @FaisalMMerchant @MRobinsonEP @melchami99 VF baby

I’ll spill the beans but shoot yo shot first. @danealson @AnandShah_MD @jason_lappe @zhalemd @zapzaplunch @JPayne_EP @JRWinterfield @docAnneSquared @SchakrabartiEP @rdschaller @FaisalMMerchant @MRobinsonEP @melchami99

#EPeeps ~2-3s into RF ablation of this mod band PVC in pt with isch CM & BTK ICD, the following happens. WTF? ICE image in next tweet

@AveragingBogey Agree looks like short QT!

#EPeeps. 45ish year old patient w ICD for VF arrest about 10 years ago. Appropriate shock for VF in 2017. Cath, MRI normal. Thoughts on this EKG?

@DGlaucomflecken Wait, is his dad the neurologist?

Congratulations to all the graduates!

Patient with long standing persistent AF on uninterrupted Warfarin with therapeutic INR, came in for catheter ablation today. No prior TEE. Worth watching!

When the EMR goes down

Catheter Ablation of the Left and Right Atrial Appendages without Isolation in Persistent Atrial Fibrillation - ScienceDirect sciencedirect.com/science/articl…