AFPanico

NEW Left to Our Own Devices episode: #HRStv host @OliverMonfredi chats with @Nicky_P_MD about the management of vegetations around the time of lead extraction. They discuss when and how to aspirate vegetations and review a real-world case highlighting a successful vegetation aspiration. See the full interview here #EPeeps ➡️ bit.ly/4q0KYKq

I agree with @naijaQRS I feel like this just supports what's already happening.... low risk, no/low burden pts are often taken off AC post successful ablation. For me these are and will continue to be an individualized decision - candid discussion with patients, review of available literature and recommendations and ultimately shared decision making #Afib # EPeeps

@NikhilShahMD @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS I believe we had scheduled it with RF... also has documented AFL and SVT (likely avnrt by history) so had planned to take care of all three at same time if we induced SVT

@AZ_EP_DOC @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS That's not a fun surprise to have. What were you planning to use for ablation? One of my colleagues used subclavian access for farapulse and the patient did great, though all the movements were backwards as expected.

Usually me: “Ah yes, another persistent left SVC (classic ~0.5%).” Staff: "Again" 🙄 Today: “Wait… interrupted IVC?! (hello 0.2% 👀). Medicine: never boring. Always double-check before you commit @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS @NikhilShahMD @JRWinterfield #Cardiology #Electrophysiology #MedTwitter #EPeeps #MedEd #cardiotwitter

UpBeat by HRS is an invaluable resource for #EPeeps and their patients. Take a look today:

@naijaQRS @lobhammCHD @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS See what your missing out on!! 😂😂

@AZ_EP_DOC @lobhammCHD @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS Practicing in the West Wild West 😂😂

@fvassallomd @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS Did you access IJ or Axillary/Subclavian?

@AZ_EP_DOC @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS Had one case this Wednesday

@lobhammCHD @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS Awaiting imaging - nothing "abnormal" was noted on previous Echo - but it was done elsewhere - all I have is a report... hence the surprise in the lab 😂

@AZ_EP_DOC @naijaQRS @rainylakedana @AlexTurinMD @svasaiw @DrRoderickTung @narrowQRS Heterotaxy?

@NikhilShahMD Yessir

@AZ_EP_DOC Interesting... The small catheter in large sheath theory makes sense. Was your catheter flushing the whole time?

🧠 Mid-ablation surprise: clot on a prominent Chiari network in the RA. Rare but real embolic risk. What would you do? ➡️ Proceed with ablation? ➡️ Abort? ➡️ Anticoagulate & re-schedule? ➡️ When do you heparinize? ➡️ How do you manage oral anticoagulation peri-procedure? @naijaQRS @DrRoderickTung @svasaiw @JRWinterfield @Drdevignair @jczerpa @MehakDhande @DanielAlyeshmer @jczerpa @MehakDhande @Nashwa_Salem_ @OliverMonfredi @NikhilShahMD Let’s hear your approach. 👇 #CardioTwitter #EPeeps #ChiariNetwork #Ablation #MedTwitter

It was a redo, atypical AFL, we got catheters up and mapped the RA first, exchanged for the dilator and Versacross wire in SVC - noticed it right before going transeptal. Last dose of OAC was previous evening Received heparin We Aspirated through the sheath Did not go left sided Ablated the CTI (partially reconnected) and bicaval scar We mapped with Octaray and were using the faradrive sheath ????? Small catheter in a larger sheath (this has been reported with the Versacross Kinect for Watchman and pigtail)

@AZ_EP_DOC 😳😵‍💫 I'm assuming this developed after getting catheters up. Would probably abort if not already in the LA. At that point, can't control the risk of embolization across the TSP. Would also try to aspirate the clot through the sheath to minimize the clot burden. What did you do?

First American pericarditis management consensus published today, special thanks to the writing committee, been my honor to chair this! @AllanLKleinMD1 @PaulCremerMD @ImazioMassimo Sarah Kohnstamm, Allen Luis, @V_Mardigyan @MMukherjeeMD @karen_ordovas @sneha_vk @GWohlfordPharmD

AFib? Your heart’s already doing extra—don’t make it fight bad food too. 💚 Eat smart. 🥦 Load up on greens, fish, whole grains. 🚫 Skip the salt, sugar, and junk. Your plate can be your power. How are you starting off your weekend?!?!? #GETFITAFib #HeartHealth #AFib @DrRoderickTung @PrashSanders @naijaQRS @DBelardoMD @jczerpa @drjohnm @MehakDhande @Nashwa_Salem_ @OliverMonfredi @DanielAlyeshmer

💙 This #NursesWeek, HRS celebrates The Power of Nurses—including 1,200 HRS members who advance the field of electrophysiology from the front lines of care to the forefront of innovation. We see you. We support you. We honor you. 👏 #ThePowerOfNurses #EPeeps #NationalNursesWeek

Standing room only! Amazing update from Dr. Niraj Varma on the INTEGRA-D clinical trial. Thank you Dr. Panico and Heart Rhythm TV! Disclaimer: CCM-D is an investigational device and is not approved for commercial use in the U.S. Heart Rhythm TV Update: Cardiac Contractility Modulation with Defibrilla... youtu.be/g3mu6rVF9fA?si… via @YouTube

CardioNeural ablation is such a promising option for a historically challenging cohort of patients. Future looks bright… #nonarrythmicablation #QSQ

@naijaQRS you and I are on the same page (no surprise there) - sometimes less is more. We need to be mindful of this data - which may change how we select the right technology/procedure for the right patient… and certainly PW for all is not likely the answer!!

The glue that holds HRSTv together!!

Day 2 of #HRS2025 wrapped up with Ron Burgundy himself — and our Heart Rhythm TV team had the rest covered. From the opening plenary to Late-Breaking Clinical Trials, Shark Tank-style showdowns, global insights, and some serious FOMO from the APs Lounge… it was Anchorman-approved. See the full interview here #EPeeps ➡️ bit.ly/4jOjyUn @DrRoderickTung @MehakDhande @DanielAlyeshmer @HeartRhythmNP @OliverMonfredi @AZ_EP_DOC @Nashwa_Salem_ @jczerpa @HRSonline

Enjoying the show at #HRS2025 @KTamirisaMD @MejiaEliany @SanaAlkhatib9