John Nguyen

🧵Surgical LAA exclusion is Class I recommendation in AF pts during cardiac surgery! But with prior #Watchman device, I wonder? This Watchman (implanted 2016) was resected along with entire LAA during CABG for unrelated reason—surgeon preference. What would most surgeons do? #Epeeps #CTSurgery #AFib #LAAO #CardioTwitter

The Height Difference in precodial leads is key to understand the propagation vector originating from the interest anatomic structure

Endocardial pulsed field ablation of an inaccessible epicardial LV summit PVC 81-yo post-CABG patient → RF failed, no veins for alcohol, epicardial access impossible Focal-bipolar PFA from inside the LV → instant PVC termination + full transmural scar on MRI + 100% PVC-free at 1 year Full text available via this shareable link (before it expires): authors.elsevier.com/a/1m9p0_,5U2zu…

@elonmusk how do u solve the perception of the passage of time. Grok doesn’t know how much time has passed since our last conversation. When I am running on a treadmill and tell Grok I have 5 minutes left, Grok does a countdown from 5 minutes to zero, but real time is like 5 seconds. This is a new Turing test.

Critical feedback about Grok is super helpful. We will keep iterating until Grok is the best in every way.

Some post-case learning with @danealson (Dr. Neal Bhatia) and @_shannonmillard: following an ischemic VT case, together we compared how the clinical VT circuit presented when mapped with the First Deflection algorithm versus EnSite™ OT Near Field.   What we found brings up an interesting question. Is it better to…. - Force the system to visualize the full circuit with First Deflection, or - Illustrate the potential midmyocardial bridges and touchdown points with OT NF? While there may not be a "correct" answer, we think there is value in appreciating both pieces of information. And if nothing else, it makes for a fun discussion with talented colleagues like Dr. Bhatia and Shannon.

Friday with 5 scheduled cases of CRT/CSP. We have experienced all kind of challenges: vein occlusion, difficult CS and branch cannullation, no suitable CS branch required rescue LBBAP CRT, IVCD case with unable to capture the CSP, etc. Each case had its own teaching points. Thankfully we had UHF-ECG beside EP system to guide our cases. @curilakarol @MirekNavratil1

What happens to CIEDS leads after TTVR? In our #Europace paper: • 31% had lead changes - mostly R-wave sensing loss,managed conservatively • 13% showed insulation breach Understanding valve/lead interactions and when to extract needed.@MayoClinicCV 🔗 doi.org/10.1093/europa…

If there is sufficient interest I might resume a monthly unknown tracing. Yes?

🚨Latest #FreeRead in @JICE_EP Microbubble & Thermal Profile of an Eight-Spline Pulsed Field Ablation System in a Pre-Clinical Model 🧐📖rdcu.be/eLyzg by Ben Niemiera, @rranjanMD, @JonPicciniSr, John Nguyen, Lakshya Mittal, Catherine Pipenhagen, Jed Overmann, Taylor Spangler & @srissundaram #EPeeps

An intravascular catheter as the return electrode for a pulsed field ablation catheter (alternative to a skin patch) can help deliver deeper lesions for ventricular ablation @M_Terricabras @atulverma_md #AHAJournals #Epeeps doi.org/10.1161/CIRCEP…

Preclinical Evaluation of a Novel 8 Spline Pulsed Field Ablation System heartrhythmjournal.com/article/S1547-…

AF ablation in pt with ASD (GSO 25mm). I believe device puncture and balloon dilatation is safe and allows for easy catheter handling. Our limited experience is that the shunt closes spontaneously during F/U. #Epeeps

After my external HDD drive suddenly crashed (taking with it *all* my 25 years of files, with most recent files not backed up 😭), I've summoned strength to reconstruct the beginnings of my VT entrainment talk. Colors don't show well on cell video, but i think this is improved.

🚨🚨🚨 New educational video!!! Temporary epicardial pacing wires after cardiac surgery - troubleshooting and other uses. Oversensing, undersensing, rising pacing threshold, proarrhythmia. Also SVT diagnosis and AT/AFL pace termination! youtu.be/dpVelE8gjOQ

@AllenAmornMD @uccardiology @pooneh_nabavi @ricardotorresmd @lsuhscardiology @UIowaCVFellows @ecgrhythms @ecgandrhythmRoe It is still avnrt, but with dissociated sinus p-waves

Is there something interesting about this 30+ min SVT episode? #CardioTwitter #CardioX #CardioEd @uccardiology @pooneh_nabavi @ricardotorresmd @lsuhscardiology @UIowaCVFellows @ecgrhythms @ecgandrhythmRoe

Updates in managing patients with atrial fibrillation in 2024 .. I had a lot of fun doing this with my brother ⁦@DrDeese99⁩ for #mayoimgr ⁦@MayoClinicCV⁩ ⁦@MayoEPFellows⁩ #Afib medprofvideos.mayoclinic.org/videos/updates…

In an upcoming YouTube video on VT entrainment, we will review the purpose of entrainment (to find the best place for successful ablation!), and how to interpret entrainment observations. Only example #4 showed the pacing site was *in* the VT circuit; the other 3 were bystanders.

@narrowQRS @narrowqrs, I have you on a list and your tweets show up just fine. Just FYI. And why not put #epeeps hashtag

And... this perfectly demonstrates exactly how #MedTwitter has been completely ruined by Elon's algorithms. In the past, a tweet about VT entrainment with images would rapidly get engagement by #EPeeps and others (views, likes, retweets, replies). Now? One like. By a sex bot.

@DrGregMichaud @ALFIEEP1 It is like a reverberations of a bell ring

In the best Epsilon wave contest, this would be my entry...