Roy Chung

Yet another reason to avoid targeting the posterior fascicle with LBBaP. Posteromedial papillary muscle perforation with preserved electrical parameters: a novel complication of LBBaP heartrhythmcasereports.com/article/S2214-…

Happy to share our last article about 3D VT substrate, depth is part of the game to plan RF approach @S_Vazquez_Calvo @aportasanchez @ADAS3D @hospitalclinic @tolosanaviu @EduGuasch @LluisMont2 @guichard_jb @PSanchezSomonte

Cardiac physiologic pacing, also known as cardiac resynchronization therapy, is indicated in patients with heart failure, reduced left ventricular ejection fraction (LVEF) of 50% or less, and either a high (or anticipated high) ventricular pacing burden or a wide QRS complex. Traditionally, physiologic pacing has been achieved with biventricular pacing with a right ventricular lead and a coronary sinus branch lead. Randomized trials involving more than 10,000 patients with heart failure have shown clinical, exercise, and quality-of-life benefits associated with biventricular pacing, as well as improved LVEF and reduced mitral regurgitation and ventricular volumes. These benefits are greatest in patients with left bundle-branch block and a QRS duration of 150 msec or longer. Recent studies support targeting the His bundle or left bundle branch as an alternative cardiac physiologic pacing strategy. Ongoing randomized trials are expected to more clearly define the comparative efficacy and safety of conduction system pacing as compared with biventricular pacing. Read the Review Article “Physiologic Pacing in Heart Failure” by @MihailChelu, MD, PhD, Jeanne E. Poole, MD, and Kenneth A. Ellenbogen, MD (@KennethEllenbo1), from the Baylor College of Medicine (@bcmhouston), University of Washington (@UW), and Virginia Commonwealth University School of Medicine: nej.md/4qqjSfI

🍩Ring-like late gadolinium enhancement (LGE) is an uncommon cardiac MRI finding, present in ~1% of patients undergoing CMR. 🍩Most commonly present in dilated and non-dilated left ventricular cardiomyopathies, and spans multiple etiologies, including genetic, inflammatory, and idiopathic causes. 🍩Over a median follow-up of three years, patients with ring-like LGE experienced ~18% with major arrhythmic events and a similar proportion of death, heart transplantation, or LVAD implantation. 🍩Ring-like LGE represents a shared high-risk myocardial substrate rather than a disease-specific imaging pattern. #whyCMR #CVimaging #SCMR2026

New in @CirculationEP: Focal monopolar #PFA lesion geometry is titratable in vivo. Voltage, #apps, CF & angle shape depth/width. Practical framework for more consistent lesions. @arwayounis2 @omwazni @Dr_Santangeli @CleClinicHVTI #EPeeps 🔗 Full article: ahajournals.org/doi/10.1161/CI…

Purkinje and septal substrate modification as a therapeutic option for patients with STEMI and refractory ventricular fibrillation #OpenAccess heartrhythmjournal.com/article/S1547-…

Trans–right atrial access to the left ventricle for catheter ablation of ventricular tachycardia in a patient with double left-sided mechanical valves: First case report from Latin America, by @FellowEP and colleagues @Ufrontera #HRO2GlobalVoices #EPeeps heartrhythmopen.com/article/S2666-…

The target paraseptal fat pads at the Waterston’s groove can be reconstructed with ICE as the only imaging modality to guide anatomical cardioneuroablation. Adjacent structures to avoid (right phrenic nerve) can also be reconstructed. @EuropaceEiC @CleClinicHVTI

ICE guided Biatrial CNA by @MedhatFarwati @Dr_Santangeli @EdSolteszMD @omwazni @CleClinicHVTI Feasibility and Outcomes academic.oup.com/europace/artic…

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.

Prolonged Hospitalization After Catheter Ablation of Ventricular Tachycardia: Predictors and Outcomes #OpenAccess @CalcagnoTess heartrhythmjournal.com/article/S1547-…

📢 Proud to share our new paper published in @JACCJournals with @MartinsRaphae15 : A multicenter analysis of electrical storm in hypertrophic cardiomyopathy. ➡️ Antiarrhythmics often effective acutely ➡️ High recurrence rates ➡️ High mortality at 18 months ➡️ Catheter ablation not associated with better long-term outcomes A rare population with a critical need for improved strategies. jacc.org/doi/10.1016/j.…

Paraseptal focal ATs arise from diverse but closely related anatomical locations. There is no site from which ablation is consistently successful. Although some are indeed perinodal & accessible from the NCC, others arise from adjacent structures. jacc.org/doi/10.1016/j.… #JACCCEP

Ablation of PVCs from outflow tract using a large-footprint lattice-tip catheter: be cautious of the coronary artery @dello88 heartrhythmcasereports.com/article/S2214-…

Localized Reentrant Ventricular Tachycardia in the Purkinje Network with Three Different Exits after Acute Myocardial Infarction @urara4114 @KamakuraTsukasa heartrhythmjournal.com/article/S1547-…

Safety and Effectiveness of Surgical Pericardial Access for Catheter Ablation of Epicardial Ventricular Tachycardia: A Multicenter Experience @JRWinterfield @KojiHiguchiCCF @SroubekJ @EdSolteszMD @CleClinicHVTI @MUSC_EP @JACCJournals sciencedirect.com/science/articl…

Elimination of VT and PVC by Ablation of Oppositely Directed Re-Entrant Circuits -PVC ablation at a site other than the earliest activation site authors.elsevier.com/a/1lv-7,siTgof…

🧑‍🎓Study #4 #EPeeps 🤔 Does Stellate Ganglion Block have a role to play in VT Storm? @hrs_journal *⃣Post-hoc subanalysis of the STAR study evaluated whether percutaneous stellate ganglion block (PSGB) has differential effects on ventricular arrhythmia types 🌟🩺 112 patients / 139 PSGB procedures Grouped as 👉 • Slow VT (≥ 375 ms) • Fast VT (< 375 ms) • VF 🎯Outcome = change in ICD therapies (ATP + shocks) 1 hour before vs after PSGB. heartrhythmjournal.com/article/S1547-…

We Publish New Technique for the “No-Entry LV”
double mechanical valves,
at Heart Rhythm transventricular approach, enabling safe entry for VT ablation or leak closure. #HeartRhythm #Electrophysiology #VTablation #Innovation #Cardiology doi.org/10.1016/j.hrth…

After the pre-clinical experience, our first-in-human study exploring the transatrial route to the epicardium is now out in JACC: EP share.google/kUit3jAbZpsU65… @Dr_Santangeli @ALFIEEP1 @DrRoderickTung @Davilandre @aalahmadmd @Arritmias_HRC @AkihikoNogami @sozi81 @JACCJournals