Jerry

This live case demonstrates a streamlined approach to concomitant pulsed field ablation (PFA) and left atrial appendage occlusion (LAAO) for AF management, led by Julian Chun. Pulmonary vein anatomy is assessed using angiography rather than routine pre-procedural CT imaging, providing sufficient information to guide procedural planning and device sizing. Following anatomical evaluation, a pentaspline PFA system is selected to proceed with pulmonary vein isolation. This workflow highlights how simplified imaging strategies can efficiently guide anatomical assessment and device selection during combined PFA and LAAO procedures. #EPeeps

In part three of this live case led by Domenico Della Rocca and Antonio Sorgente, mapping strategy during persistent AF ablation is explored. Mapping is performed while the patient remains in atrial fibrillation, focusing on anatomical reconstruction rather than voltage analysis. The aim is to define pulmonary vein and posterior wall anatomy to guide effective lesion coverage. Cardioversion is planned after pulmonary vein isolation, once the anatomical framework for ablation has been established. This approach highlights how anatomical mapping during AF can streamline workflow before rhythm restoration. #EPeeps

This live case demonstrates mapping and lesion assessment during pulsed field ablation for persistent AF, led by Domenico Della Rocca and Antonio Sorgente, in an 80-year-old patient. Mapping is performed at the pulmonary vein antrum, using the left superior vein as the reference point while carefully avoiding excessive volume acquisition. Lesion tagging is refined by reducing the fill tag size from 6 mm to 5 mm to improve visualisation of potential gaps. This workflow highlights how controlled mapping and precise tagging support clearer interpretation of lesion distribution during PFA-guided PVI. #EPeeps

Epicardial connection following radiofrequency mitral isthmus ablation heartrhythmjournal.com/article/S1547-…

How far inferior should posterior wall isolation (#PWI) extend? Prof. Boveda joins Prof. Garcia Bolao and Prof. Széplaki discuss their real-world approaches in PWI, shaped by anatomy, experience and technique. Watch now: bostonsci.co/5juRRIyct1b #Afib #Epeeps #PFA

Although verapamil is contraindicated in most forms of ventricular tachycardia, an important exception is fascicular ventricular tachycardia (also called idiopathic left VT or Belhassen VT). Fascicular VT is a rare, idiopathic VT typically seen in young patients without structural heart disease. It originates from the left ventricular fascicular system and may mimic supraventricular tachycardia with aberrancy. Unlike other VTs, this arrhythmia is calcium-dependent, which explains its characteristic termination with intravenous verapamil. This unique response was first described in 1979 by Belhassen et al., leading to the terms verapamil-responsive VT and Belhassen VT. Because of its infrequency, it is well recognized by cardiologists but often under-recognized in emergency settings

High density mapping of upper-loop macro-reentry surrounding the superior vena cava: substrate evolved ablation strategy heartrhythmjournal.com/article/S1547-…

@TrackYourHeart Flutter lives around 250ms give or take. Faster than 200 ms, its more likely afib that is traveling like a flutter in the RA. The "flutter" waves are different morphologies, and eyeballing they do not march.

What rhythm does this ECG strip show?

1. Can you identify the ECG signs marked in blue and green? 2. Which arrhythmia is associated with these findings?

🧵 Why can oxygen worsen respiratory failure in COPD? Many clinicians still fear giving oxygen to COPD patients. The reason they’re taught? "Loss of hypoxic drive" But this is mostly a myth. Here’s what really causes oxygen-induced hypercapnia 👇

This live real-world patient case explores redo persistent AF ablation using pulsed field energy, led by Devi Nair. A mid-transseptal puncture is performed using the FARADRIVE™ sheath, with intracardiac echocardiography advanced into the left atrium for real-time visualisation in a zero-fluoroscopy workflow. A guidewire is positioned in the left inferior pulmonary vein before performing a rapid voltage assessment to evaluate pulmonary vein isolation durability. Mapping is performed through the catheter’s five electrodes, supported by impedance-based contact sensing within the OPAL system. Splines illuminate on contact, providing a visual cue to confirm stable tissue interaction during mapping. This approach demonstrates how integrated imaging and contact feedback can streamline assessment during redo AF ablation procedures. #EPeeps

Interpreting an #ECG can seem overwhelming at first, but with a structured approach, it becomes far more manageable. In this thread, I’ll walk you through how to analyze an ECG like a professional, step by step. Let’s begin.🧵

@smcroasters One for Jan 12, 2016

I said only ONE FUCKING PING VASILY!!!! NOT TWO!!!!!!!

@4thOfJuly365 ...if you can see the grenade, the grenade can see you.

This is what they do for fun in the third world.

@LouisvilleGun well done internet.

God bless the internet

@CoolGuy1999ish Agreed, stupid movie.

@mikeymadison5 Acting: 8/10 Cinematography: 10/10 Soundtrack: 9/10 Plot: 4/10 One of the strangest movies I’ve ever seen. It’s a garbled mess of a plot. 3 hours long but it feels like the left a lot on the cutting room floor.

one battle after another (2025) dir. paul thomas anderson

@TristanUda Nice, but one and done does not make him a Ky legend. Just another dude who came through.

Reed Sheppard’s girlfriend had one of his Kentucky jerseys custom painted for a Christmas present. The jersey features state themed details such as Churchill Downs, as well as Reed’s team portrait from his one season at Kentucky, and his college accolades.

Sometimes, the fluro talks to me..

🚨Latest #OpenAccess Article in @JICE_EP PFA for Refractory Typical Atrial Tlutter Resistant to Multiple Radiofrequency Ablations: A Technical Report 📖🧐doi.org/10.1007/s10840… by @ShaojieChen1, Anna Neumann, Gozal Mirzayeva, Sebastian Graeger, @LukasUrbanek11, @dvidschaack, @jongichun & Boris Schmidt #EPeeps

Ablation in persistent atrial fibrillation: High long-term success with pulsed field ablation using a strict protocol @RossoRaphael heartrhythmjournal.com/article/S1547-…