Jason Garcia

@jacksondavey Only showing the giants “play ons” 😂

Only dampener on an outstanding final Q4 umpiring lowlights #AFLPiesGiants 1. Chop of the arms 2. Dangerous tackle 3. HTB 4. High contact + ITB 5. Unrealistic attempt 6. Tripped 7. Tackled without the ball 8. High tackle 9. Deliberate 10. Below the knees 11. High contact

@Callme_DrNeil @MartinsRaphae15 @finnakerstrom Nice work to dynamic this. Intrigued to see without. Great mapping 😀

@MartinsRaphae15 @finnakerstrom Agreed @JVGEP is the godfather of dynamic WOI. But I find it quite time consuming. Easier to just do it all in the mind and put location only dots to annotate

🔥I always find it amazing to see how a given scar can generate so different VTs 🔄Some lines of block are definitely functional A recent exemple ⤵️ #EPeeps #AblateVT

@ericlim1975 @James_Elliott01 @TineGoepfert More a standard in Melbourne.

@ericlim1975 @James_Elliott01 @TineGoepfert Boundary Windows on horizon which will improve NF annotation. Windows with FF signal set as “earliest” in setting of a additional boundary with right to left sweep. Dynamic WOI is becoming the standard approach for multiple Structural VT. Physician and Mapper must be skilled

1/ Here's a beautiful apical VT map. As usual, during the case, mis-annotation was frequent and required manual correction. How do you prefer to set your map window for these cases? Tips to minimise LAT errors? Will follow up with a more detailed video. #HDGrid #Ensite #Epeeps

@Callme_DrNeil @ivroca @ozgursurgitMD @EPteam_IMAEH @MBassorkun @nailguven_dr Not completely sure based on the propagation. Would be nice to signals at the Marker Marker zone

@ivroca @ozgursurgitMD @EPteam_IMAEH @MBassorkun @nailguven_dr @JVGEP where do you think the missed 3d portion is?

Last surprise of 2022!! 48 year old patient with incessant VT unfortunately with apical thrombus formation.Lucky epicardial VT ablation…#EPeeps

@DrRoderickTung @DrKatrapati @Peteweissmd @su_wilber @MikeZawanehMD Critical isthmus at 11-12 with local EGM stepping out coinciding with TCL jump by 40msec. Suggests circuit has multiple layer components. 12-lead QRS Exit same for both TCL.

Happy Thanksgiving to all! This was a delicious diastolic buffet leading into the holiday with our new tridecapolar catheter in inferoapical scar. 🍗🍽️The intricacies and complexity of this dish are deep..#ablateVT

Fast forward to 2023... please read our recent collaboration with @NVandersickel with @JoshuaHawson using Map Theory Techniques to understand and treat VT Circuits. authors.elsevier.com/a/1f%7EGO_,5U2… @JACCJournals @Dr_RobAnderson @peterkistler3 @JonKalmanEP @Ed_Gerst @BoatNoodleSoup

@Arritmias_HRC @syamkumarmd @EF_Cardiaca @hikmetyorgun @ivroca @cortezdias @Ghassanj89 @MonaghanJenieca @SignalstEPh Is it feasible to use a normal window for majority of map and then dynamically close the window around the small discrete early signals? Could you then reopen the window once navigating away from small discrete early signal?

@JVGEP @syamkumarmd @EF_Cardiaca @hikmetyorgun @ivroca @cortezdias @Ghassanj89 @MonaghanJenieca @SignalstEPh In theory there is no need in focal arrhythmias, that would only make sense if you select a very narrow WOI just at the beginning of the QRS to exclude anything not earlier than beginning of QRS. Map would be weird though

Confidense in Carto is great tool, yet you have to know its limitations (IMHO). Its "wavefront" annotation algorithm is not sensitive enough for prepotentials. It often requires manual editing, according to earliest recording-system EGMs, to track SOO in focal arrhythmias #Epeeps

@syamkumarmd @Arritmias_HRC @EF_Cardiaca @hikmetyorgun @ivroca @cortezdias @Ghassanj89 @MonaghanJenieca @SignalstEPh Have you tried using a dynamic WOI?

@Arritmias_HRC @EF_Cardiaca @hikmetyorgun @ivroca @cortezdias True. In my practice, I always ask the Carto friends to manually tag these areas. I am a bit confused about this map. Looks like AP view from the Carto screen bur the great vessel look taking off posteriorly? @Ghassanj89 @MonaghanJenieca @SignalstEPh

Great VT week with @BiosenseWebster! #ablateVT Inferoapical isthmus from large Cx infarction. White line is LOB in ILAM, serving as a surface barrier that forces intramural conduction. Need greater resolve of SNO zone, as it is most critical region. Great collaboration ahead!

@CollingwoodFC Any reason Cox starts before Cameron? Less Clangers, More Marks, More Goals, better efficiency….

R1 team. Bring on Friday night footy.

Ladies and Gentlemen: Roger Federer about Rafael Nadal’s #21

@LenSteinberg Atypical AVNRT, very early PES from His conducts Retrogradely to advance A. Selective capture of His with RV ERP. Ventricle not part of circuit.

So I only have like 3 followers, but maybe one of them will repost. 19 year old with wide complex tachycardia. During delivery of PJCs, the following tracing was encountered.

STAR AF 3 has started enrollment. Sites in Canada, EU, Australia and Japan are activating and first patients are enrolled. #STARAF3 clinicaltrials.gov/ct2/show/NCT04…

@James_Elliott01 @BartsHospital @mcfinlay @Prof_Schilling @RachaelRobsonEP @BiosenseWebster Nice signals on the LassoStar

Single shot PVI in under 6 seconds 😳 Heliostar looking promising after initial 10 cases at @BartsHospital! Minimal fluro, ablation and lab time. Keep up the good work @mcfinlay & @Prof_Schilling! 🔥 or 🧊 #EPeeps ? @RachaelRobsonEP @JVGEP @BiosenseWebster

@mheimannEP @James_Elliott01 @dickytill @Callme_DrNeil @Prof_Schilling @ERowland_Barts @DrRoderickTung @AlexCambridge9 heartrhythmcasereports.com/article/S2214-… great Case Report, shows the challenge of ablating distally.

@James_Elliott01 @JVGEP @dickytill @Callme_DrNeil @Prof_Schilling @ERowland_Barts @DrRoderickTung @AlexCambridge9 not sure regarding the diagnostic utility, pathways that are closer to distal atrial conduction tissue (uc pathway/compact AVN) it’s an excellent therapeutic maneuver once localization of ‘best site’ to ablate is determined. Pace rate to fusion through AVN to keep eye on it!

Interesting EP study. Before you ask, no we didn't try to OWM it @Callme_DrNeil. Unfortunately bumped so not very satisfying but the reversal in His/RBB activation is! @Prof_Schilling @ERowland_Barts @dickytill @DrRoderickTung @mheimannEP @JVGEP @AlexCambridge9 #EPeeps

DEEP substrate mapping for guiding VT ablation: compare the time-difference of the late potential sites during S1S2 pacing) DEEP substrate mapping identified the functional substrate critical to the VT circuit with high specificity ahajournals.org/doi/10.1161/CI…

The oblique course of AP pathway along AV groove will have a big influence on "the sites of earliest activation" and" the sites of shortest A-V interval". doi.org/10.1016/j.hrth…