Mark Marieb

@TinCup2020 @KylePorterNS What do you mean? I loved the interview

@KylePorterNS Scottie Scheffler gave a masterclass and I'm going to guess for most, his point went right over their heads. See if you can guess what he was doing, without actually saying the words.

"I love being able to play this game for a living. It's one of the greatest joys of my life, but does it fill the deepest wants and desires of my heart? Absolutely not." All-time five minutes here from Scottie. Must watch stuff.

@ALFIEEP1 @syamkumarmd @jczerpa @nlcabanillas Thank you great always enjoy your posts!

@MarkMarieb @syamkumarmd @jczerpa @nlcabanillas This neurostimulator delivers the following settings: -50V -50 Htz ( pulse frequency= 50 pulses per sec) -0.04 msecs We use a quadripolar deflectable Catheter and advance as far as we can, usually located at low orbital level. We stimulate the vagus nerve.

After working a year in this project, we did the 1st CNA using the new neurostimulator (Kovac BioMedics) proudly being a medical advisor 1) vagal response at the beginning of case 2) incomplete denervation after thinking we were done 3)complete denervation after remapping and RFA

@ALFIEEP1 @syamkumarmd @jczerpa @nlcabanillas A couple of questions, please. Would any nerve stimulator work? What are the parameters i.e. frequency, pulse width, and amplitude? Are you delivering this to the vagus nerve in the neck or to the ganglia themselves? What catheter are you using to deliver the pulses? Thank you!!!

@syamkumarmd Thanks Syam for that suggestion Functional mapping for #CNA is the right way. It is a game-changer. We are working with @jczerpa (CNA expert) & @nlcabanillas ( LAHRS president) to do that. RFA time could dramatically be reduced. We will do it as soon as we do all the research.

@annavarr @lucasmouraeef @EPeeps Still don’t see the intracardiac you have the surface and the pacemap. Can’t wait to see the potential thank you!

@lucasmouraeef @EPeeps sorry! please look at my last tweet with intracardiac electrograms

Look for this potential when mapping at the RCC- LCC when mapping PVCs. Never fails. @epeeps

@alojoh They are growing while Tesla shrinks

SAIC's global deliveries were down 49% in Q1. I know it's annoying that I keep sending these. I just want to fight the Tesla FUD which makes it look as if only Tesla was down in Q1. The whole fridging market was down!

@srissundaram @natale_md @KashifMD @Drdevignair @Siddmann @LarryChinitz @SrijoyMahapatra @StBernards Will there be a remote option and if so how to register? Thank you!

@KashifMD @Drdevignair @Siddmann @natale_md @LarryChinitz @SrijoyMahapatra @StBernards Map EP West is Nov 15-16 in SF. Same faculty with similar agenda. Join us then

Congratulations @Siddmann for another successful MAPEP program and thank you for the invite . Excellent conversations , live cases , VR cases , debates and prerecorded cases … a treat with @natale_md @srissundaram @LarryChinitz @SrijoyMahapatra @AbbtCardio @StBernards #epeeps

@kvernooy @Dominik_Linz @MaastrichtUMC @drjohnm @JLuermans @Dr_JozaEP @purerfellner @DrRoderickTung Thank you!

@MarkMarieb @Dominik_Linz @MaastrichtUMC @drjohnm @JLuermans @Dr_JozaEP @purerfellner @DrRoderickTung Galvanize generator with CARTO system and thus smarttouch catheter

Focal PFA for atypical flutters. A real game changer. @Dominik_Linz @MaastrichtUMC @drjohnm @JLuermans @Dr_JozaEP @purerfellner @DrRoderickTung

@MiguelVldrbno @ivroca @LluisMont2 @AbbottCardio @hospitalclinic @tolosanaviu @Ed_Gerst I am assuming you would use alcohol approach there?? Or at at least a coronary angio??

Last PVC ablation in 2020....summit again...thanks distal CS!!! -45 ms in comparison with -10 ms in cusps....@LluisMont2 @AbbottCardio #ablateVT @hospitalclinic @tolosanaviu

@Raquel_Adelino @DrCherylTeresEP @SergeBoveda @jongichun @bayiron123 @NRivasGandara @J_Francisco_EP Hi, what system did you use and how was the catheter positioned for mitral isthmus ablation? Thank you!

🆕 📢 Very happy to see our work published: Efficacy and safety of posterior wall isolation + mitral isthmus block (on top of PVI) with PFA for persistent AF ablation🏀🌸 @SergeBoveda #EPeeps authors.elsevier.com/a/1hHxm_,5U2zt… @jongichun @bayiron123 @NRivasGandara @J_Francisco_EP

@TimothyMaherMD1 @BidmcCvi @Davilandre @rdangeloMD @RonukModi Hi, is that a sinus rhythm map? Looks like a dead end. What was VT circuit? Where was ablation performed? Thank you in advance!

Structure Meets Function: @BidmcCvi Epi VT substrate LAM with decel/rotation around the line of block (WADL). Functional substrate mapping matches perfectly with the aneurysm borderzone, LGE and submitral wall thinning channel. #ablateVT, @davilandre,@rdangeloMD,@RonukModi

@DrCherylTeresEP Is that map in NSR? What was the actual VT circuit? The map just seems to show a dead end. Where was ablation? Thank you!

Beautiful images! #ablateVT #CardioTwitter #EPeeps

@DaneshModi @dvmEP @BiosenseWebster Assuming you switch via transseptal sheath ablation catheter for a Pentaray or Octaray?

#EPeeps, needed a roof line and anterior MI line for this atypical AFL case. Single TSP. Checked both lines with activation mapping during CS pacing. Pretty sure we're blocked. Any EP purists disagree? Excellent mapping as usual, @dvmEP! @BiosenseWebster

@bryan_johnson How did you overcome the depression?? Diet and supplements and exercise but is there more???

Death was my only wish for 10 years. Depression had me in an unbreakable choke hold. Giving thanks today that I now feel an insatiable thirst for life. Sending you all🫶🏻

@jeffrey_vinocur What was original condition, Kearns-Sayre?

Of course I would rather the patient not need a pacemaker. But after feeling sheepish for having recommended a pacemaker in someone who seemed visit after visit to have no use for one, there is something satisfying about high-grade AV block.

@UlhasDr Only slurred upstoke in V2 and V3, and no other leads. If this were a fib and preexcitation you would expect variable degrees of fusion throughout which we don’t see. My vote is a fib, LVH, atypical RBBB

Rhythm?

@javadm20 Thank you! My question more specifically was that within the CS, it is pointing way up to atrial side of CS, possibly atrial branch of CS?

@MarkMarieb That was in the cs!

2 cases in a few wks with LAP; after failed ablation from LA; was ablated successfully from inside CS! ( Epi connections)! #Epeeps

@drgastonvergara @jeffrey_vinocur In low branch of CS possibly MCV. If R-waves OK and threshold OK could test DFT’s, will probably work, could leave it. As an aside heart looks very small for someone with AICD, ? Congenital arrhythmia syndrome?

@jeffrey_vinocur The heel of the lead looks high, suspected it may have be crossed an ASD.

#EPeeps Old but educational case Reimplant following extraction for lead fracture, any observations?

@RashadKhaziSyed @Hapa_EP @drpaari @skarim01 @drimdadahmed When we discussed this I thought it would be slightly more distal than HIS based on morphology. Could that be a RBB potential? Especially I don’t see atrial electrogram? Bet if you burned it was safe from AVN but you get RBBB, which is reasonable to do.

@Hapa_EP @drpaari @skarim01 @drimdadahmed @MarkMarieb Earliest EGM right on his … you can see the retrograde His on blue spline which was -35 ms earlier #EPeeps

You d male with 30% PVCs and cardiomyopathy. SOO? #EPeeps @Hapa_EP @drpaari @skarim01 @drimdadahmed @MarkMarieb