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Kevin Brady

@Hapa_EP • 6,802 subscribers

EP Aficionado and #EnSite mapping specialist, North Washington State. I collect ECGs and localization algos. This is not medical advice, just personal tweets.

Shorts

Pesky focal AT originating from Bachmann's bundle. Mapped with #HDGrid and OT on Voxel mode. Even though it was earlier by 10 ms on the left, tachycardia did not terminate until RF was delivered on the RA side. How many #Epeeps have seen this before? Case performed by Mike Eskander

Pesky focal AT originating from Bachmann's bundle. Mapped with #HDGrid and OT on Voxel mode. Even though it was earlier by 10 ms on the left, tachycardia did not terminate until RF was delivered on the RA side. How many #Epeeps have seen this before? Case performed by Mike Eskander

46,721 görüntüleme

Strange biatrial figure-of-8 flutter going through a leak in the old right WACA and jumping epicardially from RSPV to posterior RA via an intercaval bundle connection. Where would you burn first ❤️‍🔥? #EPeeps Dr. José Ángel Cabrera Fermin Carlos Garcia Luis C. Saenz, MD Roderick Tung Gökhan Aksan

Strange biatrial figure-of-8 flutter going through a leak in the old right WACA and jumping epicardially from RSPV to posterior RA via an intercaval bundle connection. Where would you burn first ❤️‍🔥? #EPeeps Dr. José Ángel Cabrera Fermin Carlos Garcia Luis C. Saenz, MD Roderick Tung Gökhan Aksan

18,645 görüntüleme

Recurrent stable VT with inferobasal isthmus and exit. Prior VT ablation 2 years ago. Thoughts on ablation strategy? Case performed by Mike Eskander. #EPeeps

Recurrent stable VT with inferobasal isthmus and exit. Prior VT ablation 2 years ago. Thoughts on ablation strategy? Case performed by Mike Eskander. #EPeeps

20,409 görüntüleme

Redo ARVC VT. Previous ablation almost a decade ago, but VT recurred w/ ICD therapy. Data shows we should probably consider epi access for ARVC, especially as this was a repeat procedure, but we decided to try our luck endo with better tools this time around. #ablateVT #EPeeps

Redo ARVC VT. Previous ablation almost a decade ago, but VT recurred w/ ICD therapy. Data shows we should probably consider epi access for ARVC, especially as this was a repeat procedure, but we decided to try our luck endo with better tools this time around. #ablateVT #EPeeps

22,859 görüntüleme

Pinwheel 🎡 flutter in the RSPV before starting PFA PVI. Patient presented in this rhythm and ECGs going way back show only this AFL, sometimes 2:1 and sometimes Wenckebach. Do you isolate the RSPV and call it good, isolate both RPVs, or perform the full PVI as planned? #EPeeps

Pinwheel 🎡 flutter in the RSPV before starting PFA PVI. Patient presented in this rhythm and ECGs going way back show only this AFL, sometimes 2:1 and sometimes Wenckebach. Do you isolate the RSPV and call it good, isolate both RPVs, or perform the full PVI as planned? #EPeeps

10,036 görüntüleme

Strange AAFL in a patient with no prior ablation or cardiac surgery. Where would you burn? ❤️‍🔥 #EPeeps

Strange AAFL in a patient with no prior ablation or cardiac surgery. Where would you burn? ❤️‍🔥 #EPeeps

15,397 görüntüleme

Crazy RA atypical flutter on patient with prior CTI line. Where would you burn? #EPeeps

Crazy RA atypical flutter on patient with prior CTI line. Where would you burn? #EPeeps

19,506 görüntüleme

Last case of the year and redo AAFL. Patient had prior Maze, PVI + CTI line, and most recently a plethora of LA flutters. Went straight transseptal this time, thinking it had to be a recurrent LA circuit, but after extensive mapping, we found we were in the wrong chamber. #EPeeps

Last case of the year and redo AAFL. Patient had prior Maze, PVI + CTI line, and most recently a plethora of LA flutters. Went straight transseptal this time, thinking it had to be a recurrent LA circuit, but after extensive mapping, we found we were in the wrong chamber. #EPeeps

16,230 görüntüleme

Sometimes everywhere seems passive until you map every last millimeter of the chamber. First time using #HDGrid Omnipolar configuration combined with Near Field (peak frequency) roving detection on this interesting and less common atypical flutter. Where would you burn #EPeeps?

Sometimes everywhere seems passive until you map every last millimeter of the chamber. First time using #HDGrid Omnipolar configuration combined with Near Field (peak frequency) roving detection on this interesting and less common atypical flutter. Where would you burn #EPeeps?

16,181 görüntüleme

Interesting RA AFL, this one slower with 1:1 AV conduction, mimicking focal AT. Prior CTI line. TCL started out at 350 ms, but initial burns at anterior CTI slowed it further to 380 ms. This is the remap. Where to burn now? Case performed by Mike Eskander. #EPeeps #EnsiteX #flutter

Interesting RA AFL, this one slower with 1:1 AV conduction, mimicking focal AT. Prior CTI line. TCL started out at 350 ms, but initial burns at anterior CTI slowed it further to 380 ms. This is the remap. Where to burn now? Case performed by Mike Eskander. #EPeeps #EnsiteX #flutter

15,945 görüntüleme

In a denovo PVI case, how often do you see an atypical flutter like this one? 🎡 Where would you burn? ⚡ #EPeeps

In a denovo PVI case, how often do you see an atypical flutter like this one? 🎡 Where would you burn? ⚡ #EPeeps

12,184 görüntüleme

Due to the flutter wave being positive in V1 and the inferior leads, along w/ the patient's Hx of prior PVI + CTI line, we went transseptal w/out mapping the RA first. We were surprised to find only 3 of 8 color isochrones in the LA, all systolic in timing. #EPeeps #blackandwhite

Due to the flutter wave being positive in V1 and the inferior leads, along w/ the patient's Hx of prior PVI + CTI line, we went transseptal w/out mapping the RA first. We were surprised to find only 3 of 8 color isochrones in the LA, all systolic in timing. #EPeeps #blackandwhite

13,364 görüntüleme

Prior anterior mitral line, PWI, and PVI, but patient came back with recurrent flutter. Posterior wall voltage was < 0.1 mV, and there were double potentials all along the old floor line. Can roof-dependent flutter still get through epicardially via septopulmonary bundle? #EPeeps

Prior anterior mitral line, PWI, and PVI, but patient came back with recurrent flutter. Posterior wall voltage was < 0.1 mV, and there were double potentials all along the old floor line. Can roof-dependent flutter still get through epicardially via septopulmonary bundle? #EPeeps

12,388 görüntüleme

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First case using #GridX with the 2 new sensors on the tip. Mapped so much faster than regular Grid, due to it being in high confidence 100% of the time, with way less geometry editing. But the best thing is no more having to say "We need more voxels"! 😂 #EPeeps

First case using #GridX with the 2 new sensors on the tip. Mapped so much faster than regular Grid, due to it being in high confidence 100% of the time, with way less geometry editing. But the best thing is no more having to say "We need more voxels"! 😂 #EPeeps

20,175 görüntüleme • 1 yıl önce

Prior lateral mitral isthmus line and cryo PVI presenting with recurrent atypical flutter (TCL 225 msec). Where would you burn #EPeeps? JMC Christopher Woods Edward Gerstenfeld

Prior lateral mitral isthmus line and cryo PVI presenting with recurrent atypical flutter (TCL 225 msec). Where would you burn #EPeeps? JMC Christopher Woods Edward Gerstenfeld

15,401 görüntüleme • 2 yıl önce

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