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#AF #ablation is salvation. Control of #Lifestyle factors is important but should not be seen as an alternative

6/ TL;DR (Too Long; Didn’t Record) To confirm true septal RV lead position: •✅ Positive V6 •✅ Positive inferior lead •✅ QR in aVL •✅ RAO/LAO positioning •✅ Confirm with CT when needed Septal > Free Wall. Precision matters. #Pacemaker #MedTwitter

🚨 #CardioNuggets: Decoding Coronary Physiology in the Cath Lab CFR (Coronary Flow Reserve) = Total flow capacity   CFR = Normal > 2.0 FFR (Fractional Flow Reserve) = Epicardial disease?   FFR = Pd/Pa → Normal ≥ 0.80 IMR (Index of Microcirculatory Resistance) =

#CardioNuggets 🫀 What’s High-Degree AV Block? 🔹2 or more P waves blocked in a row 🔹Not complete AV dissociation (≠ 3rd° block) 🔹Often unstable & may progress to complete block 🔹Think: pacing, especially if wide QRS or symptomatic! When evaluating high-degree AV block,

🧠 #CardioNuggets: Summed Stress Score (SSS) in Nuclear Perfusion Imaging 🫀 17 LV segments scored 0–4 (0 = normal, 4 = no uptake) ➕ Total = SSS (max 68) 🔍 Interpretation: 0–3: Normal 4–8: Mild 9–13: Mod ≥14: Severe perfusion defect 📊 SSS = Scar + Ischemia SDS =

⚾️⚾️⚾️ Keeping the Heart Rhythm Society tradition alive by taking the team Arun Sau Joseph Barker Boroumand Zeidaabadi out to ball game, after a day at conference Some pics too of previous HRS baseball with research fellows Kiran Patel and Balvinder Handa Nicholas S Peters Imperial EP NHLI

Subepicardial Adipose Tissue as a Modulator of Arrhythmias Kiran Patel heartrhythmopen.com/article/S1547-…

Pleased to have our commissioned manuscript published in HeartRhythm on (sub)epicardial adipose tissue as a modulator of cardiac arrhythmias. Thank you to Prof Ruben Coronel and co-authors, and as ever, to the one and only Fu Siong Ng NHLI

1/Do radiologists sound like they are speaking a different language when they talk about MRI? T1 shortening what? T2 prolongation who? Here’s a translation w/an introductory thread to MRI.

Open it. Zoom it. Save it. Share it. This is your go-to guide for standard adult TTE views.

Echocardiographic evaluation of LV diastolic function made simple by ASE😍 #Cardiology #Echo #ASE #MedEd #CardioTwitter

Myocardial Performance Index (Tei Index)= Interesting one 😍 The Tei Index, named after Dr. Chuwa Tei is a Doppler-based, noninvasive measure of global ventricular function, combining both systolic & diastolic performance. How it’s measured: ⬜ Obtained using pulsed and

Normal & Abnormal Transmitral LV Inflow Patterns Understanding Doppler signs of LV diastolic dysfunction is key for diagnosis & prognosis. 1️⃣ Normal Diastolic Function - E/A >1, DT <220 ms - Mechanism: Normal LV relaxation & compliance → early diastolic filling dominates (E

A reminder that - Not all that leaks troponin is an MI 🔑 concept: troponin elevation, ischemic and nonischemic causes 📚

Doppler Stroke Volume (Step by Step Guide) ⬜ Stroke Volume (SV) = amount of blood ejected by the LV per beat SV = CSA × VTI Step 1: Calculate CSA (Cross Sectional Area) - Measure LVOT diameter (D) in parasternal long axis (PLAX) view during mid-systole - Apply: CSA

TEMPORARY/EXTERNAL CARDIAC PACING😍

Understanding Qp/Qs Ratio: How We Measure Blood Flow Across the Heart The Qp/Qs ratio is used to determine the presence and severity of cardiac shunts, especially left-to-right shunts such as ASDs, VSDs, and PDAs. 🔹 Qp = Pulmonary Blood Flow 🔹 Qs = Systemic Blood Flow Qp/Qs =

🚨 Heart failure (HF) decongestion ≠ simple fluid removal. Let’s explore the fascinating electrolyte changes happening behind the scenes and how they interact with diuretic therapy. 🫀💧⚡ Here follows a thread.🧵 Full review by Frederik H. Verbrugge and me: onlinelibrary.wiley.com/doi/10.1002/ej…

#CardioNuggets Acceleration time and Ejection time in prosthetic aortic valve assessment: 🔹 AT = time to peak velocity 🔹 ET = total systolic ejection time Why AT/ET is useful in prosthetic aortic valves: -Gradients can be misleading—affected by flow, valve size & design -AVA

Echocardiographic assessment of the right ventricle