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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

Left or Right ?

Recent studies, including the Volt CE Mark Study, demonstrate that mild sedation with no propofol—using midazolam, fentanyl, and lidocaine—is both feasible and safe for treating PAF and PersAF. Staying updated with the latest evidence helps us provide better patient care. Are

Surprise spontaneous ORT using a concealed left lateral pathway on a younger patient (early 40s) scheduled for PFA AF ablation (history of persistent AF). Should we still proceed with the PVI? #EPeeps

The beauty of EP is that there's a huge chance you can literally heal such patient with one gentle touch of ablation catheter. There's always room for a second stage of the therapy if needed

Atrial flutter in the RSPV. 🫀Great maps from Kevin Brady showing how mapping insights from our #EnSiteX EP System can help inform your #PFA strategy. #MappingMatters How would you approach, #EPeeps? Safety Info: bit.ly/4n7v5Av

That feeling of a one-burn ❤️‍🔥 termination during bigeminal LV summit PVC ablation! Although this time it took 11 long seconds for the PVC to suppress with RF just below the LCC. Does that mean the focus was just deep or were we not exactly on the right spot? #EPeeps #GridX

Kevin Brady Arritmias H. Ramón y Cajal, Madrid. Piotr Futyma, MD Milan Koštek Syamkumar CarinaHardyEP Roderick Tung Adrian Baranchuk MD FACC FRCPC FCCS FSIAC Jorge Gomez Dr. José Ángel Cabrera All modalities should be considered when it was failed with conventional RF!

Kevin Brady Arritmias H. Ramón y Cajal, Madrid. Piotr Futyma, MD Milan Koštek Syamkumar javad mikaeili CarinaHardyEP Roderick Tung Adrian Baranchuk MD FACC FRCPC FCCS FSIAC Jorge Gomez Dr. José Ángel Cabrera In most cases what’s needed is detailed mapping, which is not only endo and epicardial(AIV/GCV) but also intramural. Only in a minority of cases more agressive ablation and/or alcohol is needed. Andres Enriquez doi.org/10.1161/CIRCUL…

PFA for CTI ablation ❗🚦❗ Persistent PR prolongation in 23% pts (4/17) and ST elevations in 5%of pts.

The Fibrous Skeleton of the heart

Where is this PVC’s focus ; after a few hrs. ablation was failed! 🤔#Epeeps

What is the likely mechanism of this arrhythmia? #EPeeps #EPfellows

SVT with LBBB with spontaneous resolution. TCL is shorter with LBBB than narrow QRS. What is the mechanism of this tachycardia ? Hospital Posadas Sociedad Argentina de Electrofisiología Cardíaca LAHRS JICE

Thanks all for your inputs: Answer: “Reversed Coumel Sign” Typical TCL prolongation in Coumel sign is the result of interaction btw VA prolongation w/BBB & AH shortening. Reversed Coumel Sign is the result of a huge AH prolongation after BBB resolution & VA shortening.