26 year old with WPW. VAHV with short PPI-TCL and SA-VA. Spontaneous His refractory PVC advanced A. Mapped to right posterior AP. #EPeeps

Prior PVI and atypical flutter with prior mitral isthmus line (RSPV to MV) with recurrent flutter. Entrained along MV annulus. Green dots in. Circled lesion where tach terminated. #EPeeps Giancarlo Vasselli

9 yo girl with WPW. Max pre excitation with A pacing. Ablation A and V conjoined, V -20ms pre delta wave. Pressure at spot bumps pathway. One cryo lesion. #EPeeps Alejandro Jimenez Restrepo Vincent See University of Maryland Medical Center

Atrial tach localized slightly superior and anterior to His along TV annulus. Used cryo. What would you quote patient risk of AV block in this location using RF? #EPeeps Alejandro Jimenez Restrepo

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Heart transplant last month with donor heart WPW (ecg1) who had WCT (ecg2). Found to be ORT with bifascicular block. EGM septal VA 120ms with short PPI-TCL and SA-VA. Mapped parahisian AP from right and Ao cusps. Earliest A had His and didn’t ablate 🤨 #EPeeps Alejandro Jimenez Restrepo

34yo M NICM. 12 lead of clinical VT matching device EGMs. Bipolar normal voltage. Unipolar basal inferolateral scar. Entrained by exit site (septal aspect of scar), other sites unsuccessful entrainment. RF at suspected isthmus terminated VT. Paige Botie Alejandro Jimenez Restrepo

Check out inferior ST elevation (lead III best) during traction on RV lead during extraction then resolution when traction released. #EPeeps ⁦University of Maryland Cardiology⁩

Last case in fellowship! Typical AVNRT. Single lesion and no longer inducible! Thanks Vincent See Paige Botie Alejandro Jimenez Restrepo University of Maryland Cardiology #EPeeps

19 yo arrest playing b-ball EMS shocked for VF. Ecg1 post arrest ecg2 two days later. Echo nl apex and MRI Pt not cooperative for good images. HR ok on propranolol 10 tid now. Subq vs transvenous and why #EPeeps Alejandro Jimenez Restrepo Gregory Michaud JMC Faisal Merchant Kevin Brady

My first persistent left svc implant. Pt with CHB post MVR and incidentally found to have PLSVC and anomalous right SVC to LA in OR (repaired). Micra AV not available. Any future guidance/tips for success #EPeeps Alejandro Jimenez Restrepo Vincent See

Very prominent eustacian valve. ICE was crucial for this flutter line! #EPeeps Daniel Nguyen Alejandro Jimenez Restrepo

41yo healthy male with brother who has HCM and ICD. TTE normal, cardiac MRI pending. SOO? #EPeeps Alejandro Jimenez Restrepo

First His pacemaker as an attending. Selective His capture threshold <[email protected] Very gratifying case #EPeeps Alejandro Jimenez Restrepo

39 yo F with palpitations. Where is the AP? #EPeeps Daniel Nguyen

Coincidental time to start the ECG #EPeeps

68 with CAD cto rca EF 45%. SOO? #EPeeps

42 yo polysubstance abuse found down after fentanyl overdose. Initial pH 6.8 K<3 ecg nonspecific ivcd with qtc 585 EF 15%. Intubated then VF several times requiring defibrillation. Now extubated and structurally normal heart by Cath and echo. Implant ICD? Why or why not #EPeeps ?