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Proctored antidromic snare case today at Cardioinfantil Arrhythmia Center Bogota with Drs Luis Saenz & Diego Rodriguez. For detailed description see YouTube "How T0" video youtube.com/channel/UCmz-I… or direct download spaces.hightail.com/receive/6hVZ2p… Luis C. Saenz, MD Dr. Diego Rodriguez #EPeeps #ICRT

Alexander dal forno Luis C. Saenz, MD Dr. Diego Rodriguez 300cm wire advanced from lower branch to the upper then back to CS & snared. vein selector replaced with micro catheter. 90cm of wire pulled into pocket with snare while feeding wire into micro catheter. Tip of wire cut and lead advanced “backwards” over wire see BIVTIPS YouTube

CS Atresia+Unroofed CS with patent vein of Marshall case example: youtu.be/EiNwElzDqY8?a via YouTube

What makes right side implants difficult? One factor is your hands work backwards compared to a left side implant. By facing the feet as you implant your hand work the same way as if you were on the left. #ICRT #BIVTIPS #EPeeps Matt McKillop Robert Schaller Edward J Schloss MD Gareth Wynn

recent case where vein selector (VS) is essential for successful LV lead delivery. Phrenic pacing old lead need to add a lead. Tortuous & stenotic from old lead. V-18 control wire very helpful to advance & stabilize VS. A tool everyone should have.Edward J Schloss MD #EPeeps Matt McKillop

dicardiology.com/article/use-in… Seth J Worley MD Salman AlKhalawi

My article “Challenging implants require tools & techniques not tips & tricks” in Cardiac Electrophysiology Clinics Volume 11, Issue 1, March 2019, Pages 75-87i s available open access online. The article includes links to videos o…lnkd.in/eqPVpAv lnkd.in/esxTGCy

Check out the orthogonal pair on A2. Completely different timing and voltage at the same time. #HDGrid

Another case LV lead pulled back now target is occluded. Sleeve tied tight directly to the muscle but then turned to scar. Can't tie directly to the muscle with enough tension to pass tug test without causing necrosis then scar. Tie to the Knot. #EPeeps JMC Robert Schaller

Nice part about the article is that: #1 it is open access. #2 there are linked videos that explain how to do the snare technique, amplatz support wire technique etc. # EPeeps

Just another recent orthodromic snare case in case you thought it was rare.Method covered in EP Clinics sciencedirect.com/science/articl… … also a video for download spaces.hightail.com/receive/wuQXVc… … as well as on YouTube Channel youtube.com/channel/UCmz-I… … #EPeeps #dontdisthehis Lopez Cabanillas Nestor

4 years ago unable to implant LV lead due to target vein tortuosity Worse CHF . What to do? Epicardial lead? STOP-HF? Transeptal LV lead? VAD? With properly shaped vein selector, sub-selector (Merit) & 2 wires the case is not difficult! see next. Edward J Schloss MD Matt McKillop #EPeeps

What to DO? Patient with epicardial LV lead, high outputs to capture, battery change every 3.5 Y, suboptimal placement. The original implant failed due to difficult CS cannulation (wire in but unable to advance to stable CS position) #EPeeps Andrea Russo Matt McKillop #ICRT

Difficult case made easy with Merit tool set. 9-F CS access allowed Amplatz stabilizing wire beside sub-selector. Two wires into target to stabilize VS. Sub-selector then advance over VS deep in target. Easy, controlled reliable lead delivery with these tools. Edward J Schloss MD #EPeeps

Excited for the #ICRT for Fellows course at #HRS2019 on May 7th led by Drs. @matt_mckillop, Seth J Worley MD, Lopez Cabanillas Nestor, and Michael Kaufman! Great opportunity to understand tools and techniques prior to attending LV lead implant sessions. ow.ly/4vYt30oej8x

Interventional CRT programming at HRS is at its all time highest. Should be an outstanding meeting. See the below link. Seth J Worley MD merit.com/interventional…

SVC obstruction. Had to balloon with a compliant 4F coronary balloon first just to get the non-compliant balloon across. Finally got to use the techniques taught Dr Worley and Dr Mckillop. Seth J Worley MD Matt McKillop BIOTRONIK US

Yesterdays Merit course Interventional CRT in Greenville SC with Matt McKillop and @seth_j_Worley 3 cases used snare taught #ICRT on models great learning experience for all. Interested? To register to attend courses on # ICRT use link below merit.com/education/inte… MedStar Cardiac Electrophysiology

Adding micro-catheter (through vein selector) over .014-in wire very helpful. Here is an example where the wire could not be advanced or the vein straightened. Also useful in several other situations. #ICRT #cardiotwitter #EPeeps Narrated youtube.com/channel/UCmz-I… Matt McKillop

Added a mobile cart with all my iCRT inventory. What a great addition to the lab. Saves so much time for our staff.