⚡️Para-Hisian pacing ⚡️EXPERTLY explained by our senior fellow Natasha Vedage Natasha Vedage, MD MSCE 👏🏽

#TempleMade 🏥 Temple Cardiology Fellowship & Temple IM Residency

AHAMeetings #AHA23

“It’s the Journey, Not the Destination”

Thank you to our dedicated EP mentors Ziggy Whitman JMC William Perucki, MD Anuj Basil

Please enjoy our case report on a patient referred for pacemaker pocket infection who had something very different!

heartrhythmcasereports.com/article/S2214-…

William Perucki, MD Shreya Makkapati M.D David Laslett

Wordle 472 1/6*

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No one believes me. Pure luck (and maybe some influence from a nursery rhyme)

Pt weak, lightheaded, 911 called.
▪️First EKG is from EMS, performing transcutaneous pacing.
▪️Second EKG is in ER.
What's going on?

These #echofirst pictures are less than 48 hours apart showing the effect of #atrialstunning in a patient with spontaneous conversion from #afib to #sinusrhythm and paused anticoagulation due to gastrointestinal bleeding. #epeeps #cardioed Erik Rafflenbeul

Classic real-time annotation by JMC as Anuj Basil discusses #HOTB . First didactic session of the year for our new and proud EP fellow, Juergen Kloo #startwiththebasics #colorannotationhelps #TempleEP Temple Cardiology Fellowship

Management of premature ventricular complexes

heart.bmj.com/content/108/7/…

Not what we expected!

Selective His pacing with VA time ~160ms, non-selective ParaHisian pacing with VA time ~120ms.

Instead of equal VA time during ParaHisian pacing, a paradoxical difference in VA time revealed the presence of an AP! Ziggy Whitman Anuj Basil JMC

How to implant a Micra during a national contrast shortage, or in a patient with a severe contrast allergy? ICE has been described, but TTE is cheap, non-invasive and helpful to confirm septal position.
William Perucki, MD
#EPeeps

Those who claim that nothing can be done just prove they don’t have the creativity or empathy to lead.

This case report describes a patient in Sweden who had an out-of-hospital cardiac arrest and received defibrillation with an automated external defibrillator delivered by a drone (shown in a video). nej.md/3sDQhni

The result of a robust journal club discussion with the Temple EP team! Ziggy Whitman Edmond Cronin Jeff Smietana jacc.org/doi/10.1016/j.…

A submuscular CIED pocket can/should be bloodless, and is gratifying - for patients and implantor (and fellow!) alike. Should we be doing this more often, even as a standard consideration? JMC Robert Schaller Byron Lee Joshua Moss MD Jag Singh William Perucki, MD

A truly great device case. I have so many images, I almost don't know where to begin to share. Still many images to scan in, but here's a good start.
Pt. admitted with palps. Dual chamber pacer in place, with a cardiac history.
What is going on? (yes symptoms during fast pacing)

#APAF -CRT trial: ablation plus #CRT is superior to pharmacological rate control in reducing mortality in severely symptomatic permanent #AFib patients with a narrow QRS

#ESCCongress

#LOOP Study: continuous heart rhythm monitoring – with anticoagulation if #AFib is detected – does not prevent #strokes in those at risk

#ESCCongress

Great weekend full of learning at the Abbott Cardiovascular EP 301 fellows course in the Windy City (with time for a quick run).

First time feeling the satisfaction of a successful CTI line!

Compare and contrast.
2 patients. Called for bradycardia on each.
One was shown yesterday (pt 1), other is a good comparator. What do you think?
Emily Murtagh Arnel Carmona Adrian Baranchuk MD FACC FRCPC FCCS FSIAC Jeffrey M Vinocur Maruan C Chabbar Sergio Pinski