Jeffrey M Vinocur
@jeffreyvinocur.bsky.social
Pediatric/congenital electrophysiologist. Lapsed computer scientist. #ZeroFluoro. Views are my own, and not medical advice.
Reposted by Jeffrey M Vinocur
Remains the #1 missed EKG diagnosis. Which is why it was my very first telemetry tips topic!
youtu.be/BbLYOcgdPb0?...
youtu.be/BbLYOcgdPb0?...
Telemetry Tips - Atrial Flutter, Atrial Tachycardia
YouTube video by Dr. Joshua Cooper - Arrhythmia Education
youtu.be
October 23, 2025 at 2:52 AM
Remains the #1 missed EKG diagnosis. Which is why it was my very first telemetry tips topic!
youtu.be/BbLYOcgdPb0?...
youtu.be/BbLYOcgdPb0?...
Reposted by Jeffrey M Vinocur
Do #EPeeps believe in AVNRT upper common pathway (block)?
This patient had:
1. AH jump
2. Septal VA < 80 ms
3. Concentric A during SVT
4. During RVP: (Stim-A)-(V-A) > 85 ms
5. During RVP: PPI-TCL > 115 ms
6. SVT terminated by RV burst pacing
7. Ablation in TOK rendered non-inducible
This patient had:
1. AH jump
2. Septal VA < 80 ms
3. Concentric A during SVT
4. During RVP: (Stim-A)-(V-A) > 85 ms
5. During RVP: PPI-TCL > 115 ms
6. SVT terminated by RV burst pacing
7. Ablation in TOK rendered non-inducible
October 21, 2025 at 1:43 AM
Do #EPeeps believe in AVNRT upper common pathway (block)?
This patient had:
1. AH jump
2. Septal VA < 80 ms
3. Concentric A during SVT
4. During RVP: (Stim-A)-(V-A) > 85 ms
5. During RVP: PPI-TCL > 115 ms
6. SVT terminated by RV burst pacing
7. Ablation in TOK rendered non-inducible
This patient had:
1. AH jump
2. Septal VA < 80 ms
3. Concentric A during SVT
4. During RVP: (Stim-A)-(V-A) > 85 ms
5. During RVP: PPI-TCL > 115 ms
6. SVT terminated by RV burst pacing
7. Ablation in TOK rendered non-inducible
Reposted by Jeffrey M Vinocur
Arrhythmogenic cardiomyopathy, epicardial access. Pacing from ablator.
@narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @danacjohnson.medsky.social
#EPeeps
@narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @danacjohnson.medsky.social
#EPeeps
October 17, 2025 at 5:09 PM
Arrhythmogenic cardiomyopathy, epicardial access. Pacing from ablator.
@narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @danacjohnson.medsky.social
#EPeeps
@narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @danacjohnson.medsky.social
#EPeeps
Reposted by Jeffrey M Vinocur
2 hearts.
Mom?
Ecg tech?
Mom?
Ecg tech?
September 19, 2025 at 1:03 PM
2 hearts.
Mom?
Ecg tech?
Mom?
Ecg tech?
#EPeeps Very unusual tracings from epicardial pacemaker - mirror noise all well and good, but has anyone seen bipolar go flat like this? Note carefully EGM configuration.
@narrowqrs.bsky.social
@narrowqrs.bsky.social
September 12, 2025 at 2:05 AM
#EPeeps Very unusual tracings from epicardial pacemaker - mirror noise all well and good, but has anyone seen bipolar go flat like this? Note carefully EGM configuration.
@narrowqrs.bsky.social
@narrowqrs.bsky.social
Reposted by Jeffrey M Vinocur
Bilateral arm-leg reversal IMO
August 31, 2025 at 5:56 PM
Bilateral arm-leg reversal IMO
In line at coffee shop and silently cracking up randomly remembering the day somebody put hazelnut beans in the espresso machine
August 26, 2025 at 12:52 PM
In line at coffee shop and silently cracking up randomly remembering the day somebody put hazelnut beans in the espresso machine
August 23, 2025 at 3:32 PM
Reposted by Jeffrey M Vinocur
Click BP tracing to expand.
What do you think the heart rhythm is before and after the transition?
What do you think the heart rhythm is before and after the transition?
August 2, 2025 at 5:45 AM
Click BP tracing to expand.
What do you think the heart rhythm is before and after the transition?
What do you think the heart rhythm is before and after the transition?
#EPeeps My best trick for right anterior/anterolateral pathways is to use SR0, flex catheter until it points straight down, advance sheath to SVC-RA junction, and unflex onto the annulus.
You see the angle achieved in Fig 1…you have to take my word for the stability but often better than IJ access.
You see the angle achieved in Fig 1…you have to take my word for the stability but often better than IJ access.
July 27, 2025 at 9:45 PM
#EPeeps My best trick for right anterior/anterolateral pathways is to use SR0, flex catheter until it points straight down, advance sheath to SVC-RA junction, and unflex onto the annulus.
You see the angle achieved in Fig 1…you have to take my word for the stability but often better than IJ access.
You see the angle achieved in Fig 1…you have to take my word for the stability but often better than IJ access.
#EPeeps I am strangely amused by this. Epicardial pacemaker with failing atrial lead, left in place as VVI backup in case of dislodgement of new transvenous system. "V sensing episode" corresponds to interrogation of new system:
July 27, 2025 at 3:38 PM
#EPeeps I am strangely amused by this. Epicardial pacemaker with failing atrial lead, left in place as VVI backup in case of dislodgement of new transvenous system. "V sensing episode" corresponds to interrogation of new system:
Reposted by Jeffrey M Vinocur
Reposted by Jeffrey M Vinocur
Possibly PVC with retroconduction ➡️ atrial capture failure (or due to atrial refractoriness?➡️ VA conduction ➡️pacemaker syndrome.Are the narrow QRSs paced?
July 13, 2025 at 8:27 PM
Possibly PVC with retroconduction ➡️ atrial capture failure (or due to atrial refractoriness?➡️ VA conduction ➡️pacemaker syndrome.Are the narrow QRSs paced?
July 13, 2025 at 7:43 PM
Reposted by Jeffrey M Vinocur
Patient is s/p cardiac surgery with temporary epicardial wires in place. This pacing behavior was seen back and forth, also correlating with 15-20 mmHg systolic BP changes.
What could be done to prevent this from happening?
@jeffreyvinocur.bsky.social
What could be done to prevent this from happening?
@jeffreyvinocur.bsky.social
July 12, 2025 at 4:23 AM
Patient is s/p cardiac surgery with temporary epicardial wires in place. This pacing behavior was seen back and forth, also correlating with 15-20 mmHg systolic BP changes.
What could be done to prevent this from happening?
@jeffreyvinocur.bsky.social
What could be done to prevent this from happening?
@jeffreyvinocur.bsky.social
Reposted by Jeffrey M Vinocur
Patient admitted with leg injury. No history of syncope. No family history of sudden death. Any concerns?
@jeffreyvinocur.bsky.social
@jeffreyvinocur.bsky.social
July 11, 2025 at 6:02 AM
Patient admitted with leg injury. No history of syncope. No family history of sudden death. Any concerns?
@jeffreyvinocur.bsky.social
@jeffreyvinocur.bsky.social
#EPeeps Always take the opportunity to review the classics #HoltOramSyndrome
June 30, 2025 at 5:33 PM
#EPeeps Always take the opportunity to review the classics #HoltOramSyndrome
Reposted by Jeffrey M Vinocur
Oh my God.
Thank goodness for I(f) in the conduction system.
(And by the way, tug test anyone? 🤦♂️)
Thank goodness for I(f) in the conduction system.
(And by the way, tug test anyone? 🤦♂️)
June 28, 2025 at 3:04 PM
Oh my God.
Thank goodness for I(f) in the conduction system.
(And by the way, tug test anyone? 🤦♂️)
Thank goodness for I(f) in the conduction system.
(And by the way, tug test anyone? 🤦♂️)
June 26, 2025 at 5:51 PM
Reposted by Jeffrey M Vinocur
Isn't PAC a typical trigger of phase 4 block?
June 17, 2025 at 12:16 PM
Isn't PAC a typical trigger of phase 4 block?