Proud of our team and enjoying sunny San Diego! #HRS2025

Fetching a fineline.

Baseline burden, initial acceleration and pleomorphism with EtOH injection, and then complete suppression at 30 mins post injection.

Luckily had 2 septal perforators to target for EtOH ablation. #CARTOUNIVU was helpful for targeting. Double balloon to protect distal subtended myocardium of AIV.

EP Star shows polarity reversal between 2-3 and 3-4. Unipolar EGMS show progressive loss of R wave until QS, then later EGM onset. Let's leave endo lesions up for reference but keep them small. Our SOO just might be somewhere mid-myo.

#EPeeps rewarding case. NICM LVEF 48% w/ mid-wall basal septal stripe on CMR. 18% PVC burden. Consist far-field potential on Bipolar EGM ~20-30ms ahead of surface. Suppresses but recurs following 1/2NS prolonged lesions from LCC and LV endo summit. What next?

Agreed! It seemed that the LOB correlated to where the RV incision during remote repair would be, with potential isthmuses between the incision and the PV and potentially also the TV. Decided to homogenize LOB, extend to PV and to TV. Showed block with omni and diff pacing post.

Nellie….my little medical dogtor!

Took me a while to find it. Here is RV and LV.

This patient with TOF presented with recurrent ICD therapies, but VT is non-inducible in the lab via NIPS and invasive PES. Notice the stark difference between RV paced and LV paced activation maps. Where would you ablate?
#Epeeps

Hello Blue Sky! I think it’s appropriate that my first post reflects my passion in life. Ablation is an incredible tool when used for appropriate indications, and electrophysiologic mapping is a wonderfully engaging topic to dive deep into. I hope to use this platform to spread the joy of #EPeeps