Alex Turin

Does this help?

SVT or VT? More to come...

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I'm always amazed that AF can sustain through that. So much we still don't understand.

We didn't find anything abnormal the day of, but here's the strip on 1 week f/u!

Agreed. The cross-sectional design limits it a little but still very interesting results considering PVC burden is a very consistent predictor of low EF in prior studies. Would the EF decline over time if these patients were followed/untreated?

The alternative is this is actually T wave oversensing triggering a PVC response with extended PVARP

I think MVP shenanigans is right. There were more tele strips with Wenckebach during MVP that were more obvious. I suspect two QRS morphologies is fusion but I'm not sure why MVP didn't switch to DDD.

POD1 s/p DC-LBB-PPM for intermittent CHB, underlying RBBB. RA/RV lead sensing, impedance, and thresholds all normal/stable from implant. Whats going on here? #Epeeps @willyhfrick.bsky.social @danacjohnson.medsky.social @narrowqrs.bsky.social @jeffreyvinocur.bsky.social @rachelkaplanmd.bsky.social

Nice! Underlying SND (rates in the 30s) with 99% atrial pacing. Device check showed RV impedance >3000 and no capture at max output. Atrial function was normal. Here's what was causing the pauses:

What are the possibilities for what is going on here? Device check to follow 😁
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Patient with HCM and secondary prevention DC-ICD presented with sudden onset of frequent short episodes of dizziness. Tracing obtained in the ED shown below. She had been doing light arm exercises immediately prior. Original DC-PPM placed 2005. Upgrade to ICD in 2020 with abandoned pace-sense lead

Nice diagram! My hand drawn hearts definitely don't look like that 😬

A classic! #Epeeps

100%. Walked into my office Monday with a stack of 3 or 4 to start off the week

Nothing unusual on CT but good thought.

Anyone seen this de novo scar pattern before? #Epeeps @danacjohnson.bsky.social @narrowqrs.bsky.social @jeffreyvinocur.bsky.social @rachelkaplanmd.bsky.social @amrish.bsky.social

Post PVI showed line of block without additional ablation (LAT and widely split doubles with distal CS pacing shown). High output pacing within the scar did not capture the atrium. Essentially a spontaneous floor line. No AF or AFL were induced at the end of the procedure.

55yo M with PAF and typical AFL, no prior cardiac surgery or procedures. Normal LA voltage in sinus except for this strange pattern on the inferior posterior wall.

Echo images are also a nice reminder of how close these come to the RV pap muscles/chordae. Good case!

Would look at uni pacing morphology compared to implant. Uni impedance changes may be helpful too. CT may be helpful but sometimes hard to see the tip with artifact.

LBB lead that perforated? Don't see the tip but suggestive.

I haven't been using PFA for these patients. Still doing dispersion approach which has had variable results for patients this far along

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Inaugural Bluesky post! Thought this was a neat one

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