Discover and read the best of Twitter Threads about #EPEEPS
Most recents (24)
17 year girl with history of recurrent brief fainting episodes (> 8) preceded by palpitations & "anxiety". Normal vitals + physical exam on arrival at the ED.
Dismissed as panic attacks by multiple doctors, her first ever ECG.
Would you diagnose the same?
#MedTwitter Consent ✅
Dismissed as panic attacks by multiple doctors, her first ever ECG.
Would you diagnose the same?
#MedTwitter Consent ✅
Her ECG shows short PR intervals with slurred upstroke on the QRS complexes: Delta waves - signifying the presence of an accessory pathway which may lead to aberrant conduction & electrical "short circuits"
This is NOT a panic attack.
This is Wolff-Parkinson-White syndrome (WPW).
This is NOT a panic attack.
This is Wolff-Parkinson-White syndrome (WPW).
Pre-conceived anchoring bias and subsequent dismissal in clinical practice of medicine is not just #gaslighting, but also causes harm.
⛽🔥
#FOAMed #meded #CardioTwitter #EPeeps #MedStudentTwitter @EM_RESUS
⛽🔥
#FOAMed #meded #CardioTwitter #EPeeps #MedStudentTwitter @EM_RESUS
#EPeeps #ablatevt Another week another VT. Unstable induction requiring shock and CPR so case relied on functional map. S2 DEEP map shows a much more focused channel for ablation vs. sinus/paced and correlates with ADAS pre imaging. Voltage map pretty futile. See thread for EGMs
Puh, du sollst mal schnell deinen ersten Ajmalin Test machen 🤔
#YoungCardiologists #Epeeps, don't panic, hier sind die wichtigsten key-facts 🔑
@YoungDgk @YoungDZHK @AGEP_DGK @AGIKinterv @sebFeickert @DjawidHashemi @jochen_dutzmann @DavidDuncker @KardiologieHH @realdocdan
#YoungCardiologists #Epeeps, don't panic, hier sind die wichtigsten key-facts 🔑
@YoungDgk @YoungDZHK @AGEP_DGK @AGIKinterv @sebFeickert @DjawidHashemi @jochen_dutzmann @DavidDuncker @KardiologieHH @realdocdan
1/5 - Vorbereitung
- Aufklärung ✅
- 6 h nüchtern ✅
- Monitoring (Reanimationsbereitschaft, Defi) ✅
- 12-Kanal-EKG ✅
- Aufklärung ✅
- 6 h nüchtern ✅
- Monitoring (Reanimationsbereitschaft, Defi) ✅
- 12-Kanal-EKG ✅
2/5 - Durchführung
💉 Intravenöse Injektion von Ajmalin 💉
1 mg/kg Körpergewicht über 10 Minuten unter kontinuierlichem EKG-Monitoring 📺!
💉 Intravenöse Injektion von Ajmalin 💉
1 mg/kg Körpergewicht über 10 Minuten unter kontinuierlichem EKG-Monitoring 📺!
1/ Had a great time writing this @EPLabDigest article with @DrCJBradley
tinyurl.com/mryk3cwe
2️⃣ different perspectives (IC And EP) using different devices (watchman/ amulet) for LAAC in the community center.
Let’s take a dive into two different LAAC programs #Tweetorial
tinyurl.com/mryk3cwe
2️⃣ different perspectives (IC And EP) using different devices (watchman/ amulet) for LAAC in the community center.
Let’s take a dive into two different LAAC programs #Tweetorial
2/ #LAAC has come a long way over the past few years and now we have two main players in the space
🔸 @bostonsci #watchman
🔸 @AbbottNews #Amulet
Both are very effective and each has pros/cons
My center focuses on Watchman FLX while @DrCJBradley center focuses on Amulet… twitter.com/i/web/status/1…
🔸 @bostonsci #watchman
🔸 @AbbottNews #Amulet
Both are very effective and each has pros/cons
My center focuses on Watchman FLX while @DrCJBradley center focuses on Amulet… twitter.com/i/web/status/1…
3/ Historically #EPeeps has taken the driver seat in this space (rightfully so) due to experience with the LA/transeptal. HOWEVER the new gen #IC/structuralist have become a vital part of the team.
#LAAC programs require:
📌Implanter
🔎Imager
🧑🏼⚕️Anesthesiologist/Cath lab team… twitter.com/i/web/status/1…
#LAAC programs require:
📌Implanter
🔎Imager
🧑🏼⚕️Anesthesiologist/Cath lab team… twitter.com/i/web/status/1…
When your ER colleague calls you to have a quick look on an #ecg … the 28 yo pat reports frequent episodes of palpitations since childhood that he can usually terminate with deep breathing. #Epeeps @EPeeps_Bot #CardioTwitter know what’s going on. Do’s and Don’t’s? twitter.com/i/web/status/1…
10 min after giving 2mg/kg body weight Flecainid iv. twitter.com/i/web/status/1…
And 2 hours later
🫀⚡️CTI-Blockade bei rechtsatrialemp #Vorhofflattern war eine meiner ersten eigenen Prozeduren in der EP und bleibt bis heute eine faszinierende Untersuchung.
Doch wie war das nochmal mit dem Flattern und dem CTI - ein kleiner 🧵, nicht nur für #EPeeps
#FOAMed #CardioTwitter
Doch wie war das nochmal mit dem Flattern und dem CTI - ein kleiner 🧵, nicht nur für #EPeeps
#FOAMed #CardioTwitter
Rechtsatriales Vorhofflattern basiert auf einem Makroreentry im rechten Vorhof und rotiert entweder gegen den ⏰ („typisches Vorhofflattern“) oder mit dem ⏰ um den Trikuspidalklappenannulus (TKA).
Der Begriff Makroreentry beschreibt eine kreisende elektrische Aktivierung rund um ein großes Hindernis, den TKA – schön zu erkennen im elektroanatomischen Map ⬆️👆🏻
Fabry's CM is an X-linked inherited deficiency of alpha-galactosidase A which results in systemic sphingolipid accumulation.
Severity of manifestation depends on degree of X-chromosome inactivation => female carriers can have a wide range of phenotypes! doi.org/10.1016/j.jcmg…
Severity of manifestation depends on degree of X-chromosome inactivation => female carriers can have a wide range of phenotypes! doi.org/10.1016/j.jcmg…
This 67 yo pt presented with severe HCM phenocopy and strong family history of confirmed Anderson-Fabry's CM. She was determined to have a GLA mutation and successfully started on treatment with Fabrazyme.
Note the diffuse asymmetric LVH (wall thickness 24mm) with marked apical hypertrophy (30mm). Despite normal LVEF, her GLS was markedly reduced at -5.8%. CMR demonstrated 20% LGE and short T1 time (indicative of fat accumulation)
From the archives/sent by a friend series
What is the dx
Digitized using #PMcardioApp
Difficulty level:⭐️⭐️⭐️
*65 yo
*h/o HTN
*pw with fatigue
What is your ECG interpretation? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What is the dx
Digitized using #PMcardioApp
Difficulty level:⭐️⭐️⭐️
*65 yo
*h/o HTN
*pw with fatigue
What is your ECG interpretation? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What is your ECG interpretation?
🐦 ur reply if none of the 4 choices
SB-sinus bradycardia
CHB-complete heart block
SR-sinus rhythm
2AVB-second degree AV block
AHB-advance heart block
🐦 ur reply if none of the 4 choices
SB-sinus bradycardia
CHB-complete heart block
SR-sinus rhythm
2AVB-second degree AV block
AHB-advance heart block
From the 📦/📩 by a🫂series @PatSmitty1985
What is the dx
💻 using #PMcardioApp
Difficulty level:⭐️⭐️⭐
▪️16 yo
▪️ -sig ⚕️ hx
▪️p/w sz-like activity/spon recovery ~ 30 s (can't recall event)
What is the prob dx? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What is the dx
💻 using #PMcardioApp
Difficulty level:⭐️⭐️⭐
▪️16 yo
▪️ -sig ⚕️ hx
▪️p/w sz-like activity/spon recovery ~ 30 s (can't recall event)
What is the prob dx? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What is the prob dx?
🐦 ur reply if none of the 4 choices
MI-myocardial infarction
SR-sinus rhythm
AJR-accelerated junctional rhythm
isoAVD-isorhythmic AV dissociation
WPW-Wolff-Parkinson-White
MI inferior wall
SR, AJR (isoAVD)
Pulmonary embolism
WPW pattern/syndrome
🐦 ur reply if none of the 4 choices
MI-myocardial infarction
SR-sinus rhythm
AJR-accelerated junctional rhythm
isoAVD-isorhythmic AV dissociation
WPW-Wolff-Parkinson-White
MI inferior wall
SR, AJR (isoAVD)
Pulmonary embolism
WPW pattern/syndrome
Tnx for the replies. I think this is the easiest so far & almost everyone got it. Pt was referred to cards coz of WPW. 📩@PatSmitty1985
From the archives/sent by a friend series
What is the rhythm
Digitized using #PMcardioApp
Difficulty level:⭐️⭐️⭐️⭐️
▪️70 yo
▪️h/o DM HTN HF
▪️p/w palpitations
What do you think is the rhythm? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What is the rhythm
Digitized using #PMcardioApp
Difficulty level:⭐️⭐️⭐️⭐️
▪️70 yo
▪️h/o DM HTN HF
▪️p/w palpitations
What do you think is the rhythm? Poll next
#FOAMed
#MedEd
#MedTwitter
#CardioTwitter
#EPeeps
What do you think is the rhythm?
🐦 ur reply if none of the 4 choices
AF-atrial fibrillation
ST-sinus tachycardia
VT-ventricular tachycardia
AFL/AT-atrial flutter/ atrial tachycardia
🐦 ur reply if none of the 4 choices
AF-atrial fibrillation
ST-sinus tachycardia
VT-ventricular tachycardia
AFL/AT-atrial flutter/ atrial tachycardia
This is the ff-up ECG. This is not SR. The 🔑 to rhythm dx is in the PRI (long lead). You need a caliper to 👀 the PR difference. If you have 🦅👀 the extra P can be 👀. So, the ECG case can be explained with 1 reason.
Great experience in my trip to Argentine.The audience was excited. We performed a live CNA case During my visit. Lots of questions arose during the case and my lectures. Here are some misunderstood tips in #Cardioneuroablation🚨Tweetorial alert. @drraviele @CarlChiefCard
1/10 Atropine blocks the effect of the vagus, by blocking muscarinic receptors, we can use it to predict the outcome of #Cardioneuroablation doi.org/10.1016/j.hrth…. @natale_md @mdTolgaAksu @Josefkautzner @piotrowskiroman @pachon_phd @scanav1mauricio @alfieep
Working with @seth_j_worley to create a reproducible, technically "easier" and systematic approach to #VeinofMarshall ethanol ablation for #EPeeps. Advance Preface sheath over CS decapolar catheter and then advance Amplatz Super Stiff to retain wire access.
Use the @MeritMedical Worley Coronary Sinus Guide Jumbo 50 cm size. The 9 Fr inner diameter is key to provide room to easily manipulate balloons, wires, inner guide catheters, etc. #VeinofMarshall is easily identified with RAO 20° cine projection.
The 5 Fr CS Vertebral shape vein selector easily advances through the 9 Fr @seth_j_worley Jumbo sheath to cannulate the #VeinofMarshall with a Boston Choice PT Floppy guidewire.
#EPeeps Brief 🧵 on beta blocker hyperkalemia which is unfamiliar to many
The mechanism is the opposite of why we use albuterol to treat hyperkalemia - beta receptor modulation of Na K ATPase, the sodium potassium exchange channel [1/]
See great diagram from @paulpengmdphd
The mechanism is the opposite of why we use albuterol to treat hyperkalemia - beta receptor modulation of Na K ATPase, the sodium potassium exchange channel [1/]
See great diagram from @paulpengmdphd
Beta blockers rarely cause hyperkalemia in isolation, but can contribute in at-risk patients.
The patient who prompted this discussion (see link) had complex multi-system illness. Ectopy was exacerbated by diuretic-induced hypoK so had MRA + scheduled enteral KCl [2/]
The patient who prompted this discussion (see link) had complex multi-system illness. Ectopy was exacerbated by diuretic-induced hypoK so had MRA + scheduled enteral KCl [2/]
One day, because of hypoK on labs, he received IV KCl replacement almost concurrent with scheduled enteral KCl… probably would not have been a big deal, except for propranolol impairing ability to transport extracellular K intracellular [3/]
#EPeeps #FellowsFirst The cardiac ICU calls that they are preparing to cardiovert this wide-complex tachycardia. Do you agree? What may be going on?
#EPeeps Many suggested sodium channel blockade or hyperkalemia
This was BOTH! Severe transient hyperkalemia superimposed on high-dose flecainide
Very complex infant on multiple AADs including high-dose propranolol for intractable EAT
Do you know why the propranolol matters? 👇
This was BOTH! Severe transient hyperkalemia superimposed on high-dose flecainide
Very complex infant on multiple AADs including high-dose propranolol for intractable EAT
Do you know why the propranolol matters? 👇
See separate thread on hyperkalemia and beta blockers for the conclusion
🧵 on the Algorithmic Localisation of Accessory Pathways from ECG
A concept I’m getting to grips with made easier by a beautiful review by #Crinion & @adribaran in Card Electrophysiol Clinic (PMID 33161996)
#EPeeps #MedEd #Cardiology
A concept I’m getting to grips with made easier by a beautiful review by #Crinion & @adribaran in Card Electrophysiol Clinic (PMID 33161996)
#EPeeps #MedEd #Cardiology
🫀Considerations of AP localising algorithms:
A. Only apply to manifest antegrade AP & not concealed AP which conduct retrograde
B. Algorithms focused on atrioventricular AP & not other rarer AP
C. Depend on the degree of preexcitation with
D. Cautions with multiple APs
A. Only apply to manifest antegrade AP & not concealed AP which conduct retrograde
B. Algorithms focused on atrioventricular AP & not other rarer AP
C. Depend on the degree of preexcitation with
D. Cautions with multiple APs
🩻 Anatomic Nomenclature
- AP locations is described in the LAO view
- Older algorithms use anatomical descriptions derived from the Valentine heart position & not attitudinally correct nomenclature which can be confusing
- AP locations is described in the LAO view
- Older algorithms use anatomical descriptions derived from the Valentine heart position & not attitudinally correct nomenclature which can be confusing
Dx? Culprit?
@MaruanCarlos @The_Nanashi_O @doctor_roig @ShariqShamimMD @UlhasDr @DidlakeDW @ecgrhythms @syamkumarmd @kkananura @DrRajeshG1 @DocNikko @AslangerE @PPodrid @Vadeboncoeur_Al @EF_Cardiaca @smithECGBlog @EM_RESUS @EMS12Lead @DruvBhagavan #EPeeps #MedEd #PMCardio
@MaruanCarlos @The_Nanashi_O @doctor_roig @ShariqShamimMD @UlhasDr @DidlakeDW @ecgrhythms @syamkumarmd @kkananura @DrRajeshG1 @DocNikko @AslangerE @PPodrid @Vadeboncoeur_Al @EF_Cardiaca @smithECGBlog @EM_RESUS @EMS12Lead @DruvBhagavan #EPeeps #MedEd #PMCardio
@MaruanCarlos @The_Nanashi_O @doctor_roig @ShariqShamimMD @UlhasDr @DidlakeDW @ecgrhythms @syamkumarmd @kkananura @DrRajeshG1 @DocNikko @AslangerE @PPodrid @Vadeboncoeur_Al @EF_Cardiaca @smithECGBlog @EM_RESUS @EMS12Lead @DruvBhagavan Dx: Anterior+ Inferolateral AMI ♦️10
Culprit answer was in V3 postulated by having Tombstone which usually comes with LAD+ RCA or LCX (transmural injury due to limited collateral flow)
ICA (IRA/Culprit): mLAD Occlusion+ dLCX severe stenosis
Post-PCI ECG 👇🏻+ Tombstone criteria
Culprit answer was in V3 postulated by having Tombstone which usually comes with LAD+ RCA or LCX (transmural injury due to limited collateral flow)
ICA (IRA/Culprit): mLAD Occlusion+ dLCX severe stenosis
Post-PCI ECG 👇🏻+ Tombstone criteria
@MaruanCarlos @The_Nanashi_O @doctor_roig @ShariqShamimMD @UlhasDr @DidlakeDW @ecgrhythms @syamkumarmd @kkananura @DrRajeshG1 @DocNikko @AslangerE @PPodrid @Vadeboncoeur_Al @EF_Cardiaca @smithECGBlog @EM_RESUS @EMS12Lead @DruvBhagavan For other relative case (Anterior+Inferiolateral AMI) 👇🏻
#AFib is the most common sustained heart rhythm problem in the world. 🌎
#AFib increases the risk of #stroke & #heartfailure. It causes symptoms like fatigue, dizziness & shortness of breath and can reduce patients’ quality of life.
#ESCCongress
Let's get straight to the point about #INVICTUS
The only people not surprised by the results are imagers that do TOEs (TEEs) on these patients! No way VKA was going to lose to NOACs here!😂
A 🧵...
#medtwitter #cardiotwitter #echofirst #epeeps
Let's get straight to the point about #INVICTUS
The only people not surprised by the results are imagers that do TOEs (TEEs) on these patients! No way VKA was going to lose to NOACs here!😂
A 🧵...
#medtwitter #cardiotwitter #echofirst #epeeps
#ESCCongress
Patients with rheumatic MV disease typically have very different atrial appearances on TOE. No matter how well anticoagulated, there is very often spontaneous echo contrast in the LA
These atria are just different...why?
Who is this?
Patients with rheumatic MV disease typically have very different atrial appearances on TOE. No matter how well anticoagulated, there is very often spontaneous echo contrast in the LA
These atria are just different...why?
Who is this?
The answer is Ludwig Aschoff (1866 - 1942), German physician & pathologist
He described what are now known as Aschoff bodies - inflammatory infiltrates in the atrial walls that eventually turn to fibrotic tissue, which contributes to the atrial myopathy we see in these patients
He described what are now known as Aschoff bodies - inflammatory infiltrates in the atrial walls that eventually turn to fibrotic tissue, which contributes to the atrial myopathy we see in these patients
🧵 1/7 Ever wondered why the Osborn wave looks the way it does? Stay with me during my newest #tweetorial. A thread 🧵1/7
#cardiotwitter #EPeeps #CardioEd #MedTwitter @TRassafMD @YoungDgk @DGK_org @YoungDZHK @AaronGoodman33 @Steph_Achenbach @fuzzymittens @AvrahamCooperMD
#cardiotwitter #EPeeps #CardioEd #MedTwitter @TRassafMD @YoungDgk @DGK_org @YoungDZHK @AaronGoodman33 @Steph_Achenbach @fuzzymittens @AvrahamCooperMD
2/7 History
First described in 1953 by Osborn (camel-hump sign) upon #hypothermia in dogs. Upon systemic analysis similar #ECG patterns have been described in
➡️ hypercalcemia
➡️ brain injury
➡️ SAB
➡️ vasospastic angina / ischemia
First described in 1953 by Osborn (camel-hump sign) upon #hypothermia in dogs. Upon systemic analysis similar #ECG patterns have been described in
➡️ hypercalcemia
➡️ brain injury
➡️ SAB
➡️ vasospastic angina / ischemia
3/7 Emslie-Smith et al showed that Osborn waves manifested more in epicardial than endocardial leads. Others finally showed that 4-aminopyridine sensitive transient outward current (Ito) is responsible and predominantly located in epicardium. ⬇️ heart rate led to ⬆️ Ito current
🧵What does the left atrial appendage do? Is it just a nidus for thrombus?
A brief review of proposed & proven functions of the LAA👇
#CardioTwitter #EPeeps #MedEd
@drpaulfriedman @ChetRihal
A brief review of proposed & proven functions of the LAA👇
#CardioTwitter #EPeeps #MedEd
@drpaulfriedman @ChetRihal
#1 LAA plays a very important capacitance role.
Animal studies in 1990s showed:
- LAA is more compliant than LA
- LAA acts like a decompression chamber during systole
- The capacitance/reservoir role is key when LAP is elevated
- Eliminating LAA acutely ⬆️ LA pressure in dogs
Animal studies in 1990s showed:
- LAA is more compliant than LA
- LAA acts like a decompression chamber during systole
- The capacitance/reservoir role is key when LAP is elevated
- Eliminating LAA acutely ⬆️ LA pressure in dogs
- Effect of LAAO on hemodynamics in humans is debatable
- OBS data ➡️ that LAAO ⬆️ LAP, ⬇️ LA transport function, ⬆️ HF
- However, in LAAOS III RCT there was no ⬆️ in HF admissions w LAAO
- Caveat: epicardial closure vs ednocadail plugging of LAA don’t produce similar effects
- OBS data ➡️ that LAAO ⬆️ LAP, ⬇️ LA transport function, ⬆️ HF
- However, in LAAOS III RCT there was no ⬆️ in HF admissions w LAAO
- Caveat: epicardial closure vs ednocadail plugging of LAA don’t produce similar effects
Another interesting "Bigemini" pattern 😀. #EPeeps #Cardiologytrainees. Try explaining the mechanism and diagnosis? @EPeeps_Bot
Is this true bigemini or "pseudo bigemini"? Reason?
The purpose of this post was to highlight a "measurement error". When we measure the RR intervals in wide complexes, always do from the beginnings of the R waves, not the peak. here delay in the later part of the QRS is causing an illusion of a later QRS, but RR is constant.
1/ A tweetorial- Watchman Left Atrial Appendage Occlusion!
#LAAO #Watchman #StructuralHeartDisease #EPeeps #interventionalcardiology @EPeeps_Bot @RadialFirstBot @EchofirstB @BotPci @TAVRBot
#LAAO #Watchman #StructuralHeartDisease #EPeeps #interventionalcardiology @EPeeps_Bot @RadialFirstBot @EchofirstB @BotPci @TAVRBot
2/ what is the left atrial appendage?
The LAA is derived from the left wall of the primary atrium (embryo). Its diff from the true LA and its suited to function as a decompression chamber during left ventricular systole and during other periods when left atrial pressure is high
The LAA is derived from the left wall of the primary atrium (embryo). Its diff from the true LA and its suited to function as a decompression chamber during left ventricular systole and during other periods when left atrial pressure is high
3/ the appendage is like your fingerprint. No two are the same.
Common shapes are:
🥦Cauliflower/Broccoli (hardest)
💨Windsock (easiest)
🐓Chicken wing
🌵Cactus
#LAAO #Watchman #Structural #Cardiotwitter #EPeeps @EPeeps_Bot @TAVRBot @RadialFirstBot @EchofirstB
Common shapes are:
🥦Cauliflower/Broccoli (hardest)
💨Windsock (easiest)
🐓Chicken wing
🌵Cactus
#LAAO #Watchman #Structural #Cardiotwitter #EPeeps @EPeeps_Bot @TAVRBot @RadialFirstBot @EchofirstB
Is sex a critical factor for treating #AtrialFibrillation?❤️🩹
New #CardiovascularResearch study examines #SexDifferences in calcium handling & therapies in patients with #AFib
academic.oup.com/cardiovascres/…
Our tweetorial explains the findings⬇️👩🏫
@ESC_Journals @escardio #EPeeps (1/9)
New #CardiovascularResearch study examines #SexDifferences in calcium handling & therapies in patients with #AFib
academic.oup.com/cardiovascres/…
Our tweetorial explains the findings⬇️👩🏫
@ESC_Journals @escardio #EPeeps (1/9)
#Atrial #myocytes were isolated from patients with & without #AtrialFibrillation
Sex differences in #risk factors & therapies were considered in the analysis (2/9)
Sex differences in #risk factors & therapies were considered in the analysis (2/9)
To explore #SexDifferences in the mechanisms of #Afib, calcium handling was examined & calcium handling proteins investigated (3/9)
Tweetorial 1/7
#EPeeps PVs are not only Afib and not only in adults❗️ Here’s the case of LIPV tachy in 13 yo girl.
Lumipoint map with @BSCCardiology and @lydia_merbold #EP_Kiel #cardiotwitter @evgeny_lyan @ThomasDemming
#EPeeps PVs are not only Afib and not only in adults❗️ Here’s the case of LIPV tachy in 13 yo girl.
Lumipoint map with @BSCCardiology and @lydia_merbold #EP_Kiel #cardiotwitter @evgeny_lyan @ThomasDemming
2/7
13yo girl, hospital admission with palpitations. 24-h ECG Monitoring reveals episodes of tachycardia with on-off phenomen and HR up to 120 bpm.
Next Step➡️EP diagnostic
13yo girl, hospital admission with palpitations. 24-h ECG Monitoring reveals episodes of tachycardia with on-off phenomen and HR up to 120 bpm.
Next Step➡️EP diagnostic
3/7
EP study reveals 2 tachys : AT1 with CL 590ms, AT2 with CL 380ms. Note the same CS activation sequence.
Next Step➡️RA mapping
EP study reveals 2 tachys : AT1 with CL 590ms, AT2 with CL 380ms. Note the same CS activation sequence.
Next Step➡️RA mapping
