Thread by @jeffrey_vinocur

#HRS2023 #2023PaceSetter
Ed Walsh and Greg Webster debating about the best operator for ablation of a 40-year-old Fontan patient

Ed starts out reminding us of the “grease pencil” era

And concludes thinking that it is time to pass the torch

Greg now up! Starts laying out some of the challenges and the massive degree of dilation *and* hypertrophy of the Fontan atrium

Some of the downsides of ablation in an adult center

Provocative observation that adult Fontan patients have substantial complication rate after non-cardiac procedures (often much shorter and less hemodynamically stressful than EPS) that need a complex team during and after

And then concluding in favor of a shared model that brings the key elements to wherever they best serve the patient