Medical Director, Cardiac Rhythm Device Program, The Christ Hospital, Cincinnati OH. EJSMD@med-mastodon.com. Call me Jay. And my wife is pretty awesome.
Aug 20, 2020 • 20 tweets • 5 min read
How to do a coronary sinus angiogram:
1️⃣Engage the CS in LAO, then confirm and advance the sheath in RAO. I use a MPA2 or AL2 coronary catheter inside CS sheath & find the CS with a long glidewire. If wire glides in w/o ectopy and is posterior in RAO, you're in.
2️⃣So important to advance CS sheath in RAO. This allows you to see if you're off axis. In LAO, sheath may buckle in the RA & you'll never know until sheath falls out when you try to advance. RAO lets you see that & fix it by torquing sheath.
Feb 15, 2020 • 12 tweets • 9 min read
Anyone concerned by this CXR?
(Shared with permission) #EPeeps
My concern — agree w others. Feared ICD lead crossed PFO into LV. This was next day CXR after new implant.
Action— echo
Findings — Lead in RV. All OK. Pt discharged home.