I wonder how life in EP lab would be without HD Grid!!A case of de novo AF presented in atypical flutter Map # 1 shows multiple loops with CS activation distal to proximal. Flutter # 1 terminated with PVI at the appendage ridge
#Epeeps
#HDgrid
Videos like this make Simple PVIs so much fun. Recurrent incessant PV associated AT and afib in this young lady. Post PVI with isuprel left veins go into afib immediately (noted on Grid) Pt however able to mantain sinus
#EPeeps
#HDgrid
Posterior wall reentry utilizing that small channel shown in the previous tweet as seen on Grid EGM termination of flutter with couple of burns
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Special day at my clinic today. Got a full cardiovascular exam by my 95 y/o “cardiologist” patient of 10 plus years. Took his time with the exam. Great bedside manners
#epeeps
Accurate Visualization of Tactisense and Flex ablation catheters using Ensite X in a bipolar ablation case for for a redo LV summit VT
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@AbbottCardio
“Tale of two Flutters” by U Siddiqui. 68 y/o h/o AF mediated myopathy previous PVI and PWI and ant MI 4 years ago. Now with flutter. Sequence of videos. Flutter no 1 proved to be breaking through a ant MI scar. Terminated with ablation
#Epeeps
#HDgrid
Proud to be reintroducing Tactiflex to the world. Dynamic force evaluation and directionality. First pass isolation 40 mins with HOP on ablation line and no carina lesions necessary. Congratulations Abbott and Advent Health
#epeeps
Excited to see a concept come to fruition. A simple yet unique device designed to stabilize ICE during structural heart and ablation cases. First in human cases performed this week.
#EPeeps
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#Acutus
Whirlwind 2 night trip to SF. Great catching up with friends and mentors esp Dr Davila whose contributions to the field have been tremendous. From AP localization to complex flutters to epi VT abl and more recent work on same day VT discharge Keep it coming Professor
#EPeeps
So proud of Advent hosp EP team. 10 years ago when I started took almost a day to get through an AF case and just today 4 persistent# AFibs and done by 6p... thank you Advent health for your progressive approach and support to advance technology for better pt care
#EPeeps
Ty HD grid, OT and our superb Abbott and Advent support staff. Late night case AT with EF of 20% ( flutter mediated) Pt with previous PVI PWI and eg of reconnected Ant MI line. 2 burn termination. Almost reminds of scar related VT case. Skin to skin 90 mins
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Beauty of Stereotaxis pt with previous aortic root repair and reimplantation of coronaries PVC 1 from underneath left main and PVC 2 from os of RCA Stereotaxis
#RoboticEP
#EPeeps
#AblateVT
Cont to be impressed by performance of HD Grid in mapping of atrial flutters and drivers for AF. 6 cases in 2 days one of them illustrated below: a true epi -endo circuit for a MI dependent flutter in a pt with metallic mitral valve termination with in CS ablation
#Epeeps
In cases of persistent AF electrical gradient identified by HD Grid appears to work consistently. Another example of persistent AF termination and non inducibility. Series of clips attached. Zone 1 with very chaotic activity on Grid
#epeeps
Sequential vs Bipolar Abl for LV summit PVC. Which has better long term outcomes? RMT catheter showing superb stability for this deep PVC successfully ablated from RVOT and LCC sequentially. One can argue that in most cases with good catheter stability BPA can be avoided
#epeeps
For the nonbelievers, including myself... A difficult PAP VT with 3 exit sites ablated with RMT. Extremely thick PAP muscle ablated from all sides with consistent catheter stability. Termination with ablation
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#Stereotaxis
Anterior mitral isthmus flutter ablation in a pt with fresh watchman implant. ICE utilization is so critical for these case. HD grid was able to identify critical isthmus very quickly terminated with 2 burns
#epeeps
#Abbott
Series of pics describing Pitfalls of Entrainment and power of HD mapping. This 60 y/o with 1st
presentation in form of atypical flutter. CS activation suggestive of MI flutter. Decent PPI. No h/o prior LA ablation
#epeeps
# Abbott cardio
It was a pleasure to host Dr Jarred Collins from Manatee memorial at AHC to discuss fluoroless work flow. Icing on the cake was a young girl with Atriofasicular Pathway mapped fluoroless with HD Grid quick identification of AP potentials and complete elimination
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#HDgrid
Fun day at Advent Health Celebration/ Nicholson Ctr . Pleasure hosting our new CEO Amanda Maggard, Abbott CMO Dr Christopher Piorkowski and the all the brains behind “Tactiflex” and Volt” technology
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#Abbott
Wish all persistent AF patients had such obvious electrical gradients. HD grid and OT at their best in this ICM pt with several shocks due to AF. Initial fractionation FR map shows very high FR in encircled areas. Compare this to ant wall in following tweet
#epeeps
#abbottcardio
For all my hardworking peeps. Makes u love what you do in the lab “89 y/o s/p ablation for persistent AF. “ Felt so good in sinus rhythm wanted to do push-ups at the post op visit”
#epeeps
HPSD and Diamond temp in action during a CTI flutter. Drag lesions identified on “Viewflex”. Ablated area appears bright white within a few secs into ablation and clear transition zone between and non ablated area
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Often patients have words of encouragement, this 92 y/o pt of mine with persistent AF s/p ablation 2 years ago enjoying NSR and has actions of encouragement every time he comes for follow up appreciating QOL. Keep at it.
#epeeps
AF works in selective patient population.
This is why we should be utilizing ICE for all ablations especially typical Flutter ex of large RCA sitting at 6 o clock CTI line in an LVAD pt whose fib terminated to typical flutter with ablation
#epeeps
Farewell AF 2023. Kudos to the organizers Drs Moosa, Reddy and Ruskin and their team for bringing life back to AF symposium. Jam packed agenda with great scientific swssions, debates and industry exposure and late breakers
#epeeps
Establishing fluoroless workflow at the beautiful Morton plant hospital with Dr Moondra. Clear water harbor in the background . Thank you Abbott for supporting the program
#Epeeps
@AbbottCardio
Another beautiful grid case ant MI reentry able to identify 0.2 mV EGMs in area of scar critical isthmus for reentry terminated with Less than 15 second of ablation
#EPeeps
When the 12 lead for VT doesn’t make sense? Important lesson learned today In this 5p transfer from outside hospital for VT ablation. ICM s/p ICD shocks
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#Epeeps
where would you ablate this perimitral flutter in this pt with previous PVI & PWI. Entrained both from ant MI and post MI. Mid diastolic in ant MI. More fractionated signals in ant MI versus post MI
#HDgrid
#OT
My new best friend the “360” VR . Several cases recorded of persistent AF for our MAP EP symposium in December. The “Oculus” technology is truly revolutionary and great teaching tool
#epeeps
Yet another example of setting up different Window of interest WOI for an anterior LA flutter. Critical isthmus could not be identified when setting WOI at 50/50. Once critical isthmus identified it only took single lesion to terminate flutter video to follow
#epeeps
#LUMIPOINT
My first experience utilizing Grid to detect antegrade conduction over a right lateral AP in a pt with redo ORT. Grid points out conduction Over the AP. Quick elimination of delta wave with ablation AP potential identified in grid
#Epeeps
Love these single burn PVCs. This one exiting from LCC. Presented in Bigeminy Complete eradication no recurrence post on high doses of Isuprel. RMT catheter is particularly precise and safe in this location. Start to Finish 60 mins with 20 min wait period
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Honor to host Geoff Martha CEO of Medtronic at Advent Health Celebration/ Nicholson ctr. Look forward to future collaborations on Micra AV, EVICD and Diamond Temp technology
#epeeps
HD Grid in action. 52 year old male with extensive cad and non sustained but recurrent AT. Mapped to base of LAA. AOI appeared unusually thick on ICE clean termination with ablation
#hdgrid
#EPeeps
Grid in action!!! Denovo ablation. ICD shocks due to atypical flutter. Beautiful Grid signals indicating Slow conduction area at Ant MI. Termination shown In next tweet
#Epeeps
#hdgrid
Love conducting these Micra courses. Very interactive group. This occasion was special since we got to do the first live Micra AV2 case at Advent Health/ Nicholson Ctr
#adventhealth
# epeeps
First HD Grid case Key points:
Marked difference in bipolar voltage versus HD grid voltage in a pt with persistent AF : Less interpolation : easy to confirm vein isolation
#HDGrid
@AbbottGlobal
Congratulations to Abbott educational team on “closing the gap” in education and taking this concept to the next level. First ever recorded case of per AF presented as “Live” via 360 degree cameras and Oculus lenses. Truly revolutionary. Feedback was phenomenal
#EPeeps
#Abbott
Getting ready for MAP EP 2022 with our “favorite camera” Stellar faculty. Please join us on Nov 10 and 11 at Celebration Florida with live case and hands on mapping / ablation experience at adjacent Nicholson ctr
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Xmas eve spent managing this 55 y/o with Cardiogenic shock on ECMO and impella CVP incessant tachycardia VT morphology mapped out to be right where impella pigtail was trapped in pap. VT non inducible after impella repositioning and bringing flow down to P4
#Epeeps
Day is atypical flutters. They always come in pairs. This one mapped endo MI and epi in CS. Ablation in both areas was needed for termination
#epeeps
#hdgrid
Wrapping up a successful 2nd LV lead training program utilizing perfused cadavers at Nicholson ctr. Thanks to the organizing committee
#epeeps
#biotronikusa
#nshaik14
tough to resist ablating beyond PVI in pts with such “high electrical gradient” white FEGMs on HD grid vs purple organized areas. Several ex of these but in this particular Denovo long standing PeAF. Sequential ablation resulted in termination
#epeeps
Beautiful example of bipolar blindness revealed by HD grid in a pt with previous PVI and posterior box small low voltage acting as critical circuit for a posterior wall reentry no signal on ablation catheter but capture on HOP grid shows low amplitude signals in same area
#Epeeps
Is it reasonable to consider HPSD for AVNRTs and AVRT. Ablation of a SP using Medtronic’s DT system. Immediate junctional beats as 50 degrees achieved. Ablation time 3 seconds. Single insurance lesion with similar outcome
#EPeeps
#medtronic
Fantastic opportunity to come visit our lab and Nicholson training center in sunny Florida 1.5 day program includes lectures from KOLs and hands on training on perfused cadavers / swine models for Amulet implantation and HD grid
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First case of Tactisense in Florida: zero fluoro: SE field scaling improves overall map compared to impedance only map : Definitely enhanced and much improved version of a Tacticath:
“Mercedes has an AMG engine”
Pleasure to host Dr. Kevin Xiang from UF here at AH Celebration to showcase fluoro-less workflow & ICE based ablation. HD Grid in action bi-atrial mapping of this AT flutter in >30 min. Term w/ single burn. ANT MI line completed due to extensive scar
@AbbottCardio
#Epeeps
Modified “Core to border “isolation. 1st abl for LS Per AF. After PVI and PWI Af cont. NC AcQ maps displayed “ core” around AS part of LA. Similar findings on HD Grid map. Core ablation led to non inducibilty despite isuprel and rapid pacing
#epeeps
@AcutusMedical
Curious? HD grid at this particular site indicates rotational activity which spans the whole CL of passive flutter seen on CS EGMs. Would circular catheter at the site give similar information?
#Epeeps
#ablateAF
Stereotaxis and
@AcutusMedical
collaborate🤝on first integrated TeleRobotically-supported 🖥 ablation procedure to treat cardiac arrhythmia at Baptist Health Lexington
@BHLexington
. Read the press release:
#EPeeps
#MedTech
Beauty of HD Grid’ pt with previous cox maze and afib first 2 pics with reconnected PVs and post box isolation Pic 3 with atypical flutter originating from an area of rotational activity anterior to LA appendage ablation there resulted in termination Sparkle map to follow
Twitter Thursday another insane persistent AF would not convert after extensive left sided ablation. Triggers from CS requiring CS isolation and subsequently right atrial wall afib driving left atrial flutter. Non inducible afte me final lesion set
#epeeps
Ended up doing a quick EPS prior to any substrate mapping. Left posterior AP with a massive AP potential. Single burn elimination within a second. ORT induced had LBBB aberrant similar to above EKG. No VT inducible so no substrate mapping done despite scar noted on ICE
#epeeps