Jacob Koruth @jskoruth Twitter profile

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@RepulsiveMaid

Jacob Koruth

@jskoruth

2 years

#epeeps . Started doing this a few weeks ago because I hated having to shove leads in to the pouch - make a small slit at the bottom -pass leads thru and then attach generator- find everything sits better this way. Also if you like it Venmo me 1000wRVU

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Jacob Koruth

@jskoruth

3 years

Had to keep my boy with me yesterday afternoon- during clinic he kept busy drawing portraits (including some patients). and finally fell asleep standing. 😩….. He was so happy to spend the day with daddy in his doctor suit at the doctor place 🤣

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Jacob Koruth

@jskoruth

3 years

Lying on the couch with my boys. Exciting Lbb and epicardial late potentials and bidirectional block- All will come and go. While important - relationships will always outlast all -

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Jacob Koruth

@jskoruth

2 years

Electrophysiology, Pathology, and Imaging of Pulsed Field Ablation of Scarred and Healthy Ventricles in Swine- authored by our super fellow @iwanari65284818 -- out in Circ EP

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Jacob Koruth

@jskoruth

2 years

A single image of viable Purkinje fibres (PjF), despite the ablation of adjacent cardiomyocytes as evidenced by fibrosis surrounding the PjF (Panel). The sparing of PjF seen, in this study may suggest a lower susceptibility than cardiomyocytes and requires further confirmation

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Jacob Koruth

@jskoruth

5 years

FIRSSSSST. degree av block

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Jacob Koruth

@jskoruth

5 years

From pre-clinical lab to the first case. My happiest moment in EP ever !! Reversible electroporation is a new tool for us to use. !!!

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Jacob Koruth

@jskoruth

4 years

Pulsed Field Ablation in Patients With Persistent Atrial Fibrillation . Another step towards addressing afib....

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Jacob Koruth

@jskoruth

7 months

Parox AF Pre - PFA: reasonable to do CTI after PVI Post -PFA : There is good data to support not doing CTI after PVI Persistent AF Pre- PFA: PVI not enough & Postwall for all doesnt seem useful: but Mitral line/ VOM is useful Post-PFA: PVI and post wall for all!!!

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Jacob Koruth

@jskoruth

6 years

So it finally happened to me. Classic LBBB for BIV. 38 mins of fluoroscopy and no LV lead. Switched to his. In 1 min fixes with complete correction with selective capture. - then dislodged and after another miserable 15 mins - got it!! Next time I’ll switch earlier

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Jacob Koruth

@jskoruth

4 years

⁦⁦ @farapulse ⁩ team : setting up for first case PFA. From experimental lab to patients. Hats off to the founders , engineers and the team. Neat !!

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Jacob Koruth

@jskoruth

4 years

RF #1 for persistent AF case

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Jacob Koruth

@jskoruth

1 year

Reversible Pulsed Electrical Fields as an In Vivo Tool to Study Cardiac Electrophysiology: The Advent of Pulsed Field Mapping | Circulation: Arrhythmia and Electrophysiology

Reversible Pulsed Electrical Fields as an In Vivo Tool to Study Cardiac Electrophysiology: The...

BACKGROUND: During electrophysiological mapping of tachycardias, putative target sites are often only truly confirmed to be vital after observing the effect of ablation. This lack of mapping specif...

www.ahajournals.org

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Jacob Koruth

@jskoruth

6 years

S/p extraction. Pt decides to cut the annoying lead that was sticking out of pocket - luckily he cut the atrial lead (PPM @dependent !!!!)

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Jacob Koruth

@jskoruth

5 years

It’s happened. 100% durable PVI. !!! So exciting

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Jacob Koruth

@jskoruth

2 years

Pulsed Field Ablation of the Porcine Ventricle Using a Focal Lattice-Tip Catheter . Our new paper on PFA. Thanks to fantastic collaboration @iwanari65284818 @SantosGallegoMD @bingyanw @Hinaheartdoc @VivekReddyMD

Pulsed Field Ablation of the Porcine Ventricle Using a Focal Lattice-Tip Catheter | Circulation:...

Background: Our understanding of catheter-based pulsed field ablation (PFA) of the ventricular myocardium is limited. We conducted a series of exploratory evaluations of ventricular PFA in swine...

www.ahajournals.org

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Jacob Koruth

@jskoruth

2 years

Coronary spasm and changes in arterial wall after epicardial and endocardial PFA- these are important observations and their clinical relevance during PFA procedures are soon to be described as well. Congrats to @iwanari65284818 and thx to @VivekReddyMD

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Jacob Koruth

@jskoruth

1 year

ECG Characteristics of ‘True’ Left Bundle Branch Block: Insights from Transcatheter Aortic Valve-related LBBB and His-Purkinje Conduction System Pacing Correctable LBBB - Heart Rhythm A review of LBBB EKG features in the post TAVR and CSP correctable LBBB

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Jacob Koruth

@jskoruth

3 years

Sinus rhythm 😳

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Jacob Koruth

@jskoruth

3 years

6 pm…. Just a quick PVI man. In and out

Massimo

@Rainmaker1973

3 years

This is a 200 kilogram preserved blue whale heart [source, read more: ]

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Jacob Koruth

@jskoruth

3 years

Some days during a long difficult case when you are on Remap #5 - I can’t thank our mappers enough. Tough to do what I do today without them.

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Jacob Koruth

@jskoruth

3 years

Excited to see our preclinical report discussing LBB lead perforation in JACC-EP - by @iwanari65284818 - - gross appearance of what perforation looks like- note RV appearance is likely exacerbated by the use of swine model chosen and unlikely to be seen clinically.

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Jacob Koruth

@jskoruth

6 years

Cardioinsight localized this swallowing induced atrial tachycardia from near the LSPV - confirmed with activation mapping

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Jacob Koruth

@jskoruth

5 years

Helped out a colleague with failed LV. Correction at .5 @1 . Gosh I can’t stop looking at this result. And I got lucky in that this was the first position I took.

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Jacob Koruth

@jskoruth

2 years

Probably the single best piece of equipment (cautery pen - extendable blade / proximal protection/ inbuilt light ) that’s made my device procedure more pleasurable… #EPeeps

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Jacob Koruth

@jskoruth

6 years

Email today from one of my AF ablation patients early in my career -“ Don't know how close you keep tabs on your patients after a cardiac catheter ablation but I just completed my 8th year with no problems and feeling great.” We can and do get rid of AF for good in some

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Jacob Koruth

@jskoruth

2 years

During catheter mapping of scarred ventricles, creation of the electroanatomical map is often frustrated by catheter-induced ventricular ectopy. We have observed anecdotally that catheter-induced ventricular ectopy can often unmask LAVA

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Jacob Koruth

@jskoruth

3 years

Trigger mapping - redo Afib. Wish all my trigger mapping cases were this nice- and that I could actually elicit triggers !!

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Jacob Koruth

@jskoruth

6 years

Ok. So I used the new visigo sheath to help with voltage guided biopsy.

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Jacob Koruth

@jskoruth

2 years

Happy thankssquishycheeksgiving. (Pic from 4 yrs ago but one of my favorites)

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Jacob Koruth

@jskoruth

8 months

His bundle pacing is not easy for me and also for my kiddo🤣

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Jacob Koruth

@jskoruth

3 years

B/L BB pacing. On the left is RB pacing. On the right of the rhythm strip is LB pacing - middle is LB+RB pacing. - inspired by @Hisdoc1 casereport

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Jacob Koruth

@jskoruth

4 years

Post heart transplant CTI flutter - note diff rhythm marching through in recipient chamber where the grid is sitting. As always mapping with @MGadaleta is fun

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Jacob Koruth

@jskoruth

5 years

Nothing like stepping on the cold stone floor with my bare feet. Home for a few days : Kerala !!

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Jacob Koruth

@jskoruth

2 years

ICD lead extraction Tip #4 . Ask for help

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Jacob Koruth

@jskoruth

5 years

Grid in LSPV. Ablation in RSPV. Everything else in sinus. Don’t see these ultra active PVs that much anymore

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Jacob Koruth

@jskoruth

6 years

Gettin griddy with it #HDGrid

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Jacob Koruth

@jskoruth

3 years

Youngish Patient with av block and wide RBB escape. S/p LB pacing. Was difficult to get to the right spot. But when I see this EKG the next day. The extra time on Friday night makes sense. Thank you ⁦ @MdHuang ⁩ ⁦ @Hisdoc1 ⁩

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Jacob Koruth

@jskoruth

4 years

For areas of poor stability b - unflexing against the tissue is incredibly helpful. The roof and post wall ( esp on the rights) are IMO best ablated like this

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Jacob Koruth

@jskoruth

5 years

Happy to share simultaneous publication of our new fistula model that was presented at late-breakers today at AF symposium .

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Jacob Koruth

@jskoruth

1 year

PFA and VT: Check out the manuscript by Lozano-Granero et al and the editorial we wrote -

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Jacob Koruth

@jskoruth

4 years

⁦ @dredcronin ⁩ and us put together these 2 rare cases of permanent his injury that’s now out in JaccEP. Something to keep an eye out for...

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Jacob Koruth

@jskoruth

5 years

- after atrium comes @ventrcile . More preclinical data- Endocardial ventricular pulsed field ablation: a proof-of-concept preclinical evaluation

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Jacob Koruth

@jskoruth

7 years

I enjoyed being part of this effort with Vivek Reddy and @jin_iwasawa nice to see this in print- love my artwork..lol

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Jacob Koruth

@jskoruth

5 years

My home state Kerala, India giving me the chance to speak at their lovely meeting

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Jacob Koruth

@jskoruth

4 years

Our manuscript in CircEP - has all the details of focal PF. . Focal Pulsed Field Ablation for Pulmonary Vein Isolation and Linear Atrial Lesions: A Preclinical Assessment of Safety and Durability. .

Focal Pulsed Field Ablation for Pulmonary Vein Isolation and Linear Atrial Lesions | Circulation:...

Background: A novel ablation and mapping system can toggle between delivering biphasic pulsed field (PF) and radiofrequency energy from a 9-mm lattice-tip catheter. We assessed the preclinical...

www.ahajournals.org

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Jacob Koruth

@jskoruth

3 years

#EPeeps - SinaiNYC- having fun and hoping to improve efficacy and safety

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Jacob Koruth

@jskoruth

6 months

Unknown EP telling us about ablation… apparently also the Program Director as well - Ablation Summit 🤣

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Jacob Koruth

@jskoruth

6 years

Never plan a quick flutter before an epi/endo VT. No IVC but huge Azgos. So after some jujitsu and screaming - case complete : 🙄

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Jacob Koruth

@jskoruth

1 year

have nothing useful to say. so here goes ...

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Jacob Koruth

@jskoruth

4 years

I rarely get to see a 99.7 pacematch in a scar VT.... turns it worked for this pt

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Jacob Koruth

@jskoruth

2 years

Hey #epeeps #dontdisthehis So cardioverted this LBBpacing pt out of AF..and the nurse asks me. - “success ? I see ASVP right ? “. I take a moment and —— “You mean ASPP…. A sensed physiologically paced….. we don’t VP…we PP now in EP 🤦🏾‍♂️🤦🏾‍♂️🤷🏽‍♂️🤷🏽‍♂️🤣🤣

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Jacob Koruth

@jskoruth

2 years

When the mitral like doesn’t block despite alcohol/ good endo and CS lesions opposite the endo line- go around the CS in a ring …… it’s remarkable how dependent block can be on the rest of the CS circumference - use low flow to limit risk of Cx injury

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Jacob Koruth

@jskoruth

6 years

May 11. Late breaking : first Report Pulsed Electric Field ablation-Ultra-rapid, Tissue-selective Modality: exciting to see years of our preclinical work now in humans #HRS2018 @True_EP @aalahmadmd @narrowQRS @drrakeshg1 @Ed_Gerst @rdschaller @DrFerminGarcia #paradigmshift

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Jacob Koruth

@jskoruth

4 years

To this fractured world. Let kindness, tolerance and intelligence prevail.

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Jacob Koruth

@jskoruth

5 years

Our manuscript CircEP. from -days of open-chest exps to first endocardial PVI .. I actually thought that the lasso came disconnected— Preclinical Evaluation of PFA Electrophysiological and Histological Assessment of Thoracic Vein Isolation

Preclinical Evaluation of Pulsed Field Ablation | Circulation: Arrhythmia and Electrophysiology

Background: Pulsed field ablation (PFA) is a uniquely tissue-selective, nonthermal cardiac ablation modality. Delivery parameters such as the electrical waveform composition and device design are...

www.ahajournals.org

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Jacob Koruth

@jskoruth

6 years

Crazy scar VT - nothing early endo. But epi has this egm very basal. ( next to MCV on LV aspect). Multiple long 30-35 applications needed to render non- inducible

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Jacob Koruth

@jskoruth

3 years

Fun data. - in a swine model a sudden drop in impedance was a good marker of LV cavity perforation during LBBB pacing

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Jacob Koruth

@jskoruth

1 year

Walking to my train and I'm hey bud cheer up. ....Been there....😂

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Jacob Koruth

@jskoruth

6 years

In Prague - with Vivek Reddy and Peter Neuzil. Ablating AF and VT with tools that hopefully will make outcomes easier to achieve and much much quicker !!

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Jacob Koruth

@jskoruth

5 years

How many do this for SSS in younger pts... ( normal pr/Qrs)

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Jacob Koruth

@jskoruth

5 years

Awesome experience being part of the Pulse field ablation symposium. A few yrs ago I isolated a swine PV in less than a second and now I am ready for the LBCT trial tomorrow!!

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Jacob Koruth

@jskoruth

3 years

I always wonder how non- ICE users maneuver these CTI anatomies. Obviously it can be done but ....

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Jacob Koruth

@jskoruth

2 years

Occluded IJ and need an externalities temp. Use the pouch to keep leads and device neatly coiled inside and sutured closed and then suture in place at 3 points. Seemed to have been far neater than anything I've done before.

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Jacob Koruth

@jskoruth

4 years

I see this on my walk to work every day. The loss of a child must be the most painful of human experiences... to have someone snatched from you completely unexpectedly... have no words

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Jacob Koruth

@jskoruth

6 years

One of many flutters. HCM pt

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Jacob Koruth

@jskoruth

11 months

Atul Verma teaching us about PFA - at the 4th Canadian EP Summit ! ⁦ @BiosenseWebster ⁩ ⁦ @josoriomd ⁩

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Jacob Koruth

@jskoruth

6 years

#EPeeps recurrent VF - pt 10 days after TAVR. Noted transient AV block ( chr AF) on monitor and. Gets uneventful VVI PPM - Cath/ CT normal. Now 2 episode VF 24 and 56 hrs after PPM. Normal EF .. strange. Septal lead but paced morphology diff

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Jacob Koruth

@jskoruth

4 years

Folks criticize ICs for “over” stenting coronaries.... but EPs can ablate just about any Afib so long as they document fatigue or shortness of breath. I don’t get this double standard

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Jacob Koruth

@jskoruth

4 years

My favorite tweet ever so far

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Jacob Koruth

@jskoruth

5 years

More about the lattice tip Catheter and PFA. !!

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Jacob Koruth

@jskoruth

4 years

Lattice tip. PFA Preclinical data on mitral isthmus. For the first time I was able to able to ablate th CS from the endocardium. Bye bye heat sink !!

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Jacob Koruth

@jskoruth

5 years

Ebsteins anomaly

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Jacob Koruth

@jskoruth

3 years

Deviation without contrast can get you into trouble if you don’t identify the trailing edge. #eppeeps

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Jacob Koruth

@jskoruth

7 years

Deviated esophagus. Note left border being stretched. If you deviate then you need to define esophagus

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Jacob Koruth

@jskoruth

2 years

Koruth J, Kawamura I, Dukkipati SR, Neuzil P, Reddy VY. Preclinical assessment of the feasibility, safety and lesion durability of a novel 'single-shot' pulsed field ablation catheter for pulmonary vein isolation. Europace. 2023 Feb 16:euad030. doi: 10.1093/europace/euad030.

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Jacob Koruth

@jskoruth

2 years

#EPeeps What do folks think. Fellows should get trained to do fluoroscopy guided transeptal for left sided SVT. Vs. There really is no point. Just use ICE.

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Jacob Koruth

@jskoruth

5 years

Dr Marchlinski giving noon lecture. Grand rounds to follow - Telling us about ARVC progression

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Jacob Koruth

@jskoruth

7 years

Needle ablation of septum with Vivek Reddy and Dr Stevenson- !!

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Jacob Koruth

@jskoruth

4 years

Pfa cases- watching live cases. This is unprecedented. Our patients and us are going to be glad

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Jacob Koruth

@jskoruth

6 years

2 minute lesions, then some HNS ablation and then some alcohol and all was happy and calm in this left atrium that was 10mm thick in the roof....

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Jacob Koruth

@jskoruth

6 years

Purkinje related ischemic VT

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Jacob Koruth

@jskoruth

5 years

Looks at these numbers for persistent AF. Lattice tip data by Vivek. Now we have durable lines. Everything is suddenly durable. Lots to learn

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Jacob Koruth

@jskoruth

5 years

Doctors need masks and PPE here. NOW. Can everyone retweet and draw attention to this situation. NO MORE Health care workers need to get ill in NEW YORK CITY.

Brian M. Rosenthal

@brianmrosenthal

5 years

The New York Times worked with a doctor to film 72 hours at Elmhurst, the hospital that's been hardest hit by the coronavirus outbreak in NY. The result is an extraordinary piece of video journalism Everybody should watch this: (by @robinnyc7 / @rarecanary )

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Jacob Koruth

@jskoruth

4 years

How can racism even exist when there are such special moments in this world

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Jacob Koruth

@jskoruth

7 years

💎 Diamond -tip Catheter today : left PV -7 mins: right PV- 11 - CTI- 2.5 mins. Can't wait to see outcome data !

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Jacob Koruth

@jskoruth

6 years

Now I think Ive impaled (⁦ @SergioPinski )⁩ this massive Naked his. Max out put and 0.5 @0 .2 ms all have pure his capture. In this pt referred for non response to CRT for Rv pacing CMP ⁦ @rdschaller ⁩ ⁦ @gopi_gdanda1 ⁩ 😲

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Jacob Koruth

@jskoruth

2 years

At the Dead Sea Symposium. What an amazing meeting and venue. Choosing between lectures and the beach was a bit challenging.....

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Jacob Koruth

@jskoruth

5 years

Amazing. Vivek @AFsymposium - Was lucky to be part of this amazing clinically experience !!

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Jacob Koruth

@jskoruth

3 years

Interesting referral for upgrade to CRT for pacing CMP. Paced Qrs looked narrow so I looked at this echo for the pacer placed 11 yrs ago —- can appreciate that this was likely left septal pacing !!! Long before we were purposefully doing this !!

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Jacob Koruth

@jskoruth

7 years

Pvc induced VF - site of ablation by my colleagues- the only egm better than what @rdschaller showed us

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Jacob Koruth

@jskoruth

2 years

The dark region ( white arrows) is 4 week old scar. - PFA was delivered atop this and the pale regions ( yellow and blue arrows) represent a PFA lesion. You can see that PFA almost symmetrically penetrates this scar which is reassuring..

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Jacob Koruth

@jskoruth

4 years

I get into my 5yr olds bed to hug him this morning - and he mumbles “Joe Biden....Donald Trump “.. twice and falls back asleep. Never in my wildest dreams did I expect those words 🤣

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Jacob Koruth

@jskoruth

2 years

PV Isolation Using a Spherical Array PFA Catheter: Preclinical Assessm...

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Jacob Koruth

@jskoruth

7 years

Right middle vein remains connected on this cryo redo. ..

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Jacob Koruth

@jskoruth

2 years

#epeeps . A novel finding from our pre-clinical and clinical lab regarding PFA and esophagus. Did you know that many PFA pulses are stimulatory and Can directly stimulate the eso muscle providing one additional mechanism of safety @iwanari65284818 @VivekReddyMD

Virtual EP Connect

@ConnectEp

2 years

#epeeps On-Demand @connectEP . Pulsed Field Ablation: Novel Insights from Pre-Clinical Experimentation @VivekReddyMD , Francis Marchlinski, @jskoruth , @Ed_Gerst , Hiroshi Nakagawa, @DMiklavcic @HRSonline @MountSinaiHeart @PennEPFellows Access @

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Jacob Koruth

@jskoruth

6 years

HDgrid. Apex substrate on elderly male - non inducible at the end !

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Jacob Koruth

@jskoruth

3 years

New expandable one shot catheter for PFA. Very exciting to see the field move forward- Have to acknowledge all the engineers who make this sort of technological innovation possible.

Firas Zahwe

@Firaszahwe

3 years

#HRS2021 @jskoruth safety and durability of single shot PFA. 100% Durability in PV and 78% in SVC at day 7. @HRSonline

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Jacob Koruth

@jskoruth

4 years

This weekend. Anyone interested in really interesting and cool EP things!!

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Jacob Koruth

@jskoruth

2 years

So. Blue dot represents an area with a very high imp as I moved my thermacool around- 240s… other areas were all in the 170s… nothing on ice. No accessory vein or crypt like blind pouch seen on ICE

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