Gregory Michaud
@DrGregMichaud
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Beth Israel Deaconess Medical Center. Section Chief, Cardiac Electrophysiology
Boston, MA
Joined November 2017
This SVT seen on monitor Calipers show the stable SVT interval and are placed on either side of a PVC that occurs during tachy in lower panel. Thoughts #Epeeps #EPFELLOWS?
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@tung_patricia I agree. The rare 🐦"supernormal" conduction occuring in damaged H-P tissue. Here is a reference: Moore EN, Spear JF, Fisch C. "Supernormal" conduction and excitability. J Cardiovasc Electrophysiol. 1993 Jun;4(3):320-37. doi: 10.1111/j.1540-8167.1993.tb01234.x. PMID: 8269303.
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#Epeeps and #EPFELLOWS. Pre and Post TAVR ECGs discovered by @tung_patricia during a reading day. What's up with the premature beat?
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I have deleted the earlier post. I thought it was created as a joke and did not mean to offend anyone.
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In the best Epsilon wave contest, this would be my entry...
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Exceptions to every rule. This turned out to be AVNRT!! 🤷♂️
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One little P wave missing clinches it!! WCT with AV dissociation. = VT with rare exceprikns. The morphology suggests a left inferoapical septal exit and the sharp initial components indicate activation of the His Purkinje system. Probably Posterior Fascicular VT.
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#EPeeps that is me! Old 🐕 new tricks. Will present short talk at Stanford a Biodesign tomorrow. See you at HRS!
That feeling when you have been working on something so long, and your peers think it is helpful and want to use it again...🥰 @sentiarco @JonSilva_StL @mksouthworth @Berk_tash @DrGregMichaud @JagSinghMD @JohnTriedmanMD @WashUOTM @WashUBME @WashUPedsCard
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Any takers on a diagnosis ?
#epeeps Nothing better than Nature's EP study! 12 lead of initiation and pacemaker interrogation showing termination
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#epeeps Nothing better than Nature's EP study! 12 lead of initiation and pacemaker interrogation showing termination
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Absolute gold! Say no more….. ABLATE 🔥!!!
Extrastimulus with nonglobal capture terminating VT (and subsequent pacing matches VT)
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"Selective" and "non-selective" probably better terms for HB pacing. Pace capture in the more distal conduction system must quickly engage both right and left-sided elements to achieve such a narrow QRS, which is not very selective!
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#epeeps Does this represent capture of the posterior fascicle directly or must there be fusion? No change in QRS complex at various outputs.
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Could be coarse AF but earlier ECG suggests atrial flutter. + concordance V1 and inferior Leads suggest a non CTI mechanism. One thing for sure. He will have atrial fibrosis
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One of the data free zones…..
#epeeps Do you give antibiotics for endocardial catheter ablation procedures in patients with pacemaker or other implanted hardware?
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#epeeps Do you give antibiotics for endocardial catheter ablation procedures in patients with pacemaker or other implanted hardware?
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