Tissue transfer repair CPT 14001 can be applied where there is device erosion and a skin flap is created to cover the defect. Measurements of the size of flap are required for documentation/billing. Also, this allows access for complete excision of infected capsule.

Antonio Thomaz de Andrade, MD 🇧🇷 Nanashī 🫀 🫀EcgOxford Arnel Carmona Andreas Roeschl, MD Sergio Pinski David Didlake Lucas Moura Agree with the others that there is a junctional rhythm with retrograde conduction and echo beats.

There is also retrograde Wenckebach conduction and I think the aberrant echo may be due to Ashman's phenomenon (the preceding beats have the largest 'jump' in RR intervals)

Young patient with daily palpitations

Accessory pathway mapped to the right midseptum in sinus rhythm

Loss of VPE within 3.5 seconds of ⚡️

Juan Camilo Navarrete Timothy Markman Penn Electrophysiology Fellowship Tolga Aksu, MD Jeffrey Winterfield Roman Piotrowski Mauricio Scanavacca Nice maps Tim! We tried in all our patients, trying to define a way to reproduce the findings, IMO it’s pretty similar to Fractionation. We need to talk !!!

👇 #EPeeps The new tool von #Carto_V8 : Mapping and ablation of incessant AT in patients with Fontan circulation👇

#Complex_Signals_Acquisition from Biosense Webster 🤩🤩🤩

#univentricular_heart : double outlet left ventricle(DOLV) and intra-atrial tunnel via trans-tunnel…

Timothy Markman Penn Electrophysiology Fellowship JC ZERPA Tolga Aksu, MD Jeffrey Winterfield Roman Piotrowski Mauricio Scanavacca Frequency maps on top of fractionation maps are our go to to identify GPs.

Blue dots on map are the areas with high frequency AND fractionation that are consistent w anatomical locations. Green dots are where we had positive vagal response. Very specific and discreet targets.…

Zachary Koch Pablo Sánchez Millán Timothy Markman Penn Electrophysiology Fellowship JC ZERPA Tolga Aksu, MD Jeffrey Winterfield Mauricio Scanavacca Interesting findings. But I still have some doubts, bacause fragmented potentials and some peaks may be caused by various reasons, e.g. infiltration of fatty tissue, scar, perhaps nerve fibers. Fascinatig topic:)

Ultrasound-guided explantation technique for implantable loop recorder in patients with high body mass index: a practical approach
heartrhythmopen.com/article/S2666-…

Flutter day!! Redo of a 72 year old male patient, who had undergone previous ablation in another center (no more info!). Extensive scar in anterior and posterior LA. LPVs isolated from the beginning. With Καρδιολογικό Ιατρείο Δημήτριος Αθανασιάς MD, FESC . Excellent technical support from Cosmo Valkanas

🫀EcgOxford Maruan C Chabbar Nanashī 🫀 Dr Shariq Shamim Dr Ulhas Pandurangi David Didlake Syamkumar Kananura Keneth Dr Linda Dykes @[email protected] P̸r̸ Nikkტ Peschanski 𝗠𝗗 PhD ᙓᖇ𝗙𝗲𝘃ᙓᖇ ᴹᵁRennes Emre Aslanger Alain Vadeboncoeur MD EfectoElectrotónico Stephen W. Smith Sam Ghali, M.D. EMS 12-Lead Druv Bhagavan Martín #MFyC estudiomedicina Here is my theory in laddergram. If I have my preference, I would like to have LL1 and prob aVR bev it shows the different QRS morphologies. The escape is based on the deduction observed in R3. So, I think this is SR, 2AVB advance HB. The conducted PRI is ~ 200 ms.

#Epeeps who perform #CNA . LA peak frequency is valuable to find candidate GP sites beyond fractionation, especially for LI/LSGP, which are harder to target anatomically. Here peak frequency pointed to two regions that had + HFS and vagal response with ablation. Penn Electrophysiology Fellowship

A Little trick to save the radial access for an arterial line after #PCI , thanks to Gianluca Campo for the idea!

Looking forward to more of these 💪🔥:

Quarterly EP Cardiogenetics conference w/ case presentations by fantastic #EPfellows Cedars-Sinai Academic Medicine
LMNA + FLNC cases

Special guest Evan Kransdorf MD
Lead by Eugenio Cingolani, MD

Sumeet Chugh Peng-Sheng Chen, MD
Natasha Cuk Eli Simsolo, MD

ZERO FLUORO TIP OF THE WEEK...
FLOW. Ep.1 of 5: RA Geo
Takes 7 min on average to fluorolessly collect right atrial geo and voxel cloud to prepare for our #ZeroFluoro transseptal!
#EPeeps

Signals that disappear almost instantly are fun to see. But a few questions remain: Is the result irreversible? Does contact matter? What about the small gaps? Do you map for leaks? #PFAonX . #AbbottProud #MappingMatters

A pt with two prior VT ablations and recurrent ICD shocks, despite AADs. Two different VTs were easily induced with pacing stimulation, both located in the basal septal region. Following ablation, no VT was induced and 0 episodes on couple weeks follow up 🎯⚡️

Andreas Roeschl, MD 〈The QRS polarity of this PVC〉
V1→(−), V5・6→(+), Ⅱ・Ⅲ・aVF→(+), Ⅰ→(−)

➥①Transition zone of PVC 'V3'＜Transition zone of SR 'V4'
　②V2 transition ratio=(6.5/24.5)÷(1.5/18.5)≫0.6
　③No S wave in V6 lead
　④MDI＜0.55 in V3 lead
　⑤intrinsicoid deflection time in…

Part of our #fluoroless #PulseSelect #PFA workflow is to advance the CS catheter in a CS V branch and ensure high output ventricular capture in case of enhanced vagal during ablation. It was needed in ablating this LSPV. EP_Bot #epeeps #ICE

Left posteroseptal AP with negative delta wave in II. Earliest ventricular activation in CS branch was on top of LCx. Going transeptal beautiful AP potential on annulus and got it in less than 1 second! Arruda criteria not very specific CS location. Brock Gambill #EPeeps

Stefan Andric Nice example! Here is some additional illustration if helpful. We see the same activation in the before & after: an anterior LOB with a leak/isthmus in the middle. However in the before, very “late” activation at the dead end encroaches on the next WOI, creating another “early”…