Cardiac EP in Asheville, NC. Emory Cardiology/Electrophysiology Alum

Joined April 2019
257 Photos and videos
Mike Manogue retweeted
What if we stopped chasing VT from the surface… and went straight to the source? Presenting VINTAGE (intramyocardial navigation ablation) as a late breaker at #HRS2026 tomorrow. A new paradigm for deep substrate arrhythmias. Ventricular Intramyocardial Navigation and Tachycardia Ablation Guided by Electrograms (VINTAGE): First-in-Human Experience with a Novel Therapy for Refractory Ventricular Arrhythmias. Sunday April 26 12:15 PM Room SC100C, McCormick Place @FaisalMMerchant @melchami99 @rimhalabymd @ChrisGBruce13 @ajrogers_md @BadhwarNitish @AdamGreenbaumMD @emoryhealthcare
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Mike Manogue retweeted
Replying to @danealson
@danealson presenting data on using upstream sinus electrograms to predict impending onset of VT/VF. Upstream sinus likely holds pathophysiologic insights to why arrhythmias occur and may open door to preventive strategies @experienceHRX @HRSonline @emoryheart @melchami99
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#EPeeps Pulmonary vein EGM cornucopia. Prior surgical epicardial PVI (convergent), Orion in LIPV w three separate EGMs in the vein at once. An uncommon tracing in my experience. Map @JorgeI_Hernand
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Initial tweet sequence got screwed up. Here it is in proper, rational sequence.
Challenging CTI line, no block in spite of substantial effort. Pacing proxCS (star) gives this activation map from LAO caudal view. Red early,purple late. Where to target next? Answer ultimately in replies
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Challenging CTI line, no block in spite of substantial effort. Pacing proxCS (star) gives this activation map from LAO caudal view. Red early,purple late. Where to target next? Answer ultimately in replies
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Unexpected mechanical block at the back of the CTI on what correlated to position 3 from the original image. Turned out to be reproducible. Abl her produced permanent block
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Essentially a sub endocardial fiber obliquely oriented relative to the CTI line. Mad the endocardial map quite misleading. Nice to have luck too, but need to be prepared to recognize luck when it’s handed to you. Map credit @JorgeI_Hernand
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Mike Manogue retweeted
To my Cardiology people: I need you help. Please share if you think it’s appropriate. I am looking for several non-invasive and interventional cardiologists to help me grow our Ascension program in and around Milwaukee.  - Vibrant, multicultural downtown with things to do - Safe, quiet suburbs with excellent schools - Team of experienced Cardiologists who treat each other as family members - Prioritize work/life balance - Competitive compensation - Generous vacation - Fellows are encouraged to apply - Will consider part time  - Will help with H1B sponsorship and J1 visa waiver If you would like to learn more, or of you know a colleague who might be interested, please reach out to me directly via email alexander.smolensky@ascension.org or by phone at 414-298-7165. Or just PM me
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Mike Manogue retweeted
Emory reunion @HRSonline 2024! #epeeps
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#EPeeps Bachmans pacing location EGM and pacing—heavily fractionated and occurs quite late in sinus P wave, and although paced P is quite narrow, long latency at all pacing outputs. Ended up not keeping this and going with RAA lead. Other opinions?
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Me listening to rap beef tracks this weekend

ALT Cramming Democratic Party GIF by The Democrats

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It turns out this was not LBB capture. The S wave going out into V4, and lack up sharp upstroke in V6, and as @ugurcanpolatmd said, terminal S in V6 were unusual features for direct LB capture/correction, so I implanted a CS lead and used this as RV pacing lead.
#EPeeps Unipolar pacing @ 3830 LBBAP lead fixation site. Pt with LBBB QRS morph. V6RWPT (65-70ms) and V6/V1 delta (61ms)
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Shows how static measurements like LVAT etc, while appealing for their simplicity, can be misleading esp in CCB LBBB, dependent patients. Prob population where confirmation of capture is most important too.
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Here the numbers technically indicated LB capture, but it was indeed not. @jason_lappe @zhalemd @zapzaplunch @Dr_JozaEP @V_Mardigyan @KennethEllenbo1
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#EPeeps Unipolar pacing @ 3830 LBBAP lead fixation site. Pt with LBBB QRS morph. V6RWPT (65-70ms) and V6/V1 delta (61ms)
65% Yes
24% No
11% Don’t know/don’t care
99 votes • Final results
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Paced QRS, baseline QRS
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Mike Manogue retweeted
Yesterday, a fascinating case. A 68yo patient, father of three doctors (a significant risk factor), CAD with recovered EF, LBB and very frequent PVC's (pic 1)—25% on Holter with palpitations and was documented to have bradycardia while on a beta-blocker.
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