You too can make ablate and pace (CSP) an elegant procedure, approx 1hr procedure time.
Make pocket.
Get access.
Place lead.
Ablate from pocket.
Add atrial lead. (If necessary)
Tie down lead(s).
Irrigate.
Attach device and tie down.
Close pocket.
h/t @SergioPinski
Posterior wall ablation ≠ posterior wall isolation. And it’s easy to map.
We all have pretty post-ablation maps.
New rule: required, if you’re sharing one on X or LinkedIn, show the scale and settings.
🧵Should we use unipolar post wall mapping during AF ablation? Is endocardial silence in AF = posterior wall isolation?
Nice study in @CirculationEP by @Ed_Gerst et al. challenging both assumptions with human endo-epi mapping. Post wall = 3D substrate
ahajournals.org/doi/full/10.…
Pradaxa is generic. Industry won't tell you, for obvious reasons.
Dabigatran 150 mg, 60 caps: $23.80 at Cost Plus.
We swap AF patients to warfarin over cost. We push LAAO without knowing it's better.
A $24/mo generic reframes both.
#AFib#Anticoagulation#EPeeps#LAAO
What does the left atrial appendage really do? What happens when it's gone? Does it matter how it was removed/occluded/closed?
Funday Activity, stick this prompt in your favorite AI and find out.
@drjohnmgist.github.com/charles-te/3…
CHAMPION-AF is here. NEJM. 3000 patients. The biggest question in LAAC finally has RCT data.
Noninferiority: met. Bleeding reduction: real. Net clinical benefit: favorable.
Great abstract. But the devil is in the details.
Then there's the stroke signal. 50 strokes in the device arm vs. 33 with NOACs. HR 1.46. It didn't reach statistical significance, but the trial was never powered to detect a stroke difference. Not significant is not the same as not real.
We’d like to introduce the new 👉 editorial series with narrated videos and illustrated images:
Fundamental Anatomy and Its Impact on Clinical Practice in ‘Da Vinci’ Anatomy Corner @JACCJournals#JACCCaseReports
The first subject: Myocardial Bridging
eur02.safelinks.protection.o…
Transventricular VT Ablation Guided by LBBAP Lead in a Patient With Mechanical Double Valve Replacement
Thank you very much for your inspiration
@drtopaloglu@ACH_epteam@ozcanozeke@ElifhandeMD @drfiratozcan
Love the poster sessions at #HRS2025
Highlight was this MacGyver solution to DF-4 ICD lead downgrade to CRT-P problem. Since industry won't give us adapters, we have to get creative.
5mm Uni to IS-1 adapter with cut lead cap as insulator turns DF-4 ICD lead into unipolar pacing lead.
-- Woo et al, including my friend and NP superstar Kelly Bergen.
#HRS2025
* BREAKING* ABIM loses copyright infringement case against Dr. Jaime Salas-Rushford AND loses effort to seal opinion. Depositions, tactics, ABIM attorney insults, secret agreements: entire docket. All public now. medtees.com/content/SEALED%2…medtees.com/content/DNJ Se…
Imagine if your patients had their implant cards sent to their #iPhone immed’ly after their #RadialFirst coronary stent or #TAVR? Implants stored forever with legible, durable, transferable data that may prove essential. Stent size/length & serial number on back!
The long-term incidence of stroke in AF is low, especially after ablation of paroxysmals. Stroke scores are from another era and were not developed or validated in this population: CHADSVASC was derived from 20-year old data with ONE YEAR of follow-up.
The treatment effect of statins, BP control, and reduced risk of HF may be contributing more to fewer strokes in AF. Recent AF screening trials have all shown stroke event rates lower than historical. We need a clever and cautious way to redefine risk stroke in contemporary AF patients before assuming that the historical reduction is all from therapy. #AHA24
This is another huge takeaway from the OPTION trial: how low the incidence of stroke is post modern AF ablation.
The CHADSVA tool is meaningless in this cohort, where AF burden has been substantially reduced with ablation