What actually "looks good" on ICE: #ViewFlex Left Atrial imaging @EPS_PDX Training @MRazminia Sponsored @AbbottCardio Complemented #EnSiteX PFA Visualization & Contact Index software. A post PFA induced tachycardia, entrained at downstream electrogram, with long upstream capture (>75%, seen on splines) confirmed #Reentrant mechanism & circuit participation.

Despite multiple PFA applications, unable to achieve anterior block for mitral flutter. Epicardial voltage with peak frequency emphasis highlighted RF target. Lateral splits seen after first TactiFlex application. #HDGrid @AbbottCardio @EPS_PDX

A mappable VT meandering through WaDLs / Lines Of Block. Intuitive S3 Protocol discontinuities, 98% Correlation Score, and VT activation maps, supported a thoughtful ablation strategy. #EnSite @AbbottCardio

The notorious papillary muscle PVC. Originating from lateral aspect of the pap, these bigeminal PVCs were eliminated during the first RF session with the help of the tried and true PDX method. Link to publication: pmc.ncbi.nlm.nih.gov/article…

Monday started with First-in-Human Use of “ViewFlex X SE” ICE Catheter with @AbbottCardio I've always loved using the ViewFlex ICE for its exceptional image quality, but now with seamless ICE integration into Ensite X, this is a total game-changer that enhances precision like never before. Some features that stood out to me 🔹 ICE Integration with Grid and FAM Mapping - Real-time visualization that aligns perfectly with 3D GridX and FAM maps. This precision ensures more efficient targeting of critical anatomy, improving procedural accuracy. 🔹 Smooth Transition to the Left Atrium Despite its softer shaft, the ViewFlex X SE provided excellent maneuverability and control, allowing smooth navigation to the left atrium while maintaining consistent imaging quality. 🔹 Maintaining Outstanding Image Quality For those of us who’ve always trusted the ViewFlex ICE platform for its superior imaging, this new catheter doesn’t disappoint—it adds seamless integration without compromising clarity. #3DMapping #PrecisionMedicine #ViewFlexXSE #Innovation #EPWorkflow @StBernards #epeeps #ArrhythmiaResearchGroup

Premature His Bundle Complexes distinguished AVRT and AVNRT with 100% Specificity and Sensitivity irrespective of location. A simple & intuitive maneuver. PHC delivered 42 msec ahead of HIS, perturbed A1-A2 by 15 msec = AVNRT. @PadanilamBenzy @Ashit_EPS @EP_EmilyS @AbbottCardio @CirculationEP #EnSite doi.org/10.1161/CIRCEP.119.0…

Prior PVI and PWI. Narrow channel of slow conduction on the roof identified by #HDGrid. Entrainment yields a return interval of 0 ms; the roof is in this atypical flutter’s circuit. #Entrainment #PMA @bmetzlerEP @madiwcEPdrop @EPS_PDX

An unstable VT. Mappable with #StaMP. Guided by S3 Protocol. @JeffHsingMD @EP_EmilyS - StaMP @DrRoderickTung - S3 Protocol @ivroca - PDX Technique @B_Naz_MD - #EnSite @AbbottCardio

Clinical PVC mapped to moderator band via continuous score mapping with a correlation of 96%. The PDX technique was employed to project points to endocavitary structures, enabling precise identification and visualization of the ablation target. #PMA pmc.ncbi.nlm.nih.gov/article…

Hx PVI PW, presenting with typical AFL. CTI & re-isolation of LPV performed. During left atrial post mapping, induced 230 msec tachycardia. Inadvertently terminating during left atrial mapping, though incomplete, passively activated. Unable to reinduce. Right Atrial, S3 Protocol was performed. @ivroca @Ashit_EPS @jordinarymaps @AbbottCardio #EPeeps #PMA #EnSite jacc.org/doi/10.1016/j.jacep…

Increased ectopy during ablation at this AT’s site of earliest activation, demonstrating irritation of the tachycardia’s focus @JaylynnMariePDX @EP_EmilyS #PMA

S3 protocol, once again proved valuable in identifying ablation targets within this complex ischemic substrate. Impressive decoupling of EGM's, otherwise missed with fixed S1 mapping. #AblateVT @ESC_Journals @AbbottCardio academic.oup.com/europace/ar…

2nd post: Terminated Mitral to second flutter. Can you see what it is on the left side of the screen? #PMA

An untouched atrium, presenting with concordantly positive p-waves. A Reset ExtraStimulus Map helped limit ablation beyond PVI, despite multiple areas of deceleration and potential participating circuits. #PMA #Entrainment @Ashit_EPS @jordinarymaps @AbbottCardio

The right lateral tricuspid annulus, a notoriously difficult ablation, despite alluring target. sciencedirect.com/science/ar… Tricuspid annular plane systolic excursion (TAPSE), one factor for stability. sciencedirect.com/topics/nur… #PMA @DrEPCheng @EP_EmilyS @AbbottCardio

First of 3 posts on this case. Started case with Clockwise Mitral flutter despite posterior wall scar #PMA

Alternative form of entrainment with a sensed extrastimulus beat from a site of late activation. The paced wavefront travels orthodromically, captures atrial EGMs upstream, and resets the tach. The RA lateral wall is within the tach circuit. #PMA #REM pubmed.ncbi.nlm.nih.gov/3351…

VT critical isthmus (left) correlated with deceleration zones localized with S3 protocol (right) @ivroca x.com/jaccjournals/status/18… #AblateVT @Ashit_EPS @forkknifecab_EP @AbbottCardio

Farfield earliest activation corroborated with downstroke notch in V1, localization RCC/LCC commissure. innovationsincrm.com/cardiac… Initial RF lesion resulted in PVC suppression. Aortic cusp commissure imaged @AbbottCardio #ViewMate. #PMA @Ashit_EPS @jordinarymaps @georgecrowell

Hx of PVI, PWI, LAA isolation, and LA CFE. Mitral circuit using a low voltage channel on the roof and the ridge, PAC from the channel reset tach CL, confirming the isthmus. Our first lesion on the channel terminated flutter. #PMA @JeffHsingMD @forkknifecab_EP