Alex Turin

Cardiac Electrophysiology @umichmedicine and CV Network of West MI @UofMHealthWest @TrinityHealthMI | @LoyolaHealth alum

[Alex Turin @AlexTurinMD]

@naijaQRS @cclang @AZ_EP_DOC @aalahmadmd @DrRoderickTung @AnandShah_MD @rainylakedana Tough case. Not much you can do. Data from Penn group shows higher and faster block rates with septal lines (https://t.co/s8SFRpv9CS) though admittedly without VOM.

[Alex Turin @AlexTurinMD]

@naijaQRS @EF_Cardiaca @FaisalMMerchant @melchami99 @AmoleOjoMD @AZ_EP_DOC @narrowQRS @shivkumarmd @DrRoderickTung @aalahmadmd @SergioPinski @DrGregMichaud @AnandShah_MD Really nice case! Looking forward to the update after

[Alex Turin @AlexTurinMD]

@naijaQRS @AmoleOjoMD @MRazminia @AZ_EP_DOC @rainylakedana @aalahmadmd @narrowQRS @DrRoderickTung @DanielAlyeshmer Nicely done! Do you do anything different as far as your transseptal technique for cases like this compared to usual?

[Alex Turin @AlexTurinMD]

@AZ_EP_DOC @MapperMack @kickinmaps @DrRoderickTung @svasaiw @rainylakedana @naijaQRS Great maps! Anterior boundary was scar on the LPV ridge? Don't think I've seen that before in a first time case.

[Alex Turin @AlexTurinMD]

Thrilled to share our case series on epicardial connections across the CTI. Great work @emilyjanak1 #EPeeps

[Heart Rhythm Case Reports @HRS_CaseReports]

Epicardial Connections Across the Cavotricuspid Isthmus https://t.co/scNYw0sQKn

[Alex Turin @AlexTurinMD]

@naijaQRS @AZ_EP_DOC @aalahmadmd @gglovedx3 Spatiotemporal dispersion is commonly seen in the PV entrance and is my vote for how PVI affects AF substrate (and goes beyond stopping triggers). Equally fascinating when it terminated to AT/AFL rather than sinus. Did you LAT map the AT?

[Alex Turin @AlexTurinMD]

@narrowQRS @BoldiKovacsMD @MelbourneEPdoc @AmrishEP @muazzumshah @HImmoLehmann Agree. PVC starts VT which initiates AT. VT slightly accelerates before terminating, may be PVCs or the AT conducting antegrade. Near field EGM changes morphology when Vs return. AVNRT + UCP/LCL block may be possible but feels like it needs more mental gymnastics to make it work

[Alex Turin @AlexTurinMD]

@naijaQRS @AZ_EP_DOC @peterkistler3 @FaisalMMerchant @PrashSanders Trademark pending 😁

[Bradley Knight @DrBradleyKnight]

Hospital Rankings for Heart and Heart Surgery Need to Include Electrophysiology Procedures in Their Metrics https://t.co/hziUq3H9BY

[peterkistler MBBS PhD FHRS @peterkistler3]

No role for empiric PWI in persistent AF: Long term outcomes at median 3.6 years from #CAPLA presented #ESCCongress ⁦@PrashSanders⁩ ⁦@davidchieng⁩

[Alex Turin @AlexTurinMD]

EKG1 - ED
EKG2 - after diltiazem IV
EKG3 - in clinic 2 days later

What's going on here? #Epeeps @naijaQRS @AZ_EP_DOC @svasaiw @SukitRingwalaMD @rainylakedana @BoldiKovacsMD @JasneetDevgun

[Alex Turin @AlexTurinMD]

@AhmedMaraeyMD @JasneetDevgun @tontokavanich @Dan_McBride_ @SaniaJiwani Correct! Leading to Ap (which doesn't capture because RA is refractory) which leads to a Vp, leading to a retrograde undersensed A, leading to Ap, etc. This is called RNRVAS

[Alex Turin @AlexTurinMD]

Dual chamber PPM programmed DDD. What's happening here, and how to fix it? #EPFellows @JasneetDevgun @tontokavanich @Dan_McBride_ @SaniaJiwani

[Alex Turin @AlexTurinMD]

@kevin_parrottMD @JasneetDevgun @tontokavanich @Dan_McBride_ @SaniaJiwani Nice!

[Alex Turin @AlexTurinMD]

@Dan_McBride_ @JasneetDevgun @tontokavanich @SaniaJiwani Close. Falling within PVAB or PVARP could do this but in this case was atrial undersensing. The VA time is too long. This is RNRVAS

[Alex Turin @AlexTurinMD]

@tontokavanich @JasneetDevgun @Dan_McBride_ @SaniaJiwani Correct on all counts. Patient with old RA lead with undersensing but otherwise atrially dependent for SND. Harder to fix without putting a new lead in. Fortunately she also had frequent PVCs which would reset this!

[Alex Turin @AlexTurinMD]

@drashwinb Good question. Flecainide was held for 72 hours before the procedure. AF did not start to organize and terminate until we came on ablation on the septum.

[Alex Turin @AlexTurinMD]

72yo with early persistent AF breaking through flecainide. AF induced spontaneously during catheter insertion. Initial LA map with diffuse low voltage

[Alex Turin @AlexTurinMD]

@svasaiw @AZ_EP_DOC @HankoRyan @JasneetDevgun @TheEctopicBeat @muazzumshah @BoldiKovacsMD @rainylakedana @SukitRingwalaMD

[Alex Turin @AlexTurinMD]

No AF/AFL inducible after. Final lesion set and post map in sinus.