Creighton Cardiology Fellowship

Official twitter account of the Creighton University School of Medicine Cardiology Fellowship @Creighton. #CuraPersonalis #BlueJays

[Creighton Cardiology Fellowship @CreightonCards]

Great EP conference with Dr. Abuissa discussing pacemaker interrogation and troubleshooting device malfunction.

Insightful session on recognizing patterns, avoiding pitfalls, and optimizing patient care.
Always learning, always improving. ⚡️ #Cardiology #EP #Pacemaker #MedEd

[Creighton Cardiology Fellowship @CreightonCards]

Exciting update!!
We’re proud to introduce our 2026/2027 Cardiology Chiefs: Dr. Anirudh Palicherla and Dr. Muhammad Ghallab. 🩺
A massive thanks to Dr. Ahmed Elkhouky and Dr. Sean Kennedy for their outstanding leadership. We’re ready to get to work! 📈💙
#MedTwitter #Creighton

[Creighton Cardiology Fellowship @CreightonCards]

🔟 Lead impedance

Measures lead integrity.

Normal values:
•Pacing leads: 300–1000 Ω
•Defibrillator coil: ~20–125 Ω

Sudden changes suggest problems:
•Very high → lead fracture
•Very low → insulation break

[Creighton Cardiology Fellowship @CreightonCards]

Pacemaker / ICD Essential concepts

1️⃣ Sensing vs Sensitivity
•Sensing = strength of the heart’s electrical signal (mV).
•Sensitivity = device setting determining the smallest signal the device will detect.
1/10

[Creighton Cardiology Fellowship @CreightonCards]

9️⃣ Oversensing

Device detects signals that are not true heartbeats.

Examples:
•T-wave oversensing
•skeletal muscle activity
•lead noise

Can cause inappropriate pacing inhibition or ICD shocks.

[Creighton Cardiology Fellowship @CreightonCards]

8️⃣ Causes of failure to sense (undersensing)

Common causes include:
•Low intrinsic signal amplitude
•Sensitivity set too low (device not sensitive enough)
•Lead displacement
•Lead fracture or insulation damage
•Myocardial scar near the lead

[Creighton Cardiology Fellowship @CreightonCards]

7️⃣ Pacemaker malfunction patterns
•Failure to capture: spike at correct time, no cardiac response
•Failure to sense: spike at wrong time, usually still captures
•Both failure: spike at wrong time and no capture

[Creighton Cardiology Fellowship @CreightonCards]

6️⃣ Capture thresholds
Minimum energy needed to stimulate the heart.

Typical chronic values:
•Atrium: <1.0 V @ 0.5 ms
•Ventricle: <1.5 V @ 0.5 ms

Lower thresholds → reliable capture & longer battery life.

[Creighton Cardiology Fellowship @CreightonCards]

5️⃣ Capture
Capture = heart responds to pacing spike.

ECG pattern:
Spike → P wave or QRS

No response after spike → failure to capture.

[Creighton Cardiology Fellowship @CreightonCards]

4️⃣ Normal sensing values

Typical targets:
•Atrial sensing (P wave): >1.5 mV (ideal >3 mV)
•Ventricular sensing (R wave): >5 mV (ideal >10 mV)

Stronger signals → lower risk of undersensing.

[Creighton Cardiology Fellowship @CreightonCards]

3️⃣ Golden rule
The device detects signals larger than the sensitivity setting.

Example:
Signal = 4 mV
Sensitivity = 0.5 mV
✔ The device senses the beat.

[Creighton Cardiology Fellowship @CreightonCards]

2️⃣ Key rule
Lower sensitivity number = more sensitive device.

Example:
0.3 mV → very sensitive
1.0 mV → less sensitive

[Creighton Cardiology Fellowship @CreightonCards]

Impella education session for the fellows🫀
Review of Impella CP & 5.5 with focus on hemodynamics and cardiogenic shock management.
#Cardiology #Impella #MCS #MedEd

[Creighton Cardiology Fellowship @CreightonCards]

🎉 Match Day 2025 🎉
We’re thrilled to welcome an outstanding group of fellows to Creighton Cardiology! 🫀
Congrats to our new fellows and a big thank-you to everyone who helped make this happen 🫶

#CreightonCardiology #Match2025 #Fellowship #MedTwitter #CardioTwitter

[Creighton Cardiology Fellowship @CreightonCards]

EKG session with our beloved Dr. Vargha and the cardiology fellows!
Interactive teaching, great discussions, and plenty of learning.
#CardiologyFellowship #EKG #MedEd #CardioFellows #LearningInAction

[Creighton Cardiology Fellowship @CreightonCards]

So proud of last year’s #Creighton Cardiology wins! 🌟

Our great PD Dr. Aboeata took home 2 awards; the J. Sullivan & Professional Physician Awards, 👏

Dr. Elkhouly named Best Fellow Teacher 2 yrs running, & 🏆 our Division won Best Teaching Service!

#Creighton #Cardiology

[Creighton Cardiology Fellowship @CreightonCards]

Grateful for dedicated mentors like Dr. Haddad who continuously inspire and guide our fellows. Excellence in education starts with great leadership. 🫀
#Cardiology

[Creighton Cardiology Fellowship @CreightonCards]

We would like to say a HUGE thank you to our fellows! You are spectacular! #cardiologyfellowship #thankaresidentday #CreightonCardiology

[Creighton Cardiology Fellowship @CreightonCards]

Cardiology fellowship is more than rounds and research—it’s about building a community. #Zoolightful outing brought some much-needed cheer and connection to our crew! Grateful for moments like these with our fellowship family. 🌟 #fellowshiplife #teambonding

[Creighton Cardiology Fellowship @CreightonCards]

🎉 Exciting Announcement! 🎉

We are delighted to share the Creighton University Cardiovascular Disease Fellowship 2024-2025 Match Results 💙💛

#CreightonCardiology #InterventionalCardiology #FellowshipClass2028 #CardiovascularExcellence #WelcomeToCreighton