Gustavo Alejandro Costa

Jefe de la Sección Electrofisiología del Hospital Nacional Prof. Alejandro Posadas

[ALBERTO ALFIE @ALFIEEP1]

#WPW

Duodromic AVRT using a posteroseptal AP as anterograde limb and a parahisian AP as retrograde limb.

Performed by EP Division at @HospitalPosadas

Very nice case Gustavo !!

[Gustavo Alejandro Costa @GusCostaEP]

Clues: basal drive (600 ms) preexcitation mainly by anteroseptal AP (see His bundle and CS EGMs); extraestimuli and tachycardia preexcited by a posterior AP; occasional anterograde His EGM (bystander) confirms diagnosis: duodromic AVRT

[Gustavo Alejandro Costa @GusCostaEP]

EP fellows: M 16 y/o
Patent prexcitation on surface ECG; atrial premature extraestimuli induced tachycardia. What is the mechanism??
Case done today at @hospitalposadas

[CarinaHardyEP @CarinaHardy4]

#EPeeps Activation map of the initial dual loop re-entrant tachycardia. The common isthmus in the posterior LA is shown with re-entry around an area of posterior scar and around the LSPV and RSPV. REDO AF
@Scanav1Mauricio
@BiosenseWebster
@LAHRSonline1
@MujerSIAC
#WomenInEP

[ALBERTO ALFIE @ALFIEEP1]

Right lateral view of an anterior TSP and a posterior TSP.
The anterior TSP is the worst enemy for good CF.

[ALBERTO ALFIE @ALFIEEP1]

61 YOF, PerstAF, BMI 30
LA w/large scar tissue.
In view of CAPLA trial we did only WACA.
ICE out of order. 1st TSP, anterior, FAM performed. This is the worst place for good CF. RFA not attempted
ReDo new TSP more posterior. 1st pass isolation.
@GusCostaEP
CAS @Emmanue85378951

[CarinaHardyEP @CarinaHardy4]

#EPeeps Ablation of left PL WPW for epicardium,within a branch of the CS, did not work for the endo. Previous endo failure in another country. Look at the blue dot on the epi,in the same place as the #OW channel in the endo. Do you think OW helped in this case?
@EPWoodsShop

[Gustavo Alejandro Costa @GusCostaEP]

AVNRT induced only by RV extraestimuli. Thoughts?Case done with Dr Camila Olivera and Dr Gustavo Gomez at Hospital Posadas

[ALBERTO ALFIE @ALFIEEP1]

@hospitalposadas

Seguimos con nuestro programa de ablación #FibrilacionAuricular sin uso de rayos X, siendo el primer y único Hospltal Público de Argentina en realizarlo, y 2do grupo de en el país en lograr tener este programa sólido.

Que estamos haciendo en Latinoamérica?

[Gustavo Alejandro Costa @GusCostaEP]

@Speranzaric @hospitalposadas @pablospaletra @ALFIEEP1 @KamilaOlivera13 @DanielDeluso @diegoclinico @jorgeferreyrar Excelente trabajo. Felicitaciones

[Dr. Ricardo Speranza. @Speranzaric]

Cierre orejuela izq con Watchman Flex, realizado en @hospitalposadas, junto a @pablospaletra, Dr. Felipe Olivieri,y todo el equipo de Electrofisiologia. M Gracias al soporte de CCV y anestesia. @GusCostaEP @ALFIEEP1 @KamilaOlivera13 @DanielDeluso @diegoclinico @jorgeferreyrar

[ALBERTO ALFIE @ALFIEEP1]

#WPW
Dual-loop AVRT

1st & 2nd panel:
-entrainment from RV changes retrograde activation w/o interrupting AVRT. This is a compelling finding to acknowledge the presence of 2 APs in the patient

-lower panel: AVRT using only Left AP. See how His A EGM become after CSp

(Cyan=LV)

[ALBERTO ALFIE @ALFIEEP1]

@jeffrey_vinocur @GusCostaEP @KamilaOlivera13 @hospitalposadas We did not even attempt endocardial RFA. Not early point, not even on time with CS Atrial EGM. We mapped mitral annulus and LAA.
We had a similar case a few weeks ago that I posted.

[ALBERTO ALFIE @ALFIEEP1]

Single burn Left atrial flutter termination.

[ALBERTO ALFIE @ALFIEEP1]

De-Novo Left Atrial Flutter in a 60 yof pt with a scarred LA.
EF 20% very likely due to tachycardiomyopathy.
Done at #HospitalPosadas with the EP team and Super #biosensewebster CAS @M__Mosca

EP team:
@GusCostaEP @Speranzaric @KamilaOlivera13 @diegoclinico

[ALBERTO ALFIE @ALFIEEP1]

It is a pleasure to share this Video from the 1st #PVI for #AF at ⁦@hospitalposadas⁩.
2nd working group to achieve it and 1st one in the public health system in Argentina.
We are so grateful for many #Epeeps around the world to reach this.
https://t.co/1ZS35sFk78

[Gustavo Alejandro Costa @GusCostaEP]

@ALFIEEP1 It is the same arrhythmia. Flecainide prolongs ventricular refractoriness and QRS duration, for which the first ECG shows a wider QRS and greater right axis deviation

[Dr. Ricardo Speranza. @Speranzaric]

Hoy 14/5 se cumple 1 año de la compra de la SEDE de nuestra querida @sociedadsadec, durante mi presidencia. Un sueño hecho realidad, y un esfuerzo de todos @RASANSALONE, Julio Pastori,Cl Zuloaga, O Oseroff,@fcueto22 @luismedesa @JGANTL @raulguillen1956 @DanielDeluso y toda la CD.

[ALBERTO ALFIE @ALFIEEP1]

First #ZeroFluoro #PVI for #AtrialFibrillation in Public Health System in Argentina performed at #HospitalPosadas

A long and amazing journey to achieve this 10-seconds video

Congrats to all the EP Service for this achievement

Thanks to all the #ICE experts for their advice