Wanted to share our VOM EtOH experience for AF ablation over last 3 years. We initially reserved it only for highly selected patients though over the last year has become more routine. Disclaimer - not yet through peer review or published.
https://t.co/hILDhhMwDx
Device infections are NOT uncommon.
1️⃣Let’s inform our patients of the signs and symptoms of CIED infections 👩🏿⚕️
2️⃣Let’s inform them that antibiotics aren’t enough 💊
3️⃣Let’s extract. The risk of extraction is low 👨🏽⚕️
We can do this. We can beat this. 💪🏾#Treat2BeatCIEDInfection
2nd Annual Technical Annual Lead Extraction Course (TALES) coming up on Saturday, March 12th at 10 AM. Valuable for all levels.
🚨 FREE, VIRTUAL, CME 🚨
Register here:
https://t.co/ZbexsA6Emi
MicraCED linked device registration w/Medicare to eval safety. No difference in complications or survival at 30d. Higher rate perf/effusion (Micra 0.8% vs TVP 0.4%) & lower rate device-related comps (Micra 1.4% vs TVP 2.5%). #EPeeps https://t.co/LLWGfi1J6y via @JAMACardio
Redo persistent AF/tachyCM Friday with chronic IVC occlusion. Rather than transhepatic (requires interrupting AC), decided to do @Dr_Santangeli technique of left axillary.
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@manesh_patelMD@schuyler_jones@DukeCardiology
#Epeeps Stability is critical to RF ablation. This video highlights how ventilation changes can impact stability/CF. Watch as we changed from standard (500ml &12 breath/min) to High Frequency Low Volume (200ml&30 breaths/min). Notice the respiratory curve and CF graph 1/3
Interesting AF case yesterday.1st time persAF. Following PVI/PWI, rhythm transiently organized into MA flutter periodically, suggesting that it might be a driving circuit for the AF. This led to decision to do lateral MIL. We usually balloon occlude the CS to facilitate this.
Pleased to share AHA Scientific statement on ‘Managing AF in pts with HFrEF’ just published @CirculationEP. https://t.co/WRx3QnrxHF Many thanks to the writing group and reviewers for making this excellent guidance document possible @AHAScience@American_Heart@CircAHA#Epeeps
Congratulations to Marc Wish and the entire @IHVInews EP team on the first @ModulateHF Optimizer CCM implant in Northern VA! Very proud to offer this important therapy to patients with advanced HF. #EPeeps@coconnormd@ShashankSinhaMD@mpsotka
@narrowQRS Vigilance is all you can call for. However fancy this data from Framingham. No difference between stroke outcomes over long term follow up in secondary vs primary AF when detected clinically. Also recurrence is almost as often with secondary. https://t.co/Ai5DMwu5Js
@ivroca@yavin_h@EPeeps@ClevelandClinic @TallRoundsTM The most important consideration is how to deliver maximal current without overheating the sub-endocardium. This is a specific variable for each catheter based on its current density. With 3.5mm, 30-40W for 2-3 minutes (diminishing returns afterward).
Staph bacteremia in pts with CEID & no evidence of device infection, who do not undergo extraction:
✳️19% bacteremia relapse
✳️Relapse correlated with duration of bacteremia
✳️35% 1 yr mortality
Empiric extraction associated w 72% decrease in mortality
https://t.co/poOtgk66zo
Congratulations Hubert Cochet and Pierre Jais and team on a real tour de force:
Pulsed field ablation selectively spares the oesophagus during pulmonary vein isolation for atrial fibrillation https://t.co/NW46ql4c0M (note: COIs in paper)