Apoor Patel

Electrophysiologist at Houston Methodist. All views are my own

[Heart Rhythm TV @HeartRhythmTV]

NEW from Heart Rhythm TV x @CardioNerds!

In the fifth episode of our EP Spotlight series, @CBlumenthal2 sits down with @PatelApoor to discuss Pulsed-Field Ablation of the Mitral Isthmus, focusing on transmurality and autonomic effects validated by Vein of Marshall recordings. See the full interview here #EPeeps ➡️ https://t.co/U9v8UZyIwj

[Apoor Patel @PatelApoor]

Great experience with Nuvision Nav and Varipulse! Imaging quality was exceptional and love the ability to accurately assess catheter contact with multiple imaging planes. Nice catheter design and minimal manipulation needed to obtain views.
#AFib #Epeeps #NuvisionNav #4DICE

[Rajan Shah @atrialappendage]

Grateful for the opportunity @BSCCardiology to teach about conduction system pacing—and for the new friends made along the way. Cheers to learning, connecting, and growing together #LBBAP #MedEd #EPeeps @bluehoosiermd @PatelApoor @gauravaupadhyay

[Apoor Patel @PatelApoor]

Excited to share our multicenter study from Houston Methodist: Pulsed field ablation led to lower 30-day readmissions and higher same-day discharge vs RF ablation for AF. Important implications for quality and cost.
#CardioTwitter #EPeeps
https://t.co/1hlU9q8Qz8

[Adi Lador @LadorAdi]

Master the Vein of Marshall. This step by step guide details a precise, reproducible approach to ethanol infusion to improve outcomes in persistent AF and enhance mitral isthmus block.
https://t.co/ZkzgZUP6cs

@PatelApoor @MiguelValderrab
#Epeeps #Afib #CardioTwitter

[Marek Jastrzębski @Marek_Jastrz_EP]

Yesterday's FUNCTIONAL DSP case. F-DSP concept is not a licence to accept any ugly paced QRS. 1) proof of LBB capture or LVSP position is required, 2) should do something more!
#Epeeps
@ZacharyWhinnett
@OCanoPerez
@MargaridaPujol
@kvernooy
@micogriecomd
@Dr_JozaEP
@Hisdoc1

[Bengt Herweg @BengtHerweg]

•Conduction System Pacing Optimized Therapy (CSPOT)
•This rather complex acute hemodynamic study revealed incremental benefit of LOT-CRT in patients with deep septal pacing (LB capture not achieved) with a paced QRS>170 ms. Thank you to all collaborators
•@Marek_Jastrz_EP
•@Hisdoc1
•@ZacharyWhinnett
•@gauravaupadhyay
•@rdschaller
•@BengtHerweg
•@TGHcares
•@USFHealth
•https://t.co/PMFlcGzrnH

[Apoor Patel @PatelApoor]

Patient with inferior STEMI. Meets Sgarbossa criteria for MI in context of LBBB. https://t.co/uiSOn57UqA #epeeps #CardioTwitter

[Apoor Patel @PatelApoor]

Asked to see a patient with a history of LBBB and atrial fibrillation on flecainide for VF and a concern of flecainide toxicity. What is actually happening? (see next post for answer) #epeeps #CardioTwitter

[Apoor Patel @PatelApoor]

VOM ethanol is durable and most mitral reconnections post VOM involve endocardial annulus or coronary sinus.
https://t.co/0m2Q34nbmp
After termination of mitral flutter induced anterior wall reentry which was also ablated. #Epeeps #cardiotwitter @MiguelVldrbno

[Apoor Patel @PatelApoor]

Recurrent mitral flutter in a patient with prior PVI, posterior wall, inferior mitral line, and ethanol in VOM. Terminated with one endocardial burn at the mitral annulus consistent with recent publication by @miguelvldrbno (see next tweet).

[Miguel Maturana, MD @mmaturanaMD]

Open window technique to map this beautiful left lateral pathway. #curativeEP
@PatelApoor @kandacenicole13

[Antonio Frontera @sozi81]

Functional phenomena predict recurrences of #AtrialFibrillation— finally on-line #HeartRhythmJ! One of our key discoveries is that many of these functional phenomena have normal bipolar voltage and are strongly linked to extracardiac structures (aorta and esophagus).

Link https://t.co/vqyoxAjHTo

[Apoor Patel @PatelApoor]

Tug tests for Watchman! ICE is invaluable for assessment of tissue contact with the device. Third example done with 2D ICE shows minimal apposition on ridge and was repositioned. Other two images are Nuvison. #EPeeps #cardiotwitter

[Apoor Patel @PatelApoor]

@syamkumarmd Great point! Certainly possible but sinus P wave marches at regular intervals and I think sinus beat after slow pathway has decrement in fast pathway due to concealed retrograde conduction causing an intermediate PR or block.

[Apoor Patel @PatelApoor]

Great example of a dual AV nodal response! One sinus beat conducts down fast and slow pathway, resulting in two ventricular depolarizations. Can be confused for AF and VT (aberration) and lead to tachy induced cardiomyopathy. Two articles in next post. #Epeeps #cardiotwitter

[Apoor Patel @PatelApoor]

For dual AV nodal response to occur ERP of His-Purkinje system has to be shorter than the interval between fast and slow pathway conduction. Two great articles: https://t.co/vDeO94Tv1c
https://t.co/yOXP6TwMYA

[Apoor Patel @PatelApoor]

@AveragingBogey @BurtchKatelyn Sheath was back in the right atrium. Prolapsed lower in RV and then gently pushed up.

[Apoor Patel @PatelApoor]

Difficult RVOT PVC! Reverse U curve in pulmonic sinus junction led to termination. Next post has a great article that discusses pulmonic cusp PVC location based on imaging with ICE. #EPeeps #cardiotwitter @BurtchKatelyn

[Apoor Patel @PatelApoor]

@gautamsand @DanielPMorin Well deserved Dan. Congrats!

[Apoor Patel @PatelApoor]

Clinical PVC and article reviewing pulmonic cusp PVCs. https://t.co/WgSacASI6B