Roy Chung

#EP #ILAM #StaMP VT #S2 #ICE 👀

[John P Erwin III MD MBA MACC (#BigPoppy ) @HeartOTXHeartMD]

People ask me all the time why i stay in medicine when I understand business, economics, and finance so well.

Easy answer – when I got into medical school after playing college football, my Dad – who was the first kid in his family to go to college & ultimately medical school, sent me a letter and said, “you’re entering the noblest of professions”.

I still believe that! Wholeheartedly

[Roderick Tung @DrRoderickTung]

There is a lot to learn about in the inputs into Bachmann's area. Is the septal base of RAA enough?

Congrats to @alexandra_regia for publishing our alternate site leadless case & re-exploring anatomy. The band of fibers bifurcates around both appendages in McAlpine. @lusty63 @jacabreracardio @shivkumarmd @Dr_JozaEP

Septal Implantation of a Leadless Atrial Pacemaker: Relevant Anatomy for Alternate Sites into Bachmann’s Area https://t.co/yrKkcPettf

[Aaron Matthews @AMatthews0]

Multiple VTs produced by dense lateral scar. Procedure performed by @ChauVoMD of @MUSC_EP

[Aaron Matthews @AMatthews0]

Septal VT mapped by @ChauVoMD of @MUSChealth. Entrained and terminated. @AbbottCardio @inheartmedical

[HeartRhythm @hrs_journal]

Arrhythmia Substrates Accessible from the Aortic Root and Immediate Sub-aortic Areas: Mapping and Ablation #OpenAccess

https://t.co/gWrqdWIxa5

[NirajSharmaMD @NirajSharmaMD1]

CLEAR-VT is not just a “new catheter” story.

Dual-energy lattice-tip ablation may improve efficiency in complex VT, but the safety signals are just as important as the efficacy signal.

EP Edge Clinical Minute reviews the tradeoff.

#VT #EPeeps #Electrophysiology #EPClinicalMinute

Is larger-footprint ablation the future of scar VT, or are we underestimating platform-specific risk?

[JACC Journals @JACCJournals]

This #JACCCEP study suggests that endocardial radiofrequency catheter ablation of LVS VAs through an anatomical approach should first target the endocardial earliest activation site (EAS) rather than sites anatomically closest to the epicardial EAS. https://t.co/ifcDUeBfRo

[色々自粛中(ガラス細工の様な繊細なハートを持つ貴公子🤴)こちらを本稿に戻しました🌟 @ECGEPSCADEVICE]

永嶋学長が仰っておられたfast-slow AVNRTの本体はslow-slow AVNRTでfast pathwayはbystanderであるというジャックマン先生の仮説のシェーマです‼️
#小倉ライブ2026

[Sabatu @tsubazoom]

Lattice-tip catheter for septal ventricular tachycardia ablation guided by preprocedural imaging - Heart Rhythm https://t.co/1IrhbHBP1G

[Piotr Futyma, MD @ftrae]

Durable block of the anterior and mitral lines is difficult to achieve, even with a lattice-tip catheter

[Dr. José Ángel Cabrera @jacabreracardio]

Recognizing the septopulmonary region not as an isolated “bundle,” but as a functional 3D myocardial architecture, is essential for interpreting mapping data & optimizing ablation strategies
@JACCJournals @DrRoderickTung @davidgzcasal @DamianSanc1955

https://t.co/nnirFWiTnc

[Ivo Roca, FEHRA, FESC @ivroca]

Recently published in @CircAHA our long-term PAM-VT2 study: Post-ablation MRI to predict long-term VT recurrence, to assess scar evolution, new +remodelling effect after ablation proved! A long journey working together EP, imaging, bioengineers. https://t.co/frY1ugnr1U

[Roderick Tung @DrRoderickTung]

Yet another reason to avoid targeting the posterior fascicle with LBBaP.

Posteromedial papillary muscle perforation with preserved electrical parameters: a novel complication of LBBaP
https://t.co/yymXEhcGoe

[Ivo Roca, FEHRA, FESC @ivroca]

Happy to share our last article about 3D VT substrate, depth is part of the game to plan RF approach @S_Vazquez_Calvo @aportasanchez @ADAS3D @hospitalclinic @tolosanaviu @EduGuasch @LluisMont2 @guichard_jb @PSanchezSomonte

[NEJM @NEJM]

Cardiac physiologic pacing, also known as cardiac resynchronization therapy, is indicated in patients with heart failure, reduced left ventricular ejection fraction (LVEF) of 50% or less, and either a high (or anticipated high) ventricular pacing burden or a wide QRS complex. Traditionally, physiologic pacing has been achieved with biventricular pacing with a right ventricular lead and a coronary sinus branch lead. Randomized trials involving more than 10,000 patients with heart failure have shown clinical, exercise, and quality-of-life benefits associated with biventricular pacing, as well as improved LVEF and reduced mitral regurgitation and ventricular volumes. These benefits are greatest in patients with left bundle-branch block and a QRS duration of 150 msec or longer. Recent studies support targeting the His bundle or left bundle branch as an alternative cardiac physiologic pacing strategy. Ongoing randomized trials are expected to more clearly define the comparative efficacy and safety of conduction system pacing as compared with biventricular pacing.

Read the Review Article “Physiologic Pacing in Heart Failure” by @MihailChelu, MD, PhD, Jeanne E. Poole, MD, and Kenneth A. Ellenbogen, MD (@KennethEllenbo1), from the Baylor College of Medicine (@bcmhouston), University of Washington (@UW), and Virginia Commonwealth University School of Medicine: https://t.co/RuLZCpYUXn

[Dr. Purvi Parwani @purviparwani]

🍩Ring-like late gadolinium enhancement (LGE) is an uncommon cardiac MRI finding, present in ~1% of patients undergoing CMR.
🍩Most commonly present in dilated and non-dilated left ventricular cardiomyopathies, and spans multiple etiologies, including genetic, inflammatory, and idiopathic causes.
🍩Over a median follow-up of three years, patients with ring-like LGE experienced ~18% with major arrhythmic events and a similar proportion of death, heart transplantation, or LVAD implantation.
🍩Ring-like LGE represents a shared high-risk myocardial substrate rather than a disease-specific imaging pattern.
#whyCMR #CVimaging #SCMR2026

[Joe Demian @joedemian1]

New in @CirculationEP: Focal monopolar #PFA lesion geometry is titratable in vivo. Voltage, #apps, CF & angle shape depth/width. Practical framework for more consistent lesions. @arwayounis2 @omwazni @Dr_Santangeli @CleClinicHVTI #EPeeps

🔗 Full article: https://t.co/xXwZajI9MY

[HeartRhythm @hrs_journal]

Purkinje and septal substrate modification as a therapeutic option for patients with STEMI and refractory ventricular fibrillation #OpenAccess

https://t.co/UwSKKbVm3c

[Heart Rhythm O2 @HRS_O2Journal]

Trans–right atrial access to the left ventricle for catheter ablation of ventricular tachycardia in a patient with double left-sided mechanical valves: First case report from Latin America, by @FellowEP and colleagues
@Ufrontera #HRO2GlobalVoices #EPeeps
https://t.co/IpOjce4ZJP

[Pasquale Santangeli @Dr_Santangeli]

The target paraseptal fat pads at the Waterston’s groove can be reconstructed with ICE as the only imaging modality to guide anatomical cardioneuroablation. Adjacent structures to avoid (right phrenic nerve) can also be reconstructed. @EuropaceEiC @CleClinicHVTI