Takahiro Tsushima

General Cardiology Fellow @University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University,

[Heart Rhythm Case Reports @HRS_CaseReports]

Lead-mediated ventricular tachycardia and lead-mediated radiofrequency energy delivery: Innovative LEAD2ER approach for hybrid ablation with transvenous lead extraction
https://t.co/zelUcZYztu

[Dr. FEVI🫀🩺 @javier20ch]

Vena de Marshall. 🫀⚡️
🔶️La vena de Marshall es un remanente de la vena cardinal izquierda embrionaria que discurre entre la orejuela izquierda y las venas pulmonares izquierdas.
🔶️Lo importante es lo que contiene:
⚡ Fascículo de Marshall (tejido muscular arritmogénico).
⚡ Plexos autonómicos simpáticos y parasimpáticos.
⚡ Conexiones epicárdicas protegidas por grasa.
🔶️Por ello participa en los 3 pilares para generar FA:
🔸️Trigger: genera extrasístoles que inician FA.
🔸️Sustrato: favorece circuitos de reentrada y gaps epicárdicos.
🔸️Modulación autonómica: la estimulación de sus plexos puede inducir FA.
🔶️ La vena de Marshall no es un simple vestigio embrionario; es una estructura neuro-muscular capaz de iniciar, mantener y perpetuar la FA. Por eso se ha convertido en un objetivo terapéutico clave en la ablación moderna de la FA persistente (la infusión con etanol surge como nueva opción). 🫀⚡

📄🆓️⤵️ State-Of-The-Art Review 2026 @JACCJournals 💯👌🏻
https://t.co/wRtVPFbmZ6
https://t.co/qWJKrnsDI0

[javad mikaeili @javadm20]

Frequent intramural PVC’s from midseptal/ps. LV ; gone with high power/ long duration here👇! #Epeeps

[European Society of Cardiology Journals @ESC_Journals]

Ranalozine as an effective suppressant for VE's in arrythmogenic MVP: Can be an alternate for ablation therapy n selected individuals?
https://t.co/kUJdpMlnYK

#EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @girishviswa @SukritiBanthiya @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX

[EP-Live Austin @EPLive2]

Essential session on screen at #EPLive2026: Dr. Cristiano F. Pisani (@InCorFMUSP) presenting on Brugada VT Ablation! 🩺🇧🇷

Reviewing a 36yo male with Brugada Syndrome, positive for an SCN5A gene variant, experiencing disruptive ICD shocks during sleep. Highlighting epicardial substrate modification.

#EPLiveAustin #EPLive #Cardiology #EPMidst #BrugadaSyndrome

[Ez Alddin Rajjoub @EaRajjoub]

PR alternans with narrow QRS does not always reflect a shift in conduction between the fast and slow pathways

#Epeeps

[SREEVATSA NADIG DM FSCAI FESC @nadig_cardio]

Spotter for Cardiology Fellows
25y/O with cyanosis
ECG ( classic) 👇

[Heart Rhythm Case Reports @HRS_CaseReports]

Right Atrium-to-Left Ventricle Access Guided by Computed Tomography Merged with 3D Mapping for VT Ablation in a Patient with Mechanical Aortic and Mitral Valves
@veramasloo @evgeny_lyan @CKuehl2015
https://t.co/8W1TxoTbyY

[European Society of Cardiology Journals @ESC_Journals]

This ECG is a pre-operative screening of a 14-week old infant in the NICU. What is the diagnosis? https://t.co/PHtRVMlRXH

#EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @girishviswa @SukritiBanthiya @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX #EPeeps

[Chris Kowalewski MD @C_KowalewskiMD]

Tips for AVNRT.
For 92% the ablation of the right inferior extension is fine. For the remaining few a different approach might work better.

#NewtoEp
@EPDeneke

[Matthew Goldstein @mattaustein]

Gotta love physiology. #EPeeps what’s the explanation for this beauty of an ECG.

[Ahmed Teebi, MD MPH MSc(Ox)🗝️ @Teebi_MD]

🧵#EGMDecoded 9 — Explained! This is “Peel-back Refractoriness” 🍌🎯

✅Classic phenomenon where refractoriness progressively “peels back” distally before complete recovery following a PVC. Tracing shows gradual improvement in conduction:

➡️2:1 AV block (supra-Hisian) - LCP block
➡️2:1 AV block (infra-Hisian)
➡️LBBB conduction
➡️Normalization of AV conduction

Beautiful illustration of dynamic recovery within the His–Purkinje system⚡️#Epeeps

[javad mikaeili @javadm20]

Very interesting study; how to do anatomical approach abl. in LVS PVC’s! #Epeeps

[Masato Okada @MasatoOkada1105]

Important paper for all PFA users!🚩

PFA-PVI may look successful—but tiny signals matter.

Residual tiny PV potentials ≥0.03mV ⚡️on high-res mapping predicted 1-yr AF/AT recurrence + late PV reconnection (81% spatial concordance).

Do not miss tiny signals.🔍
https://t.co/MbT8cqZ5ZK

@masudamasaha @hrs_journal
#EPeeps #PFA #AFib

[Heart Rhythm Case Reports @HRS_CaseReports]

“Pure” Self-Reference Omnipolar Electrogram–Based Mapping for Localization of the Reentrant Circuit in the Dissociated Right Atrium
https://t.co/4NtX695ZQK

[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]

EHRA 2026 – Paris 🇫🇷
Cardiac Anatomy Workshop
Join us for a hands-on session with real cardiac specimens.

🎁 We will give away both Mini Atlases:
• General Cardiac Anatomy
• Ventricular Anatomy

Monday 13 April 2026 – Room 7
@cardiac_anatomy

https://t.co/pcXGLSJNYy

[Heart Rhythm Case Reports @HRS_CaseReports]

Modified submammary implantable cardioverter-defibrillator implantation after extravascular implantable cardioverter-defibrillator P-wave oversensing in a patient with desmoplakin-related cardiomyopathy
https://t.co/1vPjVpNN3Z

[EuroIntervention @EuroInterventio]

Anticoagulation for post-STEMI LV thrombus
This randomized comparison of rivaroxaban vs warfarin, paired with a prespecified pooled analysis of available RCTs, showed similar LVT resolution with #DOACs and no excess major bleeding, with pooled data suggesting numerically favorable outcomes for DOACs. #EIJBestOf
#cardiotwitter #STEMI #Thrombosis
https://t.co/H0tF8OxvZ5
@yasjenab
@psadeghipour
@bbikdeli
@Drroxmehran

[Dr G Rajesh (Gopalan Nair Rajesh). @DrRajeshG1]

INTERESTING AND RARE ANGIO FOR FELLOWS. 75 year old male had STEMI, lysed in a nearby hospital. What is the finding?