Ari Bennett

Cardiac Electrophysiologist

[Ari Bennett @arijbennett]

@drjohnm Differential includes junctional tach, Nodoventricular/nodofascicular tach, and avnrt with upper common pathway block, right? No matter what, something very rare. EPS tells all.

[Ari Bennett @arijbennett]

@JAHA_AHA I believe that the word “reduced” is not the best choice without randomization.

[Ari Bennett @arijbennett]

@mattaustein @jeffrey_vinocur I meant a-pacing. But I’m guessing based on your answer I missed the mark?

[Ari Bennett @arijbennett]

@mattaustein Other possibility for higher pacing upon return could be that initial time before reacclimation to low altitude had more pacing. If you’re looking for a more nuanced answer out of me, I might need some more of @jeffrey_vinocur ‘s Socratic method.

[Ari Bennett @arijbennett]

@mattaustein Maybe totally off? Either 1) switched to night shifts w modafinil then stopped or 2) traveled half way around the globe to high altitude for ~11 weeks. Took it easy upon return w less activity/day and more pacing, then back to nml activity/adjusting back to sea level at the end?

[Ari Bennett @arijbennett]

@jeffrey_vinocur @3MahmoudElsayed @ECG_Emily Seems to be vs and either ap or csp w intermittent capture. I don’t know of any intentional avi ppm setting, but on ddx is aai w ffrwo and concomitant pw undersensing. I’ll put my money on vvi, but could be that other ddx. Not confident. Would love an interrogation and/or cxr.

[Ari Bennett @arijbennett]

@jeffrey_vinocur @3MahmoudElsayed @ECG_Emily It’s the pwave. It just took me too long to give up that it was part of the qrs from when I had previously thought the patient was vvi pacing (anchoring).

[Ari Bennett @arijbennett]

@3MahmoudElsayed @jeffrey_vinocur @ECG_Emily @nbwiggins mentioned a pacing. As qrs morph is slightly dif at onset in paced vs conducted beats, I originally took this as evidence of v pacing. Paced a coinciding with qrs onset is one explanation; another is manifest ap during long native pr that is concealed during a pacing.

[Ari Bennett @arijbennett]

@3MahmoudElsayed @jeffrey_vinocur @ECG_Emily Agree again. Also worth noting that paced qrs VERY closely matches intrinsic qrs (tiny pos def at qrs onset visible in the strip). Likely sel ccsp w latency. Failure to capture w isorhythmic intrinsic qrs falling in the vbp unlikely w morph dif and consistent stim-qrs.

[Ari Bennett @arijbennett]

@DZack23 It’s interesting that you get such different answers when asking for a list and don’t have to specify that each unique suggestion is very different from the others.

[Ari Bennett @arijbennett]

@SeanMurphyMBBCh @GaryParizher @argulian @zilgiovineMD @CCFcards Upvote

[Ari Bennett @arijbennett]

@jeffrey_vinocur I suppose this algorithm could also lead to the wrongful discrimination of a rare case of bidirectional VT as TWOS, no?

[Ari Bennett @arijbennett]

@DZack23 I bet your friend Al would have caught on to that faster than I

[Ari Bennett @arijbennett]

@syamkumarmd @EPeeps_Bot Sinus rhythm with phase 4 rbbb that normalizes with PACs?

[Ari Bennett @arijbennett]

@DrToddLee @drjohnm @JAMACardio @lusty63 The between group stats are in the manuscript and in the visual abstract. In the abstract text, they only show the within-group stats. Agree the BL score is fairly different. Comparing final scores (not just delta) would be a helpful sensitivity analysis. Supplement has raw data.

[Ari Bennett @arijbennett]

@DrToddLee @drjohnm @JAMACardio @lusty63 That stats paper describes type 1 error caused by concluding that there’s a between-group diff after doing only 2 separate within-group comparisons showing 1 to have p<.05 and the other p>.05. The abstract from the JAMA cards paper shows a sig between-group diff. Doesn’t apply.

[Ari Bennett @arijbennett]

@syamkumarmd @EPeeps_Bot Basal inferior LV. Antidromic avrt vs preexcited flutter vs VT. Possibly a sign of delta in lead III in nsr? I’ll put my money on antidromic avrt as most likely, but needs EPS to know.

[Ari Bennett @arijbennett]

@jeffrey_vinocur @SergioPinski @ALFIEEP1 @ECG_Emily Sinus rhythm w/ ventriculophasic response, ventricular bigeminy w/ concealed conduction to the AVN, and Mobitz 2:1. That’s my guess. Spent a while thinking through this one.