HeartRhythmEducation

[Dr Vishal Luther @vish_luther]

#EPeeps - tough case👇
⚡️VF triggering pathway from CS diverticulum. Neck >5mm from PLV.
🥉Took 3 goes to get rid of it. Bumped each time - gave limited RF - back in 24hr.
🔥 Encircled neck (30W-20sec) with irrigated RF and its FINALLY gone! @LiverpoolEP
#Alwayslearning

[Dr Vishal Luther @vish_luther]

#EPeeps - epi RF ablation in transverse sinus to terminate peri-mitral flutter and block anterior mitral & LA roof lines @LiverpoolEP

Epi access with CO2 insufflation post CS exit @JohnSilberbauer 🙏

Excited for EPIC-AF @AbbottCardio - redo PVI vs redo PVI + Endo/epi lines 🤔

[Sophon @Sophon]

Are you ready to join Sophon?

Share this post and embrace this final moment...

The calm before the storm.

End of tweet.

[Dr Vishal Luther @vish_luther]

We found similar impedance drops + contact force as 50W/10-15sec lesions under GA, inferring that catheter stability may be similar under sedation with RF restricted to 4secs.

With 👍 12-month freedom from AF recurrence, a nice alternative where anaesthetic support is limited.

[Dr Vishal Luther @vish_luther]

#EPeeps – is GA/deep sedation available for every AFib ablation in your centre? 🤔
…No❓
We discuss our “@LiverpoolEP Streamlined Approach” to RF PVI under mild conscious sedation using 90W/4sec #QDot @BiosenseWebster

Now online open access @JCardioEP

https://t.co/WOIzBHJyXT

[Journal of Cardiovascular Electrophysiology @JCardioEP]

Excellent study with important findings; Available for #OpenAccess @JCardioEP: https://t.co/CpMZoUClrx

[Dr Vishal Luther @vish_luther]

📢When imaging meets #EPeeps
"RVOT ablation close to an anomalous right coronary."
Read👇 @HRS_CaseReports how we @LiverpoolEP used #CARTOSEG + #CARTOSOUND @BiosenseWebster to visualise the anomalous RCA, just 1mm from the posterior RVOT
👏Dr Pete Calvert
https://t.co/3YAC9iVY8Z

[Dr Vishal Luther @vish_luther]

#EPeeps #ablateVT
Do you set your bipolar voltage LV substrate maps to 0.5-1.5mV?

We @LiverpoolEP describe an alternative approach using CARTO Ripple Map to differentiate scar (=no ripple bars/red) from borderzone @BiosenseWebster

Open access @JCardioEP
https://t.co/8vigO5HfSS

[Dr Vishal Luther @vish_luther]

#EPeeps
Delighted to share #EHRA2022 abstract

"Using Ripple Mapping + PentaRay @BiosenseWebster to differentiate post-infarct scar from borderzone on a bipolar voltage map during VT ablation" #NoMore050to150mV
Congrats to @DibbendhuK & team @LiverpoolEP

https://t.co/ptXGyMps6D

[Dr Vishal Luther @vish_luther]

Little is known about the safety of cardiac ablation in Ehlers Danlos syndrome. Thanks to Dr Peter Calvert EP Fellow @LHCHFT @LiverpoolCCS, we share our stepwise approach to planning cardiac procedures in EDS. #EPeeps #cardiotwitter @DhirajGuptaBHRS @TheEDSociety @ehlersdanlosuk

[Dr Vishal Luther @vish_luther]

#EPeeps
🔸#QMode+ (90W-4sec) PVI (~2min RF per WACA), well tolerated under conscious sedation with little resp drift
🔸Induced this dual loop flutter involving idiopathic anterior LA scar <0.1mV #Ripplemap
🔸40W RF scar isthmus transection = sinus
@LiverpoolEP @BiosenseWebster

[Dr Vishal Luther @vish_luther]

#EPeeps Excited to learn more of @AbbottCardio #EnsiteX ingenious Omnipolar vectors timing independent activation mapping. My first use in this CTI gap @LiverpoolEP.
I wonder how the vector is assigned when a large far-field EGM is seen in low voltage scar 🧐. @aportasanchez

[HeartRhythmEducation @EducationRhythm]

#EPeeps

@TheBJCA @BritishCardioSo @HRSonline

[Heart Rhythm Congress @heartrhythmcong]

#HRC2021 #HRCLIVE

EP Traces Course:
3rd October 2021; ​2pm–5pm BST
With @vish_luther & Dr Simon Modi

FREE TO REGISTER: https://t.co/XvI3FAOD4B

[Dr Vishal Luther @vish_luther]

#EPeeps
-Watch Vid 4 (2mins) - Ripple Map in stable VT.
-Bars in diastole reveal the conduction channel. Adjusting the voltage display defines its anatomical location in relation to scar <0.15mV
-RF-1 term⚡️
👏@gkatritsis & team
Free download ends today
https://t.co/7Cj9ElPW6i

[HeartRhythmEducation @EducationRhythm]

@DhirajGuptaBHRS @DrJasonAndrade @Dominik_Linz @LuigiDiBiaseMD @PrashSanders @drraviele @MDTolgaAksu @AndreaRussoEP @DavidDuncker @bogdienache @josoriomd @GerdHindricks @SteffelJ @drjohnm @TJaredBunch

[Dr Vishal Luther @vish_luther]

#EPeeps - what do you recommend?

40M, CHA2DS2VASC=0, paroxysmal AFib (symptoms x1 per week, last few hours), plan for first time PVI under conscious sedation. Normal LA size.

(Note: ESC AF GL 2020 “>3 weeks NOAC in pt WITH stroke RF”. No recommendations for those without RF)

[Dr Vishal Luther @vish_luther]

📢Calling all #EPeeps #AblateVT "channel hunters"

Our manuscript @hrs_journal👇- ablating CARTO
#Ripplemap channel entrances alone, we show "late potential" elimination WITHOUT direct ablation⚡️
#Dechannelling #interconnectedchannels

@DrRoderickTung @DrBerruezo @BiosenseWebster

[Prof Dhiraj Gupta @DhirajGuptaBHRS]

Our Ablation Index guided 50W #AF ablation paper published in @ESC_Journals

Excellent 12-month results, safety (zero steam pop)
Much shorter Abl and procedure times than AI-guided 35-40W
https://t.co/KZsZvxFgYH

@jongichun @BorisSchmidt5 @LHCHFT #EPeeps
1/3

[Dr Vishal Luther @vish_luther]

#EPeeps
In case you’ve not seen this Carto feature yet - to compare timings of any mapped points, highlight the points as “ripple marking” (coloured bars👇) & 👀 the EGMs in the “ripple viewer”

Was useful in this VE abl (comparing timings from RVOT, LVOT & GCV)
@BiosenseWebster

[HeartRhythmEducation @EducationRhythm]

@abhishek_mbbs @MayoClinicCV @DrDeese99 @SivaMulpuruMD @akillumd That’s super @abhishek_mbbs . Please do share the link here when released! Another great resource for #EPeeps !