Mati Friehling

Electrophysiologist. Allegheny Health Network

[Mati Friehling @friemx]

@KrishKancharla @Drdevignair @MRazminia @paulzei @BiosenseWebster Looks like this is an afib case and that looks like decanav. Are you routinely using decanav and pentaray for those cases?

[Mati Friehling @friemx]

@gopi_gdanda1 @Hisdoc1 @MdHuang Interesting. Thanks for the insight

[Mati Friehling @friemx]

His pacer... narrow qrs >2.0v with change to rbbb qrs morphology <2.0v and loss of capture at 0.5v. Do you think rbbb qrs is direct LB capture? @Hisdoc1 @gopi_gdanda1 @MdHuang

[Mati Friehling @friemx]

@HHreibe @Hisdoc1 @gopi_gdanda1 @MdHuang I rotated lead more times than usual so I believe it was deep

[Mati Friehling @friemx]

@MdHuang @Hisdoc1 @gopi_gdanda1 Patient was in complete heart block with normal looking narrow QRS junctional escape. Sorry don’t have image of signal from lead, but had almost no A, small his looking signal and large V

[Mati Friehling @friemx]

@KrishKancharla @MJAckermanMDPhD You can get coronary spasm with general anesthesia which could have resulted in vf

[Mati Friehling @friemx]

Target branch with acute angle. Required double wire with .014 and .018 in order to adv renal LVI over vein sel. Difficult to advance, but Mdt lead slowly adv over .018 wire. @seth_j_worley @jeffreycliu1980 @AdelsteinEvan @fixnbroknhearts

[Mati Friehling @friemx]

Pre and post dual chamber pacer with his lead. @jeffreycliu1980 @KrishKancharla @Hisdoc1

[Mati Friehling @friemx]

@KrishKancharla @jelevenson @PittCardiology @EPatPitt @AndrewVoigtMD @KBerlacher Good example of a lead not as septal as the implanting physician thought based on fluoro https://t.co/CXqvRXIntB

[Mati Friehling @friemx]

@AndrewVoigtMD @EPatPitt @PittCardiology @JonathonWertz @TripuraneniAjay @Shivang_P_Shah @jeffreycliu1980 Nice job! Looks like you’re somewhere near the entrance site to the isthmus with very long stim to qrs

[Mati Friehling @friemx]

@FredWuMD @LisaAlderson2 Charge to pt comes from device clinic submitting to insurance. Can have device clinic download less often and therefore charge less often. Would leave device in place and monitor plugged in. If afib occurs, there will be automatic transmission

[Mati Friehling @friemx]

@DoctorPhillEP @jonascooperEP @jeffreycliu1980 @DrRoderickTung @DrFerminGarcia @narrowQRS @rdschaller

[Mati Friehling @friemx]

@DoctorPhillEP @jonascooperEP @jeffreycliu1980 @DrRoderickTung @DrFerminGarcia @narrowQRS @rdschaller Finally took patient to the lab today. @DoctorPhillEP was right on. Used agilis.

[Mati Friehling @friemx]

Sinus node mod for IST. Failed BB, CCB, ivabradine. 2 mo f/u and feeling good.

[Mati Friehling @friemx]

@narrowQRS @MRazminia @aalahmadmd @arorasandeep24 @jonascooperEP Thanks for the great discussion and learning points!

[Mati Friehling @friemx]

@narrowQRS @aalahmadmd @arorasandeep24 @jeffreycliu1980 @jonascooperEP Good point, could just be aberrancy, but looked like the VV interval was faster than the AA interval at around 11s marker.

[Mati Friehling @friemx]

Official position from Biosense below is that cases will not be supported if catheters used are reprocessed by a company not owned by Biosense. Anyone else bothered by this? @drjohnm

[Mati Friehling @friemx]

Interesting initiation of vt with atrial tach and termination with ATP @arorasandeep24 @jeffreycliu1980 @jonascooperEP

[Mati Friehling @friemx]

PM pap

[Mati Friehling @friemx]

EF 45% h/o CABG