Noel Fitzpatrick

Electrophysiology (Cardiology) Fellow

[Gavan Becton @GavBecton]

PLEASE LISTEN 🧵
This is Prof Ronan Collins @ronancollins7 (National Clinical Lead Stroke) scathing criticism of Dept of Health/@HSELive treatment of 850,000 people in Ireland living with neurology/neurodegenerative conditions and the moratorium on recruitment …

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur Marked RA dilatation.

[Micheál Martin @MichealMartinTD]

My statement on the situation in Gaza

[Noel Fitzpatrick @NoelFitzpatrick]

@SergioPinski AT with wenckebach thru AV node. First “p” conducts, second conducts more slowly, 3rd and 4th don’t reach the V.

[Noel Fitzpatrick @NoelFitzpatrick]

@LenSteinberg @jeffrey_vinocur (Near) Isorhythmic V’s and A’s, no VA conduction.

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur Atrial echoes conducted with aberrancy. VA looks longish for AVNRT, hence likely AVRT.

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur @Ed_Gerst Could you try a long-short-long-short type pacing protocol, drive train of 1 beat(long), fixed S2 (short) no delay repeat.

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur Change of atrial origin of depolarisation, PP interval shortens, rate related fascicular block. Though the first QRS of the second morphology isn't early.... hmmm.

[Noel Fitzpatrick @NoelFitzpatrick]

@Flutter_MD 1-1 flutter from flecainide.

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur BCT sensitive to adenosine, LBBB and superior axis with transition at V45. No delta wave on baseline ECG. No changes to baseline with adenosine. Antidromic AVRT with a right sided pathway, possible a Maiham but haven't demonstrated decrement, RB before His etc. Next? EPS....

[Noel Fitzpatrick @NoelFitzpatrick]

@syamkumarmd @EPeeps_Bot Concealed retrograde invasion of the RBBB, with a PAC RBBB hasn't been "invaded" by the previous beat and hence is able to depolarise "early."

[Noel Fitzpatrick @NoelFitzpatrick]

@MartowMartow Appears to be a NCT with short VA. Terminated with VOP without changing the AA CL, consistent with tAVNRT?

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur @SergioPinski @ALFIEEP1 @ECG_Emily Nice ecg. How long ago was the vsd occlusion performed? Was it a peri-membranous vsd?

[Noel Fitzpatrick @NoelFitzpatrick]

My 2 year old son is in obsessed with this song! Thanks @springsteen for spending 1,071 minutes with me in 2022. I couldn’t stop listening to Glory Days. #SpotifyWrapped https://t.co/6KmJZHj7SD

[Noel Fitzpatrick @NoelFitzpatrick]

@MartowMartow @jeffrey_vinocur Would you not just get collision (and block) of antegrade(nodal) and antegrade(pathway) conduction if this was the case?

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur Agree difference most apparent in V1. But I think mix of sinus and ectopic beats

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur Correction: (+) in II,III,aVF = suggestive high to low activation.

[Noel Fitzpatrick @NoelFitzpatrick]

@jeffrey_vinocur I think these are atrial ectopics. They appear to have high to low atrial activation (note negative in II,III,aVF). Tachy consistently ends in a V. T wave of 6th/19th beat different due to P merging w/ T.

[Noel Fitzpatrick @NoelFitzpatrick]

@mattaustein We have just published a case report regarding common inferior pulmonary trunks and the potential benefits of PFA in such cases.

https://t.co/G2T0vy36Gh