William Perucki, MD

Father, Husband, Son, Low Voltage Electrician. @UConnIM @HHCardsFellows, and @TempleCards EP Alum. Opinions my own.

[Temple Cardiology Fellowship @TempleCards]

⚡️Para-Hisian pacing ⚡️EXPERTLY explained by our senior fellow Natasha Vedage @nat_ved 👏🏽

#TempleMade 🏥 @TempleCards & @TempleIM

@AHAMeetings #AHA23

“It’s the Journey, Not the Destination”

Thank you to our dedicated EP mentors @docwhitman @narrowQRS @whperucki @AnujBasil

[JMC @narrowQRS]

Please enjoy our case report on a patient referred for pacemaker pocket infection who had something very different!

https://t.co/s68F5FdxgG

@whperucki @ShreyaMakkapati @dblaslett

[William Perucki, MD @whperucki]

Wordle 472 1/6*

🟩🟩🟩🟩🟩

No one believes me. Pure luck (and maybe some influence from a nursery rhyme)

[JMC @narrowQRS]

Pt weak, lightheaded, 911 called.
▪️First EKG is from EMS, performing transcutaneous pacing.
▪️Second EKG is in ER.
What's going on?

[Tilman Schneider @TSchneiderMD]

These #echofirst pictures are less than 48 hours apart showing the effect of #atrialstunning in a patient with spontaneous conversion from #afib to #sinusrhythm and paused anticoagulation due to gastrointestinal bleeding. #epeeps #cardioed @KardiologieHH

[Ziggy Whitman @docwhitman]

Classic real-time annotation by @narrowQRS as @AnujBasil discusses #HOTB. First didactic session of the year for our new and proud EP fellow, @kloosclues #startwiththebasics #colorannotationhelps #TempleEP @TempleCards

[Heart_BMJ @Heart_BMJ]

Management of premature ventricular complexes

https://t.co/3drhZM9G5n

[William Perucki, MD @whperucki]

Not what we expected!

Selective His pacing with VA time ~160ms, non-selective ParaHisian pacing with VA time ~120ms.

Instead of equal VA time during ParaHisian pacing, a paradoxical difference in VA time revealed the presence of an AP! @docwhitman @AnujBasil @narrowQRS

[Edmond Cronin @dredcronin]

How to implant a Micra during a national contrast shortage, or in a patient with a severe contrast allergy? ICE has been described, but TTE is cheap, non-invasive and helpful to confirm septal position.
@whperucki
#EPeeps

[Dan Rather @DanRather]

Those who claim that nothing can be done just prove they don’t have the creativity or empathy to lead.

[NEJM @NEJM]

This case report describes a patient in Sweden who had an out-of-hospital cardiac arrest and received defibrillation with an automated external defibrillator delivered by a drone (shown in a video). https://t.co/PvjYPJmO90

[William Perucki, MD @whperucki]

The result of a robust journal club discussion with the Temple EP team! @docwhitman @dredcronin @Dr_Smietana https://t.co/0wrmRTZSZo

[Ziggy Whitman @docwhitman]

A submuscular CIED pocket can/should be bloodless, and is gratifying - for patients and implantor (and fellow!) alike. Should we be doing this more often, even as a standard consideration? @narrowQRS @rdschaller @ByronKLee @JDMossMD @JagSinghMD @whperucki

[JMC @narrowQRS]

A truly great device case. I have so many images, I almost don't know where to begin to share. Still many images to scan in, but here's a good start.
Pt. admitted with palps. Dual chamber pacer in place, with a cardiac history.
What is going on? (yes symptoms during fast pacing)

[European Society of Cardiology @escardio]

#APAF-CRT trial: ablation plus #CRT is superior to pharmacological rate control in reducing mortality in severely symptomatic permanent #AFib patients with a narrow QRS

#ESCCongress

[European Society of Cardiology @escardio]

#LOOP Study: continuous heart rhythm monitoring – with anticoagulation if #AFib is detected – does not prevent #strokes in those at risk

#ESCCongress

[William Perucki, MD @whperucki]

Great weekend full of learning at the @AbbottCardio EP 301 fellows course in the Windy City (with time for a quick run).

[William Perucki, MD @whperucki]

First time feeling the satisfaction of a successful CTI line!

[JMC @narrowQRS]

Compare and contrast.
2 patients. Called for bradycardia on each.
One was shown yesterday (pt 1), other is a good comparator. What do you think?
@ECG_Emily @ecgrhythms @adribaran @jeffrey_vinocur @MaruanCarlos @SergioPinski