It can sometimes still be ablated from the RVOT, with different energy though academic.oup.com/ehjcr/artic…

80sM ➡️remote ER w CP. EKG below. Was given TNK (full/wrong dose), ASA, Plavix 300 (wrong dose) and I was contacted. Pt was transferred via ambulance and met the 🚁 on a hwy halfway. EKG in the air showed >50% ⬇️ STE. Pt arrived and had CP but improved. I waited 2hrs and went #RadialFirst @arnoldseto @SVRaoMD of course there was tortuosity. Guide wouldn’t go, not even close. Did 🦇 w an AL. For fellows/new attendings in Mid-America, this is a common scenario. TNK STEMI/OMI and dealing with extreme remote ERs who do their best but often are extremely understaffed/equipped. Use PAT/BAT and don’t be afraid to stick groin if necessary. I used an Amplatz SS (which I kept loaded in the guide while wiring w a WH wire), patience, and 4 letter words. “God I bet Seto & Rao are laughing at me right now” 🤣. @SrihariNaiduMD @nadig_cardio @noahkaufmanmd @mmamas1973 @aspergian1 @SripalBangalore @DrJayMohan @Allison_Dupont @DrSiyabMD @AntoniousAttall @Hragy @mirvatalasnag @jedicath @TWilsonMD @smithECGBlog @KPujdak

🟡 postextrasystolic changes in repolarisation 🟡 in the patient with long QTc interval The changes in T wave amplitude and shape are best seen in the upper and lower channels only in one beat after the pause. ★ two🧵🧵 of mine & one 🔗

📍Pink Mosque, Shiraz🩷 💫Where Persian architecture meets timeless beauty and artistic glory. ✨ #IRAN #PERSIA

Thank you, Dr Warren “Sonny” Jackman for sharing your extensive experience in another great webinar on accessory pathways! It’s a true delight to listen to someone who still practices the beautiful art of electrophysiology!

50 y/o M with palpitations What's the Rhythm? VT or SVT? #epeeps #epfellows #epfellow @epeeps_bot #ecg #ekg #cardioX #cardiotwitter #Foamed #cardiology

43 years old male with chest pain.

RT @PurumittalDr: It isn’t over until it is over A complex double bifurcation ending in a blot !

⚠️ Unvisualised LCA during ACS: what went wrong? This case by Gulbadin Mufti et al. highlights a rare prepulmonary anomalous LAD mimicking an LM total occlusion, featuring a unique bidirectional bifurcation. 🔗 asiaintervention.org/article… @APSIC6 @EuroInterventio @PCRonline

Old Man. Rhythm? I’ll add a post-conversion #ECG in the comments shortly. #FOAMed #EMS cc @Ecgloverr @ecgandrhythmRoe @IrmaMDv @ECGEPSCADEVICE @JasonWinterECG @PMcardioApp

Preoperative ECG of an asymptomatic 30-year-old man. Would you recommend any further workup before proceeding with surgery?

Interesting Holter Strip. @SergioPinski @KostekMilan @ecgrhythms @Ecgloverr @Frances98392343 @lucasmouraeef

Beautiful atrial flutter in an alternating pattern of bigeminy and trigeminy, due to alternating 6:2 and 8:3. This is due to multilevel block: 2:1 superior, Mobitz I 3:2 alternating with 4:3 inferior. Both at the level of the AV node. #ECG #Cardiology

In anticipation of the discussions Nov 6 #PPS10 in Chicago, I would adjudicate this pacing as:

AVRT versus AVNRT ®️and Why ? @ecgrhythms @ECGEPSCADEVICE @ecgandrhythmRoe @Ecgloverr @nihar_nayak2 @The_Nanashi_O @sumitvermaep @syamkumarmd @KostekMilan @SergioPinski @chinmayparale

Paradoxical ventriculophasic sinus arrhythmia during 2:1 atrioventricular block 🆓 sciencedirect.com/science/ar…

#Epeeps Sandwich 🥪 ablation of symptomatic LV summit PVC: earliest signal -30 ms before QRS in both, LVOT and GCV. LV ablation (40 W) supressed PVC, subsequent recurrence. Sandwich ablation from GCV eliminated PVC w 1st pulse (20 W). 1 min fluoro. Happy patient

Sent to me by a fellow paramedic 64m called EMS for chest pain. Reported it in the center of their chest and stated that it resolved approximately 3 minutes prior to EMS arrival Hx of MI Initial BP of 82/47 Thoughts on this ECG?