It’s possible that she’ll be paced >40%. Main argument was to find a solution during the same procedure. What would you have done? LBBP? This is the paced ECG

Thank you for this suggestion. I am thinking about your idea . This is the ECG before ablation

Would you have ablated this AP, #EPeeps? 68 y/o lady + syncopes + WPW, but a very slowly conducting AP. AP block at 600 ms during IAP. Ablation unmasked LBBB, AV conduction disease with AH 100 ms and paroxysmal complete AV block. AP ablated + Micra AV implanted.

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!

#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

Thank you. “Fortune favors the prepared mind” 🤓 (Pasteur). In this case, fusion of LBBP and intrinsic AV conduction to the RV first helped to create this slim QRS. This is the QRS with VVI pacing

The QRS is beautiful isn’t it? It could be HBP but it isn’t. You can see the pacing lead in the middle of the septum. The QRS is so narrow because of fusion of LBBP avd intrinsic AV conduction to the RV. Therefore you don’t see a Qr in V1 as in VVI pacing during the implant

66 yo lady w #DCM, NYHA 3+, LVEF 12%, LBBB, QRS 170 ms. 3 months ago, I upgraded her #CRT-D w #LBBP. Today: NYHA 1-2, LVEF 35%, QRS 130 ms. But the most important result was not on the echo or ECG. She told me: „Thank you, doc! This operation has changed my life.”

#TLE in a 72yo for recurrent #Enterococcus bacteremia (3 relapses despite antibiotics; PET neg). 20yo passive-fixation RV, 20 yo RA lead & 10yo RV lead. Difficult extraction from above. A combination of Micra sheath + FARAWAVE steerable sheath + needle eye snare changed the game

Unusual case of atypical #AVNRT in 12 yo boy from a neighboring island 🏝️ with daily episodes of palpitations. 2/1 and 1/1 conduction. Procedure done with only 3 s fluoroscopy (to visualize the Agilis guide wire). Cautious ablation of RIE & LIE of SP #Epeeps #Cardiology