Differential Pacing – Parahisian Pacing Interpretation

Parahisian Pacing – Quick Review   As discussed in the previous post, parahisian pacing is performed by pacing the HIS catheter at high output. A narrower QRS complex is observed with HIS capture, the pacing mA will then be decreased until a wide complex is...

Differential Pacing – Part 1

What are we doing?   A 35-year-old patient is in the EP lab with complaints of palpitations. A two-catheter study is being performed with a decapolar CS and a deflectable quad for the His and RV applications.    What test is being performed in the following...

XRay Views in EP

What are we looking at?   During catheter placement and throughout the procedure, the electrophysiologist will rotate between two main x-ray angulations. The following image are examples from my case files and are only meant for an introduction to x-ray views....

Let’s Burn!

We have tachycardia…   The patient has been determined to have AVNRT and a slow pathway ablation is being performed. This 3D image is in an RAO projection with a cutaway to see the internal aspect of the right atrium. Which of the following would you...

SVT Case Study – #3

A 45-year-old female presents to the EP lab with complaints of palpitations and the following 12 lead ECG that was recorded in the emergency room 2 weeks prior. 12 Lead ECG:  What do you observe?   Answer: Retrograde P Waves  Notice the retrograde P waves,...