What is the rhythm? Answer: This is atrial flutter. Notice the regular atrial rate and that there are more atrial events than ventricular. We can also see that the CS is depolarizing from proximal to distal. Is this typical AFL? How do you know? How can...
How do we determine success? A patient undergoing PVI (pulmonary vein isolation) for paroxysmal atrial fibrillation is in the lab. After completion of the WACA (wide area circumferential ablation), there was remaining signal in the left superior pulmonary vein. The...
What are we looking at? How would you interpret the following electrogram? Is it completely normal, just here to get you thinking? Is there pacing? If so, from which site? Did it capture & conduct? Anything other observations? Answer: In this...
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...
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...
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....
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