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cciari1.bsky.social @cciari1.bsky.social · 16/12/2025

Reposted by Jeffrey M Vinocur

IMO: flat line in DII ➡️ RA/RL lead reversal, SR with pseudofusion beats

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Reposted by Jeffrey M Vinocur

J.M. Cooper @narrowqrs.bsky.social · 23/10/2025

Remains the #1 missed EKG diagnosis. Which is why it was my very first telemetry tips topic! youtu.be/BbLYOcgdPb0?...

youtu.be

Telemetry Tips - Atrial Flutter, Atrial Tachycardia

YouTube video by Dr. Joshua Cooper - Arrhythmia Education

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 22/10/2025

#EPeeps It's not very exciting, but I see this get missed over and over. Less subtle repeat in the thread. #ACHD

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Reposted by Jeffrey M Vinocur

Willy Frick @willyhfrick.bsky.social · 21/10/2025

Do #EPeeps believe in AVNRT upper common pathway (block)? This patient had: 1. AH jump 2. Septal VA < 80 ms 3. Concentric A during SVT 4. During RVP: (Stim-A)-(V-A) > 85 ms 5. During RVP: PPI-TCL > 115 ms 6. SVT terminated by RV burst pacing 7. Ablation in TOK rendered non-inducible

Willy Frick @willyhfrick.bsky.social · 17/10/2025

Reposted by Jeffrey M Vinocur

Arrhythmogenic cardiomyopathy, epicardial access. Pacing from ablator. @narrowqrs.bsky.social @shah.md @jeffreyvinocur.bsky.social @danacjohnson.medsky.social #EPeeps

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Reposted by Jeffrey M Vinocur

J.M. Cooper @narrowqrs.bsky.social · 19/09/2025

2 hearts. Mom? Ecg tech?

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 19/09/2025

#EPeeps This baby's ECG has one of my favorite findings

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 12/09/2025

#EPeeps Very unusual tracings from epicardial pacemaker - mirror noise all well and good, but has anyone seen bipolar go flat like this? Note carefully EGM configuration. @narrowqrs.bsky.social

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Reposted by Jeffrey M Vinocur

cciari1.bsky.social @cciari1.bsky.social · 31/08/2025

Bilateral arm-leg reversal IMO

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 26/08/2025

In line at coffee shop and silently cracking up randomly remembering the day somebody put hazelnut beans in the espresso machine

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 21/08/2025

#EPeeps What do you think from the dot plot? Then see below.

J.M. Cooper @narrowqrs.bsky.social · 02/08/2025

Reposted by Jeffrey M Vinocur

Click BP tracing to expand. What do you think the heart rhythm is before and after the transition?

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/07/2025

#EPeeps My best trick for right anterior/anterolateral pathways is to use SR0, flex catheter until it points straight down, advance sheath to SVC-RA junction, and unflex onto the annulus. You see the angle achieved in Fig 1…you have to take my word for the stability but often better than IJ access.

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/07/2025

#EPeeps I am strangely amused by this. Epicardial pacemaker with failing atrial lead, left in place as VVI backup in case of dislodgement of new transvenous system. "V sensing episode" corresponds to interrogation of new system:

cciari1.bsky.social @cciari1.bsky.social · 13/07/2025

Reposted by Jeffrey M Vinocur

Possibly PVC with retroconduction ➡️ atrial capture failure (or due to atrial refractoriness?➡️ VA conduction ➡️pacemaker syndrome.Are the narrow QRSs paced?

J.M. Cooper @narrowqrs.bsky.social · 12/07/2025

Reposted by Jeffrey M Vinocur

Patient is s/p cardiac surgery with temporary epicardial wires in place. This pacing behavior was seen back and forth, also correlating with 15-20 mmHg systolic BP changes. What could be done to prevent this from happening? @jeffreyvinocur.bsky.social

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Reposted by Jeffrey M Vinocur

J.M. Cooper @narrowqrs.bsky.social · 11/07/2025

Patient admitted with leg injury. No history of syncope. No family history of sudden death. Any concerns? @jeffreyvinocur.bsky.social

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 30/06/2025

#EPeeps Always take the opportunity to review the classics #HoltOramSyndrome

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 28/06/2025

#EPeeps Are people replacing advisory SICD leads at time of gen change?

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Reposted by Jeffrey M Vinocur

J.M. Cooper @narrowqrs.bsky.social · 28/06/2025

Oh my God. Thank goodness for I(f) in the conduction system. (And by the way, tug test anyone? 🤦‍♂️)

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 26/06/2025

#EPeeps Do you look closely and the presenting rhythm strip on your remotes? Answer in the reply 👇

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cciari1.bsky.social @cciari1.bsky.social · 17/06/2025

Isn't PAC a typical trigger of phase 4 block?

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 17/06/2025

#EPeeps What explains the multiple rhythm changes across the course of this strip? Hint: there is no oversensing, undersensing, or loss of capture.

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 05/06/2025

#EPeeps What do you think of this “RhythmIQ” episode captured in device logs? (One continuous strip, sorry about the awkward page break location.)

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 25/05/2025

#EPeeps I never knew this theoretical framework for thinking about multi-level block. It’s nice to have something to explain why we see so much more 4:1 (2:1 and then 2:1) than 3:1

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 24/05/2025

#EPeeps Are you worried by loss of ventricular capture?

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 20/05/2025

#EPeeps ECG is not the mainstay of risk stratification in Tetralogy of Fallot. That said, what started with this q R R' R'' Moved barely a year from primary prevention ICD to this

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 14/05/2025

#EPeeps Have you checked your Sensing Integrity Counter today? There aren't always enough short V-V intervals to cause an episode to be stored (although there are in this case)

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Reposted by Jeffrey M Vinocur

J.M. Cooper @narrowqrs.bsky.social · 11/05/2025

60,000 / 924ms = 65 bpm Pacer no longer functioning in dual chamber mode, but rather VVI mode. And pacing at 65bpm. Medtronic dual chamber pacemaker, reached ERI, pacing at VVI 65 bpm. 😅

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 10/05/2025

#EPeeps An interesting ECG. What do you learn about the rhythm? What do you learn about the pacemaker? Hint below

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 09/05/2025

#EPeeps I always think this is cute for some reason

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/04/2025

#HRS2025 #2025pacesetter Lisa Dellefave-Castillo MS, CGC from Northwestern on genetics of LVNC …and a suggestion on the third slide for free online education modules for those interested in learning more about cardiogenetics

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/04/2025

#HRS2025 #2025pacesetter Frederic Sacher from Bordeaux on imaging prediction of VT isthmuses in congenital heart disease ➡️Despite suboptimal imaging (low res MRI, CT within late iodine sequences) in many patients, InHeart software performed remarkably well

Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/04/2025

#HRS2025 #2025pacesetter Jeremy Moore from UCLA on slow-conducting anatomic isthmuses in Tetralogy of Fallot ➡️75 is the new 50 Or at least, 0.75 m/s is the new 0.5 m/s

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 27/04/2025

#2025pacesetter #HRS2025 Eihab Ghantous from UCLA on inducible polymorphic VT in Tetralogy of Fallot Manuscript in press at JACC EP

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 26/04/2025

#2025pacesetter Anushka Desai from Georgetown on ablation risk for ACHD vs non-ACHD

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Jeffrey M Vinocur @jeffreyvinocur.bsky.social · 26/04/2025

#2025pacesetter Only in pediatrics! Cecilia Gonzalez Corcia and Georgia Sarquella Brugada refuse to debate at their debate. Instead they constructed a collaborative high-impact presentation on sodium channel blocker challenge for Brugada syndrome