EP 101 2020: A Virtual Program for Incoming EP Fellows-Fundamental Electrophysiology Maneuvers

Video Transcription

Video Summary

The video discussed the topic of EP maneuvers, which are used to perturb arrhythmias and understand their underlying mechanisms. The main focus was on two specific maneuvers: PVCs during tachycardia and para-hysian pacing. In the case of PVCs during tachycardia, pacing is used to mimic a premature ventricular contraction (PVC) and observe the resulting changes in the atrial electrogram. By analyzing these changes, one can determine whether the arrhythmia is due to AV node reentry or an accessory pathway. The para-hysian pacing maneuver, on the other hand, involves pacing at high and low output near the His bundle to determine if the atrioventricular (AV) conduction is dependent on the AV node or an accessory pathway. By comparing the activation sequences and the presence or absence of His bundle capture, the mechanism of the arrhythmia can be identified. The video also mentioned the importance of understanding the underlying physiology and anatomy in order to correctly interpret the results of these EP maneuvers. It emphasized the need to analyze changes in activation sequence and be aware of exceptions to the general rules. Overall, the video highlighted the significance of these maneuvers in diagnosing arrhythmias and making informed decisions about treatment.

Asset Subtitle

Sam Asirvatham, MD

Keywords

EP maneuvers

arrhythmias

underlying mechanisms

PVCs during tachycardia

para-hysian pacing

atrial electrogram

AV node reentry

accessory pathway

His bundle

AV conduction