Dr. Joshua Cooper - Arrhythmia Education
Dr. Joshua Cooper - Arrhythmia Education
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Surgical epicardial pacing wires - uses and management
(Quick links for topics below!) This video reviews how temporary epi pacing wires are placed, how they work, and basic management and troubleshooting in the post-op cardiac surgery setting. Loss of capture, oversensing, undersensing are reviewed, as well as using atrial epi wires for arrhythmia diagnosis and treatment.
1.Introduction - 0:00
2.Surgical epi wire basics - 0:19
3.Temp pacing and heart rate, BP - 9:51
4.Underlying rhythm assessment - 12:55
5.Pacing threshold testing - 15:29
6.Pauses from oversensing - 19:54
7.AV interval adjustment - 25:48
8.Epi pacing induced arrhythmias - 28:26
9.Using atrial epi wire for SVT diagnosis - 36:07
10.Using atrial epi wire to terminate AT/A.flutter - 41:41
11.Options to improve elevated ventricular pacing threshold - 47:35
12.Summary - 52:47
Переглядів: 5 906

Відео

TAVR and Pacemaker - May I Need Both? (In Plain English)
Переглядів 3 тис.6 місяців тому
Up to 15-20% of patients who have a TAVR aortic valve procedure end up needing a pacemaker as well. Here's an explanation why, in plain English!
Living With A Pacemaker (common questions answered) - in Plain English!
Переглядів 37 тис.8 місяців тому
Answers to common questions about pacemakers. Magnets? MRI? Microwaves? Metal detectors? Hospice care? No "doctor language", just plain English! Quick links below: 1.What is a pacemaker - 0:11 2.Electrical system of the heart - 0:31 3.Pacemaker 2 main functions - 1:52 4.Why does my heart need a pacemaker? - 4:21 5.Pacemaker maintenance - 5:40 6.Pacemaker and a.fib - 7:16 7.Microwaves & other ho...
Diagnosis of SVT in the EP lab
Переглядів 104 тис.9 місяців тому
(see below for quick links to jump to topics!) Here are the fundamentals of using intracardiac egms to diagnose the mechanism of SVT. I discuss findings during sinus rhythm, baseline pacing, in SVT, and with pacing maneuvers. Join the club of EP! 1. Introduction - 0:00 2. Baseline sinus and programmed stim pacing - 7:47 3. Is there a forward conducting accessory pathway? - 14:48 4. Is there a b...
Telemetry Tips - Sinus Node Dysfunction
Переглядів 6 тис.Рік тому
Patterns of sinus node dysfunction are reviewed, as well as fake-outs, including hidden ectopic beats, vagal events, and accelerated junctional rhythm. Making the right diagnosis is essential to picking the right treatment for the patient!
Dr. Cooper AED public service message
Переглядів 2,1 тис.Рік тому
Cardiac arrest can happen at any time. Seconds count. If you witness someone suddenly collapse, you may be able to save their life - here's how!
Telemetry Tips - Artifact
Переглядів 7 тис.2 роки тому
Electrical artifact is seen in 100% of patients on telemetry, and it can mimic a wide range of arrhythmias. This video reviews various ways to identify and correctly diagnose artifact, which is critically important to avoid unnecessary testing and treatment.
Telemetry Tips - 2nd Degree AV Block (Mobitz 1, Mobitz 2, and 2:1)
Переглядів 8 тис.2 роки тому
A deep dive into distinguishing Mobitz 1 from Mobitz 2 block, specifically figuring out if heart block is occurring in the AV node or in the His-Purkinje system (it matters!). Exceptions are discussed, and 2:1 AV block is tackled in detail!
Telemetry Tips - Atrial Flutter, Atrial Tachycardia
Переглядів 11 тис.2 роки тому
Atrial flutter & atrial tach with 2:1 and 1:1 AV conduction is often missed, mistakenly called "sinus tachycardia." Here I review how to find hidden P waves and use the heart rate trend to easily distinguish atrial flutter and atrial tach from sinus tachycardia!
WPW: Explanation and Treatment - in Plain English!
Переглядів 34 тис.2 роки тому
(Please hit "like" if you want more videos like this!) I explain what WPW (Wolff Parkinson White Syndrome) is, how it can cause symptoms, and how it can be cured. And I don't use "doctor language!" For other patient education videos, click my picture, then "Playlists" tab, and visit the Patient Education section! For an office consultation at Temple University, click www.templehealth.org/doctor...
EKG Reading: How the QRS is Made
Переглядів 33 тис.3 роки тому
(Quick links to topics are below) I explain how the QRS is created, helping the viewer *understand* rather than memorize when it comes to EKG reading. I review function of the His-Purkinje system, narrow vs wide QRS, bundle branch blocks, ventricular pacing, what is meant by "QRS fusion," and many basic concepts of physiology and anatomy. The video is intended for anyone who looks at and interp...
Antitachycardia Pacing (ATP) - How it Works, How to Improve
Переглядів 24 тис.3 роки тому
I discuss reentrant VT, how ATP works, why it doesn't work, and how to improve the success rate of anti-tachycardia pacing. A new ATP algorithm is discussed, in the context of pace-termination mechanisms. I hope you enjoy the presentation! Come join the EP Twitter community for real-time discussions! You can find me there: @narrowQRS
Atrial Flutter - Fundamentals of Diagnosis and Ablation
Переглядів 74 тис.3 роки тому
Use clickable links below to jump to any of the 11 topics! 1. Anatomy & Catheter Placement: 0:23 2. Electrograms & Activation Sequence: 13:21 3. Entrainment & Post Pacing Interval Part 1: 21:38 4. Entrainment & Post Pacing Interval Part 2: 31:47 5. 3D Activation Mapping & Window of Interest: 41:11 6. Ablation - Creating a Line of Block: 57:25 7. Ablation - Egms in the Ablation Catheter: 1:12:57...
iPhone 12 and ICD Interaction Explained
Переглядів 9 тис.3 роки тому
(Click "like" for more content like this!) This video explains how the iPhone 12 (and other items with strong magnets) interacts with an implanted defibrillator (ICDs). It is intended for all viewers, especially patients and other non-medical people who are concerned or curious about the news stories about this interaction. The basic punchline is given at the beginning, and then I go into a lit...
Window of Interest Setup for Atrial Flutter
Переглядів 13 тис.3 роки тому
From 2020 EP Fellows Summit, this video discusses principles of creating a window of interest for activation mapping of a macro-reentry atrial flutter. The impact of creating a symmetrical window around the reference point is discussed, as well as the benefits of a De Ponti window setup. This presentation supplements the material presented in much greater depth in my Activation Mapping video. E...
PVCs: Symptoms and Treatment - in Plain English!
Переглядів 216 тис.4 роки тому
PVCs: Symptoms and Treatment - in Plain English!
Intro to Intra-cardiac Electrograms & the EP Lab
Переглядів 111 тис.4 роки тому
Intro to Intra-cardiac Electrograms & the EP Lab
Entrainment Mapping: The Post-Pacing Interval
Переглядів 43 тис.4 роки тому
Entrainment Mapping: The Post-Pacing Interval
Atrial Fibrillation: How do we treat it? - Plain English, no Doctor language!
Переглядів 12 тис.5 років тому
Atrial Fibrillation: How do we treat it? - Plain English, no Doctor language!
Atrial Fibrillation: What is it? - Plain English, no Doctor language!
Переглядів 10 тис.5 років тому
Atrial Fibrillation: What is it? - Plain English, no Doctor language!
Pace Mapping: Principles and Pitfalls
Переглядів 25 тис.5 років тому
Pace Mapping: Principles and Pitfalls
Activation Mapping: Basic Concepts, Pitfalls, and Windowing
Переглядів 61 тис.5 років тому
Activation Mapping: Basic Concepts, Pitfalls, and Windowing

КОМЕНТАРІ

  • @GeraldN-vt1yz
    @GeraldN-vt1yz 2 години тому

    I had ablation mapping at 16 and a 3 hr surgery lasted 9 hrs. Not good, as soon as I was taken off blood thinners I had strokes and grand male seizures at 6 months after procedure. I waited til I was 21 to have corrective surgeries for WPW but the damage was done. It has made life difficult and I still deal with all the symptomatology and irritations from what would set my heart off. I lived but it has been a struggle and I have just been homeless most of my adult life because I need a home away from everyone else's stuff and cannot afford this. 😢

    • @GeraldN-vt1yz
      @GeraldN-vt1yz 2 години тому

      Then I have to deal with the world saying this is all mental/crazy. I hate it.

    • @GeraldN-vt1yz
      @GeraldN-vt1yz 2 години тому

      Mine never self regulated, only with medicine until no medicines worked as a teenager

  • @GeraldN-vt1yz
    @GeraldN-vt1yz 2 години тому

    People don't want to acknowledge that the sensitivities are still there with ablation so things that would have caused tachycardia still cause significant discomfort and distress. It has been difficult to live anywhere that doesn't affect this condition and I can't afford a medically necessary house. Try so hard to get no where

    • @GeraldN-vt1yz
      @GeraldN-vt1yz 2 години тому

      Also was not able to have children because the baby's heartbeat set mine off, even after surgeries this was intolerable and started having seizures again but I am not sure that I ever really stopped having them with this condition. Note to anyone with this condition: get your medical records I did not know to do this and it is part of the difficulty dealing with doctors today. Similarly neighbors, public settings with all the cigarette smokers. Being in the proximity of Illegal drugs like meth are almost unbearable even with surgery. The symptomatology is not corrected with surgery meaning all the things that would set your heart off still make you sick you just don't have to go to the ER.

  • @annedesilva1224
    @annedesilva1224 9 годин тому

    I am from srilanka. Thank you so much. ❤💐💐💐💐

  • @DCFunBud
    @DCFunBud 7 днів тому

    Can you use induction cooking stovetops or hobs?

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 7 днів тому

      @@DCFunBud Because induction heating uses an alternating current, the strength of which fades dramatically with distance, a person with a pacemaker is indeed able to use an induction stove, but they should not lean forward and have their chest be close to the induction surface while it is on. Recommended distance is ~24 inches to be safe, according to pacemaker vendors.

  • @paintedrow
    @paintedrow 7 днів тому

    I just had to wear a heart monitor for 3 days. Diagnosed with symptomatic PVC'S at a rate of 5.3 % which is moderate. Also I had a 8 second run of tachycardia. I'm already on the max dose of propranolol 160 mg er. Dr. Is deciding if metoprolol would be a better solution. I have general anxiety disorder so that's why the propranolol. But I'm wondering how different these meds are from one another?

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 7 днів тому

      Beta blocker medications (including propranolol and metoprolol) are usually not very good at suppressing PVCs. I agree that switching from one to another has a low chance of success (and may take away the benefit of propranolol, which might be helping in another regard). Catheter ablation of PVCs can be curative. Other medications can work better than b-blockers, particularly flecainide. I would recommend seeing an EP doc to discuss options in your case.

  • @JacopoImberti
    @JacopoImberti 10 днів тому

    Brilliant!!!

  • @EctopicBeat
    @EctopicBeat 10 днів тому

    What an amazing lecture. Thank you so much for taking the time to also reference the relevant papers. Invaluable!

  • @WayneStultz
    @WayneStultz 11 днів тому

    Thanks Doctor. I get my pacemaker tomorrow morning.

  • @virgillambert8835
    @virgillambert8835 12 днів тому

    Great information , now I have a clearer idea of what’s happening

  • @6thdayblue59
    @6thdayblue59 12 днів тому

    Thank you Dr Cooper. My partner is having a pacemaker, so I naturally look for as much information as possible. A balanced, informative and easy to follow post. Thank you.

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 12 днів тому

      @@6thdayblue59 thank you so much for the note! I'm so happy to hear that this video was helpful for you and your partner. Best of luck!

  • @LVCoffeeLVer
    @LVCoffeeLVer 17 днів тому

    This was VERY helpful!!! When I workout sometimes my heart rate gets high, I see that and panic some and then PVC’s start. Is that dangerous when the HR is high?

  • @doughmama1399
    @doughmama1399 17 днів тому

    Thank you so much for this thorough explanation. My 10yo was recently diagnosed with WPW after an episode where his heart was beating at 240bpm. This video has helped us understand more completely what is going on. Thank you so much.

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 7 днів тому

      Hopefully you are able to connect with a pediatric EP doc to discuss treatment options, including catheter ablation either now or in the future! Best of luck to you!

  • @Escape3005
    @Escape3005 19 днів тому

    How to resolve if it is Mobitz 2 if Holter Ecg strip goes like this: longer PR interval, shorter PR interval, longer PR interval with very little differences in interval longevity among them and then P wave with dropped QRS complex? And it is nocturnal in sleep? Thanks very much in advance for every answer.

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 18 днів тому

      Would be an unusual pattern to see a shorter PR interval after a longer PR interval in a 2nd degree AV block situation. Can certainly see different beats conducting down slow vs fast components of the AV node, giving different conducted PR intervals. And can see AV block with subsequent junctional escape beat giving appearance of long PR with conduction. But I can't come up with a good explanation for the pattern you describe without seeing the tracing. During sleep, high vagal tone is common, and can see patterns consistent with AV node slowing and/or block in the context of high vagal tone.

  • @donnahacker1699
    @donnahacker1699 20 днів тому

    Thank you so much for the information you provided. It is very helpful and appreciated. Just got my dual chamber pacemaker 5 days ago.

  • @ОлексійМ-б8к
    @ОлексійМ-б8к 21 день тому

    Amazing presentation! You are a true sensei in arrhythmology !

  • @amieriner9077
    @amieriner9077 26 днів тому

    This was the most amazing video. I have watched on PVCs. Thank you so much for doing this video. I understand what’s going on with me now.

  • @basharalsaify954
    @basharalsaify954 27 днів тому

    amazing effort Dr. Joshua! i cant thank you enough

  • @hossameldinrasmy457
    @hossameldinrasmy457 29 днів тому

    Thanks a lot dr. Joshua Cooper for your effort and systematic review of the SVT diagnosis. Really do appreciate. Waiting for more videos.

  • @b.k.3971
    @b.k.3971 Місяць тому

    great presentation !! i hope it would help me with getting specialized in arrhythmia.

  • @MooMedesh
    @MooMedesh Місяць тому

    Thank you from Thailand.

  • @DanielleRadicanin
    @DanielleRadicanin Місяць тому

    I have developed atrial bigeminy some months ago and it is terrifying, particularly when you also get PATs concurrently. Not sure what happened to my SVTs since this new arrhythmia.

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      @@DanielleRadicanin Everybody has premature atrial beats, some more than others. And just like pvcs, they can wax and wane on different days and in different months. Premature atrial beats are often the trigger for SVT, so they almost always go together. If you had SVT in the past, it was likely the case that you had premature atrial beats that triggered each episode. So this is not necessarily such a different arrhythmia from what you have had in the past, as you likely had both. I don't know if you had a catheter ablation or if you are taking medication to suppress SVT. But it is very common to have persistent premature atrial beats even after successful suppression or elimination of SVT. If the premature atrial beats and atrial bigeminy are causing symptoms and bothersome to you, certainly you should talk to your electrophysiologist about next steps in management.

    • @DanielleRadicanin
      @DanielleRadicanin Місяць тому

      @@dr.joshuacooper-arrhythmia9917 Thank you for taking the time to clarify that the ectopic beats may have preceded the SVTs. I have to wonder how much a small hiatal hernia may be impacting or exacerbating what now is an ongoing pattern of bigeminy? There is also a long history of Hashimoto's. When the autoantibodies are elevated, the cardiac irregularities are also present. I have not had an ablation given the SVTs were less bothersome than this recent 24/7 bigeminy pattern. There are also ST wave abnormalities.

  • @mikebledig7208
    @mikebledig7208 Місяць тому

    Are PVC'S the same as Ectopic heart beets? Sorry if this is a silly question, but I really don't know if they same or not

  • @tracyb1025
    @tracyb1025 Місяць тому

    This is an excellent video, thank you so much!!!

  • @autoaero3201
    @autoaero3201 Місяць тому

    Definitely a good explanation! I found out a few months ago that this was what had been going on with me during a long season of high stress. The only thing I still wasn't sure of was if the sensation to cough was related or not but assumed it was, but now I know. Luckily I was able to make some changes in job and lifestyle and I've gone from strong PVCs daily to one or two a month.

  • @sokheihom
    @sokheihom Місяць тому

    Dear Prof, Could you please create a video related to PVC ablation with 2D and more detail on the catheter location? Thank you sir, I am Sohei from Cambodia

  • @solitairewolff
    @solitairewolff Місяць тому

    I cannot even imagine the amount of time and effort that goes into making such an enlightening and educational presentation. It is remarkable how much goes into making such figures and diagrams. Without a doubt, your videos are the best educational material in the field. As an EP fellow all your videos are a very valuable resource, thank you Dr. Cooper!

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      @@solitairewolff Thanks so much for your kind words! Yes indeed, my presentations take an enormous amount of time, especially this one! 😂 But it's a labor of love👍

  • @Sporz-q3u
    @Sporz-q3u Місяць тому

    There aren’t many EPs that can break this down. You are very patient and kind for sharing this science.

  • @watchthis1316
    @watchthis1316 Місяць тому

    I’d like to add that I went to apple’s website to check on the policies they have for pacemakers they posted 6 in. away 12 in away if device in on the charger while being used. Go check it out yourself. Cheers🌼

  • @mahmoodhemami6116
    @mahmoodhemami6116 Місяць тому

    So far this is the best demonstration on EP I have seen.

  • @Luan-s8z
    @Luan-s8z Місяць тому

    What worked for me was watch my breathing I still have it but it's much better except now because it's 11pm and I can't sleep because of it

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      It is very common for PVCs to be most annoying at rest, especially when trying to fall asleep! When your heart rate slows down at rest, it gives more opportunity for PVCs to chime in and start happening more (and it's also more common to notice an irregular heartbeat in bed, when there are fewer other distractions, especially when lying on the left side, which brings the heart closer to the inside of the rib cage, where you feel the heart beating most easily!). Sometimes, doing a quick activity to bring the heart rate back up can suppress PVCs, and then you can lie back down and fall asleep!

  • @kerrysue9280
    @kerrysue9280 Місяць тому

    I know this video is old now, but you are so wonderful. Your tone of voice and the way you explain things are so easy to listen to and comforting. I'm thankful you are on this earth. I have not felt this relaxed about my PVCs ever, and it's all because of you. You have some very lucky patients. I wish I could come see you.

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      You are too kind! So glad you found the video to be helpful - that was the point and hope of making it! :)

  • @karleedu
    @karleedu Місяць тому

    I have PVC's and PAC's all the time. I take cardovil but it really doesn't help

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      Beta blockers like carvedilol sometimes help, but often the don't. There are other medications that can be more effective to suppress PVCs. Even taking a daily magnesium supplement sometimes helps. And if PVCs are frequent enough, they can be pinpointed and eliminated permanently in a catheter ablation procedure. Talk to your doc about other options (and ask to see an electrophysiologist, if you aren't already seeing one!)

  • @JoseDiaz-tf2ql
    @JoseDiaz-tf2ql Місяць тому

    This explains it so well. I always thought of how I felt them in my diaphragm, but it’s my belly! They are very annoying, and I’d say debilitating, sometimes I can do just fine, but other times they cause a lot of fatigue

  • @jaymutah
    @jaymutah Місяць тому

    Thank you for this amazing talk. I learned so much. Brilliant lecture.

  • @robcook6025
    @robcook6025 Місяць тому

    What about fast hearbeats

  • @Nishiio9
    @Nishiio9 Місяць тому

    Thank you for such a detailed review of epicardial pacing wires! When you talk about 2 different QRS morphologies that can appear as a result of lower mA capturing the cathode only (18:52 timestamp), are the wires acting like unipolar wires? I guess I'm trying to understand the pacing difference when only the cathode has capture but not the anode.

  • @SDizzzle
    @SDizzzle Місяць тому

    This is a WAY better, thorough, detailed explanation than any explanation from ANY of the doctors we’ve seen for my wife’s PVCs. Thank you!

  • @Exploringtheworldforyou
    @Exploringtheworldforyou Місяць тому

    Humans are very intelligent creatures🔥 thanks to the people who invented these kinds of medical machines and medicines❤️

  • @imranghare3181
    @imranghare3181 Місяць тому

    do you happen to have the .ppt files for these?

  • @SagunsinghYadav-h8p
    @SagunsinghYadav-h8p Місяць тому

    So thankful to you ❤

  • @bnic9471
    @bnic9471 Місяць тому

    Fascinating! I'm not an EP, just an RN with some electronics background who had an ablation. This does a lot to strip away the mystery. Thanks!

  • @polynesia8733
    @polynesia8733 Місяць тому

    Very helpful Necessary information. Thank you Doc!

  • @polynesia8733
    @polynesia8733 Місяць тому

    Can I request my own pacemaker report? From my cardiologist?

    • @dr.joshuacooper-arrhythmia9917
      @dr.joshuacooper-arrhythmia9917 Місяць тому

      Yes, every in-person pacemaker check and every remote monitoring pacemaker check generates a full report that you can ask to see/have (although there's a lot of information there and it will be mostly hard to interpret without detailed explanations!)

  • @timtunnel1996
    @timtunnel1996 Місяць тому

    Thank you so much

  • @momienmohamed7752
    @momienmohamed7752 Місяць тому

    V helpful but i doc

  • @momienmohamed7752
    @momienmohamed7752 Місяць тому

    Hi doc u are great heart doc.

  • @ОлексійМ-б8к
    @ОлексійМ-б8к Місяць тому

    Great manual! Thank you!

  • @kapsabet3
    @kapsabet3 Місяць тому

    how did I not know about this Copper before I graduated. I should have been very far with EKG. Now I will be able to catch up. Thank you so much.

  • @TheHumbleWiseMan
    @TheHumbleWiseMan Місяць тому

    I am waiting in a hospital to be discharged after they implanted a pacemaker yesterday. Now, I have a better idea of how it works. Thank you!

  • @PizzaRacer99
    @PizzaRacer99 2 місяці тому

    Thank you for this presentation. It has cleared up several questions that I had. I am on my 3rd month of having a CRT-D, biventricular pacemaker with a defibrillator. Fainting spells are gone, and I pretty much live a normal life.♥