A channel for pediatric EP conferences - basic concepts for pediatric cardiologists and fellows reviewed. Also the RU-vid home of Pediheart: Pediatric Cardiology Today podcast that is available in audio only format wherever you get your podcasts!
Hi Robert! Your video view within 8 days is only 141 !!!! Your video content is awesome and deserves to reach millions of views. But you should focus on SEO. Your SEO score is still 12.6 out of 100 scores. So, I am suggesting you to hire an SEO (Search Engine Optimization) expert who will set your videos with proper keywords. Then you will get more views and subscribers.
3 days only 28 views! how do you measure it? Your "Robert Pass" Podcast is incredibly engaging and informative, and it deserves to reach a wider audience. Have you considered strategies to expand your reach among your target listeners? (ie: 5 likes, and no shares, SEO score Z E R O out of 100, no video tags, etc) I don't want to see your good videos fail.
Hello, Dr. Robert Pass, Your videos are essential to reach your targeted Audience! but look last 1 month, Your content has only 19 views, 6 likes, no comments, and no shares, though you have 1.06K subscribers. Also, your SEO (Search Engine Optimization) score is just 18 out of SEO 100 scores. You have to solve it. You should maintain the RU-vid algorithm. Then, you will get the desired result. However, I am a subscriber and well-wisher of your channel. Thanks
What insights can be gleaned from the Amrita Institute's extensive experience with ductal stenting in low-resource settings, particularly regarding patient selection criteria, management of ductal morphologies unsuitable for intervention, and optimizing PGE administration pre-procedure? How might operators in more developed healthcare systems adapt and benefit from the strategies and outcomes observed by Dr. Navaneetha Sasikumar and her team in Kerala, India?
What an insightful episode of Pediheart Podcast #300! The roundtable with Drs. Triedman, Saul, and Walsh was inspiring. Hearing about the early days of pediatric EP and their professional achievements was fascinating. Thanks for sharing such a rich history!
Thank you, Dr Pass, for the excellent lecture. Is there any difference in the dosing regimen of antiarrhythmic medications between term and preemies, considering that preemies have immature hepatic and renal drug metabolism systems?
In the preexcited beats the depolarization is abnormal and so repolarization similarly is abnormal. Would only pay most attention to the T waves on beats that are not preexcited and these are largely in the normal range.
@@RobertPassPediheart thank you very much Dr, world has really become a global village, learning is accessible beyond boundries, keep spreading knowledge to save lives.stay blessed!
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Note that the formal recommendation of PACES and AHA is that fetal flutter be treated with Sotalol or sotalol + Digoxin .... Pharmacological Management of Cardiac Arrhythmias in the Fetal and Neonatal Periods: A Scientific Statement From the American Heart Association Anjan S. Batra, Michael J. Silka, Alejandro Borquez, Bettina Cuneo, Brynn Dechert, Edgar Jaeggi, Prince J. Kannankeril, Christine Tabulov, James E. Tisdale, Diana Wolfe and … See all authors Originally published5 Feb 2024doi.org/10.1161/CIR.0000000000001206Circulation. 2024;0
Why would we call it ventricular tachycardia rather than an idioventricular rhythm since the rate is 130 beats per minute, which is around sinus rate in a three month old?
Great cases and discussion! How would you distinguish atrial bigeminy vs sinus with a 2:1 block and ventriculophasic arrhythmia? Asking because this would perhaps change management as you would avoid a bb for the latter?
Thank you. Very nice lecture. What about flecanaide? Do you use it in addition to a beta blocker therapy? If yes, when do you decide to introduce flecainide and how do you dosage it? All the best from Slovenia.
Yes we do use flecainide rarely but in the US Nadolol is commonly available and so flecainide is usually for nonresponders. Please take a listen to this episode of my podcast:podcasts.apple.com/us/podcast/pediheart-pediatric-cardiology-today/id1341472214?i=1000591069950
As in most things, the devil is in the details. If the patient was observed in the hospital for 2-3 days and not observed to have Mobitz I block except at sleeptime, we might well choose to send home with maybe a 14 day ambulatory ECG monitor like a ZIO patch. However, if there were many such episodes while awake during the day, then consideration of pacemaker implantation might be warranted. Would need more detail to really know. Another approach might be ILR implantation but I personally would almost always try first with the less invasive patch recorder.
If you have suspicion that tachyarrythmia is present for a long time do you need to asses appendage in children? Did you ever have a case of thrombi in LAA in children?
Very interesting as usual. What is your take on Ivabradine for JET ? What about special pacing mode ( R wave synchronized atrial pacing or ventricular paired pacing) for refractory JET in your institution or in previous institutions ?
Ivabradine has been reported, especially a report from India about a year ago. My general view is that because it is enteral, I am less enamored of an agent that must be administered in this manner in a patient in low output which is usually the situation for its use. That said, the results reported have been encouraging. The pacing technique you report is complicated and may result in more myocardial oxygen consumption than is needed. My personal preference is cooling +/- procainamide with sedation. That combination is likely still the most 'tried and true'. IV sotalol also promising! The good news is that it is a self-limited disease and so if one can just slow it down (in many different ways), the outcome is usually favorable. Thank you for watching.
So are you saying that the difference between unipolar and bipolar pacing on an ECG has to do with the size of the pacing spike? Bipolar being a small pacing spike (it looks about 5mv), Unipolar being a large pacing spike (perhaps > 5mV,)?
Basically and generally, unipolar pacing causes a much larger spike on the ECG. This is NOT 100% of the time true but yes, in general, when one sees very large pacing spikes, it typically means that the patient has a unipolar lead, rather than bipolar. I hope this is helpful.
ultimately this is more of a semantic question . Many different EP docs have different definitions from hemodynamic embarrassment deserving the nomenclature of VT or some have rate cut offs like 170 bpm . Probably either term is reasonable - identifying that it is an accelerated rhythm from the ventricle puts you ahead of a lot of others! Good luck and thanks for the question!
@@danadecarlo1429 the main reason that I would suggest treating this is useful is because one does not know the near term natural history of the rhythm. If, for example, one knew that 70% of the time the patient would be in sinus and that the ventricular rhythm was only ~5 BPM faster than the sinus, it would be reasonable to monitor closely without therapy given that we know that in general neonatal VT normally improves with time. However, as we do not know what the natural history will be of this patient, if 'stuck' in this rhythm for long periods of time, dysfunction or dilation could develop of the ventricle. Thus, it would be unusual to not treat this degree of VT/idioventricular rhythm.
