Paul Chacko (@drpchacko) profile picture

Electrophysiologist with a mind to learn, adopt and adapt. Drexel IM-OSU MRI-Case Western Cardiology-Mayo EP alumni. Tweets = observations, not med consults.

Joined April 2018
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Be not afraid of life. Believe that life is worth living, and your belief will help create the fact. - William James
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The MOC Monopoly Wins Another Round practicingphysician.org/the-… Nevertheless, it up to us as physicians to advocate with local credentialing committee to accept alternate agencies.. we as physician can make a difference.
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this is what medical industrial complex looks like. physicians need to wake up and fight for their cause doximity.com/newsfeed/b4f6b5…
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Eliminate ABIMs MOC requirement - Sign the Petition! chng.it/sTYMhqfQ via @Change
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Replying to @HHSGov
@HHSGov @CMSGov @drmeenasesh 60/371 EP fellowship positions went unfilled last year due to your cuts (the longest training field in medicine). Only 1600 EP's performed afib ablations on Medicare patients last year. What do you think will happen now?
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Interesting case.. would favor a discussion. SOO?? I found an interesting thing on ICE.
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It was not easy to get thru the membrane.. and this posed a challenge when mapping in RVOT.
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Pre abln.. then suppression with abln and later on recurrence. 30ms pre qrs. 40ms pre qrs at adjacent.. Tried sandwiching.. even catheter pressure suppressed pvc.. what next?
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Should this be called bi-bundle pacing? PPM implant 48 hrs post inferior STEMI. Not LBBA pacing (no RBBB). Not his pacing (no HV/pacing delay or fusion, no his recorded on the lead). QRS morphology nearly identical compared to presenting ECG with evolving ST-T changes
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I Just realized I can pace and record from the ring electrode Of the Vizigo sheath . Another great use for this sheath . I Can check for roof line conduction block with one catheter and the sheath on the other side of the line #EPeeps @BiosenseWebster – at Indianapolis, IN
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thoughts on EKG. pt with h/o of cryomaze, CABG (SVG-RCA)+TV repair. #EPeeps fellows first @narrowQRS @SchakrabartiEP
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Have not seen one like this... ur thoughts on SOO? ECHO/cath normal from prior reports. @DrFerminGarcia
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Here is the follow up. Found early spot and bracketed in cs but no good pre qrs. So went endocardial at the basal aspect opposite the cs site.. it was tricky to get a good stable reliable force. Ablated at 30-35W. Will review in 1 month update. @dredcronin @manak_18 @ReddyEPS
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No further pvc so far.
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PVC dilemma.. Input appreciated. 63yr old with NICMP who had PVC induced PMVT.. will share more as I get response.. EKG and what I saw in lab. @Hapa_EP @KrishKancharla @abhishek_mbbs @manak_18 @rdschaller @narrowQRS @DrRoderickTung
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Follow up on this case.. with no pacing 0% pvc after 1 week.. after enabling biV 10% pvc burden in 6 days.. what do u suggest.. BTW.. 2nd rv lead has high threshold anyways..
67%Program vvi 40
0%Place new quad lv/ his
33%Extract rv and lv
3 votes • Final results
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