In this episode, we clarify key terms related to pacemakers (PPMs) and implantable cardioverter-defibrillators (ICDs). What do the common two-letter labels AR, VR, AS, VS, AP, VP, FD, TD, TP, CD, RV, and RT mean on EGM of an ICD? What is the relationship between the lower rate limit and the lower rate interval? What is the relationship between the post-ventricular atrial refractory period (PVARP) and the total atrial refractory period (TARP)? What is hysteresis? What is a typical upper tracking rate? What is fusion and pseudofusion? Tune in for answers to these questions.

Difficulty Level: Advanced

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In this episode, we explore the concept of ventricular dyssynchrony and cardiac resynchronization therapy (CRT). What are the eleven scenarios in which CRT is recommended, according to the 2022 heart failure guidelines? What benefits to patients receive when CRT is appropriately used? What factors could contribute to nonresponse to CRT? How can echocardiography be used to find the atrioventricular delay to optimize LV filling? Tune in for answers to these questions.

Difficulty Level: Intermediate

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In this episode, we review the key aspects of ICD therapies. What are typical thresholds for a VT monitor zone, regular VT zone, fast VT zone, and VF zone? How is the number of intervals to detect (NID) defined deterministically vs probabilistically for VT vs VF detection? What is a typical rate and interval decrement for anti-tachycardia pacing (ATP)? What is the difference between a burst and a ramp of ATP? What do the B>AX, B>X, and B>A vectors for ICD shock describe? What are strategies for reducing inappropriate shocks? When is it appropriate to use a subcutaneous ICD or a wearable ICD? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we explore the fundamentals of permanent pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) interrogation. What are the most common pacing modes, and when are they used? What is rate-adaptive pacing, mode switching, and managed ventricular pacing? What mode do you induce when you place a magnet? How do you perform a sensing test and a threshold test? What are the timing cycles in single-chamber pacing and dual-chamber pacing? What mode is induced when the device reaches the recommended replacement time (RRT), and how many months are left when RRT is reached? Tune in for answers to these questions.

Difficulty Level: Advanced

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In this episode, we review QT prolongation and QT shortening. What is the QT interval, and how is it corrected (QTc) for heart rate variations? Which arrhythmogenic syndromes are associated with mutations in KCNQ1, KCNH2, and SCN5A? How do the T waves of long QT syndrome types 1, 2, and 3 differ? Which long QT syndrome is suggested by arrhythmia triggered from swimming? Which long QT syndrome is suggested by arrhythmia from noises and auditory triggers? Which long QT syndrome will need addition of mexiletine (on top of nadolol) sooner? What are the QT and QRS effects of hypocalcemia, hypomagnesemia, and hypokalemia? What is the definition of a prominent U wave? What is the criteria for short QT syndrome? Tune in for answers to these questions.

Difficulty Level: Intermediate

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review arrhythmogenic right ventricular cardiomyopathy (ARVC) and catecholaminergic polymorphic VT (CPVT). Other than epsilon waves at the end of QRS complexes, what other features on ECG characterize ARVC? What are the echocardiographic and cardiac MRI findings of ARVC? Is diltiazem used in atrial fibrillation in patients with ARVC? What right ventricular ejection fraction makes an ARVC patient eligible for ICD placement? Can patients with ARVC participate in competitive sports? What is the difference between the bidirectional VT of CPVT and the bidirectional VT of digoxin toxicity? Can patients with CPVT participate in competitive sports? Tune in for answers to these questions.

Difficulty Level: Easy

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review Brugada Syndrome, syndrome of syncope and/or sudden death in healthy patients associated with mutations in SCN5A. How is Brugada pattern different from Brugada syndrome? How do you recognize the three main types, and how do they differ in management? Who should receive an implantable cardiac defibrillator, and who should receive antiarrhythmics such as quinidine? Tune in for answers to these questions.

Difficulty Level: Easy

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In this episode, we go over how to localize the origin of ventricular tachycardia (VT) and premature ventricular contractions (PVCs). What clues on ECG allow you to distinguish VT coming from outflow tracts vs the inferior ventricles? What clues on ECG allow you to distinguish VT arising from the LV free wall vs VT arising from the RV or inter-ventricular septum? Which types of VT have the highest procedural success rates with ablation? Which type of VT is verapamil-sensitive, and which is propranolol-sensitive? Can individuals with PVCs participate in competitive sports? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we explore the definitions, mechanisms, and management of ventricular tachycardia (VT). What is the significance of sustained vs non-sustained VT, and monomorphic vs polymorphic VT? How is VT storm defined in patients without implantable cardiac defibrillators (ICDs) vs those with ICDs? What are common doses of medications for VT storm? What are examples of appropriate and inappropriate shocks? What should you do about ICD shocks? What morphologies in lead aVR allow you to distinguish between VT and SVT with aberrancy? Tune in for answers to these questions.

Difficulty Level: Intermediate

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In this episode, we delve into the mechanisms of arrhythmias, exploring the roles of abnormal automaticity, early afterdepolarizations (EADs), and delayed afterdepolarizations (DADs). What is the difference between disorders of impulse formation and disorders of impulse conduction? How do the phases of the ventricular action potential (0, 1, 2, 3, 4) differ from the phases of the sinoatrial nodal action potential (4, 0, 3)? Which arrhythmias occur via abnormal automaticity vs normal automaticity? Which arrhythmias occur via early after depolarization (EAD) vs delayed afterdepolarization (DAD)? Which ventricular tachycardia subtypes do not occur via EADs or DADs? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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