6 years ago on this day we lost Mark Josephson. Mark’s life and career were extraordinarily. A giant and one of the founders of clinical electrophysiology, his numerous contributions remain as relevant today as they have been originally, and his book remains the bible of EP.
Elad Anter
744 posts
Director, Arrhythmia Institute, Shamir Medical Center | Professor of Medicine | Cardiac Electrophysiology
Joined April 2020
- How to deliver RFA in the ventricle? moderate power for longer duration is preferable over higher power for shorter duration- larger lesions with less risk for steam-pops. Good remainder. Curtesy of @yavin_h anterlab.com @EPeeps @ClevelandClinic @TallRoundsTM
- Today the 11th of January 2022 marks the 5-year anniversary of the death of Mark Josephson. His greater than life personality, brilliance, curiosity, humor, and friendship are so missed. @EPeeps
- Persistent AF case with Affera: PVI+Mitral Line+PWI+CTI with transpired therapy time of 30 min. Multiple cases, durable lines, consistent results. High-Res mapping and PFA/RFA from the same lattice catheter at a switch of a button. Exciting times to be in EP and Cleveland Clinic
00:00 - Another PerAF case with Affera PFA: PVI+PWI+MAL: 1st to last lesion <30min with total procedure time <1Hr including mapping and 20min waiting period (no reconnections). We may soon be ready to re-evaluate ablation strategies to treat different types of AF w/ rapid and durable Tx.
00:00 - The lateral boundaries of the VT isthmus are functional. 65M with large AMI and recurrent VTs. 4 VT morphologies using 3 isthmus sites. Note that boundaries forming the common channel of one VT are conductive in a different VT: a functional phenomenon
00:00 - First Case of Brugada syndrome ablation @ Shamir Medical Center. A 36-year-old man after SCD and ICD shocks. Technique, endpoints, and tips. Proud of our hospital and team. @EPeeps @BarkaganMichael
00:00 - PFA may be superior to RFA for VT ablation as it eliminates myocardium separated from the catheter by collagen/fat. Our new paper also unlocked a major limitation of RFA in scar, showing lower max intra-myocardial temperature compared with healthy tissue.
- Interesting case of a previously failed PVC ablation (attempted from left+right). Today, early pre-potential and near-field EGM just above the pulmonic valve but no EGM during sinus rhythm. Terminated immediately.
- Ablation Index for ventricular ablation: An an in-vivo beating healthy ventricle, lesion dimension plateaus at ~700. More @hrs
- Should we re-map after ablation to confirm channels elimination? IMI-related VT isthmus corresponded to site of slowest conduction during substrate mapping. Term with <1sec RFA. Remapping confirmed elimination of endo slow conductiing channels. Amazing @CleClinicMD EP team
- The direction of LV activation influences the location and magnitude of activation slowing (and locations of LP). The area of maximal slowing corresponds to the site where the wavefront first interacts with the infarct (~≤0.5mV). IMI, CABG, Parallel mapping (RV+LV pacing).
- 1. Is this a localized-reentry or macro-reenty? 2. What would be your ablation approach?
- Sonny Jackman receives the HRS Teaching Award. So well deserved to such an incredible individual I’m proud to call a friend.










