A working reference for the EP lab team.

Disorganized atrial activation, most commonly driven by triggers from the pulmonary vein sleeves. Spectrum from paroxysmal to long-standing persistent, with progressive atrial remodeling over time.

Tachycardia originating from a discrete atrial focus (focal AT) or multiple competing atrial foci (MAT). Mechanisms span automaticity, triggered activity, and micro-reentry — each behaving differently on the table.

Macro-reentrant atrial tachycardia using a circuit other than the cavotricuspid isthmus — usually left-atrial roof, mitral isthmus, or scar-mediated. Common after AF ablation or atrial surgery. Long cases, lower success rates, high-density mapping essential.

Catheter-based pulmonary vein isolation to eliminate AF triggers. Energy options include pulsed field, radiofrequency, and cryoballoon; PVI is the foundation, with adjunctive lesions reserved for persistent disease.

Catheter ablation of the cavotricuspid isthmus to interrupt the typical right atrial flutter circuit. High success, short procedure, low complication rate.

Catheter ablation of the AV node to produce complete heart block in patients with refractory atrial tachyarrhythmias who already have (or will receive) a ventricular pacing system. A short, high-yield procedure with a predictable workflow.

The Abbott Amplatzer Amulet is a dual-component lobe-and-disc LAA closure device — distal lobe anchors in the appendage neck, proximal disc seals the ostium against the LA wall. Covers design rationale, sizing, the simpler post-implant antithrombotic regimen, and Amulet-vs-WATCHMAN anatomical fit.

Cardiac resynchronization therapy combined with defibrillator — three leads (RA, RV ICD, LV via coronary sinus) for HFrEF patients who meet both resynchronization and ICD criteria. Covers when to pick CRT-D over CRT-P, BiV pacing targets, and how to optimise response.

CRT-P and CRT-D interrogation focused on the unique parameters of biventricular pacing — BiV pacing percentage, AV/VV optimization, LV vector selection, and the phrenic surveillance that protects this therapy.

Fast-on, fast-off AV-nodal blocker. Diagnostic for SVT, used to unmask dormant PV conduction, and to test accessory pathways.

Broad-spectrum antiarrhythmic for VT, recurrent AF, and rhythm control in the EP lab. Effective but slow-loading and full of late effects to remember.

Irreversible COX-1 antiplatelet. Largely not a stroke-prevention drug for AF, but it shows up constantly as background CAD therapy that shapes periprocedural bleeding risk.

Acute hypersensitivity reactions in the EP lab usually come from contrast, antibiotics, or latex. Recognition fast, IM epinephrine first, the rest in parallel. Most cases respond to a single IM dose; biphasic reactions and refractory shock are the bad outcomes to anticipate.

What's on the crash cart, what's in the room, and what's drawn up before the case for what kind of patient. ACLS adapted to the EP-lab context — where pacing wires, ablation catheters, anticoagulation, and ongoing sedation all change the equation.

Iodinated contrast reactions span a wide spectrum — from mild urticaria to anaphylactic shock. Most are mild and self-limited; some need IM epinephrine and full anaphylaxis management. Premedication protocols matter for patients with known history; recognition matters for the rest.

Abbott's EnSite X EP platform — hybrid impedance and magnetic localization, the HD Grid catheter, and the omnipolar mapping workflow the team should know.

Medtronic's integrated platform — one catheter that maps in high density and delivers either pulsed field or RF ablation, all on the Prism mapping software.

Boston Scientific's ultra-high-density mapping platform — the IntellaMap Orion mini-basket, Lumipoint automated annotation, and the workflow nuances the team needs to know.