To understand the mechanisms of arrhythmia, one needs to apply them in practice. No matter what book you read, what web site you see – practice is key

So how do you practice ? – by not skipping !!!

Let me put it this way, the more adept we get in ablating, the more lackadaisical we get in performing maneuvers and take short cuts – this de-programmes the brain and screws up everything when the arrhythmia is tricky.

So having a methodical approach without taking short cuts is imperative to maintain the cognitive skills in tackling EP problems.

The curse of EP is slow – fast typical AVNRT – this is the commonest SVT – which is also very easy to ablate – everything lines up visually – no measurements, no maneuvers, no hypothesis testing, no exclusion of other things – just burn – along with all the cognitive skills of EP. The irony is that the same arrhythmia can be a nightmare if one has not got developed a methodical approach to EP.

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