Medicine lost one of its greats this week. My grandpa, Dr. William (Bill) Segar, had an illustrious career that spanned nearly 60 years from @IUMedSchool and @RileyChildrens, @YaleMed, @MayoClinicCV, and @uwsmph and @WiscPediatrics.

⚡ A new cardiac technology enters the real world. How do we track its safety? Pulsed field ablation (PFA) has rapidly expanded for atrial fibrillation treatment. This study used natural language processing (NLP) to analyze nearly 7,000 FDA post-market reports, exploring: 🔹 Adverse event patterns 🔹 Device malfunction profiles 🔹 Real-world safety surveillance

Officially the funniest copy editor note comment I’ve seen on a manuscript. Not sure how to address it when @VivekReddyMD is an expert on nearly all ablation technologies “We noticed that a scholar, Vivek Y. Reddy, is cited 9 times, accounting for approximately 42% of the total citations. To ensure a balanced and appropriate citation distribution, we kindly ask you to review these citations and reduce the number of references from this author to no more than 5 citations, retaining only those that are most relevant and necessary for the manuscript.”

Welcome to our JULY 29 issue of #JACCCaseReports @JACCJournals featuring Part 2 of the EKG Challenge jacc.org/journal/case-report…. Full PDF here: jacc.org/doi/10.1016/S2666-0… Thank you @aroniskn our Associate Editor for this Editor’s Page: Clues, Not Patterns: The Electrocardiogram as a Detective Story jacc.org/doi/10.1016/j.jacca… @minnowwalsh @hmkyale @Justine_Turco Wide-Complex Tachycardia: VT and VT Mimics Wide-Complex Tachycardia in a Neonate jacc.org/doi/10.1016/j.jacca… Atypical Andersen–Tawil Syndrome in an Asymptomatic Child With Bidirectional Ventricular Tachycardia and Incipient Tachycardiomyopathy jacc.org/doi/10.1016/j.jacca… An Extreme Wide-Complex Tachycardia and Tremors jacc.org/doi/10.1016/j.jacca… Seamless Transition Between Narrow- and Wide-QRS Tachycardia Revealing Double Tachycardia jacc.org/doi/10.1016/j.jacca… AVNRT With Intermittent Aberrancy-Mimicking Ventricular Tachycardia: One Tachycardia, Two QRS Morphologies jacc.org/doi/10.1016/j.jacca… Atrial Tachycardia and Bundle Branch Re-Entry Ventricular Tachycardia with Similar QRS Complex Morphology jacc.org/doi/10.1016/j.jacca… Irregularly Irregular Wide Complex Tachycardia: Look Beyond the Atrium jacc.org/doi/10.1016/j.jacca… Ventricular Tachycardia or Not?: Decoding Post-Cardioversion Wide Complex Tachycardia in a CRT-D Patient jacc.org/doi/10.1016/j.jacca… Device Interrogation Unmasking Flecainide-Induced Wide Complex Tachycardia jacc.org/doi/10.1016/j.jacca… Wide QRS Tachycardias With Syncope: Two for One? jacc.org/doi/10.1016/j.jacca… ST-Segment Deviation Patterns and STEMI Mimics Takotsubo Cardiomyopathy With Dynamic LVOT Obstruction Mimicking Inferior STEMI jacc.org/doi/10.1016/j.jacca… Atrial Repolarization as a Rare Mimicker of ST-Segment Elevation Myocardial Infarction: Revisiting Ta jacc.org/doi/10.1016/j.jacca… Reading the ECG in Time: Ta-Wave Pseudo-STEMI and Crochetage Sign in Adult Congenital Heart Disease jacc.org/doi/10.1016/j.jacca… Shark-Fin Pattern in aVR Lead as First Manifestation of Acute Left Main Coronary Artery Occlusion jacc.org/doi/10.1016/j.jacca… “Left Main” Pattern Electrocardiogram: A Diagnostic Trap for Cardiologists jacc.org/doi/10.1016/j.jacca… Isolated Cardiac Rhabdomyoma With Marked ST-Segment Elevation: Benign Tumor, Malignant ECG jacc.org/doi/10.1016/j.jacca… Midventricular Hypertrophic Cardiomyopathy With Apical Aneurysm Presenting as Persistent ST-Segment Elevation Mimicking Acute Myocardial Infarction jacc.org/doi/10.1016/j.jacca… ST-Segment Elevation Caused by Lung Cancer Mimicking STEMI jacc.org/doi/10.1016/j.jacca… ST-Segment Elevation in a Patient With Vocal Cord Cancer: A Great Mimicker jacc.org/doi/10.1016/j.jacca… A Dangerous Wave: Recognizing the Shark-Fin ECG Sign in STEMI jacc.org/doi/10.1016/j.jacca… Atrioventricular Block and Conduction A Premature Ventricular Complex as Both Culprit and Cure: Paroxysmal Intrinsic Atrioventricular Block jacc.org/doi/10.1016/j.jacca… Progressive Conduction Disease in a Mitochondrial Disorder jacc.org/doi/10.1016/j.jacca… From Ophthalmoplegia to Multilevel Atrioventricular Block: Timing Cardiac Device Therapy in Kearns–Sayre Syndrome jacc.org/doi/10.1016/j.jacca… Syncope and 2:1 Atrioventricular Block in a Middle-Aged Man jacc.org/doi/10.1016/j.jacca… Idiopathic 2:1 AV Block With Ventriculophasic Sinus Arrhythmia in a Young Male jacc.org/doi/10.1016/j.jacca… Mobitz Type I Progressing to High-Grade AV Block: Beyond Wenckebach jacc.org/doi/10.1016/j.jacca… Intermittent Simultaneous Antegrade Dual Nodal Conduction With Progressive Rate-Dependent Aberrancy jacc.org/doi/10.1016/j.jacca… Dual Atrioventricular Nodal Physiology in Sinus Rhythm: An Extraordinary Manifestation of a Common Substrate jacc.org/doi/10.1016/j.jacca… The Double Fire Phenomenon With Alternating Right Bundle Aberrancy jacc.org/doi/10.1016/j.jacca… Atrial Activation and the PR Interval: Pre-excitation and Impulse-Origin Puzzles The Many ECG Faces of Wolff-Parkinson-White Syndrome jacc.org/doi/10.1016/j.jacca… Left Ventricular Hypertrophy With Pre-Excitation: Thinking Beyond the Usual Hypertrophic Cardiomyopathy Diagnosis jacc.org/doi/10.1016/j.jacca… Evaluation of the Elusive Delta Wave in Intermittent Pre-excitation jacc.org/doi/10.1016/j.jacca… An Abrupt Doubling of Heart Rate jacc.org/doi/10.1016/j.jacca… Junctional Ectopic Tachycardia After Adult Cardiac Surgery jacc.org/doi/10.1016/j.jacca… Three Voices of the Atrium: A Unique Case Finding on a Neonate ECG jacc.org/doi/10.1016/j.jacca… Repolarization Abnormalities — T-Wave, QT and J-Wave Wellens’ Sign and Syndrome Detected With the Home Use of a Novel 12-Lead Electrocardiogram jacc.org/doi/10.1016/j.jacca… Macroscopic T-Wave Alternans in QTc Prolongation: A Warning Sign Before Torsades de Pointes jacc.org/doi/10.1016/j.jacca… Short QT Syndrome Masquerading as Lone Atrial Fibrillation: Hidden in Plain Sight jacc.org/doi/10.1016/j.jacca… A Reversible ECG Signature of Hypothermia jacc.org/doi/10.1016/j.jacca… QRS Axis, Localization and Artifact Posteroseptal RVOT PVCs in a Clockwise-Rotated Congenital Heart: A Left-Sided Illusion jacc.org/doi/10.1016/j.jacca… Northwest Axis on Electrocardiogram: Decoding an Unusual Cardiac Axis in a Young Patient jacc.org/doi/10.1016/j.jacca… Crochetage Sign on Electrocardiography as a Diagnostic Marker of Patent Foramen Ovale jacc.org/doi/10.1016/j.jacca… An Electrocardiographic Artifact Mimicking Pacemaker Malfunction jacc.org/doi/10.1016/j.jacca… This ECG Does Not Fit: Rethinking Left Ventricular Hypertrophy jacc.org/doi/10.1016/j.jacca… Pseudo-Infarction Reversal in Right Precordial Leads: ECG Evolution in Severe Pulmonary Hypertension jacc.org/doi/10.1016/j.jacca… @aroniskn @CraigBasman @JACabreraCardio @MiChen__ @aabha_divya @sarano_maurice @MarcEngels7 @Miho_Fukui_ @CardioOncCO @Nishaki1 @MMarinCuartas @ChrissyMD2000f @ACHDocTMoe @PanjrathG @jsaef1 @Kentso987 @m_taramasso @SyedZaidMD Author’s Handles: @mariaelisasales @BPushparaji @MattSegar @sudarshanballa @sthangjui @aronismd @luisreneps @DrAvinash_ @dlypourlis @dr__hunt @JustinMarkMD @jennyjlcao @abhishek_mbbs @MayoClinicC @MayoCVFellows @mazenkawji @stavrosstavrak1 @drdave0 @AishKamble67 @RobertHelmMD @YooTaeKyung1 @albcipri6 @LauraDemichiel

🚨🫀 AI-ECG for heart failure screening in Kenya AI-ECG detected LV systolic dysfunction with: ✅ AUC 0.96 ✅ Sensitivity 95.6% Great work @ambarish4786 @NeilKeshvani @MattSegar @JAMACardio Paper: doi.org/10.1001/jamacardio.2… #CardioTwitter #AIinMedicine #GlobalHealth #HeartFailure

Been an exciting journey! Even more excited for what’s next.

We’ve been acquired!

Can standard ECGs flag aortic stenosis years earlier and predict higher mortality post-TAVR? Yes. 🫀 @CardioCareToday highlighted groundbreaking research by Dr. @MattSegar (@Texas_Heart). At AccurKardia, our investigational AK-AVS pipeline is turning the standard ECG into a powerful, predictive biomarker for structural heart disease. Check the interview: cardiocaretoday.com/post/ai-… #AorticStenosis #TAVR #HealthTech #Cardiology #MedTech #AI #BetterOutcomes

#WAFIB2026 ⁦@westernAFib⁩ ⁦@nmarrouche⁩ ⁦@SanaAlkhatib9⁩ ⁦@PassmanRod⁩ ⁦@Phiso_de⁩ ⁦@TinaBaykaner⁩ ⁦@MattSegar⁩

On the standards of reporting of P-wave abnormalities in electrocardiographic studies heartrhythmjournal.com/artic…

Electrocardiographic P-wave Parameters and Lifetime Atrial Fibrillation Risk: A Multi-Cohort Study @MattSegar heartrhythmjournal.com/artic…

New peer-reviewed evidence for AI-ECG in aortic stenosis. Big thanks to Dr. @MattSegar and the Texas Heart Institute team for leading this work. academic.oup.com/ehjdh/advan… AK-AVS is investigational and not FDA-cleared.

Development and Validation of a Novel Machine Learning-Based Algorithm to Predict Incident Atrial Fibrillation – A Multicohort Analysis heartrhythmjournal.com/artic…

POLY-HF trial: Polypill containing metoprolol, spironolactone, and empagliflozin improved EF, QoL, and adherence, and reduced HF hospitalizations at 6 months in HFrEF patients compared to usual care. #AHA25 View the slides here: clinicaltrialresults.org/wp-…

Never doubted ourselves.

Interesting case with PMCardio - Queen of Hearts. On call today and paged to ED for chest pain. ECG looked completely “benign”. Clinical story suggested an ACS event. We decided to take him to the Cath lab anyways, but used the app to see if I missed anything. QoH noted a STEMI equivalent. Patient ended up having a LCx occlusion. Ended up buying a subscription to the app for that alone. @PowerfulMedical @MartinHerman_ @RobertHermanMD

I experienced my first AI scribe hallucination today. What I said: "Heart rate 71 bpm" What the AI documented: "Electrocardiogram: Normal sinus rhythm" No ECG was performed. The AI scribe extrapolated from basic vital sign data and generated documentation for a procedure that never occurred. Remember, AI scribes are powerful tools, but they're not infallible. They can (and will) "hallucinate" by creating plausible-sounding but completely fictional content. We cannot delegate our professional responsibility to validate documentation. The technology is impressive, but physician oversight remains non-negotiable. Has anyone else experienced this?

AccurKardia launches clinical pilot for AK+ Guard. Three arm study, 150+ patients across care settings. AI hyperkalemia risk from Lead I ECGs, works with FDA cleared wearables. Details: businesswire.com/news/home/2… (Investigational, not FDA cleared.)

On the standards of reporting of P-wave abnormalities in electrocardiographic studies heartrhythmjournal.com/artic…

First time I've ever seen vibe coding used in the Methods section of a medical conference abstract.

See you at #ESCCongress 2025 (Madrid, Aug 29–Sep 1)! Join Dr. @MattSegar ’s research using AK-AVS™. Details: lnkd.in/ekKznvMV Meet us: info@accurkardia.com (AK-AVS™ investigational) #ESCCongress #WCCardio