Heart rhythm doc, writer for @Medscape, host of This Week in Cardiology podcast, editor of Sensible Medicine. The more you see, the harder medicine gets.
Louisville, KY
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Twitter thread coming on what @adamcifu @VPrasadMDMPH @AndrewFoy82 and I think is the BEST approach to pt care. This is ...
The Case for Being a Medical Conservative.
amjmed.com/article/S0002-934…
Thanks to the @amjmed for publishing this.
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Pretty important 👇🏻
Paper out in @escardio #EHJ, lead by #milanmilojevic: time-dependent late mortality in a pooled analysis of trials
TL:DR: the hazard for all-cause mortality changes at 1.9 years, with 5-7 years HR of 1.64 (p < 0.001) in favor of #SAVR
@EACTS @ctsnetorg
academic.oup.com/eurheartj/a…
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Cardioverting AF w max energy only.
Imitation is the sincerest form of flattery...
The mandate is clear. We need strict regulations now. The list of legislations is obvious:
- regulate hs-troponin
- cardiology only for coronary calcium scans
- harsh sanctions for calling BP "soft"
- tariffs for tracking Lp(a)
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Newest episode of This Fortnight in Medicine with
@drjohnm, @AndrewFoy82, and me. We argue a bit about how negative to be on CGMs in Type II DM and CAC.
sensible-med.com/p/this-fort…
This Fortnight in Medicine XXXVII
CGMs for DM and CAC for ASCVD risk stratification
sensible-med.com 1
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I was in Europe a lot this year. We often discussed American politics.
This morning revealed the brilliance of the system designed by the founding fathers
The people have clearly spoken. It leaves you with hope for our healing
Wow... what a morning
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Professor Feigenbaum in IU echo conference: “never give up on AS”
Immediate improvement in LV function after mechanical AVR (23 St.Jude) in young non-TAVR candidate with neglected chronic near unicuspid AS (EF 5%) despite concomitant MVr displayed in these pre- and post cardiopulmonary bypass TEE images without escalation of preop inotropes.
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John Mandrola, MD retweeted
@theaspiredstudy also picked up by Medscape with a great summary from @drjohnm , host of the popular podcast 'This Week in Cardiology' medscape.com/p04/oct-30-2026…
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John Mandrola, MD retweeted
Interesting responses to @drjohnm post of our study. Agree PF PWI is easier BUT 1) is it more durable than RF 2) does it improve outcomes? Every study to date says NO inc PIFPAF RCT with PF! What is this obsession of EPs with PWI?
Another sobering study in AF ablation. Melbourne group reports on 121 patients who have recurrent AF despite durable PVI. All have posterior wall isolation. [Because we can.]
The results are similar to the trials. Not good.
doi.org/10.1016/j.jacep.2026…
@peterkistler3
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John Mandrola, MD retweeted
@drjohnm
"This is the crux of our problem in EP:
we don't understand the pathophysiology of the condition. PVs get isolated because we can."
Credit to the EP team in Bern for this excellent remapping study after either RF or PFA. Mandated remapping is much better than remapping for symptoms jacc.org/doi/10.1016/j.jacep…
A) PFA no better than RF for durable PVI
B) Recapitulates GAP study showing that AF still occurs in one-third of durably isolated PVs and 72% of those with reconnected veins DID NOT have AF at one year
This is the crux of our problem in EP: we don't understand the pathophysiology of the condition. PVs get isolated because we can. @TobiasReichlin
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Could not agree more with this post by @drjohnm
The Problem of Cheerleading in Medical Science open.substack.com/pub/sensib…
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Good one this morning w our oldest — Catherine. strava.app.link/9uJ3RjotI7b
PR for the >60-years-old half marathon — 1:50:13
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Super interesting
Non-Invasive Stimulation of the Median Nerve: Neuromodulation to Reduce Atrial Arrhythmias in Paroxysmal Atrial Fibrillation (The Randomized BEAT-AF Pilot Study)
heartrhythmjournal.com/artic…
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Gosh...what a beautiful post today on @Sensible__Med from Kirsten Balin sensible-med.com/p/what-is-h… What is Health For?
It reminds of the beginning of The Death of Humane Medicine from Petr Skrabenek: "The pursuit of health is a symptom of unhealth"
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John Mandrola, MD retweeted
I highly recommend listening to @drjohnm review of this study on this week’s episode of This Week in Cardiology podcast.
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Such wise comments about this one already.
open.substack.com/pub/sensib…
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John Mandrola, MD retweeted
This result may seem obvious to EPs, but it’s important such a randomized trial be performed and disseminated, particularly for the general medicine and even general cardiology colleagues that may not be aware of the apparent superiority of LBA pacing when frequent ventricular pacing is anticipated. Congratulations to the authors on this important work! @drjohnm @DrDave01
Among patients with #AtrioventricularBlock, preserved left ventricular ejection fraction, and anticipated high ventricular pacing burden, left bundle-branch area pacing reduced the 24-month composite of all-cause death, heart failure events, or upgrade to biventricular pacing vs right ventricular pacing.
Device-related complications were similar between groups, supporting clinical consideration of left bundle-branch area pacing for patients expected to require frequent ventricular pacing.
ja.ma/3Wb4sBV
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Was the Guinea-Bissau Hepatitis B Vaccine Ethical? open.substack.com/pub/sensib…
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Was the Guinea-Bissau Hepatitis B Vaccine Ethical? @VPrasadMDMPH & @drjohnm & @adamcifu weigh in on the arguments.
sensible-med.com/p/was-the-g…
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