Edward J Schloss MD Profile Banner
Edward J Schloss MD Profile
Edward J Schloss MD

@EJSMD

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Medical Director, Cardiac Rhythm Device Program, The Christ Hospital, Cincinnati OH. EJSMD @med -mastodon.com. Call me Jay. And my wife is pretty awesome.

Cincinnati, OH
Joined April 2011
Don't wanna be here? Send us removal request.
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@EJSMD
Edward J Schloss MD
6 years
Guiding principles for me & (I hope) other MDs: -All patients we touch get high quality care. -Care decisions arise from an informed, empathetic doctor/patient relationship. -In gray/undecided areas, the best path is usually the less intrusive/invasive/expensive path.
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Edward J Schloss MD
4 years
CMS has removed review of systems as a billing requirement for office E&M services starting Jan 2021. Pinch me. Is this real?
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Edward J Schloss MD
6 years
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Edward J Schloss MD
8 years
This is kind of like saying @Allstate and @Nationwide make great cars.
@realDonaldTrump
Donald J. Trump
8 years
Great meeting with CEOs of leading U.S. health insurance companies who provide great healthcare to the American people.
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Edward J Schloss MD
1 year
Ultrasound guidance for axillary vein access in pacer/ICD implant. Discussion of technique and live demonstration. 6 min video created for HRS, but unpublished until now. #EPeeps
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Edward J Schloss MD
1 year
Comes as no surprise thatchairman of @ABIMcert Board of Trustees is not participating in MOC. -- Do as I say, not as I do . .
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Edward J Schloss MD
5 years
Obvious false positive. No way David has RV failure and still can fight Goliath. EJ likely distended due to valsalva from tensing up abs to look buff.
@JAMA_current
JAMA
5 years
The external jugular vein on the right side of David’s neck in Michelangelo’s famed sculpture in the Accademia Galleria in Florence is distended well above his clavicle. Classic physical diagnosis teaching tells clinicians to observe the height of the ju…
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@EJSMD
Edward J Schloss MD
6 years
Recall, when Public Health initiatives fail, they can fail in spectacular fashion. —low fat diet & obesity crisis —chronic pain Rx & opioid crisis — #EHR , metrics & MD burnout Central health planners need #skininthegame @nntaleb @afrakt @aaronecarroll
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@EJSMD
Edward J Schloss MD
7 years
Marked LVH with cavity obliteration in cardiac arrest survivor with hypertrophic cardiomyopathy.
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@EJSMD
Edward J Schloss MD
2 years
Pearls on LBBA pacing fr @rdschaller on @MDT_Cardiac webinar ✳️ Point sheath 2 o'clock in RAO/LAO ✳️ Use 1 pair of gloves during lead spin ✳️ If lead goes off axis or torque builds, remove & start over ✳️ Don't confuse anodal capture with non-selective
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Edward J Schloss MD
2 years
Today is the 5 year anniversary of my Afib ablation(Cryo PVI). Thanks to @DrBradleyKnight and his amazing team at @NMCardioVasc , I remain symptom free in sinus rhythm, off all meds. Thanks!! #EPeeps
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@EJSMD
Edward J Schloss MD
6 years
US MDs-- Have you paid for & completed these childish essays to claim #MOC credit? Do you see any value in this activity? Please “like” if you oppose @ABIMcert rent-seeking; RT to spread the word. Let’s get to 100 + RTs & show @ABIMcert we are united.
@EJSMD
Edward J Schloss MD
6 years
I just completed my silly, insulting, but forced series of “what I did at my scientific session” 50-100 word essays in order to collect #MOC credit & earn the right to continue my 20 yr practice. Congratulations, @ABIMcert and @HRSonline : Are you proud of this charade? #hrs2018
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@EJSMD
Edward J Schloss MD
7 years
It’s ironic that a post deriding “self-proclaimed expert” MDs who use Twitter as a source of medical information is written by someone who has no Twitter account.
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Edward J Schloss MD
5 years
So grateful for our amazing #EPeeps community. I humbly accept the #OTE award (even it means wearing the silly crown). Thanks @gautamsand & all for putting this together. [but I’m still not confident I wasn’t being elaborately punked 😏] #HRS2019
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@EJSMD
Edward J Schloss MD
8 years
Quote of the month comes fr 91 yo woman in office today: “The only way I stay in touch with my friends these days is with a Ouija Board.”
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@EJSMD
Edward J Schloss MD
8 years
Mouse click counter today in office on Epic #EHR . So far 12 patients, 1233 clicks. That’s ~100 mouse clicks per pt.
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@EJSMD
Edward J Schloss MD
6 years
I just completed my silly, insulting, but forced series of “what I did at my scientific session” 50-100 word essays in order to collect #MOC credit & earn the right to continue my 20 yr practice. Congratulations, @ABIMcert and @HRSonline : Are you proud of this charade? #hrs2018
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Edward J Schloss MD
1 year
Back in 2015, @drjohnm and I talked about @ABIMcert MOC -- "insulting and irrelvant." I was freshly hot after my 20 yr recertification. "I'd go to Starbucks, which is my go-to place to get away from home distractions. I'd get there and look around; I'd be the only 51-year old
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Edward J Schloss MD
2 years
Looking for #HRS2022 posters? Sadly, they’re gone—replaced by oddly silent hall of lonely presenters in front of TV screens. Big loss. Casual interactions at poster sessions were big part of HRS experience. So much collegial interaction now lost. Can we go back? #EPeeps
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Edward J Schloss MD
6 years
US MDs are disappointed to be subject to onerous non-evidence based testing imposed upon them by an unaccountable, unelected board. They will defend their right to practice, recognizing that doing so will consume resources far better dedicated to caring for their patients.
@RichDuszak
Rich Duszak, MD
6 years
"ABIM is disappointed to learn of a lawsuit filed on behalf of four diplomates. The organization will vigorously defend itself, recognizing that doing so will consume resources far better dedicated to continuous improvement of its programs."
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@EJSMD
Edward J Schloss MD
4 years
@DGlaucomflecken Looks like a carry to me . . .
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Edward J Schloss MD
1 year
“If we don’t engage, nothing’s going to change.” @DJ_Lakkireddy addresses near empty hall at session on CMS reimbursement cuts to EP. #ironyalert #EPeeps need to wake up and take on the job of advocacy. @ep_advocacy #HRS2023
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Edward J Schloss MD
8 months
-- @DrRoderickTung -- Only two PVI + strategies have been shown to improve outcomes (CONVERGE and VoM). Both address the epicardium. "I don't believe that's a coincidence. #WAFib2024
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@EJSMD
Edward J Schloss MD
1 year
@molly_knight We got a Fi collar for Chester. One day he busted out of the yard. We got message that led him to directly neighbor's house where he was getting snuggles.
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Edward J Schloss MD
3 years
Idea for less costly CRT-D. Any #EPeeps try this or know of report? ✳️Dual Chamber DF-1 ICD Generator ✳️RA lead ✳️DF-1 RV ICD lead: P/S capped, shock active ✳️LBBA pace lead in RV ICD port Off label? Of course But . . . is it good for pts & HC system???
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Edward J Schloss MD
1 year
Here’s why we should use contrast at leadless pacer implant 😳 @melchami99 #HRS2023
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@EJSMD
Edward J Schloss MD
6 years
Micra leadless pacer extraction due to high threshold at ~2wks. Main lesson learned: Agilis sheath allows larger diameter snare. This makes device capture considerably easier. Note the difference w small snare from delivery system
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@EJSMD
Edward J Schloss MD
4 years
. @DrRoderickTung Atrial Epicardium is in afib Atrial Endocardium is quiet 🤯 #WAFib2021
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Edward J Schloss MD
4 years
#EPeeps take note! Today is 40th anniversary of first catheter ablation for cardiac arrhythmia. Congratulations and thanks to @MelScheinman and @UCSFCardiology and Mr. Paul Christian Anderson.
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Edward J Schloss MD
4 years
Modern ICD & pacers are complex devices. Simple programming choices can have long term consequences. Docs and #EPeeps that walk away after implant & relinquish care of these devices to caregivers w/o device expertise +/- industry reps are doing their patients a disservice.
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Edward J Schloss MD
6 years
Critical messaging of trials like #ORBITA and #CABANA should not be —Treatment (PCI/AFAbl) doesn’t work. But rather, — How do we select appropriate patients for these treatments? #HRS2018
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@EJSMD
Edward J Schloss MD
6 years
“What do you do?” “I’m an electrophysiologist” “A what?” “Heart rhythm doc. We treat heart beats fast, irregular, put wires into. . “ Eyes glazing over “So, you if you’re a heart doc, why r you eating that bagel stuffed w cream cheese?” “That’s plumbing-I don’t do that”
@MarkELindsay
MarkELindsay
6 years
“What do you do?” “I’m a scientist and a doctor, I do research” “Like with test tubes?” “Yes, very expensive test tubes” “How do you get money for your lab?” “Grants and donations, have you ever thought about supporting medical research?” POOF! *cloud of smoke remains*
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Edward J Schloss MD
2 years
"That picture is what his face looked like every day . . . His loss is almost impossible to estimate." @KennethEllenbo1 Sad moment at #PPS6 RIP Dr. Padala
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@EJSMD
Edward J Schloss MD
4 years
Been telling pts not to carry their cell phone in shirt pocket over device forever. Now it looks like there may be a legitimate reason to avoid this. @hrs_journal #EPeeps
@hrs_journal
HeartRhythm
4 years
After IRB approval, the authors demonstrate that an Apple iPhone 12 brought into immediate proximity to Medtronic ICD will suspend tachy therapies (figure). The ICD community should be aware of this interaction, and include this in pt counseling.
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@EJSMD
Edward J Schloss MD
7 years
It’s been my impression that senior academics may be threatened by Twitter because of its democratizing effects. Strength of voice/influence is determined by the merits of the argument rather than reputation/eminence.
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@EJSMD
Edward J Schloss MD
4 years
How to do a coronary sinus angiogram: 1️⃣Engage the CS in LAO, then confirm and advance the sheath in RAO. I use a MPA2 or AL2 coronary catheter inside CS sheath & find the CS with a long glidewire. If wire glides in w/o ectopy and is posterior in RAO, you're in. #EPeeps
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@EJSMD
Edward J Schloss MD
4 years
Trump Cardiomyopathy — A New Form of Takotsubo Cardiomyopathy New from my @TCHheart @ChristHospital colleagues @santoshgmenon
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@EJSMD
Edward J Schloss MD
6 years
It's a good day when you find this on the EP lab bulletin board weeks after your nursing student daughter comes to visit.
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@EJSMD
Edward J Schloss MD
6 years
Probably you all know this already. But if not . . . @EPICEMRparody is killing it. Please follow. This is the closest thing we’ll get to an Epic #EHR twitter account since EPIC HAS NO TWITTER ACCOUNT. Nice work, folks, controlling the message.
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@EJSMD
Edward J Schloss MD
6 years
Got my first Apple Watch 4 Afib positive this weekend. Note termination was caught on the recording. #EPeeps
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@EJSMD
Edward J Schloss MD
1 year
Echo outcomes in LBBAP are equivalent with multiple V1 paced morphologies - QS, qR, rSR' Implications for decision whether to accept LV septal as final position at LBBAP implant? @jaykoneru @KennethEllenbo1 #HRS2023
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@EJSMD
Edward J Schloss MD
3 years
Medical word of the day, and common source of EP consults: Bradysphygmia: Slowness of the pulse; can occur without bradycardia, as in ventricular bigeminy when every alternate beat may fail to produce a peripheral pulse () H/t @SergioPinski
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@EJSMD
Edward J Schloss MD
8 years
Here’s what happens when you put non-clinicians is charge of healthcare. #EHR #ClickingIsCaring #LOL
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Edward J Schloss MD
1 year
Data supports 3 FTEs to manage each 1000 pts on remote monitoring. “Take this to your administrators” — @brynndechert30 👏👏👏 #HRS2023
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@EJSMD
Edward J Schloss MD
4 years
Exciting to see annual Stanford Biodesign New Arrhythmia Tech Retreat ( @Wanginnovate ) will be proceeding as free Zoom virtual event this yr, Tues May 5. In 6 min blocks, you will see the future of our discipline. #EPeeps gonna want to check this out 👇
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@EJSMD
Edward J Schloss MD
8 years
WSJ piece calls Epic #EHR “the leading obfuscator” in interoperability. Wanna offer them your thoughts? Good luck:
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@EJSMD
Edward J Schloss MD
1 year
Paper posters are BACK, and people are talking. Thank you @HRSonline #HRS2023
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@EJSMD
Edward J Schloss MD
5 years
@nickkokonas If it will help, let us donate our upcoming reservations (Tokyo and St. Clair) to help you support your staff. We’ll raise a toast to you from Cincinnati.
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@EJSMD
Edward J Schloss MD
4 years
In press @hrs_journal -- 20 PAF pts get antral PFA and voltage maps They return 3 mos later for protocol driven repeat procedure. No sig difference in L or R sided antral isolated areas ✳️Pulsed field ablation lesions do not regress at 3 months.
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Edward J Schloss MD
3 years
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@EJSMD
Edward J Schloss MD
5 years
So sad to hear of the senseless assault & death of @MDT_Cardiac engineer Alex Sambelashvili. Alex was instrumental in development of AdaptiveCRT algorithm, and leaves a wife and 2 children. I remember him as a brilliant & warm man & will miss him greatly.
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@EJSMD
Edward J Schloss MD
6 years
If you are a fan of dark humor, you won’t want to miss the @ABIMcert knowledge check-in video. Equal parts Orwell and Brazil-era Terry Gilliam. If you just wanna skip to the good parts, check out the security check at 3:40. Enjoy!!
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@EJSMD
Edward J Schloss MD
8 months
@DrRoderickTung In endocardial posterior wall left atrial ablation -- "If there's anything going on in the endo, there's a party going on in the epi." Supports Allessie model of endo/epi reentry as AF substrate driver. #WAFib2024
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@EJSMD
Edward J Schloss MD
6 years
VT patient walks out of lab after his 10 minute ablation #WAFIB2019 @DoctorPhillEP
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@EJSMD
Edward J Schloss MD
5 years
In 23 yrs of EP practice, I’ve been to a few meetings. Not sure I’ve ever seen anything like #PPS2019 . Real science getting done right in front of us. Bravo @DrRoderickTung @gopi_gdanda1 @KennethEllenbo1 @Hisdoc1 and all others who made this happen.
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Edward J Schloss MD
5 years
If we had animated maps like this years ago, I might still be ablating. Beautiful stuff, @BiosenseWebster #VA2019
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@EJSMD
Edward J Schloss MD
5 years
@chrissyfarr Patient data should be owned by the patient and stored in a standardized portable format. Anyone who disagrees with this principle has an agenda. This isn’t complicated.
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@EJSMD
Edward J Schloss MD
6 years
Afib ablation of the future?? 👏👏 @DoctorPhillEP (love the Marrouche 3000 MRI scanner) #WAFIB2019
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@EJSMD
Edward J Schloss MD
5 years
. @andreanatalemd “The ultimate sham trial" was already done. “John was too busy on Twitter to notice.” AF vs AF/AFl ablation in APPROVAL trial #WAfib2020
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@EJSMD
Edward J Schloss MD
8 years
Mainstream media is now the third leading cause of death in America :)
@cardiobrief
Larry Husten
8 years
Bad News Bears: After Scary Headlines Some Patients Stopped Taking Statins
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@EJSMD
Edward J Schloss MD
2 years
Kirchoff -- Pts with CHADS-Vasc scores ≥ 4 drive the outcome benefits of AF rhythm control in EAST-AFNET trial. No outcome benefit in score 0-3. #WAFib2023
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@EJSMD
Edward J Schloss MD
8 years
Neither Clinton nor Trump’s physicians are participating in @ABIMcert MOC:
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@EJSMD
Edward J Schloss MD
5 years
New protocol for AVNRT induction complements classic maneuvers — in press @hrs_journal Ventricular-triggered atrial pacing: A new maneuver for slow-fast atrioventricular nodal reentrant tachycardia Editorial by Pat Tchou #EPeeps
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@EJSMD
Edward J Schloss MD
6 years
Population health should be practiced at the system level. Once we get down to the the doctor and the patient, medicine is all about the individual.
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@EJSMD
Edward J Schloss MD
8 years
If CRT pt is not responding, look at ECG. If Lead I is strongly positive, suspect suboptimal LV lead and talk to EP.
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@EJSMD
Edward J Schloss MD
8 years
Ambulatory VF in a VAD pt. Sent to ER for defibrillation. We confirmed with AliveCor and 2nd 12 lead.
@EJSMD
Edward J Schloss MD
8 years
New office consult had interesting ECG:
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@EJSMD
Edward J Schloss MD
3 years
Well, here’s a first. Grateful patient called @LaRosasPizza direct from his post op holding bed and had these delivered to @ChristHospital EP lab. Wow. Thanks!!
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@EJSMD
Edward J Schloss MD
7 years
Before Twitter, I only got to do this a few days each year.
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@EJSMD
Edward J Schloss MD
3 years
. @EPrystowskyonEP — “We still don’t know what causes Afib.” #wafib2022
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@EJSMD
Edward J Schloss MD
5 years
It’s remarkable to see such consistently vital work coming from @drjohnm and @doctorwes . Here are two brave full-time real doctors taking time and risk to take bold, contrarian positions, defending the truth, year after year. I’m proud to call them colleagues and friends.
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@EJSMD
Edward J Schloss MD
2 years
@DGlaucomflecken We all need a Jonathan
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@EJSMD
Edward J Schloss MD
8 months
If warfarin had never existed, and DOACs were generic, would patients be asking for Watchman? #WAFib2024
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@EJSMD
Edward J Schloss MD
8 months
David Haines death is a gutting loss for the #EPeeps community, his patients, family and friends. One of EP's true giants -- his brilliance was matched by his warmth and kindness. He was a regular at #WAFIb2024 and everything he said was gold. We will miss him dearly.
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@EJSMD
Edward J Schloss MD
5 years
Thanks to this dinner, all EP problems officially have been solved. Moving on now to #VA2019 @PrashSanders @leftbundle @drjohnm
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@EJSMD
Edward J Schloss MD
4 years
Is there a better example of first generation medical device tech than @Medtronic Micra leadless pacer? It’s really remarkable how well this was executed right out of the gate.
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@EJSMD
Edward J Schloss MD
3 years
Bradysphygmia — “Abnormal slowness of the pulse” Useful when discussing PVC pt & concerns re low palpated radial artery pulse rate. i.e. "pacemaker is not indicated for bradysphygmia due to frequent PVCs" How did I not know that word before?? Love it. Thanks, @SergioPinski
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@EJSMD
Edward J Schloss MD
2 years
Benefits of CRT visualized -- #EPeeps
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@EJSMD
Edward J Schloss MD
2 years
@DGlaucomflecken We’re all caregivers. Problem solved.
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@EJSMD
Edward J Schloss MD
8 years
A few years ago, we would hang a heart on the office wall after each ICD save. These each represent likely averted funerals.
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@EJSMD
Edward J Schloss MD
6 years
Tonight I got to hang with the two bravest, most talented writers in medicine I know. How cool is that? Thanks, @LisaRosenbaum17 & @drjohnm ! #HRS2018
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@EJSMD
Edward J Schloss MD
2 years
Info on AppleWatch AF burden: ✳️FDA 510(k) cleared ✳️PPG based ✳️Coming this fall in WatchOS9 ✳️<1% diff comp to FDA cleared alternative ✳️Post ablation monitoring cited as use case ✳️Graphs lifestyle correlates - sleep, wt, exercise, EtOH, mindfulness ✳️PDF shareable #EPeeps
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@EJSMD
Edward J Schloss MD
5 years
OK #EPeeps , who wants to take a crack at this?👇
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@EJSMD
Edward J Schloss MD
8 years
Wow. Mayo clinic CEO explicitly asks employees to prioritize care delivery based on quality of patient insurance
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@EJSMD
Edward J Schloss MD
6 years
I’m proud to coauthor "Internal Insulation Breaches in an ICD Lead with Redundant Conductors" in press HeartRhythm journal by Robert Hauser MD et al. In this tweetatorial, I'll share our important findings regarding the Durata ICD lead and some background
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@EJSMD
Edward J Schloss MD
5 years
Kuck— Ablation at parahissian AP sites: “If you cannot capture the His at 10 mA @ 2 msec you are safe. “ #VA2019
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@EJSMD
Edward J Schloss MD
8 years
New office consult had interesting ECG:
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@EJSMD
Edward J Schloss MD
1 year
@emily_fri As a doctor raising kids, you don’t really even get to come up for air until you hit your 40s. Hang tight. Best times are ahead of you.
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@EJSMD
Edward J Schloss MD
5 years
Today I drafted a #COVID -19 priority list for our EP procedures to share with our hospital. I’ll share with #EPeeps for your use and comment. Special thanks to @JonPicciniSr who tweeted out his version, which formed the basis of my adaptation.
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@JonPicciniSr
Jonathan Piccini, MD, MHS
5 years
Agree. Canceling elective cases is the "easier" part, deciding priority/timing is hard. Here are draft triage considerations for elective vs other considerations relevant to #COVID -19 Curious to hear what #Epeeps think. @leftbundle @Dr_Santangeli @atwater_brett
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@EJSMD
Edward J Schloss MD
1 year
#EPeeps lost a giant. I lost a mentor and friend. Pat Tchou is the reason I'm an EP. My first and most important teacher. Pat was brilliant, creative, skilled, patient, humble, tireless, committed, generous, compassionate, authentic. The real deal. I will miss him dearly.
@mbelshazly
Mohamed Elshazly, MD MBEE
1 year
Today, a giant in the field of cardiac #EP has left us. Dr. Pat Tchou was a founding father of EP and a phenomenal teacher. He was also one of the most humble and genuine people I've ever met. He will be missed and his legacy will live on. Thank you Pat! #EPeeps #CardioTwitter
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@EJSMD
Edward J Schloss MD
2 years
Lab Hack for #EPeeps -- We sometimes see bad cables or missing monitor signals w lead testing at device cases. During prep for implant, try testing cable integrity & signal path by shorting cable. Apply pacing current. If impedance is low and signal on screen OK, you're good.
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@EJSMD
Edward J Schloss MD
6 years
Hey @EPICEMRparody , I know you feel unappreciated from all those grumpy clinicians. This should make you feel better. These folks “get you.” #clickingiscaring
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@EJSMD
Edward J Schloss MD
7 years
This blog comment from @ajaykirtane nails it. Dr. Packer — are you listening?
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@EJSMD
Edward J Schloss MD
5 years
. @drjohnm — “Dr. M, Now I feel great.” 2 yrs after AF ablation. Gets this ECG in office last week. Discusses the power of the placebo effect. #WAfib2020
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@EJSMD
Edward J Schloss MD
7 years
@Gil_Bashe @CardioIAN Smart doc who’s made big contributions to the field of cardiology. Big time respect. But . . . he is no more of an expert on the utility of Twitter to MDs than I am an expert on multi-center trial design. Look in the mirror. There’s room for everyone.
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@EJSMD
Edward J Schloss MD
3 years
QRS is narrowest in non-selective LBB pacing across all conduction patterns compared to selective. “This is the exact opposite of His bundle pacing” @DrRoderickTung #PPS5
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@EJSMD
Edward J Schloss MD
3 years
. @Ed_Gerst — Patient — “I’ve got 10,000 PACs, does this mean I’m gonna get afib.” Data show PACs are very strongly predictive of future Afib. But . . . Are all PACs arrhythmogenic? #WAFib2022
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