Yday I felt like I had a new born all over again! I got to play with one of my early patents which is being clinically tested incl at Beaumont!This not only moves the esophagus for AF ablation, it takes care of the trailing edge by suctioning the esophagus to move it en masse.
Another proud moment: I️ mentored 3 medical students last summer on Electrophysiology projects with an engineering angle and they bagged the first prize in the UVA engineering research symposium. Way to go girls!
@uvahealthnews
@BMESociety
@DrMarthaGulati
@DrQuinnCapers4
@dhaines901
recruited me, was as a mentor, sponsor & friend. He invited us into his family & has now left his family as mine. This week was awful but I want to celebrate his legacy. Thx
@HeartRhythmTV
⬇️- colleagues, trainees, industry and friends pls send your video memories 🙏
We are deeply saddened by his passing, and in honor of all he did for electrophysiology,
@HeartRhythmTV
will release a special episode dedicated to Dr. David Haines. This will consist of video tributes and we encourage all who wish to submit, please send to
@Nishaki1
by 2/26.
Proud to share REDEFINE trial
#HRS2022
where simple installation of semi transparent motorized blades ⬇️ radiation not only to EPs , our amazing staff but also our patients. Inspired our vision biophysics.Continuing to build on reduction reduction to improve safety all around!
Happy Diwali to the Twitterverse!I can’t recall the last time I was so thrilled to sign up for a conference.
@AHAMeetings
thank you for offering child care on site & leading the way for moms of young uns to attend. This is critical to fix the leaky pipeline for women.
#aha2022
Starting
#aha2022
right with my mentor and friend
@DrMarthaGulati
and baby snuggles.
Thankful for the fabulous child care services on site which lets me get through the sessions and pop by when I want.
Thank you
@manesh_patelMD
@AHAMeetings
and all who make this possible
From a napkin sketch as a fellow to FDA approval for a catheter to protect the esophagus, my journey in electrophysiology has been incredible! Excited to share this S4 medical team milestone at
#HRX2023
during a panel on engineers + physicians. 🙌
#MedicalInnovation
"
Yday I tiptoed around the esophagus as I isolated the pulm veins using all my tricks - LPLF&HPSD
Yday I heard our esophageal patent (which sucks the walls in and deviates) EASY AF trial was term early as it met its primary endpoint for 🔻eso injury.
Yday was a landmark day!🥳
UVA: thank you for the excellence in research 2019 award. Your kind words made the dash from clinic worth it! Plus it wouldn’t be possible without the fab combination of of students, collaborators, research resources and mentors.
@ChrisKramerMD
@uvahealthnews
Excellent talk on ivabradine va digoxin for rate control in atrial fibrillation.
Ivabradine is better tolerated and reduced rate by 11 bpm. Likely from impact on funny current at the Av node.
Helpful as a bail out.
@HRSonline
#HRS2023
What is cooler than winning 25K?
Having your Embark mentee tell you that our project won the top manuscript award and he got a 25k scholarship for his final year of med school!
This is Josh France from
@OUWB
presenting his research at ACC this year. So proud!
@CorewellHealth
This was one of my very first medical innovation patents- as a fellow working w Dr Emile Daoud and GI buddy to develop a better way to protect the esophagus during ablation procedures - six years later I see it clinically tested and we are excited to use it at
@BeaumontHealth
@s4_medical
announces first patient enrolled and treated in the Easy AF IDE Study. A big accomplishment and huge thanks to the clinical team at The Ohio State University Ross Heart Medical Center!
While I enjoyed some baby snuggles this weekend, I am proud of our Oakland medical students and Beaumont team presenting on
❤️real life complication rates following CIED placements
❤️hematoma incidence following CIED placement
❤️management of AF in post partum period
#ACC2023
So grateful for
#acc2024
for providing child care on site with kiddie corp. I know I am one amongst many grateful parents. It’s hard to leave my little one behind and the snuggles at night are too precious. Plus she gets to meet my friends!
Dr P Tchou : your son and wife were amazing!! A standing ovation today and forever for all the lives you influenced. You have such a wonderful legacy! RIP
@HRSonline
#HRS2023
@HRSonline
NEW from Heart Rhythm TV: In Memory of Dr. David Haines. This tribute was spearheaded and produced by Dr. Nishaki Mehta (
@Nishaki1
), and contains heartfelt messages from colleagues and friends. See the full video here
#EPeeps
➡️
Great talk by Dr Sauer on half normal saline and ionic shunting or lack thereof. Especially in the coronary sinus and pericardial access w possibility to reduce pericarditis. Note: studies done on ST platform.
#Signalsummit
@True_EP
As a MI innovation awardee 2021, I loved these pearls to succeed:
💡Your biggest competitor is challenging
#status
quo
💡Evaluate need not utility
💡Target your ideas to PEOPLE not companies
💡Customer doesn’t buy technology but buy benefits
💡Know when to stop
Using media for changing perceptions- show black men as doctors and not as danger. Love the work you are doing - also identifying the pipeline leaks as OSU leads the way with kto12 program. Congrats on the teaching award so well deserved! Proud to be your mentee.
@DrQuinnCapers4
Childcare in conferences is leading the way to having moms make it !! Can’t wait for my little one’s second HRS but with on site support! This will change my plans and help me enjoy the conference more! Thank you .🙏
@KTamirisaMD
@AndreaRussoEP
@HRSonline
@WomenAs1
@skarim01
Pt musings post pacemaker procedure:
Me: “your X-ray pics looks good!”
Pt: “ I know”
Me: “ Great, did my team discuss this already?”
Pt: “ No but I know. I take good pictures, I have always been photogenic.”
💕 my patients!
@BeaumontCards
@ChinnaiyanMD
@heartdoc44
@AkhilGulati
How to manage AF post CABG: take a look at our meta-analysis where we found impact of new onset afib (NOAF) post CABG was associated with higher in hospital mortality, higher stroke risk, higher all cause and CV mortality. We excluded valvular surgery.
Gr8 overview
Pfa can hurt phrenic nerve
Pfa appears to spare esophagus likely from fat and regenerative potential
Pfa beyond 4 mm of tissue contact➡️no lesion. What is role of contact magnitude?
Bipolar egm is not a surrogate for lesion formation
@atulverma_md
Thanks for an incredible 1st year and such a thoughtful celebration for my first work anniversary. A glimpse of the last yr- It’s been a joy and honor working here with brilliant colleagues, and making good friends!
@BeaumontHealth
@dhaines901
@heartdoc44
@ChinnaiyanMD
@dhaines901
- we know you were there . Your legacy on PFA will live on forever. You gave the first talk on this in 2018 and this week, we helped patients using this.
We had so much planned together on advancing the field. I know you will guide the
@BeaumontCards
family forever.
Our EP team lead by
@Nishaki1
and Dr. Ilana Kutinsky performed their first AFib ablation using
@Medtronic
PulseSelect Pulse Field Ablation System.
Dr. Haines presence was surely felt throughout the case. He would be so proud.
Okay more bragging rights! Today
@LuaiMadanat
won the research award for south east michigan research forum. I have seen this rising star as an intern and now we are ecstatic to retain him as a
@BeaumontCards
fellow!!
Moving from subcut to Inter muscular to subserratus implant. With the latter tack device down well,else it is a wide open space for the generator to travel the world of the thorax.
Incision has to be higher at the level of the breast meeting the chest
@rdschaller
fabulous idea!
Research Alert: My pt with IVC filter needing a Micra inspired this systematic review on IVC filter management in EP + cath lab. Highlights:
1. 95% safety
2. Attempt lateral crossing w diff x-secns of filters
3. Diagnostic algorithm to approach such pts
JUST IN! Proud to have an A++ ⭐️⭐️⭐️⭐️⭐️
#JACCCaseReports
@JACCJournals
Ed Board team: 2 🚺Deputy Editors, 16 Associate Editors >60% 🚺, diverse background, expertise, 🌎, carrier stages. 1st time w/ allied health &
@VeteransHealth
rep. Congrats & look fwd to an amazing 5y!
SVT in pregnancy can be bad
New pregnancy labeling instead of categories , FDA introduced nuanced labeling with pregnancy and lactation which describes available data
Amiodarone is no longer category D!!!
Don’t shy from ablation, <50 Gy doesn’t hurt fetus
#ACC2024
Three superb years at
@UVA
:thank you for the camaraderie, opportunities, friendships4life& trust. 👇is the team that applied the first PressRite- a hematoma prevention/wound healing device which we developed at
@CardioUva
. RCT: 112 enrolled pts &are now analyzing data. Go hoos!
Don’t let coronary sinus dissection faze you. It can be quite forgiving.
Try to re engage the coronary sinus.
Dr Mela
@HRSonline
#HRS2023
PS full room with a riveted audience!
@netta_doc
you have the best way to bring out the core of the study results. Thank you for highlighting
@ControlRad
outcomes on radiation reduction in EP device procedures. I love the fact that we can layer this technology on other techniques to beat radiation - goal for 0 mrem!
So proud of my interventional cardiology attending , friend, sponsor
@DrQuinnCapers4
who is moving back to his alma mater Howard University as Chair of Medicine.👏👏👏
You are a beacon of inspiration&having enjoyed your support as a fledgling fellow, I was so lucky!
Don’t short change the physical exam
To optimize the patient interaction, your first few seconds are critical to make a connection.
AI will allow us to practice to the top of our scope. It will help us focus on the zebras while AI works out the rest.
#HRX2023
Every time I hear folks reminisce about NASPE, I wonder how it must have been. Now I get to be a part of the 1st innovation conference at
@HRX2022
- confluence for digital tech, data and cardiology. Excited to share my views as an HRXexplorer with this dream team!
This research on novel amiodarone order set to improve compliance with testing is close to my ❤️- it was resident initiated&a multidisciplinary effort. This intervention did NOT improve compliance. Negative studies are as impt and showcase EMR fatigue.
@CardiacRX
@CardioUva
Long story short: without electrode tissue contact, pulsed field ablation is unlikely to cause a lesion.
Dr Nagakawa
Our poster yday showed the same observation.
@HRSonline
#hrs2023
#AHA2022
. This breaks my heart.
80% pregnancy deaths are preventable
40% women do not show up for post partum f/up
45% of death is from ppm cardiomyopathy, which manifests in post partum period
The historical context slide is sad, shocking but needs to be shared
Role of Pre AF CT scan can reveal surprises. Once I️ saw this narrow fingerlette of the fifth vein from the post wall, I️ was able to trace the shadow on ICE and work around it. But it could have been an easy miss on ICE. All about preparation.
#Epeeps
#afablation
#afib
T-3 for
@HRSonline
.. excited to be
#2023pacesetter
. Here are my top session picks.
Also excited to see our gen cards fellow
@SGudipatiMD
do an oral presentation on class I AAD safety in patients w CTA identified CAD! Safe travels everyone!
Mama bear pride! My fellow
@swapna_gudipati
is presenting on class I drug safety in patients with cad diagnosed with pre procedure cta. I often encounter this issue and haven’t figured out how to reconcile w the CAST study.
Room 229 in ten mins!
@HRSonline
As I️ look back at this yr : we had exciting medicine- BME collaborations at UVA. I️ secured $120K on 2 collaborative grants, recruited a Fulbright scholar n mentoring 9 BME students. We are always looking for top engineering talent to take cardiology to next level!
@BMESociety
Highlights GR w
@DrMarthaGulati
:
1. ❤️pain:cardiac, probable or non ❤️
2. CXR & EKG in 10 mins
3. Don’t use % w patients. Say 1 in 100
4 Cardiolinguistics show 👱🏻♀️ use word chest pain just as much as 👱♂️
5. RCT on shared decision making in low risk pts
6. Ca> 100 = CAD
Great discussion on NICM scar patterns by
@utedrow
@rheapimentel3
✅Septal scar in nicm= sarcoid , lamin and phospholamban ,✅Af + heart block + VT + negative sarcoid work up = ? lamin ✅Nice ex of peri aortic scar with late egms resulting in multiple morphs
New afib guidelines 2023 by Dr Joglar.
Coffee is not bad for AF, unless specific trigger for a patient ( my editorial note)
I plan to use Atria and Garfield score for CKD and dementia in addition to C2V scores
With CM, target HR<80 at rest and <110 with exercise
#ACC24
So excited for Dr Jodie Hurwitz incoming presidential session .. and her monthly updates.
Also the DEI initiative is such a welcome addition
@HRSonline
#HRS2023
#practical
updates in cardiology 2023
Learning from my very smart colleagues
@amrabbasmd
opened with bio prosthetic valves.
If we see regurgitation with trifecta valve, escalate attention to structural heart specialist. The degeneration can be rapid and sudden!
Think BIG. Start SMALL. Move FAST.
I would add “ Be REPETITIVE”
50% of encounter info lost by pt at the end of the visit. My goal is to keep chipping away for preventive care.
Applying digital health for wellness.
#HRX2023
1st foray into health economics: Early placement (EP 5 days)vs Watchful waiting (WW upto 12 d) for pacemakers following AV block for valve surgeries.
🔵 Incremental cost effective ratio < 50000 is considered high value care
🟣 WW won with ICER ~ 13000
🟠 TAVR analysis next?
So much joy at the academic heart and vascular clinic
@BeaumontHealth
Congrats to the 1st recipients of the daisy team award- fabulous team
@suzeeern
@heartdocelvis
Jim C and Jodi- hooray to an incredible team!!
And the holiday cheer from Mrs Goldstein and her magic baking!
Guess who we ran into at Starbucks today- Dr Dan Carey. Meet the new president of Corewell William Beaumont University. The kicker is that he is an interventional cardiologist!
Looking forward to an era of physician leadership!
@CorewellHealth
@heartdocelvis
The pillars of AF are so fluid.
Life style is moving up and rate control is moving out.
We keep moving upstream of the AF disease process.
@PrashSanders
I am totally on the same page!
What does the future look for AF?
#HRX2023
@JonPicciniSr
VT in pregnancy - incidence increasing.
PVC may be low burden but symptomatic
Higher doses of sotalol needed in pregnancy
Higher doses of adenosine needed for fetal management
Remember moving uterus for patients in cardiac arrest
@MRobinsonEP
#ACC2024
**Faculty Spotlight**
(1/3)
Dr. David Haines (director of EP) is 1 of our best educators.
A few interesting facts:
1) AF pathophysiology and ablation has been his focus since 1991
2) A meeting deciding the future of RF ablation was attended by ~10 ppl including Dr. Haines
Syncope and driving priviledges.
Vaso vagal syncope - no syncope in 1 yr- no restriction.
>6 syncope/yr-> no driving.
1-6 syncope/yr- 1 mo observation.
Surg Gen
@JeromeAdamsMD
highlighted CV is
#1
killer for pregnancy. Sadly this is also the most striking example of structured racism where education, $ cant bridge the gap. Join me
#AHA2022
braindate to discuss how
@BeaumontHealth
is seeking collaborators to tackle this.
Enjoyed moderating VT session w
@LuigiDiBiaseMD
at
#AHA2023
He presented that wall CT thickness was not a good measure for guiding ablation
@Davilandre
WADL - wavefront discontinuity may facilitate quick same day discharge VT ablation procedures
Encore VT- I️ loved how there were min exclusion criteria allowing for a sick population! Encouraging primary and secondary end points - look forward to lesion evolution and bio marker trends which will be analyzed in the near future. Truly ground breaking
@Pcuculich
We are excited & have practical experiments lined up to see what transpires under the ablation catheter- real 👀 opener to improve biophysics understanding and how to harness configurations ! Tx to
@True_EP
&an incredible team
@utedrow
@Davilandre
@JDMossMD
and Duy!
#HRS2021
We are all set for the hands on ablation session in room 203 this afternoon. Made preparations last night and reviewed the experimental protocols for ex vivo RF ablation.
#HRS2021
⭐️ Collaborating with Health Tech, Biopharma, & Industry in Your Early Career
⭐️ 4/8, 10a-11a
⭐️ You're going to want to stick around to catch this 🔥 panel giving insights you can't get anywhere else —
@medtmaddox
,
@mvaduganathan
,
@DemiladeMD
,
@Nishaki1
, w/
@Adam_Kisling
& me!
Really enjoyed interacting with a diverse group of cardiology and EP fellows with
@AndreaRussoEP
@aalahmadmd
@ep_travis
and Paul Wang.
Highlight: assembling leads manually. So much respect when I handle a lead next!
So much to share and so much more to learn!
#EPeeps
I’m going to brag.
@ArulChinnaiyan
is the Sjoberg 2022 recipient! His team discovered that the fusion of TMPRSS2 and ERG gene drives prostate ca. Sjoberg is generally considered a pre Nobel prize award. Go
@ChinnaiyanMD
team! We are rooting for you 🤗
Dr Wael Jaber:
Take 🏡 for amyloid and AF
💎 AF upto 70% in amyloid
💎intracard clots in 30%
💎most treated w CV and aad prior to era of disease modifying drugs
💎TC PYP scan w Atrial signal predicts higher risk for AF
Our work on a novel lead garment which won the first prize in the design of medical device conference 2018 for innovation was published. Our prototype combines the benefits of being able to use fluoro without bearing the burden of lead garments.
Amid COV19, I am very proud of my 16 graduating Capstone students who presented on 7 projects on zoom. They utilized pre and post user surveys( thanks EP Lab MDs, RNs & techs) & CAD simulation to overcome limitations. Creativity to innovate in times like this is 👏👏👏
@UVABME
Top highlights: can’t compare PFA from one manufacturer to another. Unlike RF. Impedance in PFA is not equivalent to RF impedance drops. Whether thermal temp rises can occur is a question but swine studies show less than 5 C heating.
IN-DEPTH LOOK: DocWire News Editorial Board member Dr. Nishaki Mehta (
@Nishaki1
), and colleague Dr. Luai Madanat, present in-depth look at pocket
#hematomas
for cardiac devices, and the challenges they present for practitioner and patient
#CardioTwitter
India has capped drug eluting stent price at $440 and the talent study showed that an affordable stent was non inferior paving new avenues to provide more affordable care. I️ hope some of this market competitiveness spills over for device care and NOACs!
Digital health is the new super social determinant of health.
@DemiladeMD
shout out to your talk yday.
india
@narendramodi
has introduced digital health at a mass scale
Poverty is defined when diet budget is 1/3rd of your income. Compound digital poverty on that
#HRX2023
Amazing talk on how COVID-19 spurred digital health in EP.
Now let’s harness this to level the playing field and reduce disparities
@HRSonline
#HRS2023
Dr K Thomas
REACT AF is a landmark trial to use digital health through the lens of equity. Oversample black pts!
#practical
updates in cardiology 23
@zdemertzis
👏on mitral annular disjunction
❤️cmr is gold standard
❤️ low threshold for prolonged arrhythmia detection - made it to the guidelines
❤️no prophylactic meds or surgery unless severe valvular involvement
Pulsed field ablation uses electric field to induce pores in the cell membrane. This ⬆️permeability➡️ cell death. Its cardio selective-imagine not worrying about collateral injury. Rock ⭐️ partners
@dhaines901
@ikutinsky1
did their first round at
@BeaumontCards
this week!
Cardio neural ablation- could it be the way for cardioinhibitory syncope in patients <40. The ppm data is mostly over age 40. There is case control data, meta analysis and RCT supporting role in select patients. Love the algorithm proposed by
@MDTolgaAksu
AI is here to reinvent the way we are using our time.
We have survived a mass extinction - perspective shift. Time for me to take a moment to be grateful!
Amazing fireside chat
@SanaAlkhatib9
and
@jojobickley
#HRX2023
Thanks for organizing an incredible session along w anatomy &mapping .For biophysics we went through irrigated and non irrigated settings at low and high power, played with different irritants, did the bipolar ablation with
@True_EP
specialty cables and of course steam POP!
Great pearls on SGLT2i and GLP
I am happy to say w our amazing fellows
@BeaumontCards
I have initiated these drugs in the EP patients
Next frontier - starting both medications
Signal of hemoglobinuria with PFA which was seen w over 95 ablation applications. IV hydration can circumvent this.
PFA less impact on stiff LA
@natale_md
insightful talk 🙏
#AHA2023
Clinic musings: While sharing a normal cardiac test result with a pt, he smiled & pointed, “ I read on MyChart already. Isn’t it surprising that something normal is reported as “grossly unremarkable”. How is that a good thing?”
I mused.. is it time to change our parlance?