#Genetics 🧬 is playing an increasingly important role for #Epeeps. Participating in this interuniversity diploma course in inherited cardiac diseases was a great opportunity to deepen my knowledge in #cardiogenetics. Merci beaucoup to everyone involved.
60F with longstanding AF after rheumatic valve disease. Bioprosthetic MVR. Extensive LA scar, unstable flutters limiting mapping. Empirical point-by-point PFA: first-pass PVI + PWI + anterior line with block. Will SR hold? 🤞 What would have been your strategy, #Epeeps ?
LEAP2: A First-in-Human Evaluation of a Chronically-Implanted Novel Leadless Pacemaker for Conduction System Pacing #OpenAccess
https://t.co/0RCoZ8QPS4
#EHRAtopicweek on electrical storm⚡
What to do when amiodarone and propranolol fail and catheter ablation is not feasible? Stellate ganglion block may be helpful.
Read more #Europace
https://t.co/gLhrxbQX3M
@EuropaceEIC
Last week‘s straightforward #ablation of an incessant focal left atrial tachycardia in symptomatic 65 yo gentleman. Immediate suppression with #RF after some firing. Mapping support by Yacine Taalla. Procedure done together with #Epeeps Francesco Montereggi.
🧵Should we use unipolar post wall mapping during AF ablation? Is endocardial silence in AF = posterior wall isolation?
Nice study in @CirculationEP by @Ed_Gerst et al. challenging both assumptions with human endo-epi mapping. Post wall = 3D substrate
https://t.co/79yhOWiGUG
@C_KowalewskiMD@DrJohn Not very surprising. SMASH‑VT, VTACH, VANISH, SURVIVE‑VT and VANISH‑2 have shown that VT ablation reduces arrhythmia burden without effect on mortality.
Same athlete, same heart condition,but different country- different career. Policies on professional sports participation for ICD carriers are NOT UNIFORM.
@EPWaveDoc at #HRS2026 : ❓Should athletes with ICDs be allowed to compete❓
Vote below and share your opinion!
@HRSonline
There’s something uncomfortable about watching our field race forward with blinders on. Not out of ignorance, but because the path is familiar, the tools keep improving, and every new tech is met with celebration.
Stopping to question our direction has become harder than building the next catheter.
New tools are helpful, but they have not moved the needle enough to meaningfully change outcomes, and something important, I feel, is being missed.
I’ve had my share helping to build some of these technologies, and I believe in this work. But that’s exactly why I feel the responsibility to say this.
Take posterior wall isolation. It doesn’t help everyone. Trials keep coming back neutral, and they will continue to, until we understand which patients actually benefit and why.
We’ve spent decades refining how we record and read voltage and activation data, adding electrodes, improving algorithms. Indeed, the maps look better, but the outcomes, not so much.
PFA is a great advancement, easier to use, procedurally efficient, creates more consistent lesions. That matters, but it will not change the trajectory of clinical outcomes.
At some point, that pattern stops being a coincidence. It becomes a signal that we may not be solving the right problem. The real gap, I suspect, isn’t in our catheters or our maps. It’s in our understanding of the disease itself.
Why does an APC trigger AF in one patient and not another, or from one location and not from another? What is the true arrhythmogenic substrate- is it really scar? Is AF really a left atrial disease? We know it is not, so how do we identify who has right atrial disease, and how do we map and target it?
We don’t fully have those answers, and no new tool will give them to us.
Closing the mechanism gap, that’s the work we need to do. Everything else, is refinement within a paradigm that may have already reached its ceiling.
The blinders come off when we’re willing to slow down and ask whether we’re racing in the right direction.
I’m fortunate to have worked with an incredible team over the past many years, that has taken on some of these questions directly. We’ll be presenting our findings on April 25 at 9:30AM at the High Impact Science session, and I hope it’s the beginning of a longer conversation.
@HRSonline@BarkaganMichael@MilmanAnat@drjohnm
#Epeeps#Chicago is calling! At #HRS2026 I’ll talk about return to play of #athletes with #ICD: “Professional Sporting Organizations SHOULD Adopt Uniform Global Policies” I’ll defend my arguments against former #EHRA president Hein Heidbuchel @Heidbuchel60722
#SportsEP is having a moment, and we're all in!
Kicking off #HRS2026 in Chicago, Global Summit 2026 will bring together international leaders to tackle one of the biggest topics in EP today. Dive into fascinating conversations on:
🏈 Arrhythmias in Athletes
🏀 Exercise & Cardiovascular Health
⚽ Physiological Monitoring & Safety
⚾ SCA Prevention
Join the huddle and RSVP: https://t.co/sxdwFyLr2U
Not registered for the meeting yet? Get in the game: https://t.co/CjzeUHqYXG
@EduardoSaad3@eugenechung01 @bdebneygray @SusanEtheridg12@PrashSanders
@dhairyalakhani@HAlvinChenNeuro Very interesting observation! I remember a case of a woman with mechanical AVR and 20 years of VKA treatment w/o problems. Problems and lots of discussion w unfavorable outcome started when there was a coincidental discovery of cerebral amyloid angiopathy.
@drjohnm@PrashSanders Very interesting observation! I remember a case of a woman with mechanical AVR and 20 years of VKA treatment w/o problems. Problems and lots of discussion w unfavorable outcome started when there was a coincidental discovery of cerebral amyloid angiopathy.
Honoured that our case series on LMNA-related cardiac laminopathy was selected as Case of the Year 2025 (inherited conditions) in the European Heart Journal – Case Reports. Free access: https://t.co/0lVhRx0Tv1
Grateful to editors & co-authors especially Dr Patrice Bouvagnet 🙏
Pre-market release at CHU #Martinique: Abbott TactiFlex™ Dual Energy (#RF and #PFA) now in use. First cases by my colleagues while I was at #EHRA. Promising point-by-point approach to complement single-shot devices. #Epeeps#Cardiology
@drjohnm I suggest “how I read a medical study” or “studies that I would like to be conducted” or “critical appraisal for dummies” or “how medicine and bike racing have changed along my career”