DrNWij

Clinical Research Fellow in Electrophysiology and Imaging, King’s College London. Cardiology Reg and Aspiring EP, board game enthusiast, vegan, cancer survivor

[JAHA @JAHA_AHA]

Smaller heart size and increased relative dyssynchrony in females may drive sex-specific cardiac resynchronization therapy response. #AHAJournals @NadeevW @KingsCollegeLon https://t.co/rnl3yUl88X

[DrNWij @NadeevW]

@ecgandrhythmRoe WCT. Classic LBBB morphology. Appears to be 2.1. The premature beat does not reset the tachycardia. Likely AT

[DrNWij @NadeevW]

Really pleased to put this out there - should we be using sex-specific CRT eligibility criteria? #epeeps

Heart Size Difference Drives Sex‐Specific Response to Cardiac Resynchronization Therapy: A Post Hoc Analysis of the MORE‐MPP CRT Trial | JAHA https://t.co/NStzyix1GB

[Dr. Ish (they/them) @ishsulin]

… what’s a physician again??

is this not just straight up misleading and lying what’s happening 😭😭😭

literally ask any general member of the public and they won’t have a clue who these ppl are - this is shady and how ppl still don’t think this is a bad idea is tapped ‼️

[DrNWij @NadeevW]

@PurumittalDr What was the mode of arrest? VF/monomorphic VT? Was the first presentation with chest pain and ischaemic changes? If not an STE-ACS is there a place for CMR, then ICD, GDMT, and revasc following optimisation if there are symptoms? No critical LMS disease

[DrNWij @NadeevW]

@ECGwithReid Atrial arrhythmia with 2.1 conduction. Not a typical BBB - is there congenital heart disease?

[DrNWij @NadeevW]

@syamkumarmd Ortho AVRT. Subtle pre-excitation, loss of initial Q wave in V6 in sinus…

[DrNWij @NadeevW]

@jdrwilcox PGY-12 for me, about 4.5 years left! Tbh I think there’s something to having “life experience” unrelated to the job, I’ve found personally that certain things in my personal life have made me a better dr, eg having health issues myself, dealing with tragedy, having kids

[DrNWij @NadeevW]

@narrowQRS Such a great video! I’ve been in research for a couple of years and nowhere near the lab but this brought it all back so succinctly with great example traces

[DrNWij @NadeevW]

@Umair2017 @SCAI @BCMHeart @JingLiu_MD @Hragy @mmamas1973 @ShariqShamimMD @iamritu @dr_benoy_n_shah @djc795 @SyedYNaqvi1 But he presented with angina - so would perhaps fall into an ORBITA 2 type population where PCI could be offered for symptom relief and to come off anti angina tablets? Evidence is not there to treat lesion on prognostic basis IMO

[DrNWij @NadeevW]

@ecgandrhythmRoe I think focal AT from the left. Would give adenosine in the first instance to confirm that it’s not typical flutter, but given the history it’s likely related to the myxoma

[DrNWij @NadeevW]

@Hragy He had angina at one point now requiring BB. Would be reasonable to offer PCI or OMT and inform that PCI is mainly for symptom relief/coming off BB. He has aggressive CAD so would save the LIMA for when he is in his 60s and possibly has multivessel disease at that stage

[DrNWij @NadeevW]

@Umair2017 @sargsyanz @mmamas1973 @ShariqShamimMD @JingLiu_MD @HadyLichaaMD @djc795 @Hragy @iamritu @NMerke @hahn_rt This sort of issue is screaming out for an RCT!

[DrNWij @NadeevW]

@Arron_Pearce_ Doesn’t seem to be rhetorical if the question is whether it’s a shockable or non-shockable cause of arrest no?

[DrNWij @NadeevW]

@MubarakAlhatemi @syamkumarmd @The_Nanashi_O @DidlakeDW @smithECGBlog @EM_RESUS @PendellM @RobertHermanMD Would treat the RCA. Then inpatient cardiac MRI to determine if that was an acute lesion as 1. ECG not diagnostic of STEMI and 2. TIMI 2/3 flow down RCA to start with ?reperfused. If there’s transmural scar then I would implant ICD on this admission.

[DrNWij @NadeevW]

@EhdaieMd Paced morphology of S2 different to S1. Retrograde activation seems identical throughout. My theory - the S1 beats are fusion with intrinsic rather than pure RV. So fast pathway is refractory for those beats hence retrograde slow. S2 - fast pathway is not refractory

[DrNWij @NadeevW]

@jdrwilcox @LKoliastasis @panosxap @PCRonline Once he’s on the table in the first place, I think most would treat any low hanging fruit. Trouble is, can’t see any in this case, not a clear STEMI, his LVEF was almost certainly impaired to begin with rather than as a result of ACS given angio findings