OneRhythm

OneRhythm. Fighting invisible bears through visibility. Rhythms that circle the world.

[OneRhythm @OneRhythmOrg]

This past 2 weeks has been the hardest past 2 weeks of my life.

I wish I didn't ask the questions. It's simply not how my brain works.

To do the things that need to be done mean that my life and my peace - those things are ending.

Relationships that I spent a decade building - those are also over.

Companies that I praised - don't meet your heroes.

I am doing this while having a battery in my chest and scars in my heart.

These scars are not just caused by radiofrequency or electroporation - they are caused by what this system is allowing to happen to our seniors.

I've learned with this condition that the war is never over - and you just have to keep fighting.

This isn't for me. It isn't for money.

It is for our moms, our dads, sisters, brothers - our families.

Some things you simply cannot unsee.

I am going to break the American Healthcare system in the way that this system has tried to break me.

It failed.

I don't.

[OneRhythm @OneRhythmOrg]

When the pool has an algae problem - you shock it.

Said differently - the American healthcare system has an algae problem.

Could benefit immensely from a liberal application of shock.

Pinch these pennies and call me your pool boy.

[OneRhythm @OneRhythmOrg]

10 years in the system.
A relentless operator.
A slave to the dollar.
I am immune to the poison.
Pragmatic - yes.
Always.

But there is righteous anger within me.

I have reasons. You will know them.

[OneRhythm @OneRhythmOrg]

If I am an industry sponsored biostatistician right now - and I know that people that have the right questions can shred my bullshit in a matter of minutes.

This is me right now.

You do not need to wait for the G in AGI.

You are the G.

Ask your questions, expect hallucinations, mitigate them.

This is no different than Encyclopedia Britannica becoming the Internet becoming Search.

Even if you reduce frontier LLM capabilities to "it is just better search"

You would be correct. It is a vastly superior search (and far more).

So if you ask a question like such

"Why is @bostonsci pumping CHAMPION-AF like it was a win when very clearly, by any objective measure, it was not?"

And then of course you go on to feed it all of the data it needs to provide you actionable research because you know how (and why) the game is played.

Again.

Industry sponsored biostatisticians.

Big sweat rn. Yikes 😬

[OneRhythm @OneRhythmOrg]

American Exceptionalism.

We are equally as talented at breaking things as we are at building them.

While the social contract is in flames. I for one am glad that I never signed it.

Never needed to.

Still got in the rooms.

In other words, and specifically as it relates to our healthcare system, I know the money game.

And I am going to start talking about how it is played.

[OneRhythm @OneRhythmOrg]

Software should be distributed now to the marginalized. The dismissed. The ones that were passed on.

It should be free.

Open heart.

My hands.

They serve One.

The rhythm of our people.

While my heart fails me, like Tyson, I move forward - relentlessly.

[OneRhythm @OneRhythmOrg]

My name is Matthew James Adams.
Born September 18th, 1985.
I HAIL from Meeeeeechigan.
A sparrow that they say is of no value.

And yet.

God's Speed the Revolution.

[OneRhythm @OneRhythmOrg]

They want a fucking revolution.

They are going to get one.

[OneRhythm @OneRhythmOrg]

Truth telling is hard work. Incredibly unsafe.

Have a lot on my mind. Collapsed yesterday walking home from the grocery store.

2nd time in 3 months, 5 ablations deep.

And yet - I am still going to fully send it

I know no other way.

Heart Rhythm Week seems like a perfect time to start cardioverting the American health system.

It is on life support anyways.

Background

I spent a decade as one of the most criminally talented healthcare sales and marketing executives in the industry - device sales, physician recruitment, regenerative medicine, insurance, personal injury - didn't matter - I was a one man wrecking ball - in a state that turns a blind eye to the corporate practice of medicine.

Before I ultimately do collapse - and who knows when that will actually be - I do have quite a bit on my mind.

This system exploited me.
I became the system.

I did it for the money.

So did everyone else. Work in healthcare long enough - you will be faced with moral dilemmas - the system we have makes them unavoidable.

I chose wrong.

And for it - I have a deep understanding of how this system exploits our people at population scale.

You want to fix the system? Start with radical transparency.

I'll go first.

[John Mandrola, MD @drjohnm]

Really amazing critique of a terribly flawed paper. What were the editors thinking? Just say no to stuff like this. Or... publish the paper and then another paper explaining the flaws--like below. The flaw-explainer offers 10x the value

[OneRhythm @OneRhythmOrg]

This podcast restored some faith for me today...

I'll leave it at that.

[Heart Rhythm Society @HRSonline]

NEW EPISODE OF THE LEAD!

[Ep. 152] A Discussion of Outcomes of Left Atrial Appendage Closure versus Oral Anticoagulation in Patients with Atrial Fibrillation and Prior Ablation: A Sub-Analysis of the CHAMPION-AF Clinical Trial (Heart Rhythm Journal)

🎙️ Host: Danesh Kella, MBBS, FHRS
🎤 Guests: Jason T. Jacobson, MD, FHRS (@DrRhthm), Ammar M. Killu, MBBS (@akillumd), and Gregory M. Marcus, MD, FHRS (@gregorymmarcus)

Listen on your preferred podcast platform
➡️ https://t.co/VXfAm8TCpL

#EPeeps #medpod #podcast #CardioTwitter #EPTwitter #PodcastAndChill

[OneRhythm @OneRhythmOrg]

This was simply excellent to listen to.

From a patient perspective (I have had 5 ablations myself - I live with ARVC), I have found the way that this study has been marketed from BSX to be thoroughly disappointing.

@gregorymmarcus @akillumd @DrRhthm - they all did an outstanding job breaking down the CHAMPION-AF study for what it was. Not one of them expressed any thoughts that the study justified expanded indications for usage.

The doctors who author @CVtrials agree.

And yet, if you review BSX's most recent 10-Q filing with the SEC - quote:

“Patients indicated expands from ~4M to ~18M by 2030+.”

And yet there are physicians on this platform who advertise CHAMPION-AF as a slam dunk.

We have our seniors struggling to afford their bloodthinners. They are being economically squeezed into accepting a higher risk of stroke with this device.

And if BSX is successful in expanding indications for use through the FDA - are we all just supposed to accept that they should take the risks?

What are we doing here folks?

Stroke is the number one cause of adult disability in America. The burden it places on our patients and their families - it is incredibly consequential.

So thankful to have found this podcast from HRS today. Someclearly great doctors providing fantastic information.

It needs to be patient facing as well - this debate isn't just for the pros 💜 ❤️

[OneRhythm @OneRhythmOrg]

@CCHRInt I'm in.

Protect out children. They are the future.

[OneRhythm @OneRhythmOrg]

@tylerblack32 is a paid institutional shill. Not a serious doctor.

But I get it. If I had been recklessly prescribing kids drugs that there is this much public debate about at present, with patients all over the place coming out and speaking up, I'd probably be trying to fish my way out of the guilt as well.

Some folks are just this way. Zero accountability.

[OneRhythm @OneRhythmOrg]

And in your own research on the psychiatric medications.

How - is certainly one question to ask.

The deeper and darker question is why.

And it has everything to do with our trade relationships with foreign nations and exporting liquidity, as is our responsibility as the nation supporting the global reserve currency in the dollar.

Triffin dilemma economics.

To put it bluntly, American citizens were used.

Pax Americana is ending - clearly.

And now all of the sudden we are wanting to rebuild our manufacturing base, cut off expenditures for APUs from foreign nations (including adversaries), and throttle the additives we allowed to be imported for our food?

And people think this is just a coincidence?

People need to wake up.

[OneRhythm @OneRhythmOrg]

Same type of thing is happening right now with @BSCCardiology's Watchman device.

2 studies published nearly simultaneously.

CHAMPION-AF - industry sponsored - they used composite endpoints to bury the fact that the device arm is causing more strokes than the control arms (NOACs)

CLOSURE-AF - independent study - shows the device arm clearly not meeting non-inferiority endpoints and the physician who led the study, who previously had been supportive of LAAC procedures, publicly stated he would be changing his practice as a result.

What study is getting all of the headlines? The industry sponsored study.

Who made SEC filings seeking to expand indications for use to the broader and more high risk populations? Boston Scientific did.

Who are they going to be supported by in this pursuit with the FDA?

Public has no idea about the deep institutional financial entanglements that craft these kind of narratives to push them through and into the hearts of our people.

Public is going to find out. Myself, and many others now, are going to make absolutely certain of that.

Preprints incoming.

[OneRhythm @OneRhythmOrg]

@PatriekKarayil @SecKennedy @LauraDelano Like.

Take for example @BSCCardiology making SEC filings to expand billable population 4x on the results of a study - CHAMPION-AF - that showed the device arm causing more strokes than the control arm of oral anti-coagulants.

Wonder why that is?

I have questions.

[OneRhythm @OneRhythmOrg]

“People have been taking the drugs for years without evidence of widespread harm.”

Or maybe people don't self-report because we just watched an absolutely massive cohort of psychiatrists gaslight not only their peers - but also the patients as well - for simply being asked to provide people with more information before they make the decision to accept what they are prescribing.

People say things have gotten better for mental health in America.

Sadly, this is far from reality.