Tom Klein

Cardiac EP, Washington State

[Tom Klein @tom_m_klein]

@Toaster_Pastry We do this for all extractions for pocket infections. Infected nonviable tissue is not likely to heal with surgical closure. Not sure why you say it’s unthinkable.

[Tom Klein @tom_m_klein]

@AsurisNWHealth So disappointing how you dictate the care of your members. Young woman with presyncope and polymorphic VT on lasting up to 25 sec on monitoring denied cardiac cath and ICD if indicated by EPS. Shame on you. @EPeeps_Bot @DGlaucomflecken

[Tom Klein @tom_m_klein]

@DaneshModi @mattaustein @CMovsowitz @DGlaucomflecken @ACCinTouch @HRSonline

[Tom Klein @tom_m_klein]

@CarelonRx - seems like your business model is to deny every claim submitted and then force healthcare providers to waste their time on the phone to appeal. Pacemaker denied for a patient with near syncope, fatigue, and a non reversible sinus rate in the low 30s in clinic?

[Tom Klein @tom_m_klein]

Stress echo denial for a female patient with risk factors, an uninterpretable EKG? Even did the treadmill as you insisted, and as predicted - uninterpretable. Still denied the repeat request. Shame on you. You are the problem. @DaneshModi @mattaustein @CMovsowitz

[Tom Klein @tom_m_klein]

@DaneshModi Why would I not do 2 TSP? It adds under 5 min to the procedure and gives me confidence I am getting the result I want.

[Tom Klein @tom_m_klein]

@jeffrey_vinocur @chris_monkhouse @ProfDConnelly @BHRSociety @IbhreInfo @HRSonline @BartsHospital @EJSMD Not to mention when the patient has a failed shock and needs a SQ coil the adapter necessary for the DF4 is as bulky as it gets. With a DF1 adding the coil is easy.

[Tom Klein @tom_m_klein]

@DaneshModi @evicorehc I have been told by administration where I work that if under 50% battery left medicare will cover it.

[Tom Klein @tom_m_klein]

Eliminate ABIMs MOC requirement - Sign the Petition! https://t.co/N0MY1wmkJ2 via @Change

[Tom Klein @tom_m_klein]

@CRB_EP @pjsm83 @nyulangone @ExtraStim @azrielleib Awesome thanks a lot. Great study, by the way.

[Tom Klein @tom_m_klein]

@CRB_EP @pjsm83 @nyulangone @ExtraStim @azrielleib Unable to read the full text. What power did you use?

[Tom Klein @tom_m_klein]

@jeffrey_vinocur @JoelSimonEP @HRS_O2Journal I use it only when using fluoro and then step out of it for all other parts of the procedure.

[Tom Klein @tom_m_klein]

@JoelSimonEP @HRS_O2Journal I was concerned about that previously, but have now done a ton of implants with it and have not had infections

[Tom Klein @tom_m_klein]

@mattaustein The real problems go down with the patient is on NPH insulin. Skip the protamine in those cases.

[Tom Klein @tom_m_klein]

@mattyortman Carotids for syncope maybe the most low yield frequently ordered test I can think of

[Tom Klein @tom_m_klein]

@CuitlhuacArroy1 @CyntiaMachain @SONECOM_AC @NMerke @fazalabul @wikimagen @cardio_sonora @ecolabincich @Cardiotweets83 Very bad prognosis regardless of management of effusion. Would address this with patient/family. Not a small risk of hemodynamic collapse and death with drainage.

[Tom Klein @tom_m_klein]

@MdSimsolo @BakhshiHooman @HeartOTXHeartMD @gina_lundberg @echo_stepbystep @JGrapsa @JACCJournals @IndahSP_MD Did you end up taking it out? Any issues?

[Tom Klein @tom_m_klein]

@mattaustein Wholey for CS access (prolapses into CS). BMW to deliver lead.

[Tom Klein @tom_m_klein]

@myallegianceins has denied my patient with a class 1 indication for AF ablation (paroxysmal, failed antiarrhythmic drug, young patient without comorbidities) his procedure without justification or option to appeal. Not sure how this is legal in the US. @DGlaucomflecken #EPeeps