Need to help #Epeeps patients understand their condition? Over 1000 copies given out so far, now available for Kindle (tried to make it completely free but Amazon wouldn't let me 😞). Hard copy available soon. @drjohnm @narrowQRS amazon.com.au/dp/B0BWVYFRB4/…

Z-E-R-O % !!!🫤

PFA may have taken away Fellows' chances to learn detailed PVI catheter skills but, in return, they're getting to map a lot more atypical flutters...

At @JAMA_current today, 2 radiologists publish what should be the consent form for a total body MRI in healthy people Note: "no major medical society recommends whole-body MRI screening in the general population because it is unproven, and the harms likely outweigh the benefits." jamanetwork.com/journals/jam…

Zero Fluoro-guided ablation for AF substantially reduces radiation exposure without evidence of higher procedural complication, 12-month freedom from atrial arrhythmia recurrence or procedure duration #OpenAccess onlinelibrary.wiley.com/doi/…

For the love of God #EPeeps journals - please can PFA catheters be described by their trade names rather than theses stupid circular array / penta-spline / lattice tip / variable loop descriptions that are no less bloody specific!!!!!

More than 10 years ago Oussama and I started our journey of investigation, trying to the define the optimal first treatment for patients with atrial fibrillation.  Separately we pursed randomised studies in populations with treatment-naive paroxysmal AF.  Five years ago we presented our RCTs in the paroxysmal AF population, which ended up sitting side by side in the same issue of the New England Journal of Medicine.  nejm.org/doi/full/10.1056/NE… nejm.org/doi/full/10.1056/NE… Since then we have been working together to examine the same question of optimal initial therapy, but instead looking at patients with more advanced forms of atrial fibrillation.  Today Oussama presented the results of the AVANT-GUARD study, which definitively demonstrated the value of initial catheter ablation in the treatment naive persistent AF population. Like EARLY-AF, AVAT GUARD used implantable cardiac monitors to evaluate arrhythmia endpoints   Like EARLY-AF - initial catheter ablation reduced recurrences in AVANT GUARD by about 50%, which was about 25% in absolute terms. To put this another way, only 4 patients need to be treated with ablation to prevent a recurrence of arrhythmia.  However, binary recurrence doesn’t tell the whole story. Because we had loop recorders we were able to assess the time spent in AF (or AF burden). In this regard significantly more patients had none or negligible burden after ablation (<0.1%), with significantly more AAD treated patients having a very high burden (>5%). This is important as AF burden is associated with clinical outcomes such as hospitalisation. In terms of risk - the rates of any adverse event or serious adverse event were comparable between randomised arms. Highlighting that persistent AF patients with high CHADS-VASc score are high risk irrespective of treatment provided. This is important as we reflect on treatment options as part of shared decision-making. Congratulations to Oussama for the presentation and leadership, to the co-investigators and study sites for their participation and dedication, and a huge thank you to the Boston Scientific team for their support and commitment to advancing science.  To end, I want to acknowledge and thank Oussama for this shared journey, I’m grateful for our collaboration and friendship, and look forward to what we will do next.

New consensus statement on CIED management and extraction heartrhythmjournal.com/artic…

Hot off the press 2026 @HRSonline #CIED management guidelines just dropped - and these ones have a real pulse! Honored to contribute and represent @IDSAInfo @bcmhouston @BCMCME heartrhythmjournal.com/artic…

Very deep septal...

Errr @JAMACardio... publishing PhysioSync-HF (LBBAP inferior) and HeartSync-LBBB (CSP superior) simultaneously is certainly confusing but I think you are supposed to know the difference between the two studies 😬

Open access... @drjohnm @DrJasonAndrade @epfellow @karan_chauhan3 Safety of catheter ablation compared with antiarrhythmic drugs for atrial fibrillation: A systematic review and meta-analysis of randomized trials - Heart Rhythm heartrhythmjournal.com/artic…

FlecaED: safety & efficacy of IV FLEC in selected AF pts with stable CAD EF > 35% in RCT vs Amio #EHRA2026

Safety of Catheter Ablation compared with Antiarrhythmic Drugs for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomised Trials #OpenAccess @MelbourneEPdoc @DrJasonAndrade @drjohnm @epfellow heartrhythmjournal.com/artic…

Register now for free: talesymposium.com #EPeeps

Avoid referring for PVI due to risk concerns? Safety of Catheter Ablation compared with Antiarrhythmic Drugs for Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomised Trials - @hrs_journal heartrhythmjournal.com/artic… @drjohnm @epfellow @DrJasonAndrade

"the burden of proof lies with LAAO" 🙏 🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏

Be suspicious... when something seems too good to be true, it probably is! 😀 1c almost definitely safe in CCS and the over-extended stigma of CAST needs to be banished 😭 this sort of mortality and MACE benefit from controlling AF is a major 🚩 for selection bias

Spanish Prime Minister Pedro Sánchez on Iran: Today more than ever, it is essential to remember that one can be against a hateful regime, as is the case with the Iranian regime, as is the whole of Spanish society, and at the same time be against an unjustified, dangerous military intervention outside of international law. That one must be against a war initiated without the authorization of the United States Congress or the United Nations Security Council and, as I have said before, one that violates international law. And that there is always room for a negotiated solution, instead of being dragged along by the devastation of arms as the only possible way out. Therefore, I would like once again, as we have done since the beginning, to appeal for immediate de-escalation, for full respect for international law in all the conflicts we are unfortunately suffering, and for the urgency of resuming dialogue as soon as possible. That is where Spain will be, and that is where I believe the whole of the European Union should be.

Here we describe a novel approach to vascular conduit creation to enable CIED implantation in a 4-patient series with limited venous access. A useful technique to explore in those with limited vascular access. @Dr_JHAnderson @JACCJournals @MayoClinic jacc.org/doi/10.1016/j.jacep…

Outcome of Pentaspline PFA outside PVs 👇 Acute success does not necessarily translate into long-term success.