Sanjeev Saksena

@DrJasonAndrade @PrashSanders @VivekReddyMD Perhaps the trial teaches us that regardless of the technology our current ablation approach only treats 60 to 70 percent of the problem. The case for biatrial onset of AF even in PAF keeps getting stronger!!

@Matt_Pinner E

Simple poll. Please be honest! As of today, how much do you still trust this team? A. 100% B. 75% C. 50% D. 25% E. 0%

@hrs_journal Finally, on the right track

Inflammation and Heart Failure Risk in Atrial Fibrillation: Prospective Evidence from UK Biobank heartrhythmjournal.com/article/S1547-…

@gautamsand Atrial resynchronization pacing outperforms RV pacing, no increased side effects and in hybrid therapy can prevent the greatest enemy of physiologic pacing, atrial fibrillation Time to deal realistically with disease states and Achilles heel of physiologyic pacing in SSS.

🧑‍🎓My take *⃣An exciting — but delicate — era of physiologic resynchronization ⭐️What’s needed next: • Better patient selection • Better lead design & delivery systems • Better long-term surveillance ⭐️Beware of: ➡️Pseudo-LBBA Pacing ➡️Procedural shortcuts Understand: ➡️Physiology & anatomy of conduction system ➡️Lead Structure - 'Apples & Oranges' 🚀 AI may help: emerging work suggests machine-learning models using ECG, imaging, and device data could: • Predict optimal lead position • Identify high mechanical-stress configurations prone to fracture • Anticipate pacing-induced cardiomyopathy before EF declines heartrhythmjournal.com/article/S1547-… clinicaltrials.gov/study/NCT07206…

📢Physiologic pacing under the microscope: cure or not? *⃣The latest @hrs_journal Feb 2026 issue features a Point–Counterpoint on conduction system pacing (CSP) for prevention of pacing-induced cardiomyopathy (PICM). ⭐️On one side: concerns that LBBAP may trade one iatrogenic disease for another. ⭐️On the other: the argument that CSP represents preventive physiologic care superior to RV pacing. 🎯A must-read debate as CSP rapidly becomes mainstream.#EPeeps @rdschaller @Hisdoc1 @HRSonline heartrhythmjournal.com/current#

@Elonpappy 15

More food for thought as we enter the phase of critical reappraisal.

@drjohnm So the axiom in "olden" days for the Bruce protocol was simple If you can do 9 minutes, complete stage 3, your prognosis was excellent in differing scenarios from screening to post-MI

I would put Bruce protocol time on a treadmill up against anything the tech industry offers. Heck…touching your toes may beat HRV as a health measure.

My take on this hard hitting expose of the flawed for profit US Health Care system ..a must read ..an uncomfortable, gripping look at the submerged iceberg of truths..directed at the final arbiter, the US public who pays for it..and needs a new direction kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F%2…

A final tribute to a friend of four decades, now published, honoring his significant contributions to the field of heart rhythm disorders. His work has made a lasting impact, and this tribute serves to enshrine his legacy in the medical community. doi.org/10.1016/j.hrth…

When engineering science and medicine converge , great things occur..the pacemaker lead that does not dislodge with millions of moving heart contractions or ablation of heart rhythm disorders In Memoriam: Prof. Dr. Peter Osypka (1934-2025) - Heart Rhythm heartrhythmjournal.com/article/S1547-…

Today, at the American Heart, we presented the continuing challenge of new comorbidities in the largest longest ablation study for atrial fibrillation

@gautamsand @hrs_journal We have a body of work that should be scrutinized with atrial pacing in AF and AF and HF. HF pacing requires AF rhythm control for long-term efficacy. This requires hybrid or complementary (C) therapy as in EHRA terms

@gautamsand @hrs_journal High interatrial septal pacing has been intermittently practiced for 25 years. Being rediscovered now. Septal pacing reynchronizes as first reported from our group JACC 1996 by Delfaut. There is little controversy that sheathed interatrial pathways exist in man. They don't,

🧵 Heart Rhythm | November 2025 Issue: Spotlight on Bachmann Bundle Pacing #EPeeps 📢 The November 2025 issue of @hrs_journal features a special focus on the Bachmann Bundle (BB) — the key interatrial conduction pathway and a hot topic for atrial resynchronization. *⃣Does BBAP help to optimize atrial activation and reducing arrhythmia burden?👇 #EPeeps #HeartRhythm #CardioTwitter 🖼️ Let's start with the beautiful #Artrhythm cover by @KTamirisaMD

An International Physician Survey Of Current Ablation Practices In Atrial Fibrillation: An AIM-AF Substudy @CardiacepPA heartrhythmjournal.com/article/S1547-…

The next great pivot in AF therapy: GLP-1s & AF Time for a sea change and moving beyond rhythm control in AF management to substrate management 432. Journal Club: The TRANSFORM-AF Trial with Dr. Sanjeev Saksena and D... youtu.be/9a3vD_vUtvA?si… via @YouTube

Dr. Kowey's masterful book on the lapses in our current system for both health care professionals and laymen brings these failings to the forefront. To evolve to a better place, he identifies the limitations of what we have. Impactful, simply phrased cases studies hit the mark

Dear colleagues, It is my sad duty to report the passing of Professor NabilEl-Sherif,whose pioneering work ranged from figure of 8 reentry to many contributions in conduction system physiology, & disease to Pharmacology and Pacing. He will be mourned by his worldwide trainees.

The continuing support of the Electrophysiology Research Foundation and commitment of our colleagues has led to meaningful Cardiovascular Research .

RETWEET if you stand with Bruce Springsteen against Donald Trump!

@HRSonline @KTamirisaMD Great..

Focused. Informed. Practical. See which #HRS2025 sessions Pace Setter Kamala P. Tamirisa, MD, FHRS (@KTamirisaMD) recommends attending: bit.ly/3EbIPZl #2025PaceSetter