Gareth Wynn

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/…

46.2 Vs 53.8... it can be done!! Come on non-reform and reform who've seen the light, Vote @CountBinface and rid us of this pernicious maggot

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/article/S1547-…

Vaccines work bbc.com/news/articles/…

Z-E-R-O % !!!🫤

@DavidLBrownMD There may be issues with today's approach but this is still a really bad thing that happened. I agree with much of your approach and qualified 23 years ago but any Doc should be able to understand the need to recover properly from critical illness, irrespective of profession.

It was my chief resident informing me that she had arranged the 1:3 call schedule so I wouldn’t have to miss a single call day. I was relieved, not wanting to impose on my fellow interns. I was discharged the next day and back at work the following. If that were to happen today,

When I was an intern I developed massive acute bronchospasm from exposure to cat dander. I ended up intubated in the ICU at one of my program’s teaching hospitals. Thanks to high dose steroids, I was extubated the next day. The nurse then handed me the phone to answer a call.

@tylerblack32 There use to be though, before gell came in pads and then we switched to stick-on patches rather than paddles. You also don't need to stand clear. Ad a cardiac EP, I am usually holding my patients tightly when they get cardioverted

3/ (beeeeeeeeeeeeeep) "Clear!" We don't shock asystole (the flat line everyone shocks on TV). We shock VF and pulseless VT. The flat line gets compressions and epinephrine. (also, there is no reason to, nor do we, rub the paddles together) /3

Things doctors don't say but people think they say 1) "You have six months to live." We quote median survival from a curve. Half the people are alive past that number. We don't know which half you're in. We have no idea who is going to live in 6 months. /1

@sumitvermaep @drjohnm @KostekMilan Really?? Have literally NEVER seen this that I can recall.

@drjohnm @KostekMilan Not infrequently multivessel CAD drives AF recurrence. In the right patients it’s the correct thing to do after failed AF treatment. There isn’t a study for everything unfortunately.

That’s another thing that drives me bananas: sending pts w AF for coronary angiography. Dumb. Dumb. Double dumb.

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/jama/…

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/epdf/10.11…

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/10.10… nejm.org/doi/full/10.10… 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/article/S1547-…

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/article/S1547-…

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/article/S1547-…

@bogdienache But also, don't put your paper on a poster. Less is more. No one remembers the details. Just go for the big message

The serious topic of ICD deactivation at end of life. Are we getting the font right? #EHRA26

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

@fvassallomd Diathermy to a conducting part of a lead is also a good way to induce VF

We can also use an eletrocautery. It works very well and is simpler.