Derek Connelly

@KnowYourPulse @BHRSociety

Encouraging all NHS Trusts to participate in the PROFID-EHRA randomised clinical trial testing the effectiveness of primary prevention ICD after #heartattack in severe #heartfailure on optimised pharmacotherapies. Contact me if you would like to join.

Is AI replacing EP thinking in mapping and ablation? Session 5 at LAS tackles the question directly. Prof. André Ng, Prof. Paul Friedman & Prof. Sana Al-Khatib on where the technology is actually going — and what it means for how you practice. londonarrhythmiasummit.com

LAS 2026 approved for 6 CPD credits! Join us for a focused, one-day update in arrhythmia and pacing featuring: ✔️ Practical clinical decision-making ✔️ Expert debate ✔️ Interactive discussion ✔️ Short, high-yield talks Register: londonarrhythmiasummit.com

This is an excellent thread 🧵 on the comparative effects of warfarin and DOACs on coagulation factors, and the reasons that warfarin is more effective than DOACs in preventing thrombus on mechanical valves...

Atrial fibrillation recurrence and outcomes in patients with hypertrophic cardiomyopathy: Insights from a nationwide real-world cohort @AmroAglanMD @WMCHealth @EthanRowin @LaheyHospital heartrhythmjournal.com/article/S1547-…

Do not miss out! If you work in EP, this is the room you want to be in on Friday 12 June. 🌍 World-class faculty 🔥 Unfiltered debates 📊 Practice-changing data No fluff. No safe opinions. ⚡ #LAS2026 👉 londonarrhythmiasummit.com @SanaAlkhatib9 @Mel_Gunawardene @ProfDConnelly @g_andre_ng @JohnWhitaker20 @DavideFabb @DocWajidHussain @drjohnm #LAS2026 👉 londonarrhythmiasummit.com

@PrashSanders @adelaide87018 @nhmrc @Vortex_mapper @martinkstiles @ProfSNicholls @walabheart @JonKalmanEP @JonathanAriya @AlexisPuvrez @melissaemm1 @thecsanz @HRSonline Congratulations! Previous data was dodgy. The Gasparini data was observational ... and the Brignole trial (2011) compared CRT with RV pacing post AVN ablation. Despite this, they managed to influence ESC guidelines ... which now need to be changed

CAAN-AF Trial #CHRD @adelaide87018 Our previous meta-analysis of observational studies suggested CRT patients with AF had a significant 58% reduction in all-cause mortality with AV node ablation - jacc.org/doi/10.1016/j.… We designed the CAAN AF Trial supported by the @nhmrc and critical industry partners - in order of support @bostonsci @AbbottNews @Medtronic @MicroPort - Methodology paper - heartrhythmopen.com/article/S2666-… CAAN AF Trial: doi.org/10.1093/eurhea… RCT showing no benefit in the routine use of AV node ablation

📅 SAVE THE DATE – #BHRSymposium 2026 A full day of arrhythmia-focused debate, discussion & interactive scenarios where your input shapes the conversation. 📍 Royal College of Physicians, London 🗓️ 5 Nov 2026 More details soon 👀

Great news for MVLS 🎉 The University of Glasgow has once again performed strongly in the latest QS World University Rankings by Subject. We’re particularly proud to see Life Sciences and Medicine ranked in the global top 50, and Anatomy and Physiology in the global top 20

@OungSavly @Frances98392343 @jeffrey_vinocur @RobertHPass @KaraMotonaga @iamritu @CASivaram1 @AEPCcongenital @SIwa23288585 @loomba_rohit @alex1708ander @ecgandrhythmRoe Very unusual ECG. The rate and irregularity might suggest pre-excited AF ...but the QRS morphology suggests an RVOT origin. So either RVOT tachycardia or an epicardial accessory pathway taking a circuitous course...

6-year-old, girl presented with chest pain. 📌Structurally normal heart 📌 Hemodynamically tolerated. @jeffrey_vinocur @RobertHPass @KaraMotonaga @iamritu @CASivaram1 @AEPCcongenital @SIwa23288585 @loomba_rohit @alex1708ander @ecgandrhythmRoe

@ncurzen @hrs_journal ...or a better outcome measure such as AF burden. We need to tell our patients from the outset that ablation for AF is (almost always) not curative, but it can hugely delay progression and improve QOL ... and we need to manage patients' expectations re repeat procedures)

@hrs_journal The recurrence rates are eye watering? What will they be at 2,3,5 years ?? What proportion of the 25-30% with recurrence will have more ablation? Surely time to invest in some research to identify benefit/futile subgroups?

Impact of Left Atrial Posterior Wall Isolation using Pulsed-field Ablation in Patients Undergoing Repeat Catheter Ablation for Atrial Fibrillation #OpenAccess heartrhythmjournal.com/article/S1547-…

🌍 New insights in cardiac resynchronisation therapy for adults with a systemic right ventricle 💡🫀 A new international multicentre study has just been published, exploring the impact of cardiac resynchronisation therapy (CRT) in adults with a systemic right ventricle (sRV) — a growing and uniquely complex patient population. 📄 Fusco et al., Heart (2025) 🔬 What makes this study remarkable? This is the largest cohort ever reported, including patients with ccTGA and d-TGA after atrial switch. Thanks to a robust propensity-matched analysis, it provides the strongest real-world evidence to date on CRT in this challenging anatomy. 📉 Key findings Despite expectations and past small-scale studies, CRT did not improve survival or event-free survival in adults with an sRV. Even after adjusting for confounders, CRT remained associated with worse outcomes, likely reflecting advanced disease stage and suboptimal timing at the moment of implantation. Moreover, only a minority of patients achieved significant QRS narrowing—highlighting how challenging true resynchronisation can be in this substrate. ⚙️ Why does this matter? Patients with an sRV face increasing rates of heart failure as they age. Understanding which therapies truly work — and which need refinement — is essential to guide future care. This study underscores the need for: ➡️ Better patient selection ➡️ Earlier identification of candidates ➡️ Optimised pacing strategies adapted to sRV physiology ➡️ Exploration of conduction system pacing (CSP) as a more physiological alternative 🔌✨ 🚀 Looking ahead While CRT, as currently applied, may not deliver meaningful benefit in this population, the field is moving fast. Advances in CSP and refined timing may soon reshape how we approach electrical therapy in adults with congenital heart disease. 🔗 A milestone paper that pushes the field forward and reminds us how essential tailored, anatomy-specific strategies are in ACHD. #Cardiology #ACHD #SystemicRV #CRT #HeartFailure #CongenitalHeartDisease #Innovation #Research doi.org/10.1136/heartj…

@docmoiz66 @Frances98392343 @ecgrhythms @ecgandrhythmRoe VT - originating from LV outflow tract probably.

VT or something else? @ecgrhythms @ecgandrhythmRoe

@Frances98392343 @TheECGMedic The original paper by L Wolff, J P and PD W in 1930 was entitled "short PR interval and bundle branch block...". A totally pre-excited RV gives delayed LV activation similar to LBBB. Theoretically one could ablate the pathway and find co-existing LBBB (but I've never seen that).

@TheECGMedic I've always wondered: what would a pre-excitation with LBBB look like? Here I see a ST with a short PR, is there a delta wave along with an atypical LBBB? Or would it be preferable not to define it as atypical LBBB, but as a wide QRS as in WPW?🤔

What do you see? #ECG #ECGChallenge

Trainees — this one’s for you 🎟 £1 BHRS places 🎟 50% off BJCA trainees 🎟 Early bird rates One day. Real-world arrhythmia & pacing. Limited places — first come, first served londonarrhythmiasummit.com

@wesstreeting is in the pocket of private health providers & is dumbing down & dismantling our NHS. He is using resident doctors as scape goats. If you’re waiting to see a specialist, remember he has just slashed 1,000 specialist tracing posts. Hit Labour in the May elections.

@ecgandrhythmRoe Seriously, anyone who needs PMCardio to interpret this ECG should probably not be responsible for treating people with chest pain!

What PMcardio can do now: 😍

A 60 yo man with acute chest pain. What do you think? a) digitized original file, 50 mm/s @PMcardioApp

We’re pleased to confirm an outstanding faculty for LAS 2026, including: • Prof Sana Al-Khatib • Dr Derek Connelly • Dr John Mandrola • Prof John Camm and more to be confirmed soon. londonarrhythmiasummit.com

@Arron_Pearce_ @Frances98392343 Sinus rhythm!

Are you able to identify this patient's rhythm? 🧐