Ian Parker

@DrRoderickTung In the advent of wider WACAs with some PFA systems; whats your threshold of finishing a PWI when an isthmus remains? Another area of uncertainty of whats safe to leave.

PVI+ is the one area where RCTs have been unable to supercede anecdotes – because operator bias is so powerful. Only two randomized trials have shown efficacy beyond PVI (CONVERGE and VENUS), yet only a minority have adopted. And multiple PWI studies show no systematic benefit when applied widely, yet the majority continue to do so in persistent patients. The time is ripe for personalization targeting individual mechanisms, as one size has been proven to not fit all.

@DrewHinojos1 Which veins did you try? Worth trying LBBAP before referral for epicardial

Interesting device case: Dual chamber PPM referred for CRT-P (High VP% and newly declined EF 40-45%). Right sided occluded. IJ access and tunneled to pocket. Now has phrenic nerve capture in all configurations and LV lead is off. Thoughts on next step? #EPeeps

@Factor_XII Haha twitter isn't for nuances. Latest ACC guidelines this year are pretty detailed. And what do I know? I'm a simple electrical guy now

@SirCaptainIan Ian this a classic consultant answer. Great way to keep your job 😂

Something I still struggle with. New dx HFpEF. Is an ischemic eval needed (similar to HFrEF)? I do eval/tx the usual HTN/DM/CKD/Obesity and amyloid if suspicion, but worry there’s other “can’t miss” etiologies. Heart failure/Cards input appreciated!

@JBSupdate @emilylangok

@dstock01 @OutsiderSports Ya just hate seeing it don't you? 🤣

@OutsiderSports @SirCaptainIan

Be better, FSU 😂

@dstock01 @SHistorians @CaseyFBannon Ybor was one of the wilder places I've ever been. Can't say I've been to the Castle though

@SHistorians @CaseyFBannon #TampaTalk @SirCaptainIan

They said this Drake album was trash yet it just moved a piece of my pelvis that hadn’t been used since a very dark 2016 night in Ybor City. Haters smh.

@LPerrytheGeriMD Congratulations! Who did you talk to about said "finagling"? 8 years of fellowship in, have 2 years left to qualify but joining a similar situation. I just can't find someone who knows the system well enough to work around it.

Florida is a special land with ambitious people that push the limits of human capability

@dstock01 I'll take your DMB + Hendrix/Dylan 4 min irrelevant jamband intro, incredible fiddle solo, & band diversity by raising you with the greatest cover/musical story of all time. Inject this straight into my veins continuously youtu.be/Nnfs2ThSeaE

This one is for @SirCaptainIan. youtu.be/p7wAohYGf04

@MKIttlesonMD I try to do the same in a city like OKC when we have rural patients traveling 2+ hrs to come to the city. The trouble becomes when they prefer grouping then go long periods without eyes on them.

#TipsForNewDocs Living in a city like LA, where it can take 1 hour to drive 10 miles, I try to go the extra mile (no pun intended) to coordinate multiple same-day appts for pts. Don’t underestimate the inconvenience and expense incurred by transportation! #kittlesonrules

Credit to my wife for crushing it on the second guess 🟨🟨⬛⬛⬛ 🟩🟩🟩🟩🟩

Today is the last day to vote #WPMOYChallenge + @MikeEvans13_! 1 RT = 1 Vote #WPMOYChallenge + Evans #WPMOYChallenge + Evans #WPMOYChallenge + Evans

@delatorre Oklahoma City here

35! (I was promised there would be no math)

So, we’ve reached 34 deaths per day from COVID. It’s a shocking number that really gets swamped over by all the other numbers. I’m going to describe the usual dying process in the ICU from this disease. I’m wearing my clinical hat, be warned.

@DanielEshDO @AG_EM33 @drcsalerno @bsotstethoscope

@AG_EM33 @drcsalerno @bsotstethoscope @SirCaptainIan I voted EP

“Nerdiest” specialty? Tune into our podcast to find out what @drcsalerno (and I) think the answer is. 😂 See what I did there? @bsotstethoscope

Enjoying this new 'educational initiative' around ECGs that has been posted up in my hospital common room 🤣

How similar is coronary anatomy of identical twins? Below coronary angiography in identical twin brothers. @escardio #cardiotwitter @Drroxmehran @mirvatalasnag @M_Marwan_ @monique_trobs @HolgerNef @thiele_holger @JEscaned @mmamas1973 @beatscaduk @doc_cardio @BayerMatthias