Corbin Rayfield

“AI beats physicians” is an arbitrary benchmark with arbitrary measurement structures. AI papers compared against physicians need better benchmarking and a validated design

⚡ #EHRATopicWeek on Atrial Tachycardias Catheter ablation has become the preferred treatment strategy for most symptomatic or recurrent ATs, while antiarrhythmic drug therapy often shows limited long-term efficacy. 📌 Key concepts from the latest evidence: • Beta-blockers and calcium channel blockers remain important for rate control • Catheter ablation is now first-line in many patients • High-resolution electroanatomical mapping has transformed our understanding of AT circuits • Entrainment and activation mapping remain essential tools for distinguishing focal vs reentrant mechanisms • Pulsed-field ablation and ultra-high-resolution mapping are opening a new era in AT treatment 💡 Success in AT ablation depends on identifying the “critical isthmus” — the key region maintaining the arrhythmia — while durable bidirectional block is increasingly recognized as a crucial procedural endpoint. Importantly, recurrence remains a major challenge, especially in patients with structural heart disease, prior AF ablation, or extensive atrial scarring Find out more in the #EHRA_ESC Consensus document on Atrial Tachycardias 👉bit.ly/4wk5sBn @escardio @EuropaceEiC

@cremieuxrecueil Where is the evidence expanding propranolol to all beta blockers?

In light of the hot new beta blocker trend, I want to remind people: They reliably impair memory consolidation!

@nikillinit Like board certification?

need a different indicator for docs that completed med school vs docs that finished residency

Daily home-based stellate ganglion phototherapy reduced ATP/ICD shock burden from 3.9 to 0.0 events/month (P<0.01) in 28 patients with refractory VT — no serious adverse events. A novel outpatient neuromodulation strategy ahajrnls.org/3PiETvA

⚡️New ELECTRICAL STORM paper out We propose the 5-stage STORM classification for electrical storm – a simple bedside scale that stratifies 30-day mortality from 5% to 50% and helps structure multidisciplinary care academic.oup.com/ehjacc/advance…

@ftrae @JACCJournals @lukaszzarebski1 @shivkumarmd How does one prove that a patients AF is vagally mediated? The context in which it occurs? Certain voltage or trigger patterns?

Some patients with vagally mediated AF can benefit most from cardioneuroablative effect and may not need full PVI Some of them may not even require any ablation in the left atrium Check out our @JACCJournals paper using shareable link (before it expires) authors.elsevier.com/a/1j39w,siTgkp…

The acute toxicity of glyphosate is considerably less than that for common substances like vitamin D, caffeine, aspirin, and even table salt. Glyphosate thread🧵

Bachmann’s bundle architecture, its extensions & clinical implications. Excellent Editorial by @JustinTretterMD & @OCanoPerez highlights framework for BB rightward extensions presented in Part II-III coming soon in JACCCR jacc.org/doi/10.1016/j.… jacc.org/doi/10.1016/j.…

@DrMarthaGulati I’m not arguing for or against it. I’m deciphering what he said. If we don’t at least try and meet skeptics where they are and understand where they are coming from, I don’t think we have any hope of reaching them.

@Wenckeback Everyone should then be practicing “value based care” if it saves lives and improves the health of people. But most are not paid this way or we would have better health of this nation

How are we incentivized to medicate patients? I am truly asking because I must have missed this. It is not how anyone gets paid. No one gets bonuses based on vaccinations. Stop spreading lies Joe Rogan. We advise meds & vaccines when they are needed to save lives.

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!!!!!

Adjunctive Purkinje Denetworking at the time of ablation led to improved VT/VF-free survival in VT patients with a history of shocks for PMVT/VF. Pardigm shifting approach. Free read through this author share link: authors.elsevier.com/a/1m%7Em1,siTg…

Presented at #HRS2026: In patients with persistent atrial fibrillation, first-line treatment with pulsed field ablation reduced the recurrence of atrial arrhythmias at 12 months as compared with antiarrhythmic drugs. Full AVANT GUARD trial results: nejm.org/doi/full/10.10… @HRSonline

I’ve heard the Sec say this before and it’s still extraordinarily offensive. Maybe it’s just that he’s never worked in a healthcare environment, never come into a hospital in the middle of the night during a snowstorm to take care of a stranger, or never seen a team of ICU nurses struggle to keep a critically ill patient alive. But, no one is incentivized to keep a sick patient sick. We have only one incentive. It’s getting our patients well.

@EnjoyingCrisis @TWilsonMD @BrentAWilliams2 Interesting. Didn’t know that. Thank you!

@Wenckeback @TWilsonMD @BrentAWilliams2 DEA number isn't required for inpatient orders, just out patient pharmacies.

I think that it is ridiculous that MDs are de facto forced to have and maintain a DEA number even if they do not prescribe controlled substances.

@TWilsonMD @BrentAWilliams2 Do you not mod sedate your patients in cath lab?

@BrentAWilliams2 100%. I haven’t prescribed a narcotic since graduating sub-specialty training. Yet I have to maintain a DEA license ($900 every 3 years?).

@DrCasteelEM @operationdanish Bedside REBOA by an intern without flouro?

@operationdanish Other than the C spine reduction I’m not aware of another procedure on the show that an ER doc hasn’t done that I personally know. I’m a new attending and I’ve done several of them.

I’m gonna say it… The Pitt over glorifies ER docs. It’s like Matt Damon and Good Will Hunting, but for ER docs. 99% of them wouldn’t be able to do half the 💩 they pretend to do on that show. I love you guys, but you know I’m right.

A back table illustration of the technique published by @PCRonline to remove a stuck perclose footplate in the vessel! Simple and I believe can get us out of trouble! pcronline.com/Cases-resource… #CardioX peeps, comments welcome

The ICU is always a humbling place. It reaffirms that the best things to treasure and not take for granted are one’s health and the people who will be there for you if your health is compromised😔 Invest in people.