David E. Albert, M.D

Wearables and the Electrophysiology Practice: Challenges and Opportunities eplabdigest.com/wearables-and-… via @khaldountarakji

This ECG is from an older woman with new-onset severe CP (Chest Pain). — How would you interpret this ECG? — Would you activate the cath lab? (Why or why not?) — GO TO — tinyurl.com/KG-Blog-523 — :)

In 2004 Boston Scientific recalled their Taxus stent because a defect in the catheter could make the balloon fail to deflate, putting the patient at risk of a heart attack. But the company sold the defective device until they had built sufficient inventory of replacement catheters without the defect.

Great new case report in @AnnalsofEM kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F%2… @PendellM @PMcardioApp

Bad T waves vs Good T waves

AI turns wearable device data into actionable insights for heart failure patients cardiovascularbusiness.com/topics/clinica…

Why should tumor whole genome sequencing (WGS) be done for cancer? In real practice of medicine study of 888 patients with solid cancers, WGS directly led to clinical consequences in over 40% @NatureMedicine nature.com/articles/s4159…

The FDA approved Wegovy HD (semaglutide 7.2 mg) today. Here's the clinical context every obesity medicine provider needs. The STEP UP trial delivered 20.7% mean weight loss at 72 weeks in people with obesity — with approximately 1 in 3 patients achieving ≥25% weight loss. In the T2D subgroup, the figure was 14.1%. A few things worth noting beyond the headline number: The 20.7% figure is the efficacy estimand — the effect if everyone remained on treatment. The treatment-regimen estimand (which captures real-world dropouts) was 18.7%. Both figures are meaningful improvements over semaglutide 2.4 mg, which has been the ceiling for injectable GLP-1s since 2021. The FDA awarded a Commissioner's National Priority Voucher, accelerating review — a signal of how seriously the agency is treating the obesity epidemic as a public health priority. For our patients who have plateaued on 2.4 mg, or who came in with higher baseline BMI and greater metabolic burden, this opens a legitimate clinical conversation about dose escalation. This isn't about chasing a number. It's about getting people to durable, meaningful weight reduction — and increasingly, the data shows higher doses get more people there. US launch is expected April 2026. The trajectory of this field continues to move faster than most of us anticipated even two years ago. Press Release: novonordisk.com/news-and-media…

The last paragraph of this editorial is the first thing we teach our interventional fellows. “In general, the benefit from any percutaneous intervention in cardiology is often the greatest with regard to the most acute or life-threatening problem the patient is facing. In contrast, in clinical situations in which the patient’s life is not directly at risk and the symptoms are controllable by medical treatment, conservative management should always be considered to be an equally effective alternative.” nejm.org/doi/full/10.10…

Traditions unite us; technology keeps us connected. 🌏✨ Celebrate Gudi Padwa, Ugadi, and Eid al-Fitr with the gift of a healthy heart. Get medical-grade ECGs in just 30 seconds with Kardia. ⚡️ Use code: KARDIAFEST 🛒 Shop here: alivecor.com/in/products #GudiPadwa #Ugadi #Eid

An important addition to the literature. Interestingly- and let me know if you see things differently- this should not change the practice among those who were already following the @AHAScience @ACCinTouch @HRSonline guidelines: if an AF patient at risk for stroke truly cannot safely tolerate long-term anticoagulation, it remains reasonable (as a 2A recommendation) to place one of these devices. Also, more based on anecdote and common sense, those with a prior LAA clot, particularly if found while on a #DOAC, may still benefit from placement of an LAA occlusion device AND continuation of an anticoagulant. There really never was adequate evidence to support large scale use of these devices as straight-up substitutes for DOACs. @DrJMarine @UCSF @UCSFCardiology @UCSFHospitals @drjohnm @ethanjweiss @DrDave01 @DrRoderickTung @JonPicciniSr

The CLOSURE-AF trial randomized 912 older adults (avg age 78) with AF at high stroke AND bleeding risk to left atrial appendage closure device vs physician-chosen best medical therapy (often DOACs/blood thinners). After median 3 years, device group had more primary events (stroke/embolism/major bleed/death): 16.8 vs 13.3 per 100 patient-years. It failed noninferiority (P=0.44). Layman's: In these high-risk folks, the implant didn't match meds' protection and had slightly worse outcomes overall. Suggests meds remain preferable when feasible.

Questioning the benefit of an implant to close the left atrial appendage vs medical therapy in a randomized trial @NEJM nejm.org/doi/full/10.10…

> 600,000 left atrial appendage devices have been placed NOT NONINFERIOR 👇🏻 Trial is large, nonindustry funded and done in experienced centers in Germany Endpoint had both efficacy and safety components and still did not make non-inferiority I tried to tell you all

@DocPriyamMD Ask him if he has relatives who died young? Brugada Type 1.

A 32yo man is brought to the ED after his wife found him "gasping for air" and "shaking" in his sleep at 3 AM. ​By the time he arrives, he is awake, alert, and annoyed. "I just had a weird dream, I am fine. Let me go home." Vitals are 120/80, HR 72, SpO2 99%. Physical exam is 10/10 perfect. ​You run a quick ECG and see THIS

Scientists, researchers, and their intellectual property are the true source of value. Publishing companies are becoming commoditized. The system persists because of brand, distribution, and incentives—not because it’s irreplaceable. If the underlying research is what matters, the platform itself is increasingly easy to replicate.

Arguably my favorite piece I’ve published. Built on deep mechanistic insight. Grounded in a comprehensive review of the clinical evidence. With clear, forward-looking perspective on what comes next. The definitive guide to retatrutide drops tomorrow. Sign up to get it first ➡️ substance-over-noise.beehiiv.com

The peptide space is full of hot takes and zero citations. I don't know who needs to hear this, but "my guy on YouTube said BPC-157 healed his knee" is not a clinical trial. I actually read the research. Here's what the science says is safe — and what it doesn't 👇 Part 1: substance-over-noise.beehiiv.com/p/the-peptide-… Part 2: substance-over-noise.beehiiv.com/p/the-peptide-…

Can AI read an ECG like a cardiologist - from just an image? We built ECG-GPT, a vision-text transformer that generates complete diagnostic reports directly from photos of 12-lead ECGs Now out in @ESC_Journals #EHJDigitalHealth Kudos to @aakhunte & @Veer_Sangha_ for leading this @cards_lab 🧵

I would love this to be true but there is no “adjustment” technique that could replace randomization. I’d go as far to say attempting such a comparison is unwise b/c pts who convince a doc they are robust enough for ablation will be healthier than pts who don’t get ablated

We need people to get more active not less. This means addressing the global issue of climate change. One thing people can do is stop driving everywhere. Can you walk to the store? Can you walk to an appointment? Can you walk to work? Can you get rid of a car? Or have no car at all? #hearthealth #climatechange (& yes I have no car & walk everywhere to do my part!)