Kousik Krishnan

Ocean Trial - Real world decision making poll. A yr after a successful Afib ablation with monitoring in a chadsvasc 3 pt. Is ocean (and other trials) enough or do we need more?#epeeps

📢LBCT #HRS2026 — REAL AF Registry (VLCC PFA) (Simultaneous pub @hrs_journal ) #SciComms @krishmd @paulzei *⃣Real-world variable loop circular catheter (VLCC) PFA safety—beyond the trials: ➡️Real AF Registry data of 1,014 AF ablations w Varipulse PFA • Complications: 0.6% • No device-related events • No stroke, death, or esophageal injury ➡️Most events linked to adjunctive RF—not PFA itself ➡️Efficiency: • 99.6% acute PVI • 86.5% same-day discharge • ~65% zero fluoroscopy 🙂 🎯Takeaway: VLCC PFA is shifting AF ablation toward a safer, faster, outpatient-first paradigm ⚠️ Caveat: Observational registry data with rare events, no randomized comparator, and operator-dependent workflows—interpret cautiously heartrhythmjournal.com/article/S1547-…

@DJ_Lakkireddy @drrakeshg1 @Drdevignair @KTamirisaMD @drsuneet @JagSinghMD @SDoshiMD

Please join us for a fun evening at HRS #epeeps

Once you see the variability in the femoral vascular anatomy, you will understand why some complications happen with manual palpating of the artery and blind access. This is not expensive technology and really should be the standard.

@EJSMD @doctorwes Wes was my first ep chief at my first job out of fellowship. Thank you for your efforts on this front. Meaningful work and change may be slow, but it won’t change without people like you.

Cheers to #medtwitter pioneer @doctorwes who's done far more than he'll admit to advocate for working doctors. - First to blog EP and cardiology content with Dr Wes - He's the true "Blogfather" of medicine. - Introduced Twitter to yours truly, and much of the medical community - Exposed ABIM excesses and catalyzed real reform - exposed egregious perks, exposed heavy handed MD surveillance, double jeopardy ends, MOC requirements simplify, and more. - Raised >$400K to fight for working docs and took the MOC fight farther than anyone imagined it could go. - Inspired a new generation of working doctor advocates who will pick up this fight. Thank you Wes!

🚨Newest #FreeRead Article in @JICE_EP Real-World Strategies for PFA Using a Variable-Loop Circular Catheter: a Compendium of Best Practices from Early Adopters by @LuigiDiBiaseMD, @BrettGidneyMD, @krishmd Arfaat Khan, @ZagrodzkyJD, @drimdadahmed, David Weisman, Jitender Munjal, Jonathan Dukes, Alexandru Costea, Xiao-Dong Zhang, Charles Athill, Linda Justice, @AllysonVarley, Susan M. Bezenek, @josoriomd, @paulzei & @cporterfieldmd #EPeeps

There may be concerns about lesion size/durability when using higher irrigation rates to cool PFA electrodes. We performed experiments using an in vitro model to demonstrate the equivalence of cellular electroporation at different irrigation rates. authors.elsevier.com/a/1mSgP5VtUyaL…

#EPeeps: you won't want to miss our upcoming town hall in November to hear from HRA and HRS leadership on the Evolving EP Practice Landscape. Register at bit.ly/4ohgK4L

All #EPeeps Time for the 2025 #HRSTweetup #2025PaceSetter #HRS2025 Thursday 04/24/25 at 6 PM PST at The Marina Kitchen Bar at Marriott Marquis San Diego Marina marriott.com/hotels/maps/tr… Roll in & out or stay. Enjoy, meet your peers, imbibe. 🎉🎉🍾🍾 Meet IRL folks you know only from profile pics & X aliases ⭐️⭐️Fellows/ Trainees - Don't worry about💲(Be reasonable 😎) @KTamirisaMD @MGKatz036 @Nishaki1 @True_EP @jeffrey_vinocur @JRWinterfield @sgreenbergmd @ftrae @drjohnm @DrDave01 @omarjavedbaqal @np_varghese @DJ_Lakkireddy @drrakeshg1 @drsuneet @doctorwes

Want to find out more about volunteering for an EP based medical mission? Come to our reception on Thursday night of HRS to find out more #EPeeps scheinmanfoundatiion.rsvpify.com/?securityToken…

@Mdmetzl @EndeavorHlth Very important topic.

#EPeeps need to join the Heart Team to collaborate with our colleagues on how to address severe TR in the presence of CIED leads. Our approach @EndeavorHlth onlinelibrary.wiley.com/doi/epdf/10.10…. #dontjailextractableleads

👉Interested in contributing to the 'Art Rhythm' section @hrs_journal ? 🤔What's that, you ask? ❤️ You must have noticed the bold heart motif cover pages 🔎 Look in TOC for artist reference 💪We are recruiting submissions. ✍️DM me if interested 🙏 #EPeeps #CardioTwitter

@drjohnm Safe and effective. I use fluoro for procedures I have to. Fortunately my professional life is 75% ablation, which affords a large % of my day being lead free. Staff enjoy not wearing lead as well.

@drjohnm ZF probably isn’t for you and may be harmful to the patient. Also, with good ice skills, I don’t understand what I would ever see on fluoro that isn’t better visualized on ice with 3d mapping. It’s a marriage of this imaging and having good skills with ice that make it n/2

Complications happen—to EVERY operator, but, I stand by my contention that flouroless ablation is an unnecessary parlor trick. 1-2 min of X-ray is not a problem. Plus, the same operator doing a zero fluoro case, often does a CRT device w 45+ min of fluoro.

@praneet_manekar @HeartOTXHeartMD Ebsteins. Mahaim pathway.

A classical A4C view of a CHD. What are the classical ECG findings and the most common arrhythmia associated with this condition? #echofirst #ase #cardiotwitter

#CardioFellows -- Do you want to understand pacemakers and ICDs better? Join us tonight for part one of our webinar, focused on pacemakers. @krishmd presents “Introduction to Pacemakers” and Dr. Ali H. Shakir presents “Introduction to Pacemaker ECGs.” Register now: zollcms.com/40ChBCu

#Cardiology #Fellows -- Mark your calendars now for our three-part webinar, "Understanding Pacemakers and ICDs" on Feb. 3, 6, and 10. Presenters will be @krishmd, Dr. Ali H. Shakir, @DrVerdino, @gauravaupadhyay, and @NishantVermaMD. See the full agenda and register: cardiocurious.com/devices