Mintu Turakhia, MD MS

@Hragy 😳

@leftbundle In 1985, I left a post inferior STEMI woman with her son who was an intern, while I left the CCU for a while, when I came back he was CPR’ing her as she begged him to stop, i shouted STOP he said VF pointing at the monitor….

One of the challenges of #medtwitter is that the teaching is sometimes wrong. This is a great example of artifact, but the teaching thread calls this torsades. Not only can the QRS be seen marching through, but the pulse ox has a bar that shows a pulse corresponding to each QRS. While intentions may be good, accuracy matters.

My first entry to science as an undergrad was to characterize the frequency of skeletal muscle shivering patterns based on which motor neurons were inhibited under general anesthesia. We created an accelerometer and PPG based set of wearables to do this in the OR. And we are still using these technologies on our wrist! journals.lww.com/anesthesiology…

@leftbundle @SVRaoMD Treatment is warm blankets.

@Hragy The original video source also suggested TdP.

@Hragy The thread included an answer post by the OP that said it was TdP. That post has since been deleted.

@TrackYourHeart That is not correct.

A 86-year-old with pneumonia develops this telemetry pattern. Electrolytes are normal, no culprit drugs, and no cardiac history. What rhythm are you seeing, and what would you do next?

@AnilMakam I’m not convinced but would be a good study. Look at physician risk-adjusted outcomes stratified by risk-adjusted propensity to image. The unit of obs should be the physician (which answers a different q than patient level outcomes stratified by physician propensity to image).

I am sympathetic to this, but I've come around on this Its often the same doctors who order indiscriminately who misdiagnose and undertreat So at least with mass testing and imaging, a not great doctor still might stumble into a diagnosis correctly

@TrackYourHeart Excellent case of artifact confirmed by QRS complexes marching through and a regular pulse seen next to the SpO2 reading.

@ethanjweiss @JimmysSeafood I was here too. If only I were scrolling — I would have known you were here!

@JimmysSeafood Also good luck against Spain

SFO——->SEA and no this is not a humble brag. It’s a full blown brag. Go 🇺🇸

@ethanjweiss Pretty big flex by Karl.

Well this is the most San Francisco 4th ever. Happy 250 America!

can't even en passant without offsides anymore

@bogdienache OMG. Didn't see that.

@leftbundle That’s a hilariously bad graph. (Note that the X axis is time.)

Imagine if the EP community got together and did the same, replacing “HF” with “AF”. All hell would break loose. Less is more.

@nikillinit Having done both (and doing both concurrently), there are tradeoffs. Each is unique and amazing but only at the right time in a person’s life. Best to not view it as a fork on the road but a journey.

I get why a lot of doctors come to me about careers outside of medicine, but I really do think it's a grass is greener situation the salary and stability of the median doctor job is far higher than the median stability in tech/finance/consulting right now IMO and regardless of what the internet thinks docs still hold higher social status than any of those positions

One challenge in healthcare is the Lake Wobegon effect. Everyone wants to believe that their center is above average. That may be true for a given center, but it's not true for all. Master clinicians are scarce. AI can be an equalizer, raising the median and reducing variation.

What exactly is meant by “AI”? Grammar and semantic checkers like Grammarly have moved from rule based to language model approaches (like autocomplete). Does Grammarly require disclosure? What if someone used Cursor or Codex to debug their SAS code? We have had debuggers for years but these are now LLM based. Photoshop and PowerPoint use AI. Same issue. I don’t think you can differentiate. And I don’t think it matters. It’s a tool.

@AmitGoyalMD You do have to be very diligent about hallucinated references and plagiarism

Question for journal editors, peer-reviewers, authors, and readers... What should journals do when a manuscript is flagged by AI-detection software to likely be >75% AI-written❓️ The references are all verified and the authors say AI was used just for grammar and flow? Disclaimer: this image is >75% AI-generated.

@drjohnm AI equalizes human variation in diagnostic ability and shifts the median dramatically upward. That the story.

ECG from NYT story on AI saving a pt. A highly abnormal ECG. Fragmented wide QRS and first degree av block likely infranodal. Any cardiologist should be able to look at that ECG and predict serious cardiomyopathy. YOU DON’T NEED AI for this

It was two in the morning, the hour when even the bravest samurai retires to his bedroll, yet here, a fortress of light beckoned me from the darkness. Every castle I have ever known has fallen. Fire, siege, taxes. Eight hundred years of my family learning one lesson: nothing stays open forever. This house has never closed. Not for storms. Not for holidays. Not for the hour when even the moon looks tired. I asked the waitress when they lock the doors. "We don't have locks, hon." No locks. I own walls, moats, and a sword older than this country, and I have never once said anything that powerful. Inside, a cook was scraping the grill at 2 a.m. with the calm of a man guarding something. I asked if he was the night watch. "I'm Darnell." A trucker two stools down raised his coffee. "Place stayed open during the hurricane," he said. "FEMA's got a whole index about it." An index. The government of this nation measures disasters by whether THIS HOUSE is still standing. In Japan, we measured a clan's strength by its castle. Same thing. Theirs serves waffles. I ordered. I ate. I confess what happened next. I did not want to leave. The night outside was large. The booth was warm. I am a grown warrior, and I sat in a yellow fortress at 3 a.m. feeling protected by hash browns. A castle does not promise to stand forever. It simply leaves the lights on. I drive past at night now. Just to check. The lights are always on. Sentries of the griddle — I see you. Hold the line.

Identifying the limitations of traditional arrhythmia monitoring is key to reducing time to diagnosis and improving patient experience. Join Dr Emma Svennberg, Dr Isaac Whitman and Dr Joseph Mills for a live webinar exploring the clinical, operational and economic value of 14-day ambulatory ECG monitoring. 📅 Wednesday 24 June 2026 🕕 18:00 BST | 19:00 CEST Register now: ow.ly/SRXE50Z9g8U This webinar is supported by iRhythm.