Nikhil Shah, MD, FACC, FHRS
@shah.md
Cardiac Electrophysiologist at Reliant Medical Group and Cardiology Fellowship Associate Program Director
Husband, dog dad, musician, technology enthusiast
#EPeeps #CardioSky #MedSky
(Thoughts + posts are my own)
Husband, dog dad, musician, technology enthusiast
#EPeeps #CardioSky #MedSky
(Thoughts + posts are my own)
Pinned
Nikhil Shah, MD, FACC, FHRS
@shah.md
· Nov 13
This is the most interesting ECG I've seen in a long time. It was presented at the @LaheyCardiology weekly General Fellows ECG conference without any clinical history. Thoughts on this #CardioTwitter and #EPeeps?
Was literally talking to my fellow about this on Friday. I've always preferred the anchor method for this theoretical risk... But apparently it's not so theoretical anymore!
#EPeeps #CSP #CardioSky
@jice-ep.bsky.social rdcu.be/emm0I
#EPeeps #CSP #CardioSky
@jice-ep.bsky.social rdcu.be/emm0I
May 18, 2025 at 12:56 PM
Was literally talking to my fellow about this on Friday. I've always preferred the anchor method for this theoretical risk... But apparently it's not so theoretical anymore!
#EPeeps #CSP #CardioSky
@jice-ep.bsky.social rdcu.be/emm0I
#EPeeps #CSP #CardioSky
@jice-ep.bsky.social rdcu.be/emm0I
MR severity should NOT be a reason to avoid AF ablation (recurrence similar mild vs mod/severe MR, ~43% in both)
MR often ⬇️ s/p ablation (89% ⬇️ ≥1 grade of severity, OR 0.93)
#HRS2025 #EPeeps
www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
MR often ⬇️ s/p ablation (89% ⬇️ ≥1 grade of severity, OR 0.93)
#HRS2025 #EPeeps
www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
April 27, 2025 at 7:12 PM
MR severity should NOT be a reason to avoid AF ablation (recurrence similar mild vs mod/severe MR, ~43% in both)
MR often ⬇️ s/p ablation (89% ⬇️ ≥1 grade of severity, OR 0.93)
#HRS2025 #EPeeps
www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
MR often ⬇️ s/p ablation (89% ⬇️ ≥1 grade of severity, OR 0.93)
#HRS2025 #EPeeps
www.jacc.org/doi/10.1016/... @jaccjournals.bsky.social
Live music, free beer and taquitos at the epicenter! What could be better? #HRS2025 #dysrhythmics #EPeeps
April 25, 2025 at 12:36 AM
Live music, free beer and taquitos at the epicenter! What could be better? #HRS2025 #dysrhythmics #EPeeps
The data shows it's time to think 2️⃣x before #PFA on the CTI. Severe spasm may occur w/o ECG changes. There is also on average a 10% ⬇️ in vascular luminal area at 3 mo repeat cor angio but long term symptoms/impact remains unknown. 1 mg NTG can ⬇️ spasm severity
#HRS2025 #EPeeps
#HRS2025 #EPeeps
April 25, 2025 at 12:31 AM
Reposted by Nikhil Shah, MD, FACC, FHRS
March 15, 2025 at 1:45 PM
Fascinating study: in HCM patients, PFA is associated with better outcomes than thermal ablation. Thermal + non-PV ablation is FAR inferior to PFA + non-PV ablation. Small study but thought provoking! #EPeeps #CardioSky
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
March 15, 2025 at 12:45 PM
Fascinating study: in HCM patients, PFA is associated with better outcomes than thermal ablation. Thermal + non-PV ablation is FAR inferior to PFA + non-PV ablation. Small study but thought provoking! #EPeeps #CardioSky
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
Fascinating data. Should the next iteration of CHADS VA be CHADS V2A? #CardioSky #EPeeps
Patients with device-detected #AFib & vascular disease are at ⬆ risk of stroke & CV events & may derive a greater benefit from A/C than patients w/o vascular disease
#CardioSky #Epeeps
academic.oup.com/eurheartj/ar...
@escardio.bsky.social @victoriadelgadomd.bsky.social @cardiacpa1.medsky.social
#CardioSky #Epeeps
academic.oup.com/eurheartj/ar...
@escardio.bsky.social @victoriadelgadomd.bsky.social @cardiacpa1.medsky.social
March 2, 2025 at 4:48 PM
Fascinating data. Should the next iteration of CHADS VA be CHADS V2A? #CardioSky #EPeeps
Reposted by Nikhil Shah, MD, FACC, FHRS
Among patients with ventricular tachycardia and ischemic cardiomyopathy, catheter ablation as an initial therapy led to a lower risk of adverse outcomes than antiarrhythmic drug therapy. Full VANISH2 trial results and Research Summary: nej.md/3Z5ECOD
#MedSky #CardioSky
#MedSky #CardioSky
February 23, 2025 at 8:41 PM
Among patients with ventricular tachycardia and ischemic cardiomyopathy, catheter ablation as an initial therapy led to a lower risk of adverse outcomes than antiarrhythmic drug therapy. Full VANISH2 trial results and Research Summary: nej.md/3Z5ECOD
#MedSky #CardioSky
#MedSky #CardioSky
Reposted by Nikhil Shah, MD, FACC, FHRS
Anticoagulation & Antiplatelet Therapy for #AFib & Stable CAD:
Meta-Analysis of RCTs
#CardioSky #Epeeps #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @bbikdeli.bsky.social @mohammadkeykhaei.bsky.social @drroxmehran.bsky.social @gbarnesmd.bsky.social @cardiacpa1.medsky.social
Meta-Analysis of RCTs
#CardioSky #Epeeps #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @bbikdeli.bsky.social @mohammadkeykhaei.bsky.social @drroxmehran.bsky.social @gbarnesmd.bsky.social @cardiacpa1.medsky.social
February 11, 2025 at 10:04 PM
Anticoagulation & Antiplatelet Therapy for #AFib & Stable CAD:
Meta-Analysis of RCTs
#CardioSky #Epeeps #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @bbikdeli.bsky.social @mohammadkeykhaei.bsky.social @drroxmehran.bsky.social @gbarnesmd.bsky.social @cardiacpa1.medsky.social
Meta-Analysis of RCTs
#CardioSky #Epeeps #JACC
www.jacc.org/doi/10.1016/...
@jaccjournals.bsky.social @bbikdeli.bsky.social @mohammadkeykhaei.bsky.social @drroxmehran.bsky.social @gbarnesmd.bsky.social @cardiacpa1.medsky.social
Great data presented in this study of >23k patients with AF from 2007-2021 regarding AAD use after ablation (46% after 1st), redos after index ablation (16%), RR of repeat ablation with various risk fx's (lsps AF vs pAF 2.26, AAD use 1.42, etc). Worth a read for #EPeeps
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
February 15, 2025 at 1:14 PM
Great data presented in this study of >23k patients with AF from 2007-2021 regarding AAD use after ablation (46% after 1st), redos after index ablation (16%), RR of repeat ablation with various risk fx's (lsps AF vs pAF 2.26, AAD use 1.42, etc). Worth a read for #EPeeps
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
Fascinating population level study in JACC EP suggesting that there is no PVC burden cutoff associated with cardiomyopathy. #EPeeps
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy: A Cross-Sectional Study
www.jacc.org
February 15, 2025 at 1:00 PM
Fascinating population level study in JACC EP suggesting that there is no PVC burden cutoff associated with cardiomyopathy. #EPeeps
www.jacc.org/doi/10.1016/...
www.jacc.org/doi/10.1016/...
This editorial and the associated article are eye-opening. PFA is not as effective as we originally thought. One takeaway from this is that mapping and ICE have a more vital role in ensuring contact for durable ablation.
Worth a read #EPeeps
academic.oup.com/europace/art...
Worth a read #EPeeps
academic.oup.com/europace/art...
Pulmonary vein reconnection rates after pulse field ablation: time for a reality check?
This editorial refers to ‘Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation: MANIFEST-REDO Study’, by D. Scherr et al., https://doi.org
academic.oup.com
February 7, 2025 at 2:46 AM
This editorial and the associated article are eye-opening. PFA is not as effective as we originally thought. One takeaway from this is that mapping and ICE have a more vital role in ensuring contact for durable ablation.
Worth a read #EPeeps
academic.oup.com/europace/art...
Worth a read #EPeeps
academic.oup.com/europace/art...
Reposted by Nikhil Shah, MD, FACC, FHRS
To our American friends who may now be struggling to find health information on US websites: Please check out the Public Health Agency of Canada's website for helpful resources, updated dashboards & practical health tips.
🇨🇦🇨🇦🇨🇦
canada.ca/en/public-he...
🇨🇦🇨🇦🇨🇦
canada.ca/en/public-he...
February 1, 2025 at 12:06 PM
To our American friends who may now be struggling to find health information on US websites: Please check out the Public Health Agency of Canada's website for helpful resources, updated dashboards & practical health tips.
🇨🇦🇨🇦🇨🇦
canada.ca/en/public-he...
🇨🇦🇨🇦🇨🇦
canada.ca/en/public-he...
Reposted by Nikhil Shah, MD, FACC, FHRS
In an attempt to start GDMT, a 70yoF with recently diagnosed HFrEF and Stage 3b CKD is started on an ARB and a beta-blocker. A week later, she presents to the ED with bradycardia, hyperkalemia, and hypotension.
What happened?
A 🧵
#PhysiologyFriday #MedSky #CardioSky #NephSky
What happened?
A 🧵
#PhysiologyFriday #MedSky #CardioSky #NephSky
January 17, 2025 at 1:00 PM
In an attempt to start GDMT, a 70yoF with recently diagnosed HFrEF and Stage 3b CKD is started on an ARB and a beta-blocker. A week later, she presents to the ED with bradycardia, hyperkalemia, and hypotension.
What happened?
A 🧵
#PhysiologyFriday #MedSky #CardioSky #NephSky
What happened?
A 🧵
#PhysiologyFriday #MedSky #CardioSky #NephSky
Beautiful dissection of an incredibly important anatomic region.
This link works: www.jacc.org/doi/10.1016/...
This link works: www.jacc.org/doi/10.1016/...
January 18, 2025 at 3:16 AM
Beautiful dissection of an incredibly important anatomic region.
This link works: www.jacc.org/doi/10.1016/...
This link works: www.jacc.org/doi/10.1016/...
Reposted by Nikhil Shah, MD, FACC, FHRS
#CardioSky community, I am reposting this because posts are still being “liked”.
Pls “repost” if you like to share with others.
Pls “repost” if you like to share with others.
December 31, 2024 at 1:30 AM
#CardioSky community, I am reposting this because posts are still being “liked”.
Pls “repost” if you like to share with others.
Pls “repost” if you like to share with others.
Looking forward to this!
December 30, 2024 at 5:21 AM
Looking forward to this!
Great for rising thresholds. Also an important tool for troubleshooting if you see noise on the lead
#EPeeps Don't forget you can change polarities
December 30, 2024 at 5:17 AM
Great for rising thresholds. Also an important tool for troubleshooting if you see noise on the lead
Reposted by Nikhil Shah, MD, FACC, FHRS
Atypical flutter mapping with @medtronic.bsky.social Affera Sphere9. Went right to the posterior wall channel and 1 zap terminated flutter! #EPeeps
December 27, 2024 at 10:34 PM
Atypical flutter mapping with @medtronic.bsky.social Affera Sphere9. Went right to the posterior wall channel and 1 zap terminated flutter! #EPeeps
Reposted by Nikhil Shah, MD, FACC, FHRS
I‘m non an #epeeps doc but this really fascinates me:
New research shows that you can ablate the pulmonary veins to prevent… wait for it … atrial flutter! With the same efficacy as CTI-ablation! Short bursts of afib seem to be the trigger for typical flutter…
doi.org/10.1136/hear...
New research shows that you can ablate the pulmonary veins to prevent… wait for it … atrial flutter! With the same efficacy as CTI-ablation! Short bursts of afib seem to be the trigger for typical flutter…
doi.org/10.1136/hear...
Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter
Objective We aimed to compare cryoballoon pulmonary vein isolation (PVI) with standard radiofrequency cavotricuspid isthmus (CTI) ablation as first-line treatment for typical atrial flutter (AFL).
Me...
doi.org
December 26, 2024 at 10:20 PM
I‘m non an #epeeps doc but this really fascinates me:
New research shows that you can ablate the pulmonary veins to prevent… wait for it … atrial flutter! With the same efficacy as CTI-ablation! Short bursts of afib seem to be the trigger for typical flutter…
doi.org/10.1136/hear...
New research shows that you can ablate the pulmonary veins to prevent… wait for it … atrial flutter! With the same efficacy as CTI-ablation! Short bursts of afib seem to be the trigger for typical flutter…
doi.org/10.1136/hear...
Reposted by Nikhil Shah, MD, FACC, FHRS
#Epeeps Is this lead where it shouldn’t be?
#echofirst ?
@alexturinmd.bsky.social @davidjchang7.bsky.social @shah.md
#echofirst ?
@alexturinmd.bsky.social @davidjchang7.bsky.social @shah.md
December 26, 2024 at 4:23 AM
#Epeeps Is this lead where it shouldn’t be?
#echofirst ?
@alexturinmd.bsky.social @davidjchang7.bsky.social @shah.md
#echofirst ?
@alexturinmd.bsky.social @davidjchang7.bsky.social @shah.md