Things are pretty quiet in the summer so let's go back to an old-school medical reversal in electrophysiology. One I lived through. If you like trials you will like this story
I cannot escape from thinking that this interesting outcome paints a picture of what happens frequently, likely more than we know because trials are not conducted to reveal it.
Understandably as trials are a huge investment.
I believe there is a tendency to believe that therapies have greater benefit than harm.
It may be just my cognitive bias but my 3 plus decades of practice leave me with the notion that the first do no harm principle could be given more emphasis.
My experience with patients is that they greatly appreciate an approach that is cautious where benefit is uncertain.
An element to this mindset is the notion that it is entirely reasonable to accept our limitations and leave some outcomes in the hands of God.
A sentence from pharmacology class to never forget : “ anti-arrhythmics can have a pro-arrhythmic effect “ . Wasn’t there a study on otherwise healthy medical students that surprisingly showed many to have asymptomatic arrhythmias that in patients we would’ve been treating ?
“Arrhythmias documented by 24-hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease” (Brodsky et al., American Journal of Cardiology, 1977).
Thanks for looking it up. I guess they would not have been placed on “ the PVC killer “ then ( Sectral ). The now ubiquitous wearables and the implantable cardiac monitors are providing us with exponentially more data and medicalization of “ normal variability “ is to be avoided.
Awesome
I cannot escape from thinking that this interesting outcome paints a picture of what happens frequently, likely more than we know because trials are not conducted to reveal it.
Understandably as trials are a huge investment.
I believe there is a tendency to believe that therapies have greater benefit than harm.
It may be just my cognitive bias but my 3 plus decades of practice leave me with the notion that the first do no harm principle could be given more emphasis.
My experience with patients is that they greatly appreciate an approach that is cautious where benefit is uncertain.
An element to this mindset is the notion that it is entirely reasonable to accept our limitations and leave some outcomes in the hands of God.
RIP AJ Moss ❣️
A true gentleman and clinical scholar !
All who had the privilege of working with him respected him as a mentor and role model to strive to emulate !
Appreciate the clear writeup, thanks!
Seeing as the article was really good, I'll only award one demerit for the following headline:
"The results shocked the EP community"
;-)
HA!
A sentence from pharmacology class to never forget : “ anti-arrhythmics can have a pro-arrhythmic effect “ . Wasn’t there a study on otherwise healthy medical students that surprisingly showed many to have asymptomatic arrhythmias that in patients we would’ve been treating ?
“Arrhythmias documented by 24-hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease” (Brodsky et al., American Journal of Cardiology, 1977).
Thanks for looking it up. I guess they would not have been placed on “ the PVC killer “ then ( Sectral ). The now ubiquitous wearables and the implantable cardiac monitors are providing us with exponentially more data and medicalization of “ normal variability “ is to be avoided.
My pleasure.
Great article. Well written.
What is the point of posting an AI-generated summary of the article and passing it off as a comment?