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Extraordinary slide from Milton Packer's wonderful lecture 🤯
What a time to be a #HeartFailure specialist... we just need a lot more of us (doctors, nurses and AHPs) to deliver all the therapies at our disposal.
#GDMTworks #BSH2021 #BSHAM2021
Colin C retweeted
Some geritricians and AE docs will often tell all about the harms of overprescribing they see every day. IMO, problem is they have selection bias- they are more likely to see the patients who have side effects. Yes overprescribing can be a problem - but the reflex of stop the statin or antianginals or GDMT in HF could well lead to harm for many patients.
For the secondary care deprescriber they may well also see a nocebo effect that is then misattributed, but never see the stroke that happens in community to the 80 yo that could have been avoided, or the worsening angina or the readmission with decomensated heart failure. Give GPs funding and time and we can prevent inappropriate prescribing.
🚨 EXC: An over-prescribing epidemic is sending 1,000 elderly patients to A&E every single day - a consequence of a fragmented NHS unprepared for the ageing silver tsunami heading its way as 468k baby boomers turn 80 this year: thetimes.com/article/ddf452b…
Colin C retweeted
ATP fails for three distinct reasons. Understanding which one and why is where the real EP fun starts.
#Electrophysiology #ICD #VentricularTachycardia #BHRS #HRS #EPeeps
Colin C retweeted
Earlier today one of the BBC's leading stories was about patient harm after heart surgery in Newcastle, the focus upon a single surgeon
This highlighted text caught my eye
Why? Because we've been here before sadly...
1/3
Colin C retweeted
Hate switching to a new set of trust values.
I think I have to stop being nurturing and start being compassionate. And switch from being honest to being trustworthy.
Something like that, it's not like these are vapid meaningless buzzwords after all.
Colin C retweeted
Yearly reminder
NHS mandatory training should include a section and a quiz about the difference between REPLY and REPLY ALL
TAVI is obviously the correct option.
It also helps to distinguish from tAVR (= tissue AVR).
Colin C retweeted
VF arrest on POD#2 after uncomplicated CABG surgery EF 30%. Normal lytes. Resuscitated.
The next best step?
Poll below 👇
#CardioTwitter #Epfellows
Colin C retweeted
Check out our ✨ChristmasBMJ paper✨
Ever wondered who in the hospital has the steadiest hands?
We tested with a @JohnLewisRetail children’s buzz-wire game🎄….
…. and also discovered who swears the most! 🤬
Link: bmj.com/content/387/bmj-2024…
Colin C retweeted
QFR is surrogate of a surrogate (FFR) of a surrogate (Ischemia) which itself is a surrogate (for atheroma burden). So it turns out that perpetual surrogacy is perpetually inferior. #TCT2024
Ouch, QFR. In the FAVOR III Europe trial, it loses out against FFR for PCI guidance. For those who enjoy statistical tortures, QFR didn’t just fail to show noninferiority; it was actually inferior. More stents, more myocardial infarctions. Who will give me back the hours I spent obtaining the certification? #TCT2024 thelancet.com/journals/lance…
Colin C retweeted
Every HF 🫀researcher 🔬🥼lives in the hope that their research will be clinically impactful and change the way we deliver care for people with heart failure.
TriageHF alerts were today recommended by NICE as an option for use in people with HF and a cardiac device.
Developed in Manchester, TriageHF Plus is an innovative care pathway uses cardiac device data to predict and flag high-risk heart failure patients for clinical review. Use of HF 🫀alerts as part of a structured pathway has been shown to cut hospitalisations.
Huge thanks to @JoTaylorMCR1, @NWhearts, @Doc_Tiger, @doc_ccc, @glen_martin1, @MedtronicUK, @Medtronic @HealthInnovMcr, @PennineCareNHS, @MFTnhs, @MFT_Research, @GMEC_SCN and @mmamas1973 for their support in bringing this to patients in the NHS! #HeartFailure #Innovation #Healthcare #wic @BCSWIC
🗞️ NICE recommends use of Manchester developed remote digital heart failure system, which has the potential to dramatically reduce hospital admissions.
Researchers at @MFTnhs developed the remote heart monitoring pathway, TriageHF Plus with @Medtronic.
🔗research.cmft.nhs.uk/news-ev…
Colin C retweeted
Dispiriting events at Reading should concern everyone in English football. Fans are lied to, players and an impressive manager are let down, and so are staff. A thoughtless, heartless owner damages a historic club. It’s another warning to all in football. If we tolerate this, then your club could be next.
Fans at some other clubs fear similar pain or just feel relief to have escaped danger. Many will simply focus on their own form and fortunes. Football’s tribal. Most headlines revolve around the big names, the big games like Manchester City versus Arsenal. But Reading embody the pyramid, a local beacon and hub for nurturing talent. Neil Webb started there. The windfall from the Michael Olise deal helps sustain the club currently. Ted Drake learned his managerial trade at Reading before guiding Chelsea to their first title.
Football clubs are community assets and have to be protected from individuals like Dai Yongge wreaking such misery at Reading. He has his motives and his methods but none seem aligned to the club’s future wellbeing. He doesn’t communicate with fans. Reading FC Women withdrew from the Championship because of financial difficulties. Sustained mismanagement of the club has seen a failure to pay men’s players and HMRC lead to points deductions.
A proposed takeover by Rob Couhig, an American businessman welcomed by the fanbase, collapsed, leaving Yongge still in charge and supporters still in torment and again asking questions. Does Yongge really want to sell? If the club goes under is it then all about valuable real estate? Would administration and another points deduction actually be better than this shambles?
And so Reading fans rally again, fighting for their club’s life. But Yongge doesn’t listen. He doesn’t appear to care about the negativity his ownership brings to the door of the dressing-room. Ruben Selles and his whole-hearted squad give everything they can on the field, and sit a defiant 12th in League One, but they aren’t detached from the mess. It must be dismaying and distracting.
Losing Selles would be a disaster. He’s doing a good job in trying circumstances. If he left, Selles would be picked up swiftly by a better run club. Reading fans post messages of support to Selles and his squad. They will back them loudly at Bolton Wanderers today. It’s about finding the balance between demonstrating support for the team while demonstrating against the owner.
Much is right about Reading: committed fanbase, stadium, training ground, the attitude of manager, squad and club staff. It’s just the owner. It’s a nightmare that Reading are living through. And it’s a cautionary tale all football needs to heed. #ReadingFC #EFL
Colin C retweeted
What a day! I am so incredibly proud to see the #OPTPACE manuscript in the flesh!
This study began my #clinicalacademic career; and has directly led to my work with the combined heart failure and device service @LeedsHospitals @cardiorespLTHT and @NIHRresearch
Does #echocardiography screening for #HF in a #pacemaker population improve clinical outcomes?
See our paper @NatureMedicine - only when delivered by specialised integrated #heartfailure and devices clinic.
nature.com/articles/s41591-0…
Colin C retweeted
Clip from 1967 magazine describing the state of health care in the UK 🇬🇧.
Note how similar the struggles were to the current ones we read about online today.
(see next page for the same thing - but describing the US 🇺🇸).
(1/2)
Colin C retweeted
What if I told you that there was a heart failure treatment that reduces heart failure hospitalisations, improves QOL and doesn't risk hyperkalemia. #ESC2024 #finerone #FINEARTS_HF
Colin C retweeted
Congrats to Rob Couhig and also well done to all those #ReadingFC fans like @SellBeforeWeDai @STARReading @TheTilehurstEnd + others who fought so hard for their Club. Also important voices like @james_e1871, sponsors who care in @SC_Leasing and a good coach in Ruben Selles👏











































