Rajat Goyal
@drrgoyal
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Cardiac Electrophysiologist @Sutterhealth - California Pacific Medical Center. Dad Joke Expert. Views are my own.
San Francisco, CA
Joined March 2009
@HeathVeuleman @BLS_gov “Statistics are like bikinis. What the reveal is suggestive. What they conceal is vital.” Art Fougner MD
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We proudly present our very own Latin version of the Dysrhythmics — The Moderator Band! Great performance during the welcome cocktail. 🎶🍸 #LAHRS2025 @LAHRSonline1 #EPEEPS
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📢New in @hrs_journal *⃣ A rare Hypothesis-generating study on AF ablation in these days of almost mechanical #PFA 🌟Ectopy-triggering ganglionated plexus (ET-GP) ablation may be a solo strategy for persistent AF! ➡️ Study (n=49, Imperial College London): High-freq stimulation
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🔥HOTLINE #ESCCongress ALONE Trial: OAC after AF ablation? 👥 840 pts w/o AF recurrence in 12 months randomized: OAC vs no OAC 📊 Primary endpoint (stroke, embolism, bleeding) lower in no OAC (2.2%vs 0.3 p=0.2) 🩸 Difference mainly from↓major bleeding ⚡️Ischemic events:similar
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The CPT system is incredibly complicated and frustrating. Many electronic health records make it so you can't even find the correct code to book a procedure. It's even tougher when, as is the case with spine surgery, there might be 8+ different codes for the case. But that's
Ditto that for spine surgery. Never seen this level of friction for approvals that would have been routine not even 24 months ago. The latest tactic - need to specify the vendor for any spine implants as well as the corresponding CPT code. Any mismatch? They get to deny solely
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Ditto that for spine surgery. Never seen this level of friction for approvals that would have been routine not even 24 months ago. The latest tactic - need to specify the vendor for any spine implants as well as the corresponding CPT code. Any mismatch? They get to deny solely
American Physician Assistant who has worked in cardiology for 8 years says “I have NEVER seen so many echos denied like I have this year” She says health insurance companies are denying routine scans at rates like never before and making it harder to appeal. Just this one phone
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Interesting pacemaker alternans. What's going on? Is the pacemaker malfunctioning? #ECG #Cardiology #fellowsfirst
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High Incidence of Phrenic Nerve Injury in Patients Undergoing Pulsed Field Ablation for Atrial Fibrillation #OpenAccess
https://t.co/KMAoBdriHl
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We’ve seen this phenomenon with all PFA catheters delivering energy on or very near to exposed metal. Stay tuned for a more thorough evaluation to be published in the near future. @danielcamposll
Visible Arcing Observed with Pulsed Field Ablation Applications Delivered Near a Left Atrial Appendage Occlusion Device @True_EP
https://t.co/Wb0dQgewu4
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Here is another look at 20,000 fps. This is less than a millisecond and was a barely perceptible spark seen with the naked eye. The electrode is touching the fabric of the device but still arcing to the underlying metallic frame.
Here is the video of PFA delivered near a LAA occlusion device
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Management of oral anticoagulation after pulsed field ablation for atrial fibrillation: Insights from a multicenter study https://t.co/2hRGGSHMXq
heartrhythmjournal.com
The endothelial injury that can promote thrombus formation during radiofrequency ablation (RFA) of atrial fibrillation does not occur with pulsed field ablation (PFA).
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Severe TR due to septal leaflet entrapment from pacemaker lead
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Patients want to blame physicians for the failure of the healthcare system. We are frustrated as well and we DON’T have anymore control than you do. Physicians and patients need to work together to save our healthcare system.
Physicians should be paid like plumbers. Plumbers don't have there rates set by a federal agency. Plumbers don't have to wait for an insurance company to determine if they deserve to get paid. Plumbers can decide to charge more for evening, weekend, and holiday services.
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Catheter Ablation of Paroxysmal Atrial Fibrillation and Disease Progression: Magnitude of the anti-progression effect and role of intervention timing @KarimBenali42 @DrJasonAndrade
https://t.co/iow8tAghb3
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It’s not that “root causes” are completely irrational to discuss. But also telling people they ate too much, didn’t exercise enough, slept like crap, destroyed their circadian biology, and probably used alcohol, THC, adderal, oxys, or sleeping pills. Build a time machine.
I recently had a conversation with a friend who runs a clinic network of 1,000+ MDs. She said the main conversation among doctors is frustration that patients are asking about the "root cause" and "more natural cures" for their conditions. She said 0% of patients asked these
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#EPeeps - tough case👇 ⚡️VF triggering pathway from CS diverticulum. Neck >5mm from PLV. 🥉Took 3 goes to get rid of it. Bumped each time - gave limited RF - back in 24hr. 🔥 Encircled neck (30W-20sec) with irrigated RF and its FINALLY gone! @LiverpoolEP
#Alwayslearning
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Hard to Die:M.FL ablation using the Affera system. Failure of Endocardial and distal CS ablation.Activation mapping revealed an epicardial connection, and subsequent (VOM) ethanol ablation successfully resulted in bidirectional block.@SteliosDragasis @Kariki_O
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