tag:blogger.com,1999:blog-18943510.post1027742661560457681..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: Defibrillator ComplacencyDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger20125tag:blogger.com,1999:blog-18943510.post-55166638291841716552007-05-13T18:41:00.000-05:002007-05-13T18:41:00.000-05:00Dr Wes,Also be aware that Brian Hassine (dflawed),...Dr Wes,<BR/><BR/>Also be aware that Brian Hassine (dflawed), is one of the greediest and most self-serving individuals I have ever met. He claims to own a significant amount of stock in Cambridge Heart Inc, although the number he states is probably as bloated as his ego; still he badgers those who do not share his point of view. Brian Hassine is like a piece of gum stuck to the sole of your shoe,Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-68095157502790419622007-05-13T18:07:00.000-05:002007-05-13T18:07:00.000-05:00Dr Wes,I would like to apologize for Brian Hassine...Dr Wes,<BR/><BR/>I would like to apologize for Brian Hassine (dflawed); he is just a jeweler from Mission Viejo, CA who has foolishly poured his entire life savings into this company. He attacks anyone who will not say something good about the company. He is a pathetic soul, and better off ignored.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-64854658869574833632007-05-06T21:07:00.000-05:002007-05-06T21:07:00.000-05:00wes..did u disclose your mdt ties in your blog?all...wes..did u disclose your mdt ties in your blog?<BR/><BR/>all you have to do is listen to comments at morgan stanley and deutche this week form stj and you will understand their plan to lose patients who test neg while gaining from increased population pool of missed patients..since the old way wasted icds on people who didnt need them, and excluded patients who did..the argument has never been weAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-25441668207925836842007-05-06T16:55:00.000-05:002007-05-06T16:55:00.000-05:00Dr Wes, Do you know of any reason why the release...Dr Wes, Do you know of any reason why the release date of the Masters 1 trial in conjunction with Medtronic has been delayed? What about the Refine trial from Canada? The ABCD trial did in fact show that both the EP test and MTWA indeterminant/positive worked best together in determining the patients at risk at SCD. But once again, like every other trial to date, the MTWA negative test on Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-76265173632460763862007-05-06T12:41:00.000-05:002007-05-06T12:41:00.000-05:00Sayspine-None of our tests (EP study, t-wave alter...Sayspine-<BR/><BR/>None of our tests (EP study, t-wave alternans, EKG, echocardiography, CT scanning, etc) are worth a damn in its own context at determining risk for SCD. We do the best we can with the limited data from trials available to us when recommending or not recommending an ICD to a patient. But we cannot discard the results of carefully controlled prospective mortality trials done toDrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-45408209224603306512007-05-06T11:53:00.000-05:002007-05-06T11:53:00.000-05:00Do you still do the EP study even though it's "wor...Do you still do the EP study even though it's "worth a Damn"?<BR/><BR/>How many of those "worth a Damn" studies are done daily nation wide and ICDs implanted based on those?<BR/><BR/>What kind of prospective randomized study would you recommend that the EP community and the ICD industry would ever accept? Have you or HRS proposed this study? Is there even a chance of this type of study that Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-35303072829470261592007-05-06T11:18:00.000-05:002007-05-06T11:18:00.000-05:00Dr Wes,Do you think too many are being put in pati...Dr Wes,<BR/><BR/>Do you think too many are being put in patients that won't derive the benefits of what is intended and not enough are going in patients that do need them, some of the 400K a year that still die. Wouldn't a screening device of a non invasive nature, utilized by more MDs find some of those 400K. <BR/><BR/>And I can assure you, prior to March 21, 2006. MTWA was DOA. Medtronic Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-29670144949607606822007-05-06T10:30:00.000-05:002007-05-06T10:30:00.000-05:00Sayspine - Funny how we've gone from putting in to...Sayspine - <BR/><BR/>Funny how we've gone from putting in too many defibrillators to not putting enough of the devices, all in one thread, eh?<BR/><BR/>But to speak to your point - the topic that started all of this was "defibrillator complacency." I agree with you that too many people die without the benefit of ICD therapy - especially those at high risk for arrhythmic death. I also agree withDrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-13063075564392015602007-05-06T10:07:00.000-05:002007-05-06T10:07:00.000-05:00Come on Dr Wes, You know that 95% of the patients...Come on Dr Wes, You know that 95% of the patients that come to you and depend on your judgement for their well being because you are the "expert". Do you even mention the non-invasive MTWA as an option? Do you talk every patient into an ICD? probably not. As an industry that still has over 400K die annually from SCD, how else can you help identify some of these? wouldn't you concede there is aAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-89291361948795389942007-05-06T09:37:00.000-05:002007-05-06T09:37:00.000-05:00Gosh, the comments are coming fast and furious, ar...Gosh, the comments are coming fast and furious, aren't they? <BR/><BR/>dflawed-<BR/><BR/><I>"not only does it work wes, but its the underlying cause of scd..."</I><BR/><BR/>I suppose the heart attack they suffered has nothing to do with it...<BR/><BR/>Regarding your questions regarding why doctors are buying the machine. This deserves some comment:<BR/><BR/>ICD companies have seen a recent DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-42705642776034939082007-05-06T09:11:00.000-05:002007-05-06T09:11:00.000-05:00dflawed-I guess it's not okay that look at this di...dflawed-<BR/><BR/>I guess it's not okay that look at this differently than you, is it? <BR/><BR/><I>"SINCE YOU ARE SO BRAZEN WITH YOUR HONESTY , I THINK YOU SHOULD CERTAINLY SHARE YOUR ATTITUDE WITH THEM.."</I><BR/><BR/>Hence the blog...<BR/><BR/><I>"Or could this test just be one more way of helping doctor and patient make a rational decision?,,why couldnt you give test and tell patient 99% of DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-25308125417265233052007-05-06T08:57:00.000-05:002007-05-06T08:57:00.000-05:00Speaking of a finacial stake, which companys ICD i...Speaking of a finacial stake, which companys ICD implant do you and Ann use. Should we Google search your names with consulting agreement for the answer.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-5581363225952008092007-05-06T08:53:00.000-05:002007-05-06T08:53:00.000-05:00one more thing wes,...how do explain why some doct...one more thing wes,...how do explain why some doctors ARE buying the unit?...WHAT IS THEIR RATIONALE?...WOULDNt it be weird to have some doctors using and some not?...WHAT doctor would you send your dad to ,,,you or this guy at ucla?....more proof...not only does it work wes, but its the underlying cause of scd...<BR/><BR/> T-wave Alternans and Sudden Cardiac Death: How Are They Mechanistically Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-62673520031470583372007-05-06T08:03:00.000-05:002007-05-06T08:03:00.000-05:00wes,,,now its getting better...of course you are i...wes,,,now its getting better...of course you are in bed with the lovely ann curtis..And for the record with me you have met your match..I have read every comment anne has made in her lifetime on icds, and i have expressed my opinion on her stance many times, which of course as a leader at HRS, comes from the same text book of greed over life, so its funny you would choose anne as your savior, butAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-70150436702415091922007-05-06T00:56:00.000-05:002007-05-06T00:56:00.000-05:00Anony 5:23PM, if I had a financial stake in the co...Anony 5:23PM, if I had a financial stake in the company that made these devices, I'd be disappointed in my position, too.<BR/><BR/>But for the sake of argument, read <A HREF="http://www.medscape.com/viewarticle/527551" REL="nofollow">this</A>. I respect Anne Curtis - and I think she does a good job explaining the issues. While I respect your views, certainly you do not respect mine. So lets DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-70559228562552463602007-05-05T17:23:00.000-05:002007-05-05T17:23:00.000-05:00"Does not doing this test make me dangerous" YES...."Does not doing this test make me dangerous" YES. How many recalled implants have you had to deal with? How many patients are walking around with the unneccesary ICDs? The 98% negative predictive value of this test far outways any explinantion that you could give to reason that you should not be utilizing this test. Not to mention the number of patients that you can't talk into the invasive Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-60589354768719080842007-05-05T12:41:00.000-05:002007-05-05T12:41:00.000-05:00Brian-Does not doing a test make me dangerous? Th...Brian-<BR/><BR/>Does not doing a test make me dangerous? There are many other ways to test patients at risk for sudden death. <BR/><BR/>To suggest that doctors should work for free is also flawed, is it not? Don't forget the cost of the technician to prep the patient, the receptionist and billing staff who struggle to get any reimbursement, and even the electricity bill to power the t-wave DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-46288905016902213952007-05-05T12:05:00.000-05:002007-05-05T12:05:00.000-05:00mr wes.,..i wont even use dr. because you should b...mr wes.,..i wont even use dr. because you should be ashamed of yourself...first of all average is 322.00 -75=250.00...but either way do you tell your patients you dont do twave test because there is no money i n it for you?....not because it doesnt work?...you have just proven to all your patients you are a DAngerous doctor to go to....Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-17074886550276042412007-05-04T20:38:00.000-05:002007-05-04T20:38:00.000-05:00TBTAM-Some of my earlier thoughts about t-wave alt...TBTAM-<BR/><BR/>Some of my earlier thoughts about t-wave alternans testing can be found <A HREF="http://drwes.blogspot.com/2006/03/microvolt-t-wave-alternans-approved.html" REL="nofollow">here</A>. <BR/><BR/>Since that post, I met with the t-wave alternans guy to see if this might be good for our office. I learned about what makes a test "indeterminant" - things like PVC's, or poor electrode DrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-38079332063737258552007-05-02T21:57:00.000-05:002007-05-02T21:57:00.000-05:00What's your opinion on this t-wave alternan's thin...What's your opinion on this t-wave alternan's thing? DOes it really triage who needs an implantable from those who don't?Margaret Polaneczky, MD (aka TBTAM)https://www.blogger.com/profile/16555722791007332247noreply@blogger.com