Pinned Tweet
Absolutely thrilled to Match into Interventional Cardiology at @BeaumontIC — Huge thanks to my mentors @SaurabhSDani, @mickeylev1, and @Fred_Resnic for guiding me every step of the way. Excited for the next chapter with the outstanding Beaumont faculty @RyanMadderMD @amrabbasmd
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Amitoj Singh, MD retweeted
Presented at #TCT2026:
In a randomized trial, CCTA-guided PCI with structured preprocedural planning and intraprocedural guidance was noninferior to intravascular ultrasound–guided PCI with respect to target-vessel failure at 12 months. Full P4 trial results: nej.md/48jfVly
@crfheart
In a randomized trial, CCTA-guided PCI with structured preprocedural planning and intraprocedural guidance was noninferior to intravascular ultrasound–guided PCI with respect to target-vessel failure at 12 months. Full P4 trial results: nej.md/48jfVly
@crfheart
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Amitoj Singh, MD retweeted
🚨 Just Published🚨
Simplified Jailed Balloon Technique: Proof-of-Concept for Side Branch Preservation Without Routine Proximal Optimization or Final Kissing Balloon
@DLBHATTMD #cardioTwitter #cardioX #cardiology #interventionalcardiology
Simplified Jailed Balloon Technique: Proof-of-Concept for Side Branch Preservation Without Routine Proximal Optimization or Final Kissing Balloon
@DLBHATTMD #cardioTwitter #cardioX #cardiology #interventionalcardiology
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Amitoj Singh, MD retweeted
AI is transforming cardiovascular medicine—and how we learn, teach, and understand.
Excited to share The Physiology Lab, a new, open-access interactive tool to explore coronary physiology.
💻 systole.live/lab.html
This is just the beginning.
🫀 The U.S. Physiology Course | te, NC: event.fourwaves.com/systole-thephy…
@esbrilakis @ColletCarlos @wfearonmd @DrArgyle @claireraph @BernardBruyne @JEscaned @MortonKern @SYSTOLE_live @realarainmd #TCT2026
Excited to share The Physiology Lab, a new, open-access interactive tool to explore coronary physiology.
💻 systole.live/lab.html
This is just the beginning.
🫀 The U.S. Physiology Course | te, NC: event.fourwaves.com/systole-thephy…
@esbrilakis @ColletCarlos @wfearonmd @DrArgyle @claireraph @BernardBruyne @JEscaned @MortonKern @SYSTOLE_live @realarainmd #TCT2026
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Amitoj Singh, MD retweeted
Intracoronary imaging to assess atherosclerosis and to guide percutaneous coronary intervention. Read this State-of-the-Art review just published in #EHJ
academic.oup.com/eurheartj/adva…
@escardio @ESC_Journals #OCT #imaging
academic.oup.com/eurheartj/adva…
@escardio @ESC_Journals #OCT #imaging
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Amitoj Singh, MD retweeted
ECG patterns suggestive of left main disease. Pay close attention to lead aVR.
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Amitoj Singh, MD retweeted
When Is a Coronary Artery “Small”?
RCTs suggest DCBs are non-inferior to DES in small vessels. But where’s the cutoff?
The magic number for long-term stent patency is an MSA of 5.5 mm², corresponding to a vessel diameter of 2.6 mm. See the sizing chart below.
The question of el dia. (RVD) of 2.75 mm the tipping point for choosing DES over DCB? 🤔
RCTs suggest DCBs are non-inferior to DES in small vessels. But where’s the cutoff?
The magic number for long-term stent patency is an MSA of 5.5 mm², corresponding to a vessel diameter of 2.6 mm. See the sizing chart below.
The question of el dia. (RVD) of 2.75 mm the tipping point for choosing DES over DCB? 🤔
@Hragy @realarainmd @mmamas1973 @mirvatalasnag @ShariqShamimMD @AntoniousAttall @aymanka @TWilsonMD @jedicath @NishithChandra If 3mm DCB fully yielded without recoil in this young man without heavy calcium then that’s an MLA of 7mm2. It’s adequate.
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Amitoj Singh, MD retweeted
.@GBarnesMD updates that LMWH NOT IV UnFx heparin is now the class I recommended Rx for initial rx of acute #PE , even for pts undergoing intervention #VSS2026 . Spread the word!
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Amitoj Singh, MD retweeted
Web flow disruptor +/- stent. Here’s the link. Lesion in is not surgically accessible. jacc.org/doi/10.1016/j.…
Here an interesting case. How would you approach this wide base LM bifurcation aneurysm? Pt with severe calcific CAD and angina
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Amitoj Singh, MD retweeted
My #interventionalcardiology Toolkit 🧰⚙️🔨: Reverse the challenge: tackling complex #bifurcation PCI
🔗pcronline.com/Cases-resource…
Severely angulated side branches can turn conventional wiring into a frustrating challenge. This article, submitted by Nima Mohan and @RGeuns, wiring technique, from wire shaping and setup to step-by-step SB engagement, with practical tips on when to streamline the approach or escalate to balloon 🎈 blocking.
Reviewed by @juliendjdj
#interventionalcardiology #cardioed
@kiadeb87 @sbrugaletta @fjsawaya
🔗pcronline.com/Cases-resource…
Severely angulated side branches can turn conventional wiring into a frustrating challenge. This article, submitted by Nima Mohan and @RGeuns, wiring technique, from wire shaping and setup to step-by-step SB engagement, with practical tips on when to streamline the approach or escalate to balloon 🎈 blocking.
Reviewed by @juliendjdj
#interventionalcardiology #cardioed
@kiadeb87 @sbrugaletta @fjsawaya
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Amitoj Singh, MD retweeted
1/2 Our updated meta-analysis of intravascular imaging guidance publ in JACC. Since our last synthesis in Lancet 2024, there have been 6 new RCTs with 8,670 additional pts. Total is now 28 RCTs with 24,634 patients with mean FU 22 mos. Should be enough for a definitive answer!
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Amitoj Singh, MD retweeted
An incredible number of trials published simultaneously in the NEJM: I honestly can’t quite wrap my head around what is happening. Congratulations to everyone involved. It was difficult to choose only five trials, but these are the ones I selected for the interventional #ESCCongress
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Amitoj Singh, MD retweeted
🚨 10 striking conclusions from ESC 2026
1. HFmrEF is essentially gone.
ESC now defines HFrEF as LVEF <50% and HFpEF as ≥50%.
2. MRAs have broken the EF barrier.
Mineralocorticoid receptor antagonists now have a Class I recommendation in chronic HF irrespective of LVEF. Semaglutide/tirzepatide receive Class IIa recommendations for HFpEF with obesity.
3. SINGLE-AF: anticoagulation may start earlier than we thought.
In AF patients at intermediate stroke risk, DOAC therapy reduced adverse clinical outcomes by 69% versus no anticoagulation.
4. Severe TR is no longer just “give diuretics and watch.”
TRIC-I-HF: transcatheter tricuspid repair reduced HF hospitalisation and all-cause mortality compared with medical therapy alone.
5. Unexplained syncope deserves early prolonged ECG monitoring.
ASPIRED: immediate 14-day monitoring did not prevent recurrent syncope, but substantially improved arrhythmia diagnosis/treatment and was associated with lower mortality.
6. Intermediate–high-risk PE may be entering the catheter era.
PRAGUE-26: catheter-directed thrombolysis improved short-term clinical outcomes versus anticoagulation alone, without an obvious major bleeding penalty.
7. Cardiac arrest + no STEMI ≠ automatic immediate cath lab.
DISCO: immediate angiography after OHCA without ST elevation did not improve 30-day survival.
8. Being ≥70 is not a reason to abandon primary-prevention statins.
STAREE: atorvastatin reduced major cardiovascular events by about 30% in older adults without known CVD, although disability-free survival was unchanged.
9. AF ablation has a surprisingly large placebo component for symptoms.
PVI-SHAM-AF: ablation reduced AF recurrence, yet improvement in AF-related quality of life was not significantly greater than sham treatment.
10. Even the definition of MI has changed.
The 5th Universal Definition of MI replaces the traditional numbered framework with primary MI, secondary MI and procedure-related MI, while incorporating sex-specific troponin thresholds and greater use of imaging.
🔥 The one-line ESC 2026 message:
Treat HF across the EF spectrum, anticoagulate selected AF patients earlier, intervene on TR, monitor syncope sooner—and stop rushing every post-arrest patient without STEMI to the cath lab.
1. HFmrEF is essentially gone.
ESC now defines HFrEF as LVEF <50% and HFpEF as ≥50%.
2. MRAs have broken the EF barrier.
Mineralocorticoid receptor antagonists now have a Class I recommendation in chronic HF irrespective of LVEF. Semaglutide/tirzepatide receive Class IIa recommendations for HFpEF with obesity.
3. SINGLE-AF: anticoagulation may start earlier than we thought.
In AF patients at intermediate stroke risk, DOAC therapy reduced adverse clinical outcomes by 69% versus no anticoagulation.
4. Severe TR is no longer just “give diuretics and watch.”
TRIC-I-HF: transcatheter tricuspid repair reduced HF hospitalisation and all-cause mortality compared with medical therapy alone.
5. Unexplained syncope deserves early prolonged ECG monitoring.
ASPIRED: immediate 14-day monitoring did not prevent recurrent syncope, but substantially improved arrhythmia diagnosis/treatment and was associated with lower mortality.
6. Intermediate–high-risk PE may be entering the catheter era.
PRAGUE-26: catheter-directed thrombolysis improved short-term clinical outcomes versus anticoagulation alone, without an obvious major bleeding penalty.
7. Cardiac arrest + no STEMI ≠ automatic immediate cath lab.
DISCO: immediate angiography after OHCA without ST elevation did not improve 30-day survival.
8. Being ≥70 is not a reason to abandon primary-prevention statins.
STAREE: atorvastatin reduced major cardiovascular events by about 30% in older adults without known CVD, although disability-free survival was unchanged.
9. AF ablation has a surprisingly large placebo component for symptoms.
PVI-SHAM-AF: ablation reduced AF recurrence, yet improvement in AF-related quality of life was not significantly greater than sham treatment.
10. Even the definition of MI has changed.
The 5th Universal Definition of MI replaces the traditional numbered framework with primary MI, secondary MI and procedure-related MI, while incorporating sex-specific troponin thresholds and greater use of imaging.
🔥 The one-line ESC 2026 message:
Treat HF across the EF spectrum, anticoagulate selected AF patients earlier, intervene on TR, monitor syncope sooner—and stop rushing every post-arrest patient without STEMI to the cath lab.
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Amitoj Singh, MD retweeted
Presented today and published in NEJM, our PADN-HF-PH trial in which 264 pts with left-heart failure (HFrEF or HFpEF) and pulmonary hypertension (mPAP >20 mmHg and PCWP >15 mmHg) were randomized at 25 centers to pulmonary artery denervation (PADN) + GDMT vs GDMT alone.
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Amitoj Singh, MD retweeted
New Video: How Do You Determine the Shape Size?
When shaping a guide wire, how do you determine the appropriate size? The key is to make the shape larger than the inner diameter of the main vessel before entering the target vessel. See this in action: ow.ly/G9fR50ZCKa5
echnique #MedTwitter
When shaping a guide wire, how do you determine the appropriate size? The key is to make the shape larger than the inner diameter of the main vessel before entering the target vessel. See this in action: ow.ly/G9fR50ZCKa5
echnique #MedTwitter
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Amitoj Singh, MD retweeted
SCAI Bifurcation Club | Step-by-Step Approach to Treating Complications x.com/i/broadcasts/1…
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Amitoj Singh, MD retweeted
Teaching points: LIMA-PCI
1: Use short guide
2: Look for native LAD PCI
3: Pseudostenosis is common
4: Favor hydrophilic wire
5: Use less mag to track 🎈& stents
6: Do L subclavian pullback
7: Anastomotic lesions common<6m after CABG
8: IMA fails to mature if native LAD is not dx
1: Use short guide
2: Look for native LAD PCI
3: Pseudostenosis is common
4: Favor hydrophilic wire
5: Use less mag to track 🎈& stents
6: Do L subclavian pullback
7: Anastomotic lesions common<6m after CABG
8: IMA fails to mature if native LAD is not dx
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Amitoj Singh, MD retweeted
You've seen the apex on echo a thousand times. You've never seen it like this.
Exclusive to the #JACC Amara Yad image series, the LV apex’s spiral vortex of muscle fibers converging on a point so thin that light shines right through.
More: bit.ly/4n7Iglq
@shivkumarmd
Exclusive to the #JACC Amara Yad image series, the LV apex’s spiral vortex of muscle fibers converging on a point so thin that light shines right through.
More: bit.ly/4n7Iglq
@shivkumarmd
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Amitoj Singh, MD retweeted
Diagnostic, therapeutic curiosity and dilemma. What do you see?
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