Of Smartwatches, Holiday Hearts, and AI-assisted Clinical Trials: Dr. Zachary Laksman
If you’re tired of seeing your inbox flooded with patients forwarding their Apple Watch tracings with “Is my heart OK?”—you’re not alone. But when you sit down with someone like Dr. Zachary Laksman, an electrophysiologist who thrives on deciphering the squiggles of the heart’s electrical system, suddenly all those smartwatch alerts seem like the prelude to a medical revolution.
https://medicine.med.ubc.ca/zachary-laksman/
On the latest episode of Ditch the Labcoat, Dr. Laksman and I dissected (figuratively, of course) the complex and electrifying intersection of wearable tech, atrial fibrillation (AF), and AI-driven clinical trials. In this post, I’m diving into some highlights.
AF explained: https://www.youtube.com/watch?v=ezTEc6GwLNs
The Smartwatch Conundrum
Ah, the Apple Watch: savior or menace?
Dr. Laksman gave wearables a solid thumbs-up, and why not? For many of us, they’re the medical equivalent of “pics or it didn’t happen.” Catching fleeting arrhythmias that might otherwise escape notice is no small feat. These gizmos have FDA approval for good reason, even if their readings sometimes amount to noisy guestimates.
But let’s face it—smartwatches aren’t perfect. They don’t yet replace the trusty Holter monitor or, if you’re serious about long-term surveillance, an implantable loop recorder. As Dr. Laksman eloquently put it, “Wearables are screening tools, meant to catch more, and we sift through the noise.”
So, should you treat based solely on a smartwatch alert? Maybe not. But if the patient’s story matches the squiggles, that little wrist computer just may make a meaningful impact for your patient.
Read more about Smartwatches and Atrial Fibrillation https://www.acc.org/Latest-in-Cardiology/Articles/2024/05/29/16/56/Smartwatches-and-Atrial-Fibrillation
Holiday Heart is Real (And It’s Probably Your Fault)
Holiday heart isn’t just a thing we throw around at parties to impress non-medical folks. It’s real, people. Overindulgence in alcohol, late nights, and binge-eating turn the season of joy into a cardiology clinic’s busiest time of year. Atrial fibrillation loves a stressed-out system.
But here’s the kicker: the problem isn’t just holiday binge drinking. Even that “harmless” glass of wine with dinner every night could quietly up your AFib risk. So, while we’re decking the halls, maybe skip decking your liver. Cheers!
Why the Heart is Like an Electrician’s Nightmare
Dr. Laksman—ever the humble heart electrician—helped frame the heart in layman’s terms. Plumbing? That’s the interventional cardiologist’s turf. But the electrical wiring? That’s where the EPs shine, hunting down rogue circuits and zapping them into submission with ablations.
The ablation talk was particularly illuminating. Why don’t we just ablate everyone with AFib? Turns out, we’re getting closer to that reality, but there are still logistical hurdles—like OR availability and the fact that even ablation isn’t always a one-and-done solution. “The holy grail is finding disease-modifying therapies,” Laksman mused, “but for now, ablation is the best we’ve got.”
Polygenic Risk: The Crystal Ball We’re Not Ready For
When you hear “polygenic risk,” you might feel a Thor-sized existential crisis coming on. Yes, Chris Hemsworth’s revelation about his genetic risk for Alzheimer’s made headlines, but Dr. Laksman deftly explained that we’re only scratching the surface with how we use genetic information.
Take atrial fibrillation: Polygenic testing can predict your risk, but should we start treating high-risk individuals preemptively with blood thinners or lifestyle interventions? Not yet. As Laksman admitted, the leap from prevention to intervention remains massive. Still, the future is tantalizingly close.
HERES THE CHRIS HEMSWORTH STORY
AI Meets Clinical Trials: Enter MyTrials.ai
Speaking of the future, Dr. Laksman’s newest venture, MyTrials.ai, is a beacon of hope for patients drowning in the murky waters of clinical trials. By leveraging AI, MyTrials.ai connects patients with studies tailored to their unique conditions, preferences, and values.
Why is this groundbreaking? Because, as physicians, we know how often the “I know a guy” method of referrals unfairly favors patients with connections. Laksman’s platform democratizes access, eliminating the guesswork and ensuring no patient gets left behind in the quest for cutting-edge treatment.
What We Learned
- Smartwatches: A game-changing tool, though not yet a standalone diagnostic oracle.
- Holiday Heart: Real, avoidable, and a gentle reminder to pace yourself on the eggnog.
- Ablations: Effective, expanding in use, but not yet a silver bullet.
- Genetic Testing: An evolving field with enormous potential but equally big questions.
- ai: The future of equitable, individualized medicine.
If I had one takeaway from this episode, it’s that medicine is evolving at a breakneck pace, and we’re just lucky to be along for the ride. Whether it’s a smartwatch ping or a new AI tool, the goal is the same: personalized care that makes a real difference.
As always – an electrifying chat on Ditch The Labcoat.
