2) This program is intended for #HCPs. Supported by an independent educational grant from Milestone Pharma, it is accredited 🇺🇸🇨🇦🇬🇧🇪🇺. By following this 🧵you can earn 0.5hr 🆓CE and #CME from @academiccme ! FOLLOW US for the best #MedEd programs in #cardiometabolic medicine.
— cardio-met (@cardiomet_CE) March 29, 2026
4a) #Etripamil is a non-dihydropyridine #CCB now approved for the conversion of acute symptomatic episodes of #PSVT to sinus rhythm #SR in adults. It is the 1st@US_FDA approved treatment for PSVT in 30+ years.
— cardio-met (@cardiomet_CE) March 29, 2026
Chemically it most closely resembles #verapamil: pic.twitter.com/qJqpsCYoc0
4c) Consistent safety & treatment effects were seen in all subgroups, inc pts taking #BBs or #CCBs. The most frequent #AEs seen in #RCTs were mild-mod & transient in nature, inc nasal discomfort/congestion/rhinorrhea.
— cardio-met (@cardiomet_CE) March 29, 2026
< 2% of pts in trials d/c'd therapy due to adverse events. pic.twitter.com/iicpKeb1nM
6a) First: Which monitoring practice in Ph 3 trials most directly ➡️ understanding of 👃etripamil’s #BP effects?
— cardio-met (@cardiomet_CE) March 29, 2026
a. single pre-dose BP ✅ only
b. cont/freq BP ✅in the hrs immed after dosing
c. daily home BP logs x 30d after each dose
d. annual clinic BP ✅
6c) (continuing choices for stem at 6b ⤴️)
— cardio-met (@cardiomet_CE) March 29, 2026
c. a sustained, clinically significant drop in #SBP below 80 mmHg in most patients
d. a paradoxical, consistent rise in blood pressure above baseline in most patients
8) In NODE‑301 parts 1–3, patients in sinus rhythm received a supervised “test dose” of #etripamil 70 mg (single or repeat dose) in the clinic so investigators could carefully track heart rate and #BP responses over time.
— cardio-met (@cardiomet_CE) March 29, 2026
10) Even with a repeat regimen (#etripamil 70 mg ×2, 10 minutes apart), mean systolic #BP change was 0.0 mmHg (SD 12.0) over 45 minutes in 709–714 patients—no signal of clinically meaningful BP lowering in this supervised setting. pic.twitter.com/HQM3So6Rqf
— cardio-met (@cardiomet_CE) March 29, 2026
12) The test dose requirement was dropped starting with NODE‑303; NODE‑303 evaluated at‑home #etripamil use for multiple #PSVT episodes without a pre‑randomization test dose before first use, but of course BP variability after dosing could not be tracked then.
— cardio-met (@cardiomet_CE) March 29, 2026
14) #Hypotension TEAEs were rare: 0.4% (7 of 1,610 patients) reported hypotension within 24 hours of #etripamil use, and all events resolved without additional medical intervention.
— cardio-met (@cardiomet_CE) March 29, 2026
16) Two #syncope events actually occurred before study drug administration but were conservatively counted as TEAEs, which further underscores the cautious safety accounting in this analysis. pic.twitter.com/MIVZRGmoOQ
— cardio-met (@cardiomet_CE) March 29, 2026
18) For the bedside clinician, these findings may ⬇️the perceived barrier to prescribing #etripamil for at‑home use, even in pts where #hypotension would have serious consequences, provided they are otherwise appropriate #PSVT candidates.
— cardio-met (@cardiomet_CE) March 29, 2026
20) This is particularly relevant for patients who experience #PSVT‑related chest discomfort, near‑syncope, or borderline #BP at baseline, where an additional #CCB‑mediated #BP drop would be most concerning.
— cardio-met (@cardiomet_CE) March 29, 2026
22) The authors highlight the need for high‑quality real‑world evidence to complement trial data, esp as #etripamil use expands into routine practice and potentially into other tachyarrhythmia indications like AF with rapid ventricular rate #AFRVR.
— cardio-met (@cardiomet_CE) March 29, 2026
24) When counseling patients, it may be reasonable to emphasize: recognize #PSVT, self‑administer #etripamil promptly, then sit/lie down while symptoms resolve, given underlying arrhythmia sx (not any expected drug‑induced #hypotension).
— cardio-met (@cardiomet_CE) March 29, 2026
26) And as experience with #etripamil expands, assuming the safety record doesn’t change, expect to see it prescribed increasingly from #primarycare and #emergencydepartment visits.
— cardio-met (@cardiomet_CE) March 29, 2026
27b) These data support the self administration of #etripamil in unsupervised settings and gives our patients the freedom to travel and be active without the fear of wondering what to do when the next #PSVT episode occurs! pic.twitter.com/rYlzQRsLy1
— cardio-met (@cardiomet_CE) March 29, 2026
28) Congratulations! 👏🥳You just earned 0.5hr 🆓 CE/#CME! Point your 🖱️to https://t.co/mwKF7B25AB to grab your certificate. Thank you 🙏 for joining us, and thanks to @heartdrsingh for once again providing expert-led education on @cardiomet_ce!
— cardio-met (@cardiomet_CE) March 29, 2026
B1)❓Were blood pressure/heart rate data captured during the trials WHILE patients were experiencing an episode of PSVT?
— cardio-met (@cardiomet_CE) April 9, 2026
👉Yes, HR was captured via a patch that was applied prior to administration of the dose, but #BP data were not collected during the #PSVT episode.
C)❓Were patients on background AV-nodal blocking agents in the trials?
— cardio-met (@cardiomet_CE) April 9, 2026
👉Many were–this was neither an inclusion nor exclusion criterion. Patients could be on beta-blockers or #CCBs as background therapy and still administer #etripamil as an emergency dose during #PSVT
E) Hey, don't forget 🤔to claim your 🆓CE/#CME for this program at https://t.co/ykymtr9uH7 FOLLOW US for more and more and yes even MORE 🆓#MedEd from our faculty experts!
— cardio-met (@cardiomet_CE) April 9, 2026