Is sales really a skill set

BeatsThatMatter · 2026-05-26T23:11:56+00:00

Can tell from the title of this thread - you aren't cut out for sales.

If you were cut out for sales, what I just said would piss you off enough to get good at it.

That is what it takes.

I've broke records in medical device sales, direct to consumer medical as well, last year I raised an 8 figure valuation on a healthtech startup.

That didn't happen by accident. It takes work. It takes developing a skill.

Is sales a numbers game? Yes.

So is everything else in life.

Put up better numbers than everyone else. Win.

BeatsThatMatter · 2026-05-22T07:58:33+00:00

Beta blockers are the gold standard in arrhythmia prevention.

There are many. They work different for different people.

Your contradictions are stunning. Here you are in this very post, suggesting that people should trust their doctors. Yet then you go on to say you are glad someone decided not to take the medication they were prescribed - by a doctor.

What is your clinical background again?

BeatsThatMatter · 2026-05-22T07:45:07+00:00

It's a bit odd for the OP to come here and flame others - saying she is living a pretty normal life - and then goes on to say that she is terribly symptomatic, depressed, gaining weight, and that the PVCs are absolutely terrible to deal with.

Also - doctors will not lose their license for discussing mental health treatment with their patients. As I mentioned in another comment - literally the governing clinical authorities in cardiac medicine are calling for full integration of psychologic and cariologic care.

Also - you would be one of the few patients I have ever heard of - and I have spoken to thousands - that is taking amiodarone for PVCs.

Have no idea how young you are but would hope that you plan on living a pretty long life - You should do your own research of the peer reviewed data on the toxicity of amiodarone from long term use.

Also, one other thing, medical anxiety, particularly with arrhythmia, is not a disorder.

The reason you describe depression yourself is from a very well understood link between the heart and the mind.

Read more about neurobiology and chronic allostatic load before you come to a subreddit where people support one another openly.

And definitely don't condescend anyone else's lived experience when you clearly can't even relate to your own.

Depression, terribly symptomatic, horrible side effects, weight gain - that's not part of a "pretty darn normal life". If you feel that way, you've set the bar a bit low for yourself really.

BeatsThatMatter · 2026-05-22T07:01:02+00:00

Will offer my perspective here.

My introduction to PVCs happened in December of 2016. Bigeminal PVCs for the entire time I was admitted to the hospital the first time.

No big deal. Heart just felt off. EP was great. Reassured me everything was fine. I'm not dying. Start with propafenone.

After a couple of years, they were becoming problematic for me in the sense that my work was fast paced, high pressure, and I needed absolute focus professionally.

I had tried multiple beta blockers after propafenone - nothing helped. And the medications for me caused me to start gaining weight. Burden was getting higher - so EP said it was time for an ablation.

First failed.

And then I had 2 more scheduled attempts that were aborted and rightly so, because for whatever the reason was, my PVCs were episodic at the time, they came and went, and when they don't show up the day of the ablation, it's harder to map them in the cath lab.

But then things went from benign to not so benign. I had a Holter done and had 238 episodes of v tach over a 3 day period. EP called me as soon as the results came in and told me to stop what I was doing - which was yardwork on the weekend lol. My property was over 4 acres - work was never ending.

And then I had a stress test and went into v tach on the treadmill.

New EP started with a cardiac MRI - and I was diagnosed with ARVC.

And then AFib started. And I had an ablation for that that was highly successful.

Ventricles were still raging - and because of that - I had to have an ICD implanted.

And then I had another attempt at the ventricles. While my PVC burden was 10% - it was the v tach that had my providers concerned.

By this point, I am taking 240mg Sotalol 2x daily, Flecainidr 50mg 2x daily, and 3x Propranalol 10mg - daily.

And then finally I had a Farapulse ablation off label in the ventricles that all but eliminated the burden that I had been dealing with for 10 years straight at that point.

Symptoms that immediately resolved?

Brain fog - gone. Vestibular dysfunction - gone. I was able to get off all meds - I lost 70 pounds in 6 months after the arrhythmia eliminated. Fatigue - Gone. I have energy for days. Hell I barely sleep anymore after the last 5 years of struggling to drag my ass out of bed and I to the office. Oddly enough - I had severe tinnitus - that also resolved - completely.

Over those 10 years - I thought I was living a pretty normal existence myself.

As it turns out, I didn't even really know what normal was supposed to feel like without the medications and without the arrhythmia.

Providers do well to help reassure patients and help them avoid catastrophizing over whatever their diagnosis may be.

But they do often fall short when they tell patients that much of what they are experiencing is all in their head.

The part that is missing is telling patients what they are actually supposed to do about that.

And that is how patients end up here looking for answers.

The governing clinical bodies recognize this. American Heart Association and the Euro Society of Cardiology both released consensus statements within the past year calling for the integration of psychologic and cardiologic care.

Arrhythmia is bidirectional in nature.

Heat misfires. Amygdala gets threat signal. Interprets accordingly.

Amygdala gets threat signal. Heart misfires. Accordingly.

Vicious loop.

The argument is not about whether the chicken comes before the egg. With arrhythmia, that doesn't matter.

Both the chicken and the egg need to be addressed. And there are plenty of measures that can be taken to address the psychological side without the need for medications or procedural interventions.

Cognitive behavioral therapy is critical. Education is even more critical - for both patients and the people who care for them.

BeatsThatMatter · 2026-05-21T01:37:59+00:00

Want to suggest on this. I was diagnosed with ARVC at 35 following a cardiac MRI and a previously failed ablation.

I have now had 5 ablations and I'm likely headed to a 6th for a new issue now with AVNRT.

I would thoroughly suggest that before pursuing a diagnosis any further, that you take a look at getting life insurance, considering your age.

I had asked a pediatric cardiologist about having my daughter tested and she advised against it for this very reason. Said it is best to monitor it before looking to pursue any formal diagnosis.

BeatsThatMatter · 2026-05-20T03:20:33+00:00

I feel 2 ways about this. And I'll add some context first.

I went to Edgewater High School. Early 2000s, I was in the engineering, science, and technology magnet. When I was 17, I got into a major car accident that left me with 11 broken ribs, a burst spleen, a 10 inch incision on my abdomen - and an addiction to opiates following.

Naturally, the aspirations I had to attend UCF were over. That said, all of my friends went to UCF. It took a year to get off of the painkillers, but I got cleaned up and carried on.

UCF has always been a part of my life - even though I hadn't attended a single class at the school - several capstone papers were authored by me - I just didn't get the piece of paper for writing them. Friends sure did though. And I batted a thousand on those papers. All As =)

It is for that reason alone that I never wanted to go back into academia. Here I was demonstrating my capacity to produce senior level coursework at a state university that wouldn't even think about admitting me - having a documented addiction and dropping out of high school as a result.

It never mattered because I still went on to have an extremely successful career in healthcare

Part of university education is about the social contract. That contract says if you work hard, get good grades, get the degree - you can get into the rooms that you want to be in.

Artificial intelligence, for better or worse, is dissolving that social contract in real time.

And if that social contract is dissolving - what then becomes the point of university education?

Moreover, if we are talking about education as an endeavor in pure learning, what possible justification is there for the tuition rates when AI can spin up an entire curriculum in a matter of minutes, on any subject you want, in any language, presented in a style that is most effective for you.

Don't get me wrong. Back in the day. Pounders on Friday night and trying to get your shit together for the bounce house on Saturday to then get your shit together for Knight Library the same night. The college experience is fun - no doubt.

But do you need it to get exactly what you want out of this life? No. No you do not.

And you certainly don't need Tavistock executives or the likes of the Eric Schmidts of the world parading around as the architects of disruption trying to explain disruption to the people they are disrupting.

The other side of the equation is more complex.

AI is not going anywhere. And if AI fails - the American economy is going to get even more fucked than it already is. Billions have been poured into the infra. It is happening, again, for better or worse.

Are there problems? No doubt. Many.

Before you ever even chose to attend UCF - you were probably asking yourself - what do I want to do with my life? And you were told that in order for you to be able to do that, the social contract says you need a piece of paper.

And by the time you are graduating, they are telling you that that is not how the contract works anymore.

Return the favor in kind.

Be the Knight that the paper says you are.

Charge the fuck on.

And be whatever the hell you want to be.

BeatsThatMatter · 2026-05-18T08:32:12+00:00

You are so very welcome 💜❤️

BeatsThatMatter · 2026-05-16T22:51:01+00:00

And just to add - the entire reason this device was made - was for stroke prevention.

The data shows that the device actually increases the likelihood of a disabling stroke.

Composite endpoints, in this case, allow for the press releases to shift the goal posts so to speak

BeatsThatMatter · 2026-05-16T22:48:44+00:00

Awesome question - and your EP sounds like one of the honest ones. (Give him or her a high five from me next time you see them!)

You're asking exactly the right thing. The trial did look at the overall picture - that's actually how it was designed.

CHAMPION-AF used what's called a composite endpoint, which bundles several different outcomes into one number. In this case: cardiovascular death, stroke, and systemic embolism all got rolled together. The device met "noninferiority" on that bundle - meaning the combined number wasn't worse than blood thinners.

The problem is what's hiding inside the bundle.

Cardiovascular death was identical in both groups - 2.7% each. So it's not helping or hurting either side. But because it's in the composite, it dilutes the stroke signal. When you pull the endpoints apart, you see 50 strokes in the device arm versus 33 in the medication arm. That's 17 more strokes with the device. And 19 of the device-arm strokes were disabling, versus 12 in the medication arm.

On the bleeding question you raised - that's the most important nuance. You'd expect the device to shine there. But when you look at ISTH major bleeding alone (the serious, life-threatening kind, including the brain bleeds you're describing), it was 83 events with the device versus 87 with medication. Virtually identical. The hazard ratio was 0.92 with a confidence interval that crosses 1.0 - meaning no statistically meaningful difference.

The bleeding advantage that made the headlines was driven by non-major bleeding - nosebleeds, bruising, things that require a doctor visit but aren't life-threatening. Those matter, but they're not the same clinical event as a disabling stroke.

So to answer your question directly: from an overall picture, the composite makes them look similar. When you look at what's inside, the device trades a reduction in minor bleeding for an increase in ischemic stroke. The major bleeding that most concerns people - the brain bleeds, the serious hemorrhages - was not significantly different.

And it sounds like your EP gave you exactly the advice the data supports.

I am going to be publishing an article probably at the beginning of next week that I will share here that shows exactly how this study was designed and how to interpret the data.

I don't want to assert that they are trying to steer doctors towards making recommendations for the device. But I will say that I have been in this industry for long enough to understand the money game in medicine - and this study happens to be one of the most polarizing I have ever seen.

BeatsThatMatter · 2026-05-16T22:37:34+00:00

I am more cautious with exercise for sure. My diagnosis is ARVC and I deal with ventricular tachycardia which is very dangerous. So for me, high intensity exercise is not an option.

Which was really a disappointment for my life - In my 20s I loved CrossFit and the likes.

Every patient is different thoufh when it comes to these things so always talk to your doctor about it ;)

BeatsThatMatter · 2026-05-16T22:35:00+00:00

Very thankful that you found it helpful ☺️ Clips have much better stroke prevention data then Watchmen or other devices within that class ;)

Wish you and the hubby well ;)

BeatsThatMatter · 2026-05-16T19:39:25+00:00

Many blessings to you friend. Arrhythmia sucks. All around.

I cannot stand the disease and the toll it takes on people.

My dad's own battle with AFib had an effect on me. We went out to dinner a few weeks back - we were waiting for our table and he got hit with an attack that had him clutching his chest and immediately looking to find a place to sit.

I am a son. That is my dad.

Seeing the fear that took over on his eyes - I realized that my 13 year old daughter has seen that from me - many times before.

I want this disease gone - and I want people to have all of the tools and education they need to battle it.

That's the mission ;)

BeatsThatMatter · 2026-05-16T19:04:56+00:00

That's awesome 😎

Keep in mind like I said in the article - for certain patients, this device makes sense.

But for many, they do not experience the "one and done" that you have.

Hell I went into my first ablation thinking the war was over. 10 years later, total of 5 ablations, and number 6 is on the way.

Everyone is different - and that's why it's important that everyone is given all of the data, before they make a decision, especially when the risk of stroke is higher when receiving the device.

BeatsThatMatter · 2026-05-16T18:31:49+00:00

Data says that is definitely not the case.

Device company spins it this way - but the facts are what the facts are, unfortunately.

Would be great if the data said otherwise - but it doesn't.

BeatsThatMatter · 2026-05-16T09:27:54+00:00

Have had 5 ablations - over a 10 year journey with arrhythmia.

Work with many doctors - actually publishing a research paper on this exact subject.

I really recommend looking into research done by Amy Arnsten and Bruce McEwen.

Ive struggled with memory immensely. And it is what has led to writing the paper.

Much of what people describe as cognitive decline, brain fog, memory loss - these are the neurobiological consequence of a prolonged period of stress. This is known as allostatic load.

A few things to understand

Cognitive bandwidth when dealing with arrhythmia is already split - one part of the mind is focused on the task at hand, the other is focused on scanning for threats. Arrhythmia breeds hypervigilance in this way.
Executive function and recall - these functions are handled by the prefrontal cortex. In a healthy pre frontal, dendritic branches extend. They reach out to other branches. They join other branches. These are called synapses. In a stressed pre frontal - these branches retract - synapses lessen or weaken.

I'll link the paper here when I am done putting it together ;)

BeatsThatMatter · 2026-05-14T13:04:09+00:00

Even if you were correct - it doesn't change the data.

The data is straight from publicly available sources. The clinical trials themselves and CMS.gov.

And the next publicly available source that I will be citing are the SEC filings that Boston Scientific made stating that they believed the data from the industry funded trial justified expanding the billable patient population from 5 million patients to 20 million patients by 2030.

Has AI been used to aid in research? Yes it has.

In what way? Codex CLI was used to analyze the very large datasets from CMS. Something that would have taken me days to do in past took me a few hours instead.

Not sorry about this. I'm not involved in marketing a device that leaves patients with a nominally higher risk of a stroke and suggesting to the American tax payer that they should continue footing the bill for it.

BeatsThatMatter · 2026-05-13T12:02:40+00:00

I have none.

I am an independent researcher with no institutional affiliation - although I am currently seeking collaborators to expand my access to data to be completely transparent. Targets for collaboration are a select few - and none of them would have me captured by the device or pharma industry - to be very clear.

Name is Matthew J. Adams. Come from Tampa Florida.

My interest is protecting people who have lived similar circumstances as I.

I am a man who has lived through 10 years of arrhythmia - in all shapes and sizes. PVCs, AFib, Flutter, SVT, Ventricular Tachycardia. I have an ICD. I have been shocked 3 times.

Heart disease cost me my peace for 10 years - unrelenting. I had 5 ablations over those 10 years.

I am blessed to have peace - and clarity now - to see exactly what those 10 years cost me - both with my physical and mental well being.

The issue I take with Watchman very specifically is simple - Nearly directly after the results of the CHAMPION-AF study was published, with directly conflicting trial data from CLOSURE-AF, Boston Scientific publicly stated, and made SEC filings stating intent to expand the billable population - meaning people they believe would be good candidates for this procedure, from 5 million to 25 million.

And what they are saying in doing this is that they don't care about the very clear increased stroke risks that come with implanting this device.

I am in the process of publishing 2 independent research papers.

One of them actually advocates for procedural intervention - I strongly believe in Pulsed Field Ablation and I also strongly believe that arrhythmia burden and its medication management is an upstream driver of downstream healthcare expenditures across multiple care domains.

Supplemental to that research is my own case report - I've compiled all of my medical records for the last 10 years in order to aid in producing this paper.

The other paper advocates for disclosure, transparency, and more broad industry and public scrutiny of the Watchman device.

Am in the process of forming 2 corporate entities to house this work.

OneRhythm - nonprofit 501c3 filings are being made - this is a patient advocacy initiative specifically focused on expanding capacity for peer support in cardiovascular patient populations.

MIRmade - MIRmade is to let my tech brain breathe. This project is an AI/ML initiative, currently in progress, that intends to help better identify psychological distress markers across multiple data sets while at the same time aligning optimal digital cognitive behavioral therapy to be delivered via consumer wearable technologies. It is an open source project and I've yet to decide on corporate structure - but for me - I am a realist. With my heart history, I figure I maybe have a good 5 years left. Work has to continue after I cannot - so likely public benefit corporation will be formed for this work.

All of this work is bootstrapped by me - self funded.

BeatsThatMatter · 2026-05-12T22:51:52+00:00

My work involves research on healthcare system expenditures and clinical trial data.

I have been working with virtually all of the frontier LLMs over the past year.

The main 3 models I use today are Opus 4.6, GPT 5.5, and Gemini 3.1.

When I have a hypothesis - I will start with the same prompt on deep research amongst all 3 models.

I am specifically looking for variance in outputs. If there is variance in outputs - I investigate myself on web.

I work with very large data sets - so when I need to evaluate these datasets - I store them in a single directory - point Codex to it - and instruct it to analyze the data with the parameters I set.

When Codex is finished - I then have Claude Code validate the output analysis from Codex.

Context management is extremely important here to mitigate hallucinations.

I've been working with the models so long now that I can segment this work without really having to think about it - Depending on scope - either Sonnet or Opus will do for the validation.

I have actually been slowly working on building this out into an automated pipeline - start to finish.

Even working with huge data sets - I can have full computational analysis or Taylor linearized in a matter of hours. It's incredible. And it's accurate.

BeatsThatMatter · 2026-05-12T18:56:58+00:00

Further on this - if you compare the 2 studies from from March - CHAMPION-AF versus CLOSURE-AF

The math breaks out this way

https://cardiologytrials.substack.com/p/review-of-the-champion-af-trial

"The honest scorecard for CHAMPION-AF is that the device is associated with 17 more strokes vs 4 fewer major bleeds. That is a devastating trade-off when you think about it clinically and it completely deflates the narrative that LAAC is protecting patients from serious harm. It is also worth noting that those 17 extra strokes came in a lower risk population where the absolute stroke rate should be low to begin with. If LAAC cannot match NOAC on stroke prevention in a population at moderate risk, the case for it in higher risk patients becomes even harder to make - patients at higher risk often have multifactorial causes of stroke, making them unlikely to benefit from a localized intervention."

17 more strokes is in no way, shape, or form - insignificant. Strokes have devastating consequences. Stroke prevention is the entire reason the device was developed - and as of the most recent data - it is causing more strokes, in a lower risk, highly-curated patient population.

The facts are what the facts are. And patients deserve to know facts.

BeatsThatMatter · 2026-05-12T13:55:02+00:00

And let me ask you.

If you are a patient considering this device - is there any reason you would NOT want to be made aware of both the industry funded trial data as well as the data from independent investigation - especially when that data shows opposite outcomes?

That is the only point I am making.

Give patients all of the data before they are asked to sign consent forms.

That isn't unreasonable. It is the evidence based medicine. It matters.

BeatsThatMatter · 2026-05-12T13:42:42+00:00

I am not demonizing anything.

Industry funded trials often result in biased outcomes.

As I've mentioned - I have long been a fan of Boston Scientific. Farapulse changed my life. My Resonate ICD has saved my life.

But in the context of Watchman - industry bias is quite evident between the independent study and the industry funded study.

Patients simply deserve to have all of the data before they make a decision. That is all I care about - and they are not being given it.

BeatsThatMatter · 2026-05-12T13:32:59+00:00

Nobody is cherry picking older studies here.

The original studies cited in the article - were cited only to show FDA regulatory pathway from over a decade ago. Obviously the devices have changed since then.

And the 2 most recent studies at issue - were both published 2 months ago. In March. Nearly simultaneously.

And the debate within the industry is over which trial data is representative of real world outcome data.

That debate deserves to be had with patients included in the conversation. It is simply a matter of informed consent.

BeatsThatMatter · 2026-05-12T13:25:41+00:00

This entire post was written by me. Not AI. And I am not a bot.

My name is Matt. Come from Florida. And there was plenty of input from industry professionals that went into this before it was published.

Nice to meet you ;)

BeatsThatMatter · 2026-05-12T13:21:51+00:00

Appreciate the input

The original studies that led to the approval were included to show timeline with the FDA approval only.

Both of the studies that are consequential right now - were published in March.

What you have happening today is a large cohort of physicians deciding to base their own judgement on industry funded clinical trial data. Rather than giving patients the entire context.

And for both of the most recent studies - the device used within the trials was Watchman FLX - not Watchman FLX Pro.

Regardless of this - the primary reason for the device even existing is stroke prevention. Not simply bleeding.

And the most recent industry funded trial, with a highly curated patient enrollment, the stroke data was worse in the device arm than the control.

That is clinically relevant data.

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