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Atrial fibrillation General Medicine

Atrial fibrillation therapy and a disclaimer…

It has come to be evident -although seemingly obvious- writing words on medical matters for all to see requires a disclaimer.

Medical information on the internet should serve an informational and supplemental role.  It should increase the knowledge base, provide a scaffolding of a particular problem and serve to enhance the interaction between the doctor and patient.

General information provided on a specific topic should not supplant the importance of a hands-on evaluation.

No better example exists than atrial fibrillation.  AF is one of the most diverse diseases known.  It afflicts all ages, has many presentations, differing prognoses and the therapeutic toolbox is enormous.  It sounds old-fashioned and cliched, but treating AF wisely really requires a face to face interaction with a well trained expert.  A patient’s story needs to be heard, including the chapters on background, symptoms, associated diseases and an often under recognized chapter: the motivation and ability of the patient to follow a complex treatment plan.    Although complex treatment for AF exists, it is often the simple and common sense therapy that works best.

Disclaimer done.

Be wise.  Be informed.

JMM

2 replies on “Atrial fibrillation therapy and a disclaimer…”

You make a good argument against cookie-cutter, national-guidelines-based treatment protocols.

-Steve

Guidelines provide a framework for care and for AF are fairly reasonable. However, the application of all the evolving treatment tools to an individual AF patient is not easily amendable to "protocols."

Take for example, the minimally symptomatic but drug-refractory patient with AF who is approaching the "Y" in the road of AF therapy: to either let the minimally symptomatic AF persist (likely progressing to permanent AF) or move to potentially curable, but invasive ablation therapy. With AF she grades her health a "B" and the question at hand was whether it is worth the risk of the procedure to get to an "A?" Find the answer to this one in the guidelines.

JMM

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