Top Ten Posts of 2012

You may find this hard to believe but I really don’t look at my site’s stats much. In fact, just today I discovered that WordPress has a feature that ranks posts by views.

I’m not going to give you my Top Ten just by ranking. Rather, I’ll mix in some of my favorites and those that generated the best conversation. And then a message of peace.

What’s a normal heart rate?   This one post gets double the hits of any other. The thing is: there is no normal heart rate.

Pradaxa versus Xarelto: An e-mail exchange between a cardiologist and an ER doctor. Approved for stroke prevention in AF in 2011, rivaroxaban gained the confidence of clinicians this year. Bolstered by its once-daily dosing and lack of GI side effects, rivaroxaban contrasts nicely with dabigatran—an agent beaten mercilessly by inaccurate “bad drug” ads in the mainstream media.

Is the Ironman triathlon heart-healthy?  This 2011 post got it all started. If you have done or watched an Ironman, then you know the answer. Here is a more recent update: Cycling Wed: I told you so…

The Mysterious Athletic Heart. When you do a procedure on an athletic heart you can feel the power. The adaptive ability of the human heart never ceases to amaze me.

The best tool for treating atrial fibrillation: This may sound goofy coming from a doctor who makes his living moving catheters and wires inside the human body, but I believe the most important work of the AF doctor happens in the office with a whiteboard. Providing our patients with good information helps both parties balance the risk of AF versus the risk of AF treatment. This is everything in AF–not making the treatment worse than the disease.

The NY Times gets it wrong on ECG screening of young athletes. Oh boy, did this one get me in hot water. Few problems are more vexing. It’s a terrible tragedy when a young person dies suddenly. Everyone wants to protect children. The problem is that sudden death in kids is so rare. Though mass ECG screening seems attractive, its application in the real world is highly problematic.

Does your cholesterol level matter? Dogma has held that we measure our cholesterol level and if it is high, use means to lower it. This tenet implies that either a high level of  bad cholesterol (LDL) or a low level of good cholesterol (HDL) causes heart disease. The ‘cholesterol thesis’ of heart disease may not be true. Look for this to be a big story in 2013. Rather, you should focus on the word inflammation.

Doctors and Social Media — Increasing the good we do? I love the practice of Medicine. It’s so much more than a job. Learning and teaching are its core values. Doctors are teachers. Social media is our whiteboard. Why wouldn’t we use it?

“Choosing Wisely” –A great name for a great plan. There is a strong movement afoot in the approach to medical practice. It is called less-is-more. Cynics wrongly argue that those who favor less care do so because it saves money. Though it is true that smart care is also cost-effective, it’s also becoming clear that ‘more care’ isn’t always best. Choosing Wisely is a start in the right direction.

CW: A hand surgeon’s view of non-adherent patients… I have recovered from the thumb injury–though I still get tensed up riding through that rock garden. Seriously, this injury reset my view of things–a lot.

That’s it for 2012. Thanks so much for visiting. I am grateful.

I wish you a low-inflammation and peaceful 2013.

JMM