The treatment of atrial fibrillation continues to encompass a greater percentage of my practice. Sometimes I feel less like a cardiologist and more like an afib-ologist. The persistently rapid growth of this disease in our population boggles my mind. Really folks, this is not hyperbole; this is fact. Like all things cardiac, the focus is […]
Category: AF ablation
Since writing about how obesity acts directly on the atria I have received a number of good questions. Most centered around the permanency and reversibility of fat-related cardiac effects. Even my partner mentioned to me that fat actually inserts itself between heart muscle cells. Wonder where he read that? Questions about a post are always […]
There was a lively debate on this topic at ESC 2012. One of the strategies proposed to reduce stroke in AF involves occlusion of the sack-like structure called the left atrial appendage. Two devices are being evaluated and nearing consideration for approval. There is a great deal of debate on these devices. Here is my […]
Hey all, I’m working hard here in Munich. There was news made today in the AF world. The European Society of Cardiology has updated its 2010 AF treatment guidelines with a focused update. Here’s my attempt at a summary of six major focus points over at Trials and Fibrillations on theHeart.org. JMM
I cheated–a little. I promised to post on some of the ways I use rhythm-control medicines for AF. I did indeed post about this topic–just not here. As I wrote and edited and stewed about rhythm medicine for AF, it occurred to me that this would be a great topic to write about on Trials […]
Let’s talk about some of the factors that go into choosing medicines to suppress AF episodes. We call this “rhythm control.” In Part 1, I introduced some of the complexities of heart rhythm medicine. In this post, I hope to clarify a few of the many issues that come into play when considering a rhythm […]
What’s the best medicine for treating AF? Now that is a frequently asked question. You already know the answer. But perhaps the obvious deserves a few words? First, let’s clarify what we are talking about when we use the term AF medicine. I’m speaking here about the so-called anti-arrhythmic drugs. Other names include “membrane-active†or […]
For those interested in atrial fibrillation, there was significant news made last week. Dr. Sanjay Narayan and colleagues, including highly respected Indiana University electrophysiologist, Dr. John Miller (also a JMM), finally published their exciting data on FIRM ablation. The CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) has […]
I thought this was interesting: Six-placed Tour finisher Haimar Zubeldia, who rides for the US-based RadioShack/Nissan/Trek team, disclosed that he sat out for three months earlier this season for “persistent atrial fibrillation.” As reported by Cyclingnews.com, Mr Zubeldia said this in his statement: “I had four weeks of complete rest and treatment.†Fortunately, “everything went […]
The safety of AF ablation depends greatly on the adequacy of blood thinning. AF ablation is no cardioversion. The choices of blood thinning regimens include either warfarin or dabigatran (Pradaxa)–and soon perhaps rivaroxaban or apixaban. The advantages of warfarin include the ability to confirm the level of thinness and its long-acting properties lessen after-procedure gaps […]
What could competitive athletes teach a group of heart rhythm specialists? Cyclists, runners and yes, even triathletes, know something that we wizards too often forget. I’ll tell you what it is in good time. Keep reading. I just returned from a giant gathering of heart rhythm doctors. It was, as all national meetings are, an […]