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AF ablation Atrial fibrillation Healthy Living

CW: Athletes teaching heart rhythm doctors?

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 […]

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AF ablation Atrial fibrillation

Has AF ablation reached first-line status? My Trials & Fibrillations post…

Head over to theHeart.org to read my review of the recently released RAAFT 2 trial–a randomized clinical trial of Radiofrequency Ablation vs. Antiarrhythmic Drugs as First-Line Treatment of Symptomatic AF. The study adds significantly to the growing knowledge of how best to treat AF. JMM

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Is Pradaxa a bad drug?

It’s crazy out there in blood thinner land. The novel blood thinning drug for patients with atrial fibrillation, Dabigatran (Pradaxa) cannot get a break. It’s all over the TV: Pradaxa = Bad Drug. Look at this image: Today, on the prestigious heart news site, theHeart.org, an insignificant 113-patient study presented as a poster at a […]

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Atrial fibrillation Cycling Wed Healthy Living Reflection

CW: A hand surgeon’s view of non-adherent patients…

Tonight, in the true spirit of cycling blogs, I will tell you a story. (We definitely need to lighten things up a bit.) Consider yourself warned. It is a saga of a cat-like mountain biker, who is also a heart specialist and perhaps a less than ideal patient. But first, you may be wondering why […]

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Athletic heart Atrial fibrillation Cycling Wed General Cardiology

CW: My Athlete’s Heart Podcast

I recently had the pleasure of doing a podcast with Rob Orman, an ER doctor and fellow cyclocross racer from Oregon. As Dr. Orman says, we discuss the broad intersection of sports and Cardiology. Of course they intersect; there shall be no sport without a good heart. In the 35 minute conversation, we discussed the […]

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Atrial fibrillation

A Common Error in the Treatment of Atrial Fibrillation

We have got to get back to AF. I enjoyed some fun text messages today–from a really smart primary care doctor out yonder, in the hinterlands of Kentucky. We text and exchange quick pics a lot. Call it iTeleMedicine. PCP: “I have a patient on [AF-drug X] (guess) who has diarrhea.” Me: “Stop the drug…It’s […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban General Medicine

Great Discussion on (new and old) Oral Blood Thinners

You may have heard that the new blood thinner, rivaroxaban (Xarelto) made news at the recent ACC meeting in Chicago. The Einstein PE trial showed rivaroxaban equivalent to standard therapy (enoxaparin followed by warfarin) in the treatment of pulmonary embolism (blood-clot in lungs). When the researchers looked at net clinical benefit, a measure that gives […]

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Atrial fibrillation Health Care Reform

New Post up on Trials and Fibrillations: My Choosing Wisely list for electrophysiology

In the Choosing Wisely initiative, nine medical groups have contributed their list of five misused and overused tests and treatments. Some of the highest cost-of-care groups are on board–cardiologists, oncologists, radiologists, nephrologists (kidney) and gastroenterologists. Front line doctors, like internists and family doctors, have also weighed in. Coming soon are lists of five from the […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Pradaxa-related pill esophagitis–A new adverse effect?

It’s well known that the new blood thinner, dabigatran (Pradaxa) can cause stomach pain and reflux symptoms. It occurs in slightly more than one in ten patients who start the drug. Yesterday, I learned of another potential gastrointestinal adverse effect of the new drug. A GI colleague called me about a patient taking dabigatran (Pradaxa) […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

Pradaxa versus Xarelto: An e-mail exchange between a cardiologist and an ER doctor

My friend Bill is an ER doctor and a bike racer. He’s like me in that he has rediscovered the beauty of being a learner. His most recent area of inquiry is the blood clotting cascade and the use of reversal agents for the novel new blood thinners, (dabigatran, rivaroxaban and the soon to be […]

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Atrial fibrillation Dabigatran/Rivaroxaban/Apixaban

New post up on Trials and Fibrillation blog: Dabigatran, Rivaroxaban and Apixaban

For 57 years, doctors and patients have eagerly awaited an adequate substitute for the maligned blood thinner, warfarin. Now they are here. Boy are they ever. There has been oodles written about the new blood thinners, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (soon to be Eliquis). As you might expect, thinning the blood with a […]